Chapter 68: Emergency and Disaster
Nursing Lewis: Medical-Surgical
Nursing, 10th Edition,
1. During the primary assessment of a victim of a motor vehicle collision, the nurse
determines that the affected person has an unobstructed airway. Which action have to the nurse
take next?
A. Palpate extremities for bilateral pulses.
B. Observe the affected person's respiratory attempt.
C. Check the affected person's stage of consciousness.
D. Examine the patient for any external bleeding. - ANS-ANS: B
Even with a patent airway, patients may have different problems that compromise air flow, so
the subsequent
motion is to assess the affected person's respiratory. The different moves also are part of the
initial survey however
assessment of respiration ought to be finished right away after assessing for airway patency.
1. The following 4 patients arrive inside the emergency branch (ED) after a motor
vehicle collision. In which order have to the nurse verify them? (Put a comma and a area
between
each answer desire [A, B, C, D, E].)
a. A 74-12 months-old affected person with palpitations and chest ache
b. A forty three-yr-antique patient complaining of seven/10 belly ache
c. A 21-12 months-antique affected person with a couple of fractures of the face and jaw
d. A 37-12 months-vintage affected person with a misaligned lower left leg with intact pulses -
ANS-ANS:
C, A, B, D
The maximum precedence is to evaluate the 21-yr-old patient for airway obstruction, that's the
maximum existence-
threatening damage. The seventy four-year-antique affected person may have chest ache from
cardiac ischemia and should be
assessed and have diagnostic checking out for this ache. The 43-12 months-vintage affected
person might also have belly trauma or
bleeding and need to be seen next to assess circulatory popularity. The 37-year-vintage affected
person seems to have a
,feasible fracture of the left leg and must be visible quickly, however this affected person has the
least lifestyles-threatening
injury.
12. A patient arrives in the emergency branch (ED) numerous hours after taking "25 to
30" acetaminophen (Tylenol) drugs. Which movement will the nurse plan to take?
A. Give N-acetylcysteine.
B. Discuss using chelation therapy.
C. Start oxygen the use of a non-rebreather mask.
D. Have the patient drink large quantities of water. - ANS-ANS: A
N-acetylcysteine is the endorsed remedy to prevent liver harm after acetaminophen overdose.
The different moves is probably used for other types of poisoning, but they'll no longer be
appropriate for a patient
with acetaminophen poisoning.
Thirteen. A triage nurse in a hectic emergency department (ED) assesses a affected person
who complains
of 7/10 stomach pain and states, "I had a temperature of 103.Nine° F (39.Nine° C) at domestic."
The
nurse's first action have to be to
a. Verify the patient's current critical symptoms.
B. Provide acetaminophen (Tylenol) per business enterprise protocol.
C. Ask the patient to provide a clean-trap urine for urinalysis.
D. Inform the patient that it will likely be 1 to two hours before seeing a fitness care company. -
ANS-ANS: A
The patient's ache and announcement approximately an extended temperature imply that the
nurse ought to acquire critical
symptoms before deciding how unexpectedly the affected person should be seen by means of
the fitness care company. A urinalysis might also
be suitable, however this would be achieved after the crucial signs are taken. The nurse will no
longer give
acetaminophen earlier than confirming a cutting-edge temperature elevation.
14. The emergency branch (ED) triage nurse is assessing four sufferers worried in a
motor vehicle collision. Which affected person has the very best priority for treatment?
A. A affected person with out a pedal pulses
b. A patient with an open femur fracture
c. A affected person with bleeding facial lacerations
d. A patient with paradoxical chest movement - ANS-ANS: D
Most immediate deaths from trauma arise due to issues with ventilation, so the affected person
with
paradoxical chest movements ought to be dealt with first. Face and head fractures can obstruct
the airway, however
the patient with facial injuries handiest has lacerations. The different patients also want rapid
intervention however
do not have airway or respiratory issues.
16. Gastric lavage and management of activated charcoal are ordered for an subconscious
, affected person who has been admitted to the emergency department (ED) after ingesting 30
lorazepam
(Ativan) pills. Which prescribed action should the nurse plan to do first?
A. Insert a huge-bore orogastric tube.
B. Assist with intubation of the patient.
C. Prepare a 60-mL syringe with saline.
D. Give first dose of activated charcoal. - ANS-ANS: B
In an unresponsive patient, intubation is achieved earlier than gastric lavage and activated
charcoal administration
to save you aspiration. The other actions can be carried out after intubation.
20. Following an earthquake, sufferers are triaged by means of emergency scientific employees
and
transported to the emergency department (ED). Which patient will the nurse need to evaluate
first?
A. A patient with a red tag c. A patient with a black tag
b. A affected person with a blue tag d. A patient with a yellow tag - ANS-ANS: A
The crimson tag suggests a affected person with a life-threatening injury requiring rapid
treatment. The different tags
indicate sufferers with less urgent accidents or individuals who are possibly to die.
Three. After the go back of spontaneous flow following the resuscitation of a patient who
had a cardiac arrest, healing hypothermia is ordered. Which motion will the nurse encompass
within the
plan of care?
A. Initiate cooling per protocol.
B. Avoid using sedative drugs.
C. Check intellectual repute each 15 minutes.
D. Rewarm if temperature is under ninety one° F (32.8° C). - ANS-ANS: A
When healing hypothermia is used postresuscitation, outside cooling devices or bloodless
everyday saline
infusions are used to rapidly lower body temperature to 89.6° F to 93.2° F (32° C to 34° C).
Because
hypothermia will lower mind activity, assessing mental repute each 15 mins is not achieved at
this
level. Sedative tablets are given at some stage in healing hypothermia.
4. A patient who is subconscious after a fall from a ladder is transported to the emergency
branch by means of emergency medical personnel. During the number one survey of the
affected person, the nurse
must
a. Achieve a complete set of essential symptoms.
B. Acquire a Glasgow Coma Scale rating.
C. Connect an electrocardiogram reveal.
D. Ask approximately persistent scientific conditions. - ANS-ANS: B
The Glasgow Coma Scale is protected when assessing for disability for the duration of the
number one survey. The other
Nursing Lewis: Medical-Surgical
Nursing, 10th Edition,
1. During the primary assessment of a victim of a motor vehicle collision, the nurse
determines that the affected person has an unobstructed airway. Which action have to the nurse
take next?
A. Palpate extremities for bilateral pulses.
B. Observe the affected person's respiratory attempt.
C. Check the affected person's stage of consciousness.
D. Examine the patient for any external bleeding. - ANS-ANS: B
Even with a patent airway, patients may have different problems that compromise air flow, so
the subsequent
motion is to assess the affected person's respiratory. The different moves also are part of the
initial survey however
assessment of respiration ought to be finished right away after assessing for airway patency.
1. The following 4 patients arrive inside the emergency branch (ED) after a motor
vehicle collision. In which order have to the nurse verify them? (Put a comma and a area
between
each answer desire [A, B, C, D, E].)
a. A 74-12 months-old affected person with palpitations and chest ache
b. A forty three-yr-antique patient complaining of seven/10 belly ache
c. A 21-12 months-antique affected person with a couple of fractures of the face and jaw
d. A 37-12 months-vintage affected person with a misaligned lower left leg with intact pulses -
ANS-ANS:
C, A, B, D
The maximum precedence is to evaluate the 21-yr-old patient for airway obstruction, that's the
maximum existence-
threatening damage. The seventy four-year-antique affected person may have chest ache from
cardiac ischemia and should be
assessed and have diagnostic checking out for this ache. The 43-12 months-vintage affected
person might also have belly trauma or
bleeding and need to be seen next to assess circulatory popularity. The 37-year-vintage affected
person seems to have a
,feasible fracture of the left leg and must be visible quickly, however this affected person has the
least lifestyles-threatening
injury.
12. A patient arrives in the emergency branch (ED) numerous hours after taking "25 to
30" acetaminophen (Tylenol) drugs. Which movement will the nurse plan to take?
