CEN-Emergency Nursing Content Review/Self Assessment

Specialties Emergency

Published

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

Specializes in ICU/ER/PACU.

1. B

2. A

3. D

4. A

5. B

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Specializes in Cardiac Telemetry, ED.

1) A

2) D

3) D

4) A

5) B

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Specializes in Med Surg/Tele/ER.

1) c

2) d

3) d

4) c

5) b

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Specializes in er.

1) going with B on this one. C and D are either both right or both wrong since they say the exact same thing.

2) D. AB&C are false

3) D

4) C

5) B

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Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.

cen practice questions and rationales for questions posted 12/13/09

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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.

rationale: federal law requiring all patients who present to an emergency department receive stabilizing treatment. this law is commonly known as federal emtala legislation, requiring patients to receive a medical screening exam, stabilization, and/or transfer - this law would make one "criminal" if found guilty, but not legally liable to be sued.. there is existing case law that establishes liability when a specialist on call fails to respond. state laws would establish negligence.

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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

rationale: geriatric patients have increased (not decreased) peripheral vascular resistance. normal range blood pressure may actually be hypotension in this population. weakened respiratory muscles, decreased chest wall compliance, and deterioration of ventilatory effort are present in the elderly. lack of physiological reserves results from decreased cardio pulmonary compensatory mechanisms secondary to the aging process. the geriatric patient has a decreased cardiac output and stroke volume due to the stiffness of the myocardium.

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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

rationale: pyelonephritis is characterized by fever and bilateral flank pain. pid is characterized by fever, leukocytosis, and diffuse abdominal pain. intrauterine pregnancy is painless, and uterus is enlarged on pelvic examination. both conditions (ectopic pregnancy & ovarian cysts) cause abdominal pain, usually unilaterally, menstruation is irregular, fever and leukocytosis are rare; with pelvic examination eliciting tenderness.

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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

rationale: nasal decongestant sprays may provide immediate relief, however, topical decongestants should not be used for more than 3 days because of a dangerous rebound effect. isotonic saline nose drops, not hypertonic, may help with the symptoms. use of a humidifier can help with the symptoms of sinusitis and make the patient feel more comfortable. warm, moist compresses to the sinus area promote drainage and comfort of the patient.

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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?

a)20 ml/hour

b)25 ml/ hour

c)40 ml/hour

d)100 ml/hour

rationale: you have 20000 units heparin/500 cc = 40 units/ml.

you need to run it at 1000 units/hour, thus 1000/40 = 25ml/hr

the pt's weight is a distractor.

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