CEN-Emergency Nursing Content Review/Self Assessment

These are "CEN-Like" core curriculum questions...

I'll post the answers in 3-4 days

Category: Special Populations

(1) You are discharging your 79 year old female pt who sustained a large skin tear. Which of the following is the best answer regarding patient education for this client?

A) Use pre-printed instruction sheets.

B) Prepare handwritten instruction sheets.

C) Instruct the patient to call their private physician if they have any questions.

D) Conduct a one-on-one discussion with the patient.

Category: Gastro-intestinal Emergencies

(2) A 36-year-old male is in severe distress due to upper gastrointestinal bleeding. He has been vomiting bright red blood at home for 4 hours. Which of the following interventions is the highest priority?

A) Apply 100% non-rebreather oxygen mask.

B) Initiates IV access and starts a Normal Saline bolus.

C) Inserts nasogastric (NG) tube.

D) Draws blood for a type and cross.

Category: Respiratory Emergencies

(3) The SPO2 of an ED patient suddently drops to 88%. Of the following, what should the RN do first?

A) Put the pulse ox sensor on another finger.

B) Check to see if the auto-blood pressure cuff is inflated.

C) Assess for changes in the patient's mental status.

D) Obtain an arterial blood gas.

Category: Environmental Emergencies(4) Your patient sustained a near-drowning incident. Which of the following plays the most significant role in their condition?

A) Hypothermia

B) Pneumonia

C) Dysrhythmia

D) Hypoxemia

Category: Professional-Legal Topics

(5) Which of the following legal principles applies to the RN working in the Emergency Department?

A) Duty of care

B) Breach of duty

C) Proximate causation

D) Injury

[danfif]

I'll bite; 1. d, 2. b, 3. b, 4. a, 5. a

Dan

[Medic09, BSN, RN, EMT-P]

Okay, I'm next.

1. D

2. B

3. C

4. D

5. C

[crb613, BSN, RN]

I'll give it a shot...

1) D

2) B

3) C

4) D

5) B

[gambutrol]

I'll join the bandwagon.. hehe.. hope it's correct!

1. D

2. A

3. A

4. D

5. C

[Pixie.RN, MSN, RN, EMT-P]

1. D

2. A

3. C

4. D

5. A

[pererau]

Why not?

1 D

2 D - I really hate this type of question, because in the real world we would be doing D and B at the same time, and I could see a pretty reasonable argument for either, but in the end, absent standing orders, the RN does not have the authority to start a normal saline bolus, and typed and crossed blood is always safer for the patient than o neg.

3 B

4 D

5 A - wild guess here.

1) D

2) D

3) B or A -- I am thinking along the lines of looking for a mechanical cause first

4) D

5) A

[Miss Mab]

D

D

C

C

A.....

I saw this first about 14 hours ago and for some reason I couldn't post. I do know even then my answers didn;t match most others.

So, this reminded me of the hell of," No,no, you have to pick the Right-EST answer among all the other right ones. Anyway, the best part if I end up being soooooowrong this time is that at least now I have actual 'real world' rationale behind my otherwise obviously incorrect answers. Seems more pursuasive a reasoning than JUST CAUSE(i hate this class rumble, grumble...)

Anyway, I'll just take again at midnight. ......

[emtb2rn, BSN, RN, EMT-B]

I'll give it a shot...

1) D

2) B

3) C

4) D

5) B

:yeahthat:

[TraciRN]

Here is my guess

1D

2B

3A

4D

5C

[getoverit, BSN, RN, EMT-P]

1. d

2. a

3. b

4. a

5. c

1. D

2. A

3. C

4. D

5. A

[crb613, BSN, RN]

OK....can't wait any longer what are the answers??

[Pixie.RN, MSN, RN, EMT-P]

LOL! I was coming into this thread to post the same thing.

[bjaeram]

1. D

2. B

3. C

4. D

5. B

[mwboswell]

answers with rationales

the "average" score was 63%

two people got 100%

here's the question breakdown:

1) 100% got it right

2) 31% got it right

3) 54% got it right

4) 77% got it right

5) 46% got it right

category: special populations

(1) you are discharging your 79 year old female pt who sustained a large skin tear. which of the following is the best answer regarding patient education for this client?

a) use pre-printed instruction sheets.

b) prepare handwritten instruction sheets.

c) instruct the patient to call their private physician if they

have any questions.

d) conduct a one-on-one discussion with the patient.

rationale: preprinted instructions may not be useful in an elderly patient due to reduced visual acuity. handwritten instructions "may" be useful due to the patient's visual acuity. instructing the patient to call his physician with questions is not appropriate. the nurse is responsible for teaching the patient wound care. having a one-on-one discussion with the patient enables the nurse to discuss pertinent information on wound care as well as demonstrate appropriate dressing application - this is the "best/better" answer!

category: gastro-intestinal emergencies

(2) a 36-year-old male is in severe distress due to upper gastrointestinal bleeding. he has been vomiting bright red blood at home for 4 hours. which of the following interventions is the highest priority?

a) apply 100% non-rebreather oxygen mask.

b) initiates iv access and starts a normal saline bolus.

c) inserts nasogastric (ng) tube.

d) draws blood for a type and cross.

rationale: in the patient with any critical process; airway, breathing, and circulation (abc's) are priority care. therefore, ensuring that the patient has oxygen in place for airway and breathing is the nurse's first priority. initiation of intravenous therapy should be immediately established after the abc's have been established. insertion of a nasogastric tube may be necessary but is not the priority nursing intervention. the patient will need blood replacement, and type and cross match is necessary, but not until the abc's have been initiated.

category: respiratory emergencies

(3) the spo2 of an ed patient suddently drops to 88%. of the following, what should the rn do first?

a) put the pulse ox sensor on another finger.

b) check to see if the auto-blood pressure cuff is inflated.

c) assess for changes in the patient's mental status.

d) obtain an arterial blood gas.

rationale: moving the pulse oximeter would be an action taken after assessing the patient's condition. loosening tight clothing and placing a blood pressure cuff on the opposing arm would ensure adequate circulation distally to receive an effective reading. assess your patient's condition. altered mental status is indicative that your patient's condition has deteriorated. obtaining a blood gas is appropriate after assessing a change in the patient's status.

category: environmental emergencies

(4) your patient sustained a near-drowning incident. which of the following plays the most significant role in their condition?

a) hypothermia

b) pneumonia

c) dysrhythmia

d) hypoxemia

rationale: hypothermia secondary to cold water submersion decreases metabolic demand which actually reduces potential hypoxia in prolonged asphyxia. aspiration may cause pulmonary infections in the recovery phase of the near-drowning victim. cardiac decompensation and dysrhythmias may be caused by hypoxemia and complicated acidosis which results from hypoxemia. the central clinical event in all near-drowning victims is hypoxia caused by laryngospasm and asphyxia.

category: professional-legal topics

(5) which of the following legal principles applies to the rn working in the emergency department?

a) duty of care

b) breach of duty

c) proximate causation

d) injury

rationale: duty of care is defined as presence of a relationship between the patient and the defendant which requires the nurse to provide reasonable care to the patient. with breach of duty the patient complains that the care rendered was below accepted standards of care. proximate cause is defined as proof that the breach of duty was the probable cause of the injury. patient must be able to prove that an injury occurred because of the negligence of the defendant.

[crb613, BSN, RN]

Thanks.....got any more?