NUR 275 exam 1 Questions With Accurate (A+) Answers
emergency nursing involves... - ✔✔rapid assessment and treatment of patients
priorities of care in emergency nursing - ✔✔1. prehospital care - "Golden Period"
2. transport
3. hospital care
assessment in emergency nursing is broken down into 2 categories: - ✔✔1. primary survey
2. secondary survey
primary survey focuses on - ✔✔stabilizing life-threatening conditions
ABCDE method - ✔✔- used by ED staff during PRIMARY survey
Airway
Breathing
Circulation
Disability
Exposure
airway assessment - ✔✔establish a patent airway and assess for:
- obstruction
,- injury
- is patient talking?
trauma patients must be maintained in this position until airway patency is x-ray confirmed -
✔✔c-spine
breathing or ventilation assessment - ✔✔assess:
- ineffective breathing patterns
- respiratory rate
- breath sounds
- chest movement (excursion)
- position of trachea
immediately after your trauma patient's airway is established, which injury should the nurse
assess first? - ✔✔chest injuries
circulatory assessment - ✔✔assess:
- BP
- HR
- pulses
- skin color
- cap refill
- signs of bleeding
,circulatory assessment nursing management - ✔✔- control hemorrhages
- treat and prevent shock
- restore and maintain effective circulation
- manage and prevent hypothermia
if an extremity has fracture(s) and/or dislocation(s) and is pulseless, what is performed during the
circulatory assessment? - ✔✔immediate closed reduction
disability assessment - ✔✔- determine neurologic disability by completing a brief, narrow
assessment using Glascow Coma Scale
- evaluate motor and sensory function of the spine
- look for areas that need to be investigated during the secondary survey/assessment
a quick neuro assessment may be done using AVPU - what does that stand for? - ✔✔Alert
Verbal
Pain
Unresponsive
exposure assessment - ✔✔- was patient exposed to extreme heat or cold?
- quickly but carefully undress patient entirely to assess all areas of the body
- keep patient covered with blankets so they do not become cold
, secondary survey includes: - ✔✔- reassessment of airway, breathing and vitals/head-to-toe
assessment
- identification of other injuries
- complete health history and history of current event (meds, past medical hx, allergies, anything
related to patient's condition, last meal)
- labs and diagnostic testing
- insertion or application of catheters, arterial lines or ECG electrodes
- splinting of suspected fractures
- cleansing, closure and dressing of any wounds
- performance of other necessary interventions
if abnormal vitals are assessed during the secondary survey, what should the nurse do? -
✔✔return to primary survey
who should the nurse gather patient information from during the secondary survey? - ✔✔-
patient
- EMS
- witnesses
- family
pain management for the trauma patient - what kind of agents should the nurse use? - ✔✔rapid-
acting agents that result in minimal sedation so the patient can continue to interact with ED staff
for ongoing assessment
emergency nursing involves... - ✔✔rapid assessment and treatment of patients
priorities of care in emergency nursing - ✔✔1. prehospital care - "Golden Period"
2. transport
3. hospital care
assessment in emergency nursing is broken down into 2 categories: - ✔✔1. primary survey
2. secondary survey
primary survey focuses on - ✔✔stabilizing life-threatening conditions
ABCDE method - ✔✔- used by ED staff during PRIMARY survey
Airway
Breathing
Circulation
Disability
Exposure
airway assessment - ✔✔establish a patent airway and assess for:
- obstruction
,- injury
- is patient talking?
trauma patients must be maintained in this position until airway patency is x-ray confirmed -
✔✔c-spine
breathing or ventilation assessment - ✔✔assess:
- ineffective breathing patterns
- respiratory rate
- breath sounds
- chest movement (excursion)
- position of trachea
immediately after your trauma patient's airway is established, which injury should the nurse
assess first? - ✔✔chest injuries
circulatory assessment - ✔✔assess:
- BP
- HR
- pulses
- skin color
- cap refill
- signs of bleeding
,circulatory assessment nursing management - ✔✔- control hemorrhages
- treat and prevent shock
- restore and maintain effective circulation
- manage and prevent hypothermia
if an extremity has fracture(s) and/or dislocation(s) and is pulseless, what is performed during the
circulatory assessment? - ✔✔immediate closed reduction
disability assessment - ✔✔- determine neurologic disability by completing a brief, narrow
assessment using Glascow Coma Scale
- evaluate motor and sensory function of the spine
- look for areas that need to be investigated during the secondary survey/assessment
a quick neuro assessment may be done using AVPU - what does that stand for? - ✔✔Alert
Verbal
Pain
Unresponsive
exposure assessment - ✔✔- was patient exposed to extreme heat or cold?
- quickly but carefully undress patient entirely to assess all areas of the body
- keep patient covered with blankets so they do not become cold
, secondary survey includes: - ✔✔- reassessment of airway, breathing and vitals/head-to-toe
assessment
- identification of other injuries
- complete health history and history of current event (meds, past medical hx, allergies, anything
related to patient's condition, last meal)
- labs and diagnostic testing
- insertion or application of catheters, arterial lines or ECG electrodes
- splinting of suspected fractures
- cleansing, closure and dressing of any wounds
- performance of other necessary interventions
if abnormal vitals are assessed during the secondary survey, what should the nurse do? -
✔✔return to primary survey
who should the nurse gather patient information from during the secondary survey? - ✔✔-
patient
- EMS
- witnesses
- family
pain management for the trauma patient - what kind of agents should the nurse use? - ✔✔rapid-
acting agents that result in minimal sedation so the patient can continue to interact with ED staff
for ongoing assessment
