An ED nurse is reporting on a patient who is being transferred to ICU. Which of the following
sets of people are responsible for the transfer report? - ANSWER The ED nurse and the
ICU nurse
A newly licensed nurse working in the ED is learning about the Emergency Medical Treat-
ment and Active Labor Act. During a current disaster, the ED is transferring some patients to
another facility prior to the patients being stabilized. Which statement by the nurse manager
explains this to the newly licensed nurse? - ANSWER A provision of EMTALA permits the
transfer of patients before they are completely stabilized.
A nurse is caring for a patient admitted to the ED following an injury. The nurse demon-
strates concern and involves the patient's family in decision making. Which of the following
outcomes is the nurse's primary goal from this interaction? - ANSWER Creating a trusting
relationship
A newly licensed nurse is providing care to a patient admitted to the ED who is experiencing
heroin toxicity. The patient becomes violent and strikes the nurse. The nurse speaks with the
manager about violence in the ED. Which of the following statements represents how the
nurse manager should respond to the nurse? - ANSWER Patients may fear the possible
outcome of their clinical situation, leading to stress
A nurse is caring for a 30 year old patient who experience sexual assault 2 days ago. Which
of the following is the most important to ask the patient? - ANSWER Do you know if you
were exposed to HIV
A preceptor in CCU is orienting a new nurse to the code chart. The preceptor communicates
to the new nurse that the code charts should be checked at which of the following intervals?
- ANSWER Every 24 hours
1
, A nurse in the ED is triaging a patient who is accompanied by an individual that refuses to
leave the patient alone with the nurse. While assessing the patient, the nurse notes an unu-
sual tattoo on the patients inner thigh, as well as multiple bruises near the groin and lower
abdomen. the nurse should consider that the client may need further evaluation for which
of the following? - ANSWER Potential human trafficking
A triage nurse is evaluating a patient who reports taking anticoagulation medication and ar-
rived at the ED with bleeding from both nares, which slowed after applying direct pressure
to the nose. Which of the following Emergency Severity Index (ESI) levels should the nurse
assign to this patient? - ANSWER ESI level 2
A nurse is caring for a group of patients in the ED who were exposed to a chemical spill at
their work. A student nurse asks the charge nurse where to find the info about safety regard-
ing the chemical spill. Where should the charge nurse instruct the student nurse to find
more info about a chemical spill in the workplace? - ANSWER Look up the Safety Data
Sheets (SDS0 on the hospital WiFi network.
A nurse is caring for a patient who was admitted to the ED by ambulance. the patients BP is
110/62, HR is 100 bpm, and Resp is 28/min. Which of the following represents how the
nurse should perform the "D" portion of the ABCDE assessment? - ANSWER The nurse
should check alertness and response to voice and pain
A nurse is triaging patients in the ED using the three-tiered triaging system. Which of the fol-
lowing patients should the nurse place in the delayed category? - ANSWER A patient is
reporting generalized abdominal pain, nausea, vomiting, and diarrhea for 3 days. Findings
indicate the VS are stable and the patient has no comorbidities and is taking no medications.
A nurse is caring for a patient who was admitted to the Med Surg unit via the ED 1 week ago
following a head injury. Upon further review the patient was DX with a hip fracture. While
the nurse was providing D/C instructions, the patient began to report left wrist pain. Follow
up xrays were obtained and the patient was D/C with a cast for a wrist fracture. Which of the
following describes the process performed by nurse during discharge? - ANSWER The
nurse performed a tertiary survey
2
sets of people are responsible for the transfer report? - ANSWER The ED nurse and the
ICU nurse
A newly licensed nurse working in the ED is learning about the Emergency Medical Treat-
ment and Active Labor Act. During a current disaster, the ED is transferring some patients to
another facility prior to the patients being stabilized. Which statement by the nurse manager
explains this to the newly licensed nurse? - ANSWER A provision of EMTALA permits the
transfer of patients before they are completely stabilized.
A nurse is caring for a patient admitted to the ED following an injury. The nurse demon-
strates concern and involves the patient's family in decision making. Which of the following
outcomes is the nurse's primary goal from this interaction? - ANSWER Creating a trusting
relationship
A newly licensed nurse is providing care to a patient admitted to the ED who is experiencing
heroin toxicity. The patient becomes violent and strikes the nurse. The nurse speaks with the
manager about violence in the ED. Which of the following statements represents how the
nurse manager should respond to the nurse? - ANSWER Patients may fear the possible
outcome of their clinical situation, leading to stress
A nurse is caring for a 30 year old patient who experience sexual assault 2 days ago. Which
of the following is the most important to ask the patient? - ANSWER Do you know if you
were exposed to HIV
A preceptor in CCU is orienting a new nurse to the code chart. The preceptor communicates
to the new nurse that the code charts should be checked at which of the following intervals?
- ANSWER Every 24 hours
1
, A nurse in the ED is triaging a patient who is accompanied by an individual that refuses to
leave the patient alone with the nurse. While assessing the patient, the nurse notes an unu-
sual tattoo on the patients inner thigh, as well as multiple bruises near the groin and lower
abdomen. the nurse should consider that the client may need further evaluation for which
of the following? - ANSWER Potential human trafficking
A triage nurse is evaluating a patient who reports taking anticoagulation medication and ar-
rived at the ED with bleeding from both nares, which slowed after applying direct pressure
to the nose. Which of the following Emergency Severity Index (ESI) levels should the nurse
assign to this patient? - ANSWER ESI level 2
A nurse is caring for a group of patients in the ED who were exposed to a chemical spill at
their work. A student nurse asks the charge nurse where to find the info about safety regard-
ing the chemical spill. Where should the charge nurse instruct the student nurse to find
more info about a chemical spill in the workplace? - ANSWER Look up the Safety Data
Sheets (SDS0 on the hospital WiFi network.
A nurse is caring for a patient who was admitted to the ED by ambulance. the patients BP is
110/62, HR is 100 bpm, and Resp is 28/min. Which of the following represents how the
nurse should perform the "D" portion of the ABCDE assessment? - ANSWER The nurse
should check alertness and response to voice and pain
A nurse is triaging patients in the ED using the three-tiered triaging system. Which of the fol-
lowing patients should the nurse place in the delayed category? - ANSWER A patient is
reporting generalized abdominal pain, nausea, vomiting, and diarrhea for 3 days. Findings
indicate the VS are stable and the patient has no comorbidities and is taking no medications.
A nurse is caring for a patient who was admitted to the Med Surg unit via the ED 1 week ago
following a head injury. Upon further review the patient was DX with a hip fracture. While
the nurse was providing D/C instructions, the patient began to report left wrist pain. Follow
up xrays were obtained and the patient was D/C with a cast for a wrist fracture. Which of the
following describes the process performed by nurse during discharge? - ANSWER The
nurse performed a tertiary survey
2
