Chapter 68: Emergency and Disaster Nursing 2025
1. The following four patients arrive in the emergency department (ED) after a motor vehicle collision. In which
order should the nurse assess them? (Put a comma and a space between each answer choice [A, B, C, D, E].)
A. A 74-year-old with palpitations and chest pain
B. A 43-year-old complaining of 7/10 abdominal pain
C. A 21-year-old with multiple fractures of the face and jaw
D. A 37-year-old with a misaligned left leg with intact pulses - ansANS:
C, A, B, D
The highest priority is to assess the 21-year-old patient for airway obstruction, which is the most life-
threatening injury. The 74-year-old patient may have chest pain from cardiac ischemia and should be assessed
and have diagnostic testing for this pain. The 43-year-old patient may have abdominal trauma or bleeding and
should be seen next to assess circulatory status. The 37-year-old appears to have a possible fracture of the left
leg and should be seen soon, but this patient has the least life-threatening injury.
DIF: Cognitive Level: Analyze (analysis) REF: 1630 OBJ: Special Questions: Prioritization; Multiple Patients
TOP: Nursing Process: Assessment
A 19-year-old is brought to the emergency department (ED) with multiple lacerations and tissue avulsion of the
left hand. When asked about tetanus immunization, the patient denies having any previous vaccinations.
The nurse will anticipate giving
A. tetanus immunoglobulin (TIG) only.
B. TIG and tetanus-diphtheria toxoid (Td).
,C. tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only.
D. TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap). - ansANS: D
For an adult with no previous tetanus immunizations, TIG and Tdap are recommended. The other
immunizations are not sufficient for this patient.
DIF: Cognitive Level: Apply (application) REF: 1635
TOP: Nursing Process: Planning
A 20-year-old patient arrives in the emergency department (ED) several hours after taking 25 to 30
acetaminophen (Tylenol) tablets. Which action will the nurse plan to take?
A. Give N-acetylcysteine (Mucomyst).
B. Discuss the use of chelation therapy.
C. Start oxygen using a non-rebreather mask.
D. Have the patient drink large amounts of water. - ansANS: A
N-acetylcysteine is the recommended treatment to prevent liver damage after acetaminophen overdose. The
other actions might be used for other types of poisoning, but they will not be appropriate for a patient with
acetaminophen poisoning.
DIF: Cognitive Level: Understand (comprehension) REF: 1643
, TOP: Nursing Process: Planning
A 22-year-old patient who experienced a near drowning accident in a local pool, but now is awake and
breathing spontaneously, is admitted for observation. Which assessment will be most important for the nurse
to take during the observation period?
A. Auscultate heart sounds.
B. Palpate peripheral pulses.
C. Auscultate breath sounds.
D. Check pupil reaction to light. - ansANS: C
Because pulmonary edema is a common complication after near drowning, the nurse should assess the breath
sounds frequently. The other information also will be obtained by the nurse, but it is not as pertinent to the
patients admission diagnosis.
DIF: Cognitive Level: Apply (application) REF: 1640
TOP: Nursing Process: Implementation
A 28-year-old patient who has deep human bite wounds on the left hand is being treated in the urgent care
center. Which action will the nurse plan to take?
A. Prepare to administer rabies immune globulin (BayRab).
B. Assist the health care provider with suturing of the bite wounds.
1. The following four patients arrive in the emergency department (ED) after a motor vehicle collision. In which
order should the nurse assess them? (Put a comma and a space between each answer choice [A, B, C, D, E].)
A. A 74-year-old with palpitations and chest pain
B. A 43-year-old complaining of 7/10 abdominal pain
C. A 21-year-old with multiple fractures of the face and jaw
D. A 37-year-old with a misaligned left leg with intact pulses - ansANS:
C, A, B, D
The highest priority is to assess the 21-year-old patient for airway obstruction, which is the most life-
threatening injury. The 74-year-old patient may have chest pain from cardiac ischemia and should be assessed
and have diagnostic testing for this pain. The 43-year-old patient may have abdominal trauma or bleeding and
should be seen next to assess circulatory status. The 37-year-old appears to have a possible fracture of the left
leg and should be seen soon, but this patient has the least life-threatening injury.
DIF: Cognitive Level: Analyze (analysis) REF: 1630 OBJ: Special Questions: Prioritization; Multiple Patients
TOP: Nursing Process: Assessment
A 19-year-old is brought to the emergency department (ED) with multiple lacerations and tissue avulsion of the
left hand. When asked about tetanus immunization, the patient denies having any previous vaccinations.
The nurse will anticipate giving
A. tetanus immunoglobulin (TIG) only.
B. TIG and tetanus-diphtheria toxoid (Td).
,C. tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only.
D. TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap). - ansANS: D
For an adult with no previous tetanus immunizations, TIG and Tdap are recommended. The other
immunizations are not sufficient for this patient.
DIF: Cognitive Level: Apply (application) REF: 1635
TOP: Nursing Process: Planning
A 20-year-old patient arrives in the emergency department (ED) several hours after taking 25 to 30
acetaminophen (Tylenol) tablets. Which action will the nurse plan to take?
A. Give N-acetylcysteine (Mucomyst).
B. Discuss the use of chelation therapy.
C. Start oxygen using a non-rebreather mask.
D. Have the patient drink large amounts of water. - ansANS: A
N-acetylcysteine is the recommended treatment to prevent liver damage after acetaminophen overdose. The
other actions might be used for other types of poisoning, but they will not be appropriate for a patient with
acetaminophen poisoning.
DIF: Cognitive Level: Understand (comprehension) REF: 1643
, TOP: Nursing Process: Planning
A 22-year-old patient who experienced a near drowning accident in a local pool, but now is awake and
breathing spontaneously, is admitted for observation. Which assessment will be most important for the nurse
to take during the observation period?
A. Auscultate heart sounds.
B. Palpate peripheral pulses.
C. Auscultate breath sounds.
D. Check pupil reaction to light. - ansANS: C
Because pulmonary edema is a common complication after near drowning, the nurse should assess the breath
sounds frequently. The other information also will be obtained by the nurse, but it is not as pertinent to the
patients admission diagnosis.
DIF: Cognitive Level: Apply (application) REF: 1640
TOP: Nursing Process: Implementation
A 28-year-old patient who has deep human bite wounds on the left hand is being treated in the urgent care
center. Which action will the nurse plan to take?
A. Prepare to administer rabies immune globulin (BayRab).
B. Assist the health care provider with suturing of the bite wounds.
