Emergency and Disaster Nursing mes surg
While performing triage in the ED, the nurse determines which patient should be seen first?
A. A patient with burns on the face and chest; BP 120/80 mm Hg, HR 92, RR 24.
B. A patient with a deformed leg indicating a fractured tibia; BP 110/60 mm Hg, HR 86, RR 18.
C. A patient with type 1 diabetes in ketoacidosis; BP 100/60 mm Hg, HR 100 beats/min, RR 32.
D. A patient with a respiratory infection with a cough productive of greenish sputum; BP 128/86 mm Hg,
HR 88, RR 26.
C. A patient with type 1 diabetes in ketoacidosis; BP 100/60 mm Hg, HR 100 beats/min, RR 32.
Assessment of a male patient during the primary survey indicates delayed capillary refill of the
extremities. He cannot explain the events before admission to the ED. Which action should the nurse
take immediately?
A. Apply leads to the patient's chest to initiate ECG monitoring.
B. Insert one or two large-bore IV catheters to start IV fluid resuscitation.
C. Continue the primary survey to complete a brief neurologic examination.
D. Initiate pulse oximetry by placing a monitoring device on the patient's index finger.
D. Initiate pulse oximetry by placing a monitoring device on the patient's index finger.
Several patients are admitted to the ED after exposure to an aerosolized agent that is believed to be a
hemorrhagic fever virus used as a bioterrorism agent. Which statement by the nurse is most
appropriate?
A. "Treatment for this viral disease is mostly supportive."
B. "Ciprofloxacin (Cipro) is the best treatment for this disease."
C. "This disease cannot be spread by contact with body fluids."
D."A vaccine is available to prevent transmission of this disease."
A. "Treatment for this viral disease is mostly supportive."
A client is admitted to the emergency department with reports of syncope, weakness, and dizziness.
Upon further assessment and questioning the nurse suspects the client is a victim of human trafficking.
Which of the following assessment findings may suggest that a client is the victim of human trafficking?
(Select all that apply)
A. The client is withdrawn and nervous.
B. Burns are present without a clear explanation of what happened.
C. The client appears dehydrated with a very low blood pressure and pulse rate.
D. The client is wearing a heavy sweater and pants in the middle of summer.
A, B, C, D
, An elderly man arrives in triage disoriented and tachypneic. His skin is hot and dry. His wife states that
he was fine earlier today. The nurse's next priority would be to
A) obtain a detailed medical history for his wife.
B) assess his vital signs, including a rectal temperature.
C) determine the kind of insurance he has before treating him
D) start supplemental oxygen and have the ED physician see him
B) assess his vital signs, including a rectal temperature.
A patient has a core temperature of 90F (32.2 C). The most appropriate rewarming technique would be;
A) passive rewarming with body-to-body contact
B) active core rewarming using warmed IV fluids
C) passive rewarming using air-filled warming blankets
D) active external rewarming by submersing in a warm bath
B) active core rewarming using warmed IV fluids
Effective interventions to decrease absorption or increase elimination of an ingested poison include
which of the following (select all that apply):
A) Hemodialysis
B) Milk dilution
C) Eye irrigation
D) Gastric lavage
E) Activated charcoal
A) Hemodialysis
D) Gastric lavage
E) Activated charcoal
An elderly woman arrives in the ED complaining of severe pain in her right shoulder. The nurse notes
that her clothes are soiled with urine and feces. She tells the nurse that she lives with her son and the
she "fell." She is tearful and asks you if she can be admitted. The nurse should consider which of the
following:
A) Paranoia
B) Possible cancer
C) Family violence
D) Orthostatic hypertension
C) Family violence
A chemical explosion occurs at a nearby industrial site. The first responders report that victims are being
decontaminated at the scene and approximately 125 workers will need medical evaluation and care. The
nurse receiving this report should know that this will first require activation of:
A) a code blue alert
B) a disaster medical assistance team
C) the local police and fire department
D) the hospital's emergency response plan.
