RN 402 Exam 3 Practice Questions || 100% Valid Solutions.
1. During the primary assessment of a victim of a motor vehicle collision, the nurse determines
that the patient is breathing and has an unobstructed airway. Which action should the nurse take
next?
a. Palpate extremities for bilateral pulses.
b. Observe the patients respiratory effort.
c. Check the patients level of consciousness.
d. Examine the patient for any external bleeding. correct answers b. Observe the patients
respiratory effort.
2. During the primary survey of a patient with severe leg trauma, the nurse observes that the
patients left pedal pulse is absent and the leg is swollen. Which action will the nurse take next?
a. Send blood to the lab for a complete blood count.
b. Assess further for a cause of the decreased circulation.
c. Finish the airway, breathing, circulation, disability survey.
d. Start normal saline fluid infusion with a large-bore IV line. correct answers d. Start normal
saline fluid infusion with a large-bore IV line.
4. A patient who is unconscious after a fall from a ladder is transported to the emergency
department by emergency medical personnel. During the primary survey of the patient, the nurse
should
a. obtain a complete set of vital signs.
b. obtain a Glasgow Coma Scale score.
c. ask about chronic medical conditions.
d. attach a cardiac electrocardiogram monitor. correct answers b. obtain a Glasgow Coma Scale
score.
,3. After the return of spontaneous circulation following the resuscitation of a patient who had a
cardiac arrest, therapeutic hypothermia is ordered. Which action will the nurse include in the
plan of care?
a. Apply external cooling device.
b. Check mental status every 15 minutes.
c. Avoid the use of sedative medications.
d. Rewarm if temperature is <91 F (32.8 C). correct answers a. Apply external cooling device.
5. 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). correct answers d. TIG and
tetanus-diphtheria toxoid and pertussis vaccine (Tdap).
6. A patient who has experienced blunt abdominal trauma during a motor vehicle collision is
complaining of increasing abdominal pain. The nurse will plan to teach the patient about the
purpose of
a. peritoneal lavage.
b. abdominal ultrasonography.
c. nasogastric (NG) tube placement.
d. magnetic resonance imaging (MRI). correct answers b. abdominal ultrasonography.
7. A patient with hypotension and an elevated temperature after working outside on a hot day is
treated in the emergency department (ED). The nurse determines that discharge teaching has
been effective when the patient makes which statement?
a. I will take salt tablets when I work outdoors in the summer.
b. I should take acetaminophen (Tylenol) if I start to feel too warm.
, c. I should drink sports drinks when working outside in hot weather.
d. I will move to a cool environment if I notice that I am feeling confused. correct answers c. I
should drink sports drinks when working outside in hot weather.
8. 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. correct answers c. Auscultate breath sounds.
9. When planning the response to the potential use of smallpox as an agent of terrorism, the
emergency department (ED) nurse manager will plan to obtain adequate quantities of
a. vaccine.
b. atropine.
c. antibiotics.
d. whole blood. correct answers a. vaccine.
10. When rewarming a patient who arrived in the emergency department (ED) with a
temperature of 87 F (30.6 C), which assessment indicates that the nurse should discontinue active
rewarming?
a. The patient begins to shiver.
b. The BP decreases to 86/42 mm Hg.
c. The patient develops atrial fibrillation.
d. The core temperature is 94 F (34.4 C). correct answers d. The core temperature is 94 F (34.4
C).
1. During the primary assessment of a victim of a motor vehicle collision, the nurse determines
that the patient is breathing and has an unobstructed airway. Which action should the nurse take
next?
a. Palpate extremities for bilateral pulses.
b. Observe the patients respiratory effort.
c. Check the patients level of consciousness.
d. Examine the patient for any external bleeding. correct answers b. Observe the patients
respiratory effort.
2. During the primary survey of a patient with severe leg trauma, the nurse observes that the
patients left pedal pulse is absent and the leg is swollen. Which action will the nurse take next?
a. Send blood to the lab for a complete blood count.
b. Assess further for a cause of the decreased circulation.
c. Finish the airway, breathing, circulation, disability survey.
d. Start normal saline fluid infusion with a large-bore IV line. correct answers d. Start normal
saline fluid infusion with a large-bore IV line.
4. A patient who is unconscious after a fall from a ladder is transported to the emergency
department by emergency medical personnel. During the primary survey of the patient, the nurse
should
a. obtain a complete set of vital signs.
b. obtain a Glasgow Coma Scale score.
c. ask about chronic medical conditions.
d. attach a cardiac electrocardiogram monitor. correct answers b. obtain a Glasgow Coma Scale
score.
,3. After the return of spontaneous circulation following the resuscitation of a patient who had a
cardiac arrest, therapeutic hypothermia is ordered. Which action will the nurse include in the
plan of care?
a. Apply external cooling device.
b. Check mental status every 15 minutes.
c. Avoid the use of sedative medications.
d. Rewarm if temperature is <91 F (32.8 C). correct answers a. Apply external cooling device.
5. 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). correct answers d. TIG and
tetanus-diphtheria toxoid and pertussis vaccine (Tdap).
6. A patient who has experienced blunt abdominal trauma during a motor vehicle collision is
complaining of increasing abdominal pain. The nurse will plan to teach the patient about the
purpose of
a. peritoneal lavage.
b. abdominal ultrasonography.
c. nasogastric (NG) tube placement.
d. magnetic resonance imaging (MRI). correct answers b. abdominal ultrasonography.
7. A patient with hypotension and an elevated temperature after working outside on a hot day is
treated in the emergency department (ED). The nurse determines that discharge teaching has
been effective when the patient makes which statement?
a. I will take salt tablets when I work outdoors in the summer.
b. I should take acetaminophen (Tylenol) if I start to feel too warm.
, c. I should drink sports drinks when working outside in hot weather.
d. I will move to a cool environment if I notice that I am feeling confused. correct answers c. I
should drink sports drinks when working outside in hot weather.
8. 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. correct answers c. Auscultate breath sounds.
9. When planning the response to the potential use of smallpox as an agent of terrorism, the
emergency department (ED) nurse manager will plan to obtain adequate quantities of
a. vaccine.
b. atropine.
c. antibiotics.
d. whole blood. correct answers a. vaccine.
10. When rewarming a patient who arrived in the emergency department (ED) with a
temperature of 87 F (30.6 C), which assessment indicates that the nurse should discontinue active
rewarming?
a. The patient begins to shiver.
b. The BP decreases to 86/42 mm Hg.
c. The patient develops atrial fibrillation.
d. The core temperature is 94 F (34.4 C). correct answers d. The core temperature is 94 F (34.4
C).