Med Surg 2 Exam 1 Study Guide (Evolve Qs) With Solutions 2023

Med Surg 2 Exam 1 Study Guide (Evolve Qs) With Solutions 2023 1. As a direct result of overcrowding in emergency department (ED) environments, for whom must the emergency department nurse expect to provide care? A. A variety of age groups and cultures B. "Boarding" or holding inpatient clients C. Clients with a broad spectrum of issues, illnesses, and injuries D. Uninsured and underinsured clients - ANS B. "Boarding" or holding inpatient clients ED overcrowding has become a widespread problem, with frequent boarding or holding of admitted clients in the ED because of lack of beds in the hospital. The ED nurse must be adept at providing safe and competent care to clients who are awaiting bed placement. The focus then becomes one of ongoing care (scheduled medications, testing) instead of one-time orders. Although a variety of age groups and cultures; clients with a broad spectrum of illness, issues, and injuries; and uninsured/underinsured clients are seen in the ED, this is not a result of overcrowding. 2. A client is admitted to the emergency department after reporting being raped. Who is the best team member for the admitting nurse to locate to provide care for this client? A. Forensic nurse examiner B. Physician or health care provider C. Psychiatric crisis nurse D. Police officer - ANS A. Forensic nurse examiner The forensic nurse examiner is trained to recognize evidence of abuse and to intervene on the client's behalf. Although the physician or health care provider, the psychiatric crisis nurse, and the police officer may be involved at some point in the care of this particular client, they are not the best individuals to collaborate with at this time. It is important to remember that not all rapes are required to be reported to the police. 3. A client with a gunshot wound is admitted to the emergency department (ED). Which minimum Standard Precaution activity does the nurse require for staff safety? A. Blood and body fluid precautions B. Metal detector screening of the client C. Placement of a security guard D. Use of a positive air-purifying respirator (PAPR) - ANS A. Blood and body fluid precautions The ED nurse uses Standard Precautions at all times when there is the potential for contamination by blood or other body fluids. Screening of the client with a metal detector, appointing a security guard, and use of a PAPR, although beneficial, are not minimum Standard Precautions. 4. A client comes into the emergency department (ED) clutching the chest. Which core competency for ED nurses is the first one used in this situation? A. Assessment B. Communication C. Priority setting D. Technical and procedural skills - ANS A. Assessment Similar to any nurse in practice, the foundation of the emergency nurse's skill base is assessment. The nurse must be able to discern normal from abnormal rapidly and accurately, and must interpret assessment findings according to acuity and age. Communication, priority setting, and technical and procedural skills are not the first competencies to be used in this situation. 5. There has been an explosion at a local refinery. Numerous serious and life-threatening injuries have occurred. The following clients arrive from the scene by private vehicle. Which client is considered a priority for treatment? A. Child with an open fracture of the arm B. Man with a contusion on the head C. Teenager with a closed fracture of the leg D. Woman bleeding heavily - ANS D. Woman bleeding heavily The woman critically injured with trauma or an active hemorrhage is prioritized as emergent. The emergent triage category implies that a condition exists that poses an immediate threat to life or limb and should be treated immediately. Although the child with an open fracture of the arm, the man with a contusion of the head, and the teenager with a closed fracture of the leg are urgent, they are not emergent and can wait for a short time. 6. The provider is planning to discharge a client home. The nurse suspects domestic violence as the cause of injury, although the client denies this. What is the best course of action for the nurse to take? A. Call the police. B. Consult with Social Services. C. Discharge the client as instructed. D. Instruct the client to go to a safe place. - ANS B. Consult with Social Services. If discharge home is not deemed safe, the client may be admitted to the hospital until resources can be organized to provide a safe environment. Social workers or case managers are consulted to investigate resource needs and plan a