CEN-Emergency Nursing Content Review/Self Assessment - page 3

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... Read More

  1. by   crb613
    1) c
    2) d
    3) d
    4) c
    5) b
  2. by   dan_dfc
    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
  3. by   mwboswell
    cen practice questions and rationales for questions posted 12/13/09
    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.<--correct answer
    d) there are state laws covering professional negligence and case law requiring a specialist on call to


    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.

    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
    <--correct answer

    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.

    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
    <--correct answer

    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.

    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
    <--correct answer
    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.

    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
    <--correct answer
    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.

    how did you do?