NSER 7210 - Module 1 Exam Q’s and A’s
Define Interpersonal Violence - -Pattern of assaultive of coercive behaviours, by a partner.
Include: Injury, psychological abuse, forced social isolation, intimidation, threats, stalking
-Describe the role of universal screening in the ED and how it relates to violence - -
Looking for a condition before it is overtly symptomatic
Interpersonal violence is common and high consequence
-Describe the 3 necessary components of effective violence screening - -Interview in
private place, without visitors
Use respectful, non judgmental communication
An appropriate response if screen is positive and access to resources
-Name 4 high risk groups that should receive a secondary interpersonal violence screen by
an MD - -Those admitted with mental health concerns, altered LOC and/or intox.
Those with high risk injuries (face, neck, head)
Those with repeat visits
Undocumented or dependent immigration status
-State 5 actions required if a violence screen is positive - -Allow patient to explain via open
ended questions
Validate and legitimize the patient (To address shame, blame and isolation). Affirm
disclosure was appropriate
Encourage and empower patient to seek help for abuse
Address immediate safety concerns
Document conversation and injuries
-State the 5 components of the screening tool for severe or high risk violence - -Has
violence increased in freq or severity in past 6 mo
Has your partner every used (or threatened) a weapon
Do you believe your partner is capable of killing you
Has your partner ever beaten you while you're pregnant
Is your partner violently and constantly jealous
-What 4 steps must occur once a patient discloses substance misuse, ETOH overuse - -
Provide support and resources
Ask about hx of withdrawal and prevent it
Prepare for worst case scenario
Maintain professionalism - curb negative thoughts
-Define ectopic pregnancy - -Fertilized ovum implants in a location outside of endometrial
cavity
, -State 6 risk factors for ectopic pregnancy. - -Hx of pelvic inflammatory disease
Previous tubal surgery
Previous ectopic pregnancies
Pregnancy with fertility treatment
Pregnancy with IUD insitu
Maternal age >35
-What is the classic triad of presenting symptoms of a non-ruptured ectopic pregnancy - -
Missed menstrual period
Abdominal pain
Vaginal bleeding
-What symptoms suggest a ruptured ectopic pregnancy - -Signs of internal hemorrhage
- Hypotension, tachycardia
- Lateral rebound abdominal or pelvic tenderness and guarding
-Describe the purpose/benefits of bedside Focused Abdominal Sonogram for Trauma
(FAST) - -Identifies the presence of free peritoneal or pericardial fluid
Rapid, Non invasive
-What is the treatment for an ectopic pregnancy - -If ruptured - Surgical laparotomy
If not ruptured - Methotrexate (Inhibits DNA synthesis and cell replication)
-What are the 4 contraindications to methotrexate administration in ectopic pregnancy - -
Signs of rupture (will require surgical treatment)
Impaired renal or liver function
Bone marrow dysfunction - Anemia, leukopenia or thrombocytopenia
Active GI or Resp disease
-Define compensated Shock - -The body has activated hormonal and chemical
compensatory mechanisms to maintain homeostasis.
Few signs of shock/impaired cardiac output
-Define uncompensated shock - -Compensatory mechanisms begin to fail.
Oxygen supply and demand is imbalanced
Objectively symptomatic
-Define irreversible shock - -Cellular damage and cell death is so profound and permanent
Significant organ damage occurred and death is inevitable
-State the classic symptoms of shock - -Hypotension, cool/clammy extremities,
Tachypnea
Oliguria,
Dysglycemia
Delirium
Elevated lactate (evidence of anaerobic metabolism)
Define Interpersonal Violence - -Pattern of assaultive of coercive behaviours, by a partner.
Include: Injury, psychological abuse, forced social isolation, intimidation, threats, stalking
-Describe the role of universal screening in the ED and how it relates to violence - -
Looking for a condition before it is overtly symptomatic
Interpersonal violence is common and high consequence
-Describe the 3 necessary components of effective violence screening - -Interview in
private place, without visitors
Use respectful, non judgmental communication
An appropriate response if screen is positive and access to resources
-Name 4 high risk groups that should receive a secondary interpersonal violence screen by
an MD - -Those admitted with mental health concerns, altered LOC and/or intox.
Those with high risk injuries (face, neck, head)
Those with repeat visits
Undocumented or dependent immigration status
-State 5 actions required if a violence screen is positive - -Allow patient to explain via open
ended questions
Validate and legitimize the patient (To address shame, blame and isolation). Affirm
disclosure was appropriate
Encourage and empower patient to seek help for abuse
Address immediate safety concerns
Document conversation and injuries
-State the 5 components of the screening tool for severe or high risk violence - -Has
violence increased in freq or severity in past 6 mo
Has your partner every used (or threatened) a weapon
Do you believe your partner is capable of killing you
Has your partner ever beaten you while you're pregnant
Is your partner violently and constantly jealous
-What 4 steps must occur once a patient discloses substance misuse, ETOH overuse - -
Provide support and resources
Ask about hx of withdrawal and prevent it
Prepare for worst case scenario
Maintain professionalism - curb negative thoughts
-Define ectopic pregnancy - -Fertilized ovum implants in a location outside of endometrial
cavity
, -State 6 risk factors for ectopic pregnancy. - -Hx of pelvic inflammatory disease
Previous tubal surgery
Previous ectopic pregnancies
Pregnancy with fertility treatment
Pregnancy with IUD insitu
Maternal age >35
-What is the classic triad of presenting symptoms of a non-ruptured ectopic pregnancy - -
Missed menstrual period
Abdominal pain
Vaginal bleeding
-What symptoms suggest a ruptured ectopic pregnancy - -Signs of internal hemorrhage
- Hypotension, tachycardia
- Lateral rebound abdominal or pelvic tenderness and guarding
-Describe the purpose/benefits of bedside Focused Abdominal Sonogram for Trauma
(FAST) - -Identifies the presence of free peritoneal or pericardial fluid
Rapid, Non invasive
-What is the treatment for an ectopic pregnancy - -If ruptured - Surgical laparotomy
If not ruptured - Methotrexate (Inhibits DNA synthesis and cell replication)
-What are the 4 contraindications to methotrexate administration in ectopic pregnancy - -
Signs of rupture (will require surgical treatