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CEN Chapter 6 Review Practice Test.

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CEN Chapter 6 Review Practice Test. 1. A patient is being dis- charged following treat- ment for excessive vomit- ing and diarrhea from a possible foodborne illness. You know the patient un- derstands the discharge in- structions when the patient states: Once vomiting has been controlled, oral hydration should begin with the use of fluids that contain glucose, sodium, and potas- sium, such as sport or electrolyte replacement drinks. Institution of a regular diet following vomiting and diarrhea may induce the vomiting and diarrhea again. Patients should be instructed to gradually increase their diet as tolerated. Milk or milk productes are not recommended following vomiting and diarrhea. Clear liquids are defined as liquids that a person can see through, such as water, fruit juice without pulp, broth, clear sodas, jell-o, and popsicles. Milk and orange juice are not defined as clear liquids. I will drink clear liquids, such as sports drinks, for the next Emergency nursing core curriculum 6th edition pp. 159-186 24 hours. 2. Which type of skull fracture would place the patient at the highest risk for devel- oping an intracranial infec- tion? Basilar skull fracture Category: Environment and Toxicology Emergencies, and Com- municable Diseases/Environment/Food Poisoning Basilar skull fractures include the fracture of any of the five bones at the base of the skull. T hese fractures can cause a laceration of the dura mater, resulting in an open passage of cerebrospinal fluid, which places the patient at risk for intracranail infections such as meningitis, encephalitis, and or brain abscess. A linear skull fracture is a nondisplaced fracture of the cranium and does not increase the risk of intracranial infections. A depressed skull is a fracture extending below the surface of the skull and lacerating the dura mater, which may cause intracranial infections; however, the incidence of infection is statistically higher in basilar skull fractures. Temporal b one fractures increase the risk of epidural hematoma. Trauma Nursing Core Course: Provider manual 7th ed. pp. 105-122 3. A patient is being dis- charged after being treat- ed for the presence of a cough for 3 months and increasing shortness of breath with excretion. The patient has been diag- Category: Neurological Emergencies/Trauma Studies have shown that the reduction of risk factors slows the progression of COPD. Eliminating cigarette smoking is the single most valuable therapy in the reduction of COPD. Bronchodila- tors are used to control symptoms but have no ettect on air- way iflammation, which is the main cause of worsening disease. Airway inflammation is a characteristic of COPD. Anti-inflamma- tory medications may decrease the frequency of exacerbations nosed with COPD. The emer- but have not been shown to improve lung function or decrease gency nurse knows that the only proven medical ther- apy shown to reduce the progression and mortality of COPD is: Smoking cessation. 4. A male presents to the emergency department with complaints of pain and swelling in his right groin area. The patient states the mortality. Pulmonary rehab can improve a patient's quality of life by increasing exercise tolerance, but it does not improve lung function. Category: Respiratory Emergencies/COPD An abdominal radiograph would be helpful in diagnosing a bowel obstruction but would not provide enough information to validate a diagnosis of inguinal hernia. A CT scan of the abdomen would be helpful to identify the source of the patient's discomfort in the absence of any physical signs. This patient has an obvious pain intensity has increased, bulge in the inguinal area, so a CT would yield little additional and the swelling has be- come larger over the past several days. The emer- gency nurse should antici- information. An MRI might show the hernia, but the preferred method to diagnose a hernia is an ultrasound. The patient's symptoms are most likely a result of an inguinal hernia. The patient's physical exam usually is diagnostic, but an ultrasound pate which diagnostic test to can be performed to determine if strangulation or an intestinal best identify the source of the patient's complaint. obstruction is present. Abdominal ultrasound 5. A patient arrives complain- ing of a sudden onset of chest pain. The patient is anxious and tachypnic. The initial priority intervention for the emergency nurse to perform for this patient would be to administer supplemental oxygen 6. When caring for an elderly patient with dementia, the emergency nurse is aware Category: Gastrointestinal, Genitourinary, Gynecology, and Ob- stetrical Emergencies/Gastrointestinal/Hernia Although an appropriate intervention, it is not a priority. Ensuring adequate oxygen exchange through administration of supple- mental oxygen is the priority intervention for this patient. An echocardiogram is an ultrasound diagnostic tool to determine the function and structure of the heart. Although obtaining IV access is an appropriate intervention, it is not the priority. Category: Respiratory Emergencies/Pulmonary Embolus

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CEN Chapter 6 Review Practice Test.

