Med-Surg (Adult Health)
Exam 3 – Practice
Questions, Comprehensive
Exam Review, and Test
Preparation Guide
A hospital responds to a local mass casualty ANS: A
event. Which action should the nurse To prevent staff post-traumatic stress disorder during a mass
supervisor take to prevent staff post- casualty event, the nurses should use available counseling,
traumatic stress disorder during a mass encourage and support co-workers, monitor each others
casualty event? stress level and performance, take breaks when needed, talk
a. Provide water and healthy snacks for about feelings with staff and managers, and drink plenty of
energy throughout the event. b. Schedule water and eat healthy snacks for energy. Nurses should
also 16-hour shifts to allow for greater rest keep in touch with family, friends, and significant others, and
between shifts. not work for more than 12 hours per day. Encouraging
c. Encourage counseling upon deactivation counseling upon deactivation of the plan, or after the
of the emergency response plan. emergency response is over, does not prevent stress during
d. Assign staff to different roles and units the casualty event. Assigning staff to unfamiliar roles or units
within the medical facility. may increase situational stress and is not an approach
to
prevent post-traumatic stress disorder.
DIF: Remembering/Knowledge REF: 145
,A client who is hospitalized with burns after ANS: D
losing the family home in a fire becomes Clients should be allowed to ventilate their feelings of anger
angry and screams at a nurse when dinner and despair after a catastrophic event. The nurse establishes
is served late. How should the nurse rapport through active listening and honest communication
respond? and by recognizing cues that the client wishes to talk. Asking
a.Do you need something for pain right whether the client is in pain as the first response closes the
now? door to open communication and limits the clients options.
b. Please stop yelling. I brought dinner as Simply telling the client to stop yelling and to gain
soon as I could. control does nothing to promote therapeutic
c. I suggest that you get control of yourself. communication.
d.You seem upset. I have time to talk if DIF: Applying/Application REF: 146
youd like.
A nurse is field-triaging clients after an ANS: D
industrial accident. Which client condition Clients who have an immediate threat to life are given
should the nurse triage with a red tag? the highest priority, are placed in the emergent or
a.Dislocated right hip and an open fracture class I
of the right lower leg category, and are given a red triage tag. The client with
b. Large contusion to the forehead and a multiple rib fractures and shortness of breath most likely has
bloody nose developed a pneumothorax, which may be fatal if not
c. Closed fracture of the right clavicle and treated immediately. The client with the hip and leg problem
arm numbness and the client with the clavicle fracture would be classified
d. Multiple fractured ribs and shortness of as class II; these major but stable injuries can wait 30
breath minutes to 2 hours for definitive care. The client with
facial wounds would be
considered the walking wounded and classified as nonurgent.
DIF: Analyzing/Analysis REF: 141
An emergency department (ED) charge ANS: D
nurse prepares to receive clients from a The ED charge nurse should direct additional nursing staff to
mass casualty within the community. What is help care for current ED clients while the ED staff prepares to
the role of this nurse during the event? receive mass casualty victims; however, they should not
a.Ask ED staff to discharge clients from be
the medical-surgical units in order to assigned to the most critically ill or injured clients. The house
make room for critically injured victims. supervisor and unit directors would collaborate to
b. Call additional medical-surgical discharge stable clients. The hospital incident commander is
and critical care nursing staff to come responsible for mobilizing resources and would have the
to the responsibility for calling in staff. The medical command
hospital to assist when victims are brought physician would be the person best able to communicate
in. with on-scene personnel regarding the ability to take
c. Inform the incident commander at more clients.
the mass casualty scene about how DIF: Applying/Application REF: 144
many victims may be handled by the
ED.
d. Direct medical-surgical and critical care
nurses to assist with clients currently in the
ED while emergency staff prepare to
receive the mass casualty victims.
,The hospital administration arranges for ANS: A
critical incident stress debriefing for the staff Strict confidentiality during stress debriefing is essential so
after a mass casualty incident. Which that staff members can feel comfortable sharing their feelings,
statement by the debriefing team leader is which should be accepted unconditionally. Brainstorming
most appropriate for this situation? improvements and discussing policies would occur during an
a.You are free to express your administrative review. Any employee present during a mass
feelings; whatever is said here stays casualty situation is eligible for critical incident stress
here. management services.
b. Lets evaluate what went wrong DIF: Applying/Application REF: 145
and develop policies for future
incidents.
c.This session is only for nursing and
medical staff, not for ancillary personnel.
d. Lets pass around the written policy
compliance form for everyone.
