Chapter 11: Concepts of Care for
Patients With Common
Environmental Emergencies
Ignatavicius: Medical-Surgical
Nursing, 10th Edition Questions
And Answers
1. On a hot humid day, an emergency department nurse is caring for a client
who is confused and has these vital signs: temperature 104.1° F (40.1° C),
pulse 132 beats/min, respirations 26 breaths/min, and blood pressure 106/66
mm Hg. What action would the nurse take?
a. Encourage the client to drink cool water or sports drinks.
b. Start an intravenous line and infuse 0.9% saline solution. c. Administer
acetaminophen (Tylenol) 650 mg orally.
d. Encourage rest and reassess in 15 minutes. - Answer - ANS: B
The client demonstrates signs of heat stroke. This is a medical emergency
and priority care includes oxygen therapy, IV infusion with 0.9% saline
solution, insertion of a urinary catheter, and aggressive interventions to cool
the patient, including external cooling and internal cooling methods. Oral
hydration would not be appropriate for a client who has symptoms of heat
stroke because oral fluids would not provide necessary rapid rehydration,
and the confused client would be at risk for aspiration. Acetaminophen would
not decrease this patient's temperature or improve the patient's symptoms.
The client needs immediate medical treatment; therefore, rest and
reassessing in 15 minutes are inappropriate.
2. While at a public park, a nurse encounters a person immediately after a
bee sting. The person's lips are swollen, and wheezes are audible. What
action would the nurse take first?
a. Elevate the site and notify the person's next of kin.
, b. Remove the stinger with tweezers and encourage rest. c. Administer
diphenhydramine and apply ice.
d. Administer an epinephrine autoinjector and call 911. - Answer - ANS: D
The client's swollen lips indicate that anaphylaxis may be developing, and
this is a medical emergency. The nurse would call 911 would immediately,
and the client transported to the emergency department as quickly as
possible. If an EpiPen is available, it would be administered at the first sign of
an anaphylactic reaction. The other answers do not provide adequate
interventions to treat airway obstruction due to anaphylaxis, although the
nurse would remove the stinger as soon as possible after administering the
autoinjector.
3. A client presents to the emergency department after prolonged exposure
to the cold. The client is difficult to arouse and speech is incoherent. What
action would the nurse take first?
a. Reposition the client into a prone position.
b. Administer warmed intravenous fluids to the client.
c. Wrap the client's extremities in warm blankets.
d. Initiate extracorporeal rewarming via hemodialysis. - Answer - ANS: B
Moderate hypothermia manifests with muscle weakness, increased loss of
coordination, acute confusion, apathy, incoherence, stupor, and impaired
clotting. Moderate hypothermia is treated by core rewarming methods, which
include administration of warm IV fluids; heated oxygen; and heated
peritoneal, pleural, gastric, or bladder lavage. The client's trunk would be
warmed prior to the extremities to prevent peripheral vasodilation.
Extracorporeal warming with cardiopulmonary bypass or hemodialysis is a
treatment for severe hypothermia.
4. An emergency department nurse cares for a middle-age mountain climber
who is confused, ataxic, and exhibits impaired judgement. After
administering oxygen, which intervention would the nurse implement next?
a. Administer dexamethasone.
b. Complete a mini mental state examination.
c. Prepare the client for computed tomography of the brain.
Patients With Common
Environmental Emergencies
Ignatavicius: Medical-Surgical
Nursing, 10th Edition Questions
And Answers
1. On a hot humid day, an emergency department nurse is caring for a client
who is confused and has these vital signs: temperature 104.1° F (40.1° C),
pulse 132 beats/min, respirations 26 breaths/min, and blood pressure 106/66
mm Hg. What action would the nurse take?
a. Encourage the client to drink cool water or sports drinks.
b. Start an intravenous line and infuse 0.9% saline solution. c. Administer
acetaminophen (Tylenol) 650 mg orally.
d. Encourage rest and reassess in 15 minutes. - Answer - ANS: B
The client demonstrates signs of heat stroke. This is a medical emergency
and priority care includes oxygen therapy, IV infusion with 0.9% saline
solution, insertion of a urinary catheter, and aggressive interventions to cool
the patient, including external cooling and internal cooling methods. Oral
hydration would not be appropriate for a client who has symptoms of heat
stroke because oral fluids would not provide necessary rapid rehydration,
and the confused client would be at risk for aspiration. Acetaminophen would
not decrease this patient's temperature or improve the patient's symptoms.
The client needs immediate medical treatment; therefore, rest and
reassessing in 15 minutes are inappropriate.
2. While at a public park, a nurse encounters a person immediately after a
bee sting. The person's lips are swollen, and wheezes are audible. What
action would the nurse take first?
a. Elevate the site and notify the person's next of kin.
, b. Remove the stinger with tweezers and encourage rest. c. Administer
diphenhydramine and apply ice.
d. Administer an epinephrine autoinjector and call 911. - Answer - ANS: D
The client's swollen lips indicate that anaphylaxis may be developing, and
this is a medical emergency. The nurse would call 911 would immediately,
and the client transported to the emergency department as quickly as
possible. If an EpiPen is available, it would be administered at the first sign of
an anaphylactic reaction. The other answers do not provide adequate
interventions to treat airway obstruction due to anaphylaxis, although the
nurse would remove the stinger as soon as possible after administering the
autoinjector.
3. A client presents to the emergency department after prolonged exposure
to the cold. The client is difficult to arouse and speech is incoherent. What
action would the nurse take first?
a. Reposition the client into a prone position.
b. Administer warmed intravenous fluids to the client.
c. Wrap the client's extremities in warm blankets.
d. Initiate extracorporeal rewarming via hemodialysis. - Answer - ANS: B
Moderate hypothermia manifests with muscle weakness, increased loss of
coordination, acute confusion, apathy, incoherence, stupor, and impaired
clotting. Moderate hypothermia is treated by core rewarming methods, which
include administration of warm IV fluids; heated oxygen; and heated
peritoneal, pleural, gastric, or bladder lavage. The client's trunk would be
warmed prior to the extremities to prevent peripheral vasodilation.
Extracorporeal warming with cardiopulmonary bypass or hemodialysis is a
treatment for severe hypothermia.
4. An emergency department nurse cares for a middle-age mountain climber
who is confused, ataxic, and exhibits impaired judgement. After
administering oxygen, which intervention would the nurse implement next?
a. Administer dexamethasone.
b. Complete a mini mental state examination.
c. Prepare the client for computed tomography of the brain.
