Elsevier EAQ- Test Questions and Answers
Which intervention would be the priority for the nurse to incorporate into the plan of care for
the client status post mastectomy and breast augmentation receiving anthracycline
chemotherapy? Correct Ans-Instructing the client to report a chronic cough and shortness
of breath
When providing care for a client during the first few hours after admission to the burn unit
with full-thickness burns of the trunk and head, which goal is the nurse's priority during the
emergent phase of this injury? Correct Ans-Managing fluid loss
In which order would the nurse provide care based on client condition and the 5-level triage
system? Correct Ans-1. Cardiac arrest
2. Chest pain to ischemia
3. Hip Fracture
4. Minor burns
Which triage tag and client condition pair would the triage nurse assign? Correct Ans-
major injuries with yellow tag
Which condition in a client with carbon monoxide poisoning would be given priority nursing
care? Correct Ans-Cardiopulmonary instability
In which order based on priority would the nurse perform interventions for a severely
traumatized client with difficulty breathing because of debris in the mouth, external
, Elsevier EAQ- Test Questions and Answers
hemorrhaging, symptoms of severe hypoglycemia, and bruises on the skin? Correct Ans-1.
Remove the debris from the mouth (Airway)
2.Apply pressure bandages to the bleeding areas
3. Administer intravenous glucose
4. apply bandage on the bruises
Which client would the nurse categorize in an emergent level based on condition according to
the 3-tiered triage system? Correct Ans-Client A. Respiratory Distress
The client with which change in vital signs measurements would be treated first to ensure
safety? Correct Ans-Client B. = Vital are RR: 17--> 10
HR: 72-->120 bpm
Which client would the nurse classify as requiring immediate care based on condition and
stability? Correct Ans-1. Overdoes with bradypnea 2. Cardiac arrest 3. Chest pain due to
ischemia 4. Hip Fracture
ANswer Client B= Cardiac Arrest
The emergency department nurse would provide immediate care based on priority to the
client with which condition? Correct Ans-Repeated tonic-clonic seizures
, Elsevier EAQ- Test Questions and Answers
Which client would the triage nurse classify as requiring the least priority of care? Correct
Ans-client D, foreign body aspiration/pneumonia
Once a client admitted with shock secondary to severe gastrointestinal (GI) bleeding is
stabilized, which action would the nurse take? Correct Ans-Take a blood sample for
laboratory test
Based on laboratory values, which client's needs would the nurse address first? Correct
Ans-Client B: A1C%: 6.8Fasting plasma glucose level (mg/dL): 130Two-hour plasma glucose
level (mg/dL): 200
Which client condition would the triage nurse classify as needing immediate care? Select all
that apply. One, some, or all responses may be correct. Correct Ans-1. ACtive hemorrhage
2. Substernal chest pain
Which client condition would the triage nurse provide care for first? Correct Ans-Chest
pain with diaphoresis
Which client would be given immediate care based on priority? Correct Ans-Client D:
Chemical Burns; Degeneration of exposed tissues, respiratory distress
In which order would the nurse perform the following interventions for a client with injuries
from a motor vehicle accident? Correct Ans-1. Control external bleeding
2. Elevating the injured limb
, Elsevier EAQ- Test Questions and Answers
3. Apply ice packs
4. Monitor for temperature elevation
Which client condition would the triage nurse classify as the lowest priority of care? Select all
that apply. One, some, or all responses may be correct. Correct Ans-a. Cystitis
b. Cold Symptoms
A client who takes antipsychotic medications complains of painful muscle spasms. The nurse
suspects that the client may have pseudoparkinsonism. Which medications are indicated to
counter this condition? Select all that apply. One, some, or all responses may be correct.