A nurse is caring for a client whose wife ANS: C
died in a recent mass casualty accident. The Therapeutic communication includes active listening and
client says, I cant believe that my wife is honesty. This statement demonstrates that the nurse
gone and I am left to raise my children all by recognizes the clients distress and has provided an opening
myself. How should the nurse respond? for discussion. Extending sympathy and offering to call the
a.Please accept my sympathies for chaplain do not give the client the opportunity to discuss
your loss. feelings. Stating that the children still have one parent
b. I can call the hospital chaplain if you wish. discounts the clients feelings and situation.
c.You sound anxious about being a single DIF: Applying/Application REF: 146
parent.
d.At least your children still have you
in their lives.
A nurse cares for clients during a ANS: C
community-wide disaster drill. Once of the In a disaster, military-style triage is used; this approach
clients asks, Why are the individuals identifies the dead or expectant dead with black tags. This
with practice helps to maintain the goal of triage, which is doing
black tags not receiving any care? How the most good for the most people. Precious resources are
should the nurse respond? not used for those with overwhelming critical injury or illness,
a.To do the greatest good for the greatest so that they can be allocated to others who have a reasonable
number of people, it is necessary to expectation of survival. Clients are not sacrificed. Telling
sacrifice some. students to move on after identifying the expectant dead
b. Not everyone will survive a disaster, so belittles their feelings and does not provide an adequate
it is best to identify those people early explanation. Clients are not black-tagged to allow volunteers
and move on. to give comfort care.
c. In a disaster, extensive resources are not
used for one person at the expense of many
others.
d. With black tags, volunteers can
identify those who are dying and can
give them comfort care.
, A nurse wants to become involved ANS: A
in community disaster preparedness The Medical Reserve Corps (MRC) consists of volunteer
and is medical and public health care professionals who support the
interested in helping set up and staff first aid community during times of need. They may help staff
stations or community acute care centers in hospitals, establish first aid stations or special needs shelters,
the event of a disaster. Which organization is or set up acute care centers in the community. The National
the best fit for this nurses interests? Guard often performs search and rescue operations and law
a.The Medical Reserve Corps enforcement. The health department focuses on
b.The National Guard communicable disease tracking, treatment, and prevention. A
c.The health department Disaster Medical Assistance Team is deployed to a disaster
d.A Disaster Medical Assistance Team area for up to 72 hours, providing many types of relief
services.
A nurse wants to become part of a Disaster ANS: A
Medical Assistance Team (DMAT) but is When deployed, DMAT health care providers are acting as
concerned about maintaining licensure in agents of the federal government, and so are considered
several different states. Which statement federal employees. Thus their licenses are valid in all 50 states.
best addresses these concerns? Licensure is an issue that the government would be
a. Deployed DMAT providers are federal concerned with, but no programs for temporary licensure or
employees, so their licenses are good in all rapid activation are available.
50 states. DIF: Understanding/Comprehension REF: 142
b.The government has a program for
quick licensure activation wherever you
are
deployed.
c. During a time of crisis, licensure
issues would not be the governments
priority concern.
d. If you are deployed, you will be issued a
temporary license in the state in which
you are working.
After a hospitals emergency department ANS: B
(ED) has efficiently triaged, treated, and Before standing down, the incident command officer ensures
transferred clients from a community that the needs of the other hospital departments have been
disaster to appropriate units, the taken care of because they may still be stressed and may
hospital incident command officer wants need continued support to keep functioning. Many more
to stand down from the emergency walking wounded victims may present to the ED; that number
plan. Which may not be predictable. Giving staff the chance to eat
question should the nursing supervisor ask and rest is important, but all areas of the facility need that
at this time? too.
a.Are you sure no more victims are Although the Chief Medical Officer (CMO) may be involved in
coming into the ED? the incident, the CMO does not determine when the hospital
b. Do all areas of the hospital have can stand down.
the supplies and personnel they DIF: Applying/Application REF: 145
need?
c. Have all ED staff had the chance to
eat and rest recently?
d. Does the Chief Medical Officer agree
this disaster is under control?