While performing triage in the ED, the nurse determines which patient should be seen first?
A. A patient with burns on the face and chest; BP 120/80 mm Hg, HR 92, RR 24.
B. A patient with a deformed leg indicating a fractured tibia; BP 110/60 mm Hg, HR 86, RR 18.
C. A patient with type 1 diabetes in ketoacidosis; BP 100/60 mm Hg, HR 100 beats/min, RR 32.
D. A patient with a respiratory infection with a cough productive of greenish sputum; BP 128/86 mm Hg,
HR 88, RR 26.
C. A patient with type 1 diabetes in ketoacidosis; BP 100/60 mm Hg, HR 100 beats/min, RR 32.
Assessment of a male patient during the primary survey indicates delayed capillary refill of the
extremities. He cannot explain the events before admission to the ED. Which action should the nurse
take immediately?
A. Apply leads to the patient's chest to initiate ECG monitoring.
B. Insert one or two large-bore IV catheters to start IV fluid resuscitation.
C. Continue the primary survey to complete a brief neurologic examination.
D. Initiate pulse oximetry by placing a monitoring device on the patient's index finger.
D. Initiate pulse oximetry by placing a monitoring device on the patient's index finger.
Several patients are admitted to the ED after exposure to an aerosolized agent that is believed to be a
hemorrhagic fever virus used as a bioterrorism agent. Which statement by the nurse is most
appropriate?
A. "Treatment for this viral disease is mostly supportive."
B. "Ciprofloxacin (Cipro) is the best treatment for this disease."
C. "This disease cannot be spread by contact with body fluids."
D."A vaccine is available to prevent transmission of this disease."
A. "Treatment for this viral disease is mostly supportive."
A client is admitted to the emergency department with reports of syncope, weakness, and dizziness.
Upon further assessment and questioning the nurse suspects the client is a victim of human trafficking.
Which of the following assessment findings may suggest that a client is the victim of human trafficking?
(Select all that apply)
A. The client is withdrawn and nervous.
B. Burns are present without a clear explanation of what happened.
C. The client appears dehydrated with a very low blood pressure and pulse rate.
D. The client is wearing a heavy sweater and pants in the middle of summer.
A, B, C, D
, An elderly man arrives in triage disoriented and tachypneic. His skin is hot and dry. His wife states that
he was fine earlier today. The nurse's next priority would be to
A) obtain a detailed medical history for his wife.
B) assess his vital signs, including a rectal temperature.
C) determine the kind of insurance he has before treating him
D) start supplemental oxygen and have the ED physician see him
B) assess his vital signs, including a rectal temperature.
A patient has a core temperature of 90F (32.2 C). The most appropriate rewarming technique would be;
A) passive rewarming with body-to-body contact
B) active core rewarming using warmed IV fluids
C) passive rewarming using air-filled warming blankets
D) active external rewarming by submersing in a warm bath
B) active core rewarming using warmed IV fluids
Effective interventions to decrease absorption or increase elimination of an ingested poison include
which of the following (select all that apply):
A) Hemodialysis
B) Milk dilution
C) Eye irrigation
D) Gastric lavage
E) Activated charcoal
A) Hemodialysis
D) Gastric lavage
E) Activated charcoal
An elderly woman arrives in the ED complaining of severe pain in her right shoulder. The nurse notes
that her clothes are soiled with urine and feces. She tells the nurse that she lives with her son and the
she "fell." She is tearful and asks you if she can be admitted. The nurse should consider which of the
following:
A) Paranoia
B) Possible cancer
C) Family violence
D) Orthostatic hypertension
C) Family violence
A chemical explosion occurs at a nearby industrial site. The first responders report that victims are being
decontaminated at the scene and approximately 125 workers will need medical evaluation and care. The
nurse receiving this report should know that this will first require activation of:
A) a code blue alert
B) a disaster medical assistance team
C) the local police and fire department
D) the hospital's emergency response plan.
