Emergency nurse practitioner enp ultimate exam
1. Which patient should the nurse prioritize as needing emergent treatment, assuming no
other injuries are
present except the ones outlined below?
A) A patient with a blunt chest trauma with some difficulty breathing
B) A patient with a sore neck who was immobilized in the field on a backboard with a
cervical collar
C) A patient with a possible fractured tibia with adequate pedal pulses
D) A patient with an acute onset of confusion - -Ans: A
Feedback:
The patient with blunt chest trauma possibly has a compromised airway. Establishment and
maintenance
of a patent airway and adequate ventilation is prioritized over other health problems,
including skeletal
injuries and changes in cognition.
--2. The nurse observes that the family members of a patient who was injured in an accident
are blaming
each other for the circumstances leading up to the accident. The nurse appropriately lets
the family
members express their feelings of responsibility, while explaining that there was probably
little they
could do to prevent the injury. In what stage of crisis is this family?
A) Anxiety and denial
B) Remorse and guilt
C) Anger
D) Grief - -Ans: B
Feedback:
Remorse and guilt are natural processes of the stages of a crisis and should be facilitated for
the family
members to process the crisis. The familys sense of blame and responsibility are more
suggestive of guilt
than anger, grief, or anxiety.
--3. A patient is brought to the ED by ambulance with a gunshot wound to the abdomen.
The nurse knows
that the most common hollow organ injured in this type of injury is what?
A) Liver
B) Small bowel
C) Stomach
D) Large bowel - -Ans: B
Feedback:
Penetrating abdominal wounds have a high incidence of injury to hollow organs, especially
the small
bowel. The liver is also injured frequently, but it is a solid organ.
, --4. A patient has been brought to the ED with multiple trauma after a motor vehicle
accident. After
immediate threats to life have been addressed, the nurse and trauma team should take
what action?
A) Perform a rapid physical assessment.
B) Initiate health education.
C) Perform diagnostic imaging.
D) Establish the circumstances of the accident. - -Ans: A
Feedback:
Once immediate threats to life have been corrected, a rapid physical examination is done to
identify
injuries and priorities of treatment. Health education is initiated later in the care process
and diagnostic
imaging would take place after a rapid physical assessment. It is not the care teams
responsibility to
determine the circumstances of the accident.
--5. The nursing educator is reviewing the signs and symptoms of heat stroke with a group
of nurses who
provide care in a desert region. The educator should describe what sign or symptom?
A) Hypertension with a wide pulse pressure
B) Anhidrosis
C) Copious diuresis
D) Cheyne-Stokes respirations - -Ans: B
Feedback:
Heat stroke is manifested by anhidrosis confusion, bizarre behavior, coma, elevated body
temperature,
hot dry skin, tachypnea, hypotension, and tachycardia. This health problem is not associated
with
anhidrosis or Cheyne-Stokes respirations.
--6. A patient is brought to the ED by ambulance after swallowing highly acidic toilet bowl
cleaner 2 hours
earlier. The patient is alert and oriented. What is the care teams most appropriate
treatment?
A) Administering syrup of ipecac
B) Performing a gastric lavage
C) Giving milk to drink
D) Referring to psychiatry - -Ans: C
Feedback:
A patient who has swallowed an acidic substance, such as toilet bowl cleaner, may be given
milk or
water to drink for dilution. Gastric lavage must be performed within 1 hour of ingestion. A
psychiatric
consult may be considered once the patient is physically stable and it is deemed appropriate
by the
physician. Syrup of ipecac is no longer used in clinical settings.
1. Which patient should the nurse prioritize as needing emergent treatment, assuming no
other injuries are
present except the ones outlined below?
A) A patient with a blunt chest trauma with some difficulty breathing
B) A patient with a sore neck who was immobilized in the field on a backboard with a
cervical collar
C) A patient with a possible fractured tibia with adequate pedal pulses
D) A patient with an acute onset of confusion - -Ans: A
Feedback:
The patient with blunt chest trauma possibly has a compromised airway. Establishment and
maintenance
of a patent airway and adequate ventilation is prioritized over other health problems,
including skeletal
injuries and changes in cognition.
--2. The nurse observes that the family members of a patient who was injured in an accident
are blaming
each other for the circumstances leading up to the accident. The nurse appropriately lets
the family
members express their feelings of responsibility, while explaining that there was probably
little they
could do to prevent the injury. In what stage of crisis is this family?
A) Anxiety and denial
B) Remorse and guilt
C) Anger
D) Grief - -Ans: B
Feedback:
Remorse and guilt are natural processes of the stages of a crisis and should be facilitated for
the family
members to process the crisis. The familys sense of blame and responsibility are more
suggestive of guilt
than anger, grief, or anxiety.
--3. A patient is brought to the ED by ambulance with a gunshot wound to the abdomen.
The nurse knows
that the most common hollow organ injured in this type of injury is what?
A) Liver
B) Small bowel
C) Stomach
D) Large bowel - -Ans: B
Feedback:
Penetrating abdominal wounds have a high incidence of injury to hollow organs, especially
the small
bowel. The liver is also injured frequently, but it is a solid organ.
, --4. A patient has been brought to the ED with multiple trauma after a motor vehicle
accident. After
immediate threats to life have been addressed, the nurse and trauma team should take
what action?
A) Perform a rapid physical assessment.
B) Initiate health education.
C) Perform diagnostic imaging.
D) Establish the circumstances of the accident. - -Ans: A
Feedback:
Once immediate threats to life have been corrected, a rapid physical examination is done to
identify
injuries and priorities of treatment. Health education is initiated later in the care process
and diagnostic
imaging would take place after a rapid physical assessment. It is not the care teams
responsibility to
determine the circumstances of the accident.
--5. The nursing educator is reviewing the signs and symptoms of heat stroke with a group
of nurses who
provide care in a desert region. The educator should describe what sign or symptom?
A) Hypertension with a wide pulse pressure
B) Anhidrosis
C) Copious diuresis
D) Cheyne-Stokes respirations - -Ans: B
Feedback:
Heat stroke is manifested by anhidrosis confusion, bizarre behavior, coma, elevated body
temperature,
hot dry skin, tachypnea, hypotension, and tachycardia. This health problem is not associated
with
anhidrosis or Cheyne-Stokes respirations.
--6. A patient is brought to the ED by ambulance after swallowing highly acidic toilet bowl
cleaner 2 hours
earlier. The patient is alert and oriented. What is the care teams most appropriate
treatment?
A) Administering syrup of ipecac
B) Performing a gastric lavage
C) Giving milk to drink
D) Referring to psychiatry - -Ans: C
Feedback:
A patient who has swallowed an acidic substance, such as toilet bowl cleaner, may be given
milk or
water to drink for dilution. Gastric lavage must be performed within 1 hour of ingestion. A
psychiatric
consult may be considered once the patient is physically stable and it is deemed appropriate
by the
physician. Syrup of ipecac is no longer used in clinical settings.