Exam 3 – Practice
Questions, Comprehensive
Exam Review, and Test
Preparation Guide
A hospital responds to a local mass casualty ANS: A
event. Which action should the nurse To prevent staff post-traumatic stress disorder during a mass
supervisor take to prevent staff post- casualty event, the nurses should use available counseling,
traumatic stress disorder during a mass encourage and support co-workers, monitor each others
casualty event? stress level and performance, take breaks when needed, talk
a. Provide water and healthy snacks for about feelings with staff and managers, and drink plenty of
energy throughout the event. b. Schedule water and eat healthy snacks for energy. Nurses should
also 16-hour shifts to allow for greater rest keep in touch with family, friends, and significant others, and
between shifts. not work for more than 12 hours per day. Encouraging
c. Encourage counseling upon deactivation counseling upon deactivation of the plan, or after the
of the emergency response plan. emergency response is over, does not prevent stress during
d. Assign staff to different roles and units the casualty event. Assigning staff to unfamiliar roles or units
within the medical facility. may increase situational stress and is not an approach
to
prevent post-traumatic stress disorder.
DIF: Remembering/Knowledge REF: 145
,A client who is hospitalized with burns after ANS: D
losing the family home in a fire becomes Clients should be allowed to ventilate their feelings of anger
angry and screams at a nurse when dinner and despair after a catastrophic event. The nurse establishes
is served late. How should the nurse rapport through active listening and honest communication
respond? and by recognizing cues that the client wishes to talk. Asking
a.Do you need something for pain right whether the client is in pain as the first response closes the
now? door to open communication and limits the clients options.
b. Please stop yelling. I brought dinner as Simply telling the client to stop yelling and to gain
soon as I could. control does nothing to promote therapeutic
c. I suggest that you get control of yourself. communication.
d.You seem upset. I have time to talk if DIF: Applying/Application REF: 146
youd like.
A nurse is field-triaging clients after an ANS: D
industrial accident. Which client condition Clients who have an immediate threat to life are given
should the nurse triage with a red tag? the highest priority, are placed in the emergent or
a.Dislocated right hip and an open fracture class I
of the right lower leg category, and are given a red triage tag. The client with
b. Large contusion to the forehead and a multiple rib fractures and shortness of breath most likely has
bloody nose developed a pneumothorax, which may be fatal if not
c. Closed fracture of the right clavicle and treated immediately. The client with the hip and leg problem
arm numbness and the client with the clavicle fracture would be classified
d. Multiple fractured ribs and shortness of as class II; these major but stable injuries can wait 30
breath minutes to 2 hours for definitive care. The client with
facial wounds would be
considered the walking wounded and classified as nonurgent.
DIF: Analyzing/Analysis REF: 141
An emergency department (ED) charge ANS: D
nurse prepares to receive clients from a The ED charge nurse should direct additional nursing staff to
mass casualty within the community. What is help care for current ED clients while the ED staff prepares to
the role of this nurse during the event? receive mass casualty victims; however, they should not
a.Ask ED staff to discharge clients from be
the medical-surgical units in order to assigned to the most critically ill or injured clients. The house
make room for critically injured victims. supervisor and unit directors would collaborate to
b. Call additional medical-surgical discharge stable clients. The hospital incident commander is
and critical care nursing staff to come responsible for mobilizing resources and would have the
to the responsibility for calling in staff. The medical command
hospital to assist when victims are brought physician would be the person best able to communicate
in. with on-scene personnel regarding the ability to take
c. Inform the incident commander at more clients.
the mass casualty scene about how DIF: Applying/Application REF: 144
many victims may be handled by the
ED.
d. Direct medical-surgical and critical care
nurses to assist with clients currently in the
ED while emergency staff prepare to
receive the mass casualty victims.
,The hospital administration arranges for ANS: A
critical incident stress debriefing for the staff Strict confidentiality during stress debriefing is essential so
after a mass casualty incident. Which that staff members can feel comfortable sharing their feelings,
statement by the debriefing team leader is which should be accepted unconditionally. Brainstorming
most appropriate for this situation? improvements and discussing policies would occur during an
a.You are free to express your administrative review. Any employee present during a mass
feelings; whatever is said here stays casualty situation is eligible for critical incident stress
here. management services.
b. Lets evaluate what went wrong DIF: Applying/Application REF: 145
and develop policies for future
incidents.
c.This session is only for nursing and
medical staff, not for ancillary personnel.
d. Lets pass around the written policy
compliance form for everyone.
A nurse is caring for a client whose wife ANS: C
died in a recent mass casualty accident. The Therapeutic communication includes active listening and
client says, I cant believe that my wife is honesty. This statement demonstrates that the nurse
gone and I am left to raise my children all by recognizes the clients distress and has provided an opening
myself. How should the nurse respond? for discussion. Extending sympathy and offering to call the
a.Please accept my sympathies for chaplain do not give the client the opportunity to discuss
your loss. feelings. Stating that the children still have one parent
b. I can call the hospital chaplain if you wish. discounts the clients feelings and situation.
c.You sound anxious about being a single DIF: Applying/Application REF: 146
parent.
d.At least your children still have you
in their lives.
A nurse cares for clients during a ANS: C
community-wide disaster drill. Once of the In a disaster, military-style triage is used; this approach
clients asks, Why are the individuals identifies the dead or expectant dead with black tags. This
with practice helps to maintain the goal of triage, which is doing
black tags not receiving any care? How the most good for the most people. Precious resources are
should the nurse respond? not used for those with overwhelming critical injury or illness,
a.To do the greatest good for the greatest so that they can be allocated to others who have a reasonable
number of people, it is necessary to expectation of survival. Clients are not sacrificed. Telling
sacrifice some. students to move on after identifying the expectant dead
b. Not everyone will survive a disaster, so belittles their feelings and does not provide an adequate
it is best to identify those people early explanation. Clients are not black-tagged to allow volunteers
and move on. to give comfort care.
c. In a disaster, extensive resources are not
used for one person at the expense of many
others.
d. With black tags, volunteers can
identify those who are dying and can
give them comfort care.
, A nurse wants to become involved ANS: A
in community disaster preparedness The Medical Reserve Corps (MRC) consists of volunteer
and is medical and public health care professionals who support the
interested in helping set up and staff first aid community during times of need. They may help staff
stations or community acute care centers in hospitals, establish first aid stations or special needs shelters,
the event of a disaster. Which organization is or set up acute care centers in the community. The National
the best fit for this nurses interests? Guard often performs search and rescue operations and law
a.The Medical Reserve Corps enforcement. The health department focuses on
b.The National Guard communicable disease tracking, treatment, and prevention. A
c.The health department Disaster Medical Assistance Team is deployed to a disaster
d.A Disaster Medical Assistance Team area for up to 72 hours, providing many types of relief
services.
A nurse wants to become part of a Disaster ANS: A
Medical Assistance Team (DMAT) but is When deployed, DMAT health care providers are acting as
concerned about maintaining licensure in agents of the federal government, and so are considered
several different states. Which statement federal employees. Thus their licenses are valid in all 50 states.
best addresses these concerns? Licensure is an issue that the government would be
a. Deployed DMAT providers are federal concerned with, but no programs for temporary licensure or
employees, so their licenses are good in all rapid activation are available.
50 states. DIF: Understanding/Comprehension REF: 142
b.The government has a program for
quick licensure activation wherever you
are
deployed.
c. During a time of crisis, licensure
issues would not be the governments
priority concern.
d. If you are deployed, you will be issued a
temporary license in the state in which
you are working.
After a hospitals emergency department ANS: B
(ED) has efficiently triaged, treated, and Before standing down, the incident command officer ensures
transferred clients from a community that the needs of the other hospital departments have been
disaster to appropriate units, the taken care of because they may still be stressed and may
hospital incident command officer wants need continued support to keep functioning. Many more
to stand down from the emergency walking wounded victims may present to the ED; that number
plan. Which may not be predictable. Giving staff the chance to eat
question should the nursing supervisor ask and rest is important, but all areas of the facility need that
at this time? too.
a.Are you sure no more victims are Although the Chief Medical Officer (CMO) may be involved in
coming into the ED? the incident, the CMO does not determine when the hospital
b. Do all areas of the hospital have can stand down.
the supplies and personnel they DIF: Applying/Application REF: 145
need?
c. Have all ED staff had the chance to
eat and rest recently?
d. Does the Chief Medical Officer agree
this disaster is under control?