A. Give N-acetylcysteine.
B. Discuss using chelation therapy.
C. Start oxygen the use of a non-rebreather mask.
D. Have the patient drink large quantities of water. - ANS-ANS: A
N-acetylcysteine is the endorsed remedy to prevent liver harm after acetaminophen overdose.
The different moves is probably used for other types of poisoning, but they'll no longer be
appropriate for a patient
with acetaminophen poisoning.
Thirteen. A triage nurse in a hectic emergency department (ED) assesses a affected person
who complains
of 7/10 stomach pain and states, "I had a temperature of 103.Nine° F (39.Nine° C) at domestic."
The
nurse's first action have to be to
a. Verify the patient's current critical symptoms.
B. Provide acetaminophen (Tylenol) per business enterprise protocol.
C. Ask the patient to provide a clean-trap urine for urinalysis.
D. Inform the patient that it will likely be 1 to two hours before seeing a fitness care company. -
ANS-ANS: A
The patient's ache and announcement approximately an extended temperature imply that the
nurse ought to acquire critical
symptoms before deciding how unexpectedly the affected person should be seen by means of
the fitness care company. A urinalysis might also
be suitable, however this would be achieved after the crucial signs are taken. The nurse will no
longer give
acetaminophen earlier than confirming a cutting-edge temperature elevation.
14. The emergency branch (ED) triage nurse is assessing four sufferers worried in a
motor vehicle collision. Which affected person has the very best priority for treatment?
A. A affected person with out a pedal pulses
b. A patient with an open femur fracture
c. A affected person with bleeding facial lacerations
d. A patient with paradoxical chest movement - ANS-ANS: D
Most immediate deaths from trauma arise due to issues with ventilation, so the affected person
with
paradoxical chest movements ought to be dealt with first. Face and head fractures can obstruct
the airway, however
the patient with facial injuries handiest has lacerations. The different patients also want rapid
intervention however
do not have airway or respiratory issues.
16. Gastric lavage and management of activated charcoal are ordered for an subconscious
, affected person who has been admitted to the emergency department (ED) after ingesting 30
lorazepam
(Ativan) pills. Which prescribed action should the nurse plan to do first?
A. Insert a huge-bore orogastric tube.
B. Assist with intubation of the patient.
C. Prepare a 60-mL syringe with saline.
D. Give first dose of activated charcoal. - ANS-ANS: B
In an unresponsive patient, intubation is achieved earlier than gastric lavage and activated
charcoal administration
to save you aspiration. The other actions can be carried out after intubation.
20. Following an earthquake, sufferers are triaged by means of emergency scientific employees
and
transported to the emergency department (ED). Which patient will the nurse need to evaluate
first?
A. A patient with a red tag c. A patient with a black tag
b. A affected person with a blue tag d. A patient with a yellow tag - ANS-ANS: A
The crimson tag suggests a affected person with a life-threatening injury requiring rapid
treatment. The different tags
indicate sufferers with less urgent accidents or individuals who are possibly to die.
Three. After the go back of spontaneous flow following the resuscitation of a patient who
had a cardiac arrest, healing hypothermia is ordered. Which motion will the nurse encompass
within the
plan of care?
A. Initiate cooling per protocol.
B. Avoid using sedative drugs.
C. Check intellectual repute each 15 minutes.
D. Rewarm if temperature is under ninety one° F (32.8° C). - ANS-ANS: A
When healing hypothermia is used postresuscitation, outside cooling devices or bloodless
everyday saline
infusions are used to rapidly lower body temperature to 89.6° F to 93.2° F (32° C to 34° C).
Because
hypothermia will lower mind activity, assessing mental repute each 15 mins is not achieved at
this
level. Sedative tablets are given at some stage in healing hypothermia.
4. A patient who is subconscious after a fall from a ladder is transported to the emergency
branch by means of emergency medical personnel. During the number one survey of the
affected person, the nurse
must
a. Achieve a complete set of essential symptoms.
B. Acquire a Glasgow Coma Scale rating.
C. Connect an electrocardiogram reveal.
D. Ask approximately persistent scientific conditions. - ANS-ANS: B
The Glasgow Coma Scale is protected when assessing for disability for the duration of the
number one survey. The other
