(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?
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
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.
Yes, if you do have more question to gauge where were at I would love to answer them and see where I stand. Taking the CEN in March and also looking for a review class to take. Living in Atlanta.
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
Yes, if you do have more question to gauge where were at I would love to answer them and see where I stand. Taking the CEN in March and also looking for a review class to take. Living in Atlanta.
There's a class in Greenville SC Feb 6-7th, 2010. About 80 miles from ATL
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
category: professional-legal
(1) local ems brings you, into your trauma bay, a 17-year-old female, who was involved in a pedestrian versus motor vehicle crash. a ct of the head shows that she has an epidural bleed and the neurosurgeon is summoned for emergent, life saving surgery. however, the neurosurgeon refuses to come in for this pt. which of the following best explains the possible liability for the neurosurgeon in this case?
a) federal laws that require all patients who present to an emergency department receive stabilizing treatment and state laws concerning professional negligence.
b) case law requiring a specialist on call to respond and federal law requiring all patients who present to an emergency department receive stabilizing treatment.
c) state laws relevant to professional negligence and case law requiring a specialist on call to respond.
d) there are state laws covering professional negligence and case law requiring a specialist on call to respond.
category: special populations
(2) an elderly trauma patient "might" be considered for early, invasive hemodynamic monitoring because the geriatric population has:
a) decreased peripheral vascular resistance and cardiac workload.
b) increased pulmonary compensatory mechanisms.
c) increased physiological reserves
d) decreased cardiac output
category: ob/gyn
(3)a patient with an ovarian cyst may present with signs/symptoms similar to which of the following?:
a) pyelonephritis
b) pelvic inflammatory disease (pid)
c) intrauterine pregnancy
d) ectopic pregnancy
category: general medical
(4) what is the treatment for acute sinusitis?
a) over-the-counter nasal decongestant sprays for 1 week
b) hypertonic saline nose drops
c) use of a humidifier
d) application of ice or cool compresses to the sinus area
category: cardiovascular
(5) the md has ordered a heparin drip to be started at 1000 units/hour. your pt weighs 220 lbs. you have on hand a heparin iv bag with 20,000 units of heparin in 500 cc of d5w. how fast (ml/hour) would you run the drip at?
I'm just a student now but I thought I would take a shot at this:
1) A-This is just a guess, but I chose this because EMTALA requires that necessary stabilizing treatment be given: "(b) Necessary stabilizing treatment for emergency medical conditions and labor
(1) In general If any individual (whether or not eligible for benefits under this subchapter) comes to a hospital and the hospital determines that the individual has an emergency medical condition, the hospital must provide either--
(A) within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition, or
2) D-Another guess. D is the better guess because the elderly have increased peripheral vascular resistance d/t decreased elasticity in the arterial walls.
3) D-Researching PCOS and the other conditions listed, the s/s of ectopic pregnancy matched the s/s of PCOS closely.
4) B-I really have no good reason for choosing this. It's a wild guess.
5) B-This is the only answer where I didn't guess. Using dimensional analysis, I got the answer from u/hr to mL/hr.
MauraRN
526 Posts
1. D
2. A
3. C
4. D
5. A