CHAPTER 68: EMERGENCY AND DISASTER NURSING
QUESTIONS WITH ACCURATE ANSWERS
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 correct answer ANS:
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). correct answer
ANS: 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. correct answer ANS: 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.
QUESTIONS WITH ACCURATE ANSWERS
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 correct answer ANS:
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). correct answer
ANS: 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. correct answer ANS: 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.