Correct Ans-a. Benztropine
b. Trihexyphenidyl
A client's infusion of vesicant intravenous solution through a short peripheral catheter leaks
into their extravascular tissue. After stopping the infusion and disconnecting the
administration set, which action would the nurse take next? Correct Ans-Aspirate the
medication from a short peripheral catheter
When the nurse is caring for a client who had an open cholecystectomy, which assessment
finding most indicates the need for action by the nurse? Correct Ans-Decreased breath
sounds at lung base
Which statement made by the nurse regarding the prevention of human immunodeficiency
virus (HIV) transmission by health care workers is correct? Select all that apply. One, some, or
Which intervention would be the priority for the nurse to incorporate into the plan of care for
the client status post mastectomy and breast augmentation receiving anthracycline
chemotherapy? Correct Ans-Instructing the client to report a chronic cough and shortness
of breath
When providing care for a client during the first few hours after admission to the burn unit
with full-thickness burns of the trunk and head, which goal is the nurse's priority during the
emergent phase of this injury? Correct Ans-Managing fluid loss
In which order would the nurse provide care based on client condition and the 5-level triage
system? Correct Ans-1. Cardiac arrest
2. Chest pain to ischemia
3. Hip Fracture
4. Minor burns
Which triage tag and client condition pair would the triage nurse assign? Correct Ans-
major injuries with yellow tag
Which condition in a client with carbon monoxide poisoning would be given priority nursing
care? Correct Ans-Cardiopulmonary instability
In which order based on priority would the nurse perform interventions for a severely
traumatized client with difficulty breathing because of debris in the mouth, external
, Elsevier EAQ- Test Questions and Answers
hemorrhaging, symptoms of severe hypoglycemia, and bruises on the skin? Correct Ans-1.
Remove the debris from the mouth (Airway)
2.Apply pressure bandages to the bleeding areas
3. Administer intravenous glucose
4. apply bandage on the bruises
Which client would the nurse categorize in an emergent level based on condition according to
the 3-tiered triage system? Correct Ans-Client A. Respiratory Distress
The client with which change in vital signs measurements would be treated first to ensure
safety? Correct Ans-Client B. = Vital are RR: 17--> 10
HR: 72-->120 bpm
Which client would the nurse classify as requiring immediate care based on condition and
stability? Correct Ans-1. Overdoes with bradypnea 2. Cardiac arrest 3. Chest pain due to
ischemia 4. Hip Fracture
ANswer Client B= Cardiac Arrest
The emergency department nurse would provide immediate care based on priority to the
client with which condition? Correct Ans-Repeated tonic-clonic seizures
, Elsevier EAQ- Test Questions and Answers
Which client would the triage nurse classify as requiring the least priority of care? Correct
Ans-client D, foreign body aspiration/pneumonia
Once a client admitted with shock secondary to severe gastrointestinal (GI) bleeding is
stabilized, which action would the nurse take? Correct Ans-Take a blood sample for
laboratory test
Based on laboratory values, which client's needs would the nurse address first? Correct
Ans-Client B: A1C%: 6.8Fasting plasma glucose level (mg/dL): 130Two-hour plasma glucose
level (mg/dL): 200
Which client condition would the triage nurse classify as needing immediate care? Select all
that apply. One, some, or all responses may be correct. Correct Ans-1. ACtive hemorrhage
2. Substernal chest pain
Which client condition would the triage nurse provide care for first? Correct Ans-Chest
pain with diaphoresis
Which client would be given immediate care based on priority? Correct Ans-Client D:
Chemical Burns; Degeneration of exposed tissues, respiratory distress
In which order would the nurse perform the following interventions for a client with injuries
from a motor vehicle accident? Correct Ans-1. Control external bleeding
2. Elevating the injured limb
, Elsevier EAQ- Test Questions and Answers
3. Apply ice packs
4. Monitor for temperature elevation
Which client condition would the triage nurse classify as the lowest priority of care? Select all
that apply. One, some, or all responses may be correct. Correct Ans-a. Cystitis
b. Cold Symptoms
A client who takes antipsychotic medications complains of painful muscle spasms. The nurse
suspects that the client may have pseudoparkinsonism. Which medications are indicated to
counter this condition? Select all that apply. One, some, or all responses may be correct.
Correct Ans-a. Benztropine
b. Trihexyphenidyl
A client's infusion of vesicant intravenous solution through a short peripheral catheter leaks
into their extravascular tissue. After stopping the infusion and disconnecting the
administration set, which action would the nurse take next? Correct Ans-Aspirate the
medication from a short peripheral catheter
When the nurse is caring for a client who had an open cholecystectomy, which assessment
finding most indicates the need for action by the nurse? Correct Ans-Decreased breath
sounds at lung base
Which statement made by the nurse regarding the prevention of human immunodeficiency
virus (HIV) transmission by health care workers is correct? Select all that apply. One, some, or
