MDC 4 Exam 3 Questions and
answers verified
1. A nurse on the medical-surgical unit is caring for a group of clients. The nurse should notify the
rapid response team for which of the following clients?
a. Client who has an ulceration of the right heel whose blood glucose is 300 mg/dL
b. Client who reports right calf pain and SOB
c. Client who has blood on a pressure dressing in the femoral area following a cardiac catheterization
d. Client who has dark red coloration of the left toes and absent pedal pulse - ANS✅✅B
2. A nurse is caring for a client who has ingested a toxic agent. Which of the following actions should
the nurse plan to take? (Select all that apply)
A. Induce vomiting
B. Instill activated charcoal
C. Perform a gastric lavage with aspiration
D. Administer syrup of ipecac
E. Infuse IV fluids - ANS✅✅B, C, E
3. A nurse in the ED is assessing a client who is unresponsive. The client's partner states, "He was
pulling weeds in the yard and slumped to the ground." Which of the following techniques would the
nurse use to open the client's airway?
A. Head-tilt, chin-lift
B. Modified jaw thrust
C. Hyperextension of the head
D. Flexion of the head - ANS✅✅A
,4. A nurse in the ED is caring for a client who fell through the ice on a pond and is unresponsive and
breathing slowly. Which of the following actions should the nurse take? (Select all that apply)
A. Remove wet clothing
B. Maintain normal room temperature
C. Apply warm blankets
D. Infuse warmed IV fluids - ANS✅✅A, C, D
5. A nurse is reviewing the common emergency management protocol for clients who have asystole.
Which of the following actions should the nurse plan to take during this cardiac emergency?
A. Perform defibrillation
B. Prepare for transcutaneous pacing
C. Administer IV epinephrine
D. Elevate the client's lower extremities - ANS✅✅C
6. Assign a color to the following victim on the scene of a disaster: 14-year-old male with a broken
arm walking around the scene.
Red
Yellow
Green
Black - ANS✅✅C
Assign a color to the following victim on the scene of a disaster: 42-year-old woman with no obvious
injuries and without a carotid pulse.
Red
Yellow
Green
Black - ANS✅✅black
, Assign a color to the following victim on the scene of a disaster: 16-year-old female who is
ambulatory and says she is "OK."
Red
Yellow
Green
Black - ANS✅✅green
Assign a color to the following victim on the scene of a disaster: 57-year-old female has a deformed
tibia and fibula. She is oriented with RR of 20 and a pulse of about 100.
Red
Yellow
Green
Black - ANS✅✅yellow
Assign a color to the following victim on the scene of a disaster: 50-year-old man has bilateral
fractured femurs. He has a faint radial pulse and a respiratory rate of 24.
Red
Yellow
Green
Black - ANS✅✅red
Assign a color to the following victim on the scene of a disaster: A 66-year-old male patient is sitting
on the ground. His eyes are open, but he can't answer or follow directions.
Red
Yellow
Green
Black - ANS✅✅red
answers verified
1. A nurse on the medical-surgical unit is caring for a group of clients. The nurse should notify the
rapid response team for which of the following clients?
a. Client who has an ulceration of the right heel whose blood glucose is 300 mg/dL
b. Client who reports right calf pain and SOB
c. Client who has blood on a pressure dressing in the femoral area following a cardiac catheterization
d. Client who has dark red coloration of the left toes and absent pedal pulse - ANS✅✅B
2. A nurse is caring for a client who has ingested a toxic agent. Which of the following actions should
the nurse plan to take? (Select all that apply)
A. Induce vomiting
B. Instill activated charcoal
C. Perform a gastric lavage with aspiration
D. Administer syrup of ipecac
E. Infuse IV fluids - ANS✅✅B, C, E
3. A nurse in the ED is assessing a client who is unresponsive. The client's partner states, "He was
pulling weeds in the yard and slumped to the ground." Which of the following techniques would the
nurse use to open the client's airway?
A. Head-tilt, chin-lift
B. Modified jaw thrust
C. Hyperextension of the head
D. Flexion of the head - ANS✅✅A
,4. A nurse in the ED is caring for a client who fell through the ice on a pond and is unresponsive and
breathing slowly. Which of the following actions should the nurse take? (Select all that apply)
A. Remove wet clothing
B. Maintain normal room temperature
C. Apply warm blankets
D. Infuse warmed IV fluids - ANS✅✅A, C, D
5. A nurse is reviewing the common emergency management protocol for clients who have asystole.
Which of the following actions should the nurse plan to take during this cardiac emergency?
A. Perform defibrillation
B. Prepare for transcutaneous pacing
C. Administer IV epinephrine
D. Elevate the client's lower extremities - ANS✅✅C
6. Assign a color to the following victim on the scene of a disaster: 14-year-old male with a broken
arm walking around the scene.
Red
Yellow
Green
Black - ANS✅✅C
Assign a color to the following victim on the scene of a disaster: 42-year-old woman with no obvious
injuries and without a carotid pulse.
Red
Yellow
Green
Black - ANS✅✅black
, Assign a color to the following victim on the scene of a disaster: 16-year-old female who is
ambulatory and says she is "OK."
Red
Yellow
Green
Black - ANS✅✅green
Assign a color to the following victim on the scene of a disaster: 57-year-old female has a deformed
tibia and fibula. She is oriented with RR of 20 and a pulse of about 100.
Red
Yellow
Green
Black - ANS✅✅yellow
Assign a color to the following victim on the scene of a disaster: 50-year-old man has bilateral
fractured femurs. He has a faint radial pulse and a respiratory rate of 24.
Red
Yellow
Green
Black - ANS✅✅red
Assign a color to the following victim on the scene of a disaster: A 66-year-old male patient is sitting
on the ground. His eyes are open, but he can't answer or follow directions.
Red
Yellow
Green
Black - ANS✅✅red
