Emergency & Trauma Nursing NCLEX
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An emergency room nurse assesses a client who has been raped. With
which health care team member should the nurse collaborate when
planning this client's care?
a. Emergency medicine physician
b. Case manager
c. Forensic nurse examiner
d. Psychiatric crisis nurse
Ans: C ~ All other members of the health care team listed may
be used in the management of this client's care. However, the
forensic nurse examiner is educated to obtain client histories
and collect evidence dealing with the assault, and can o ffer the
counseling and follow-up needed when dealing with the victim
of an assault.
The emergency department team is performing cardiopulmonary
resuscitation on a client when the client's spouse arrives at the
emergency department. Which action should the nurse take first?
a. Request that the client's spouse sit in the waiting room.
b. Ask the spouse if he wishes to be present during the resuscitation.
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c. Suggest that the spouse begin to pray for the client.
d. Refer the client's spouse to the hospitals crisis team.
Ans: B ~ If resuscitation efforts are still under way when the
family arrives, one or two family members may be given the
opportunity to be present during lifesaving procedures. The
other options do not give the spouse the opportunity t o be
present for the client or to begin to have closure.
An emergency room nurse is triaging victims of a multi-casualty event.
Which client should receive care first?
a. A 30-year-old distraught mother holding her crying child
b. A 65-year-old conscious male with a head laceration
c. A 26-year-old male who has pale, cool, clammy skin
d. A 48-year-old with a simple fracture of the lower leg
Ans: C ~ The client with pale, cool, clammy skin is in shock and
needs immediate medical attention. The mother does not have
injuries and so would be the lowest priority. The other two
people need medical attention soon, but not at the expense of a
person in shock.
While triaging clients in a crowded emergency department, a nurse
assesses a client who presents with symptoms of tuberculosis. Which
action should the nurse take first?
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