1. A patient is being dis- Once vomiting has been controlled, oral hydration
charged following treat- should begin with the use of fluids that contain glucose,
ment for excessive sodium, and potas- sium, such as sport or electrolyte
vomit- ing and diarrhea replacement drinks. Institution of a regular diet following
from a possible vomiting and diarrhea may induce the vomiting and
foodborne illness. You diarrhea again. Patients should be instructed to
know the patient un- gradually increase their diet as tolerated. Milk or milk
derstands the discharge productes are not recommended following vomiting and
in- structions when the diarrhea. Clear liquids are defined as liquids that a
patient states: person can see through, such as water, fruit juice without
pulp, broth, clear sodas, jell-o, and
popsicles. Milk and orange juice are not defined as clear
liquids.
I will drink clear liquids, such
as sports drinks, for the next Emergency nursing core curriculum 6th edition pp.
159-186
24 hours.
Category: Environment and Toxicology Emergencies, and
Com- municable Diseases/Environment/Food Poisoning

2. Which type of skull Basilar skull fractures include the fracture of any of the five
fracture would place bones at the base of the skull. T hese fractures can
the patient at the cause a laceration of the dura mater, resulting in an
highest risk for devel- open passage of cerebrospinal fluid, which places the
oping an intracranial patient at risk for intracranail infections such as
infec- tion? meningitis, encephalitis, and or brain abscess. A linear
skull fracture is a nondisplaced fracture of the cranium and
Basilar skull fracture does not increase the risk of intracranial infections. A
depressed skull is a fracture extending below the surface of
the skull and lacerating the dura mater, which may cause
intracranial infections; however, the incidence of infection
is statistically higher in basilar skull fractures. Temporal b
one fractures increase the risk of epidural hematoma.
1/
147

, CEN Chapter 6 Review Practice Test.

Trauma Nursing Core Course:
Provider manual 7th ed. pp. 105-
122




2/
147

, CEN Chapter 6 Review Practice Test.


Category: Neurological Emergencies/Trauma

3. A patient is being dis- Studies have shown that the reduction of risk factors
charged after being slows the progression of COPD. Eliminating cigarette
treat- ed for the smoking is the single most valuable therapy in the
presence of reduction of COPD. Bronchodila- tors are used to control
a cough for 3 months symptoms but have no ettect on air- way iflammation,
and increasing which is the main cause of worsening disease. Airway
shortness of breath inflammation is a characteristic of COPD. Anti-inflamma-
with excretion. tory medications may decrease the frequency of
The patient has been exacerbations
diag-
nosed with COPD. The emer- but have not been shown to improve lung function or
decrease
gency nurse knows mortality. Pulmonary rehab can improve a patient's quality
that the only proven of life by increasing exercise tolerance, but it does not
medical ther- apy improve lung function.
shown to reduce the
progression and Category: Respiratory Emergencies/COPD
mortality of COPD is:

Smoking cessation.
An abdominal radiograph would be helpful in diagnosing
4. A male presents to a bowel obstruction but would not provide enough
the emergency information to validate a diagnosis of inguinal hernia. A
department with CT scan of the abdomen would be helpful to identify the
complaints of pain and source of the patient's discomfort in the absence of any
swelling in his right physical signs. This patient has an obvious
groin area. The patient
states the
pain intensity has increased, bulge in the inguinal area, so a CT would yield little
additional
3/
147

, CEN Chapter 6 Review Practice Test.

and the swelling has information. An MRI might show the hernia, but the
be- come larger over preferred method to diagnose a hernia is an
the past several days. ultrasound. The patient's symptoms are most likely a
The emer- gency nurse result of an inguinal hernia. The patient's physical exam
should antici- usually is diagnostic, but an ultrasound
pate which diagnostic test to can be performed to determine if strangulation or
an intestinal
best identify the obstruction is present.
source of the
patient's complaint.




4/
147

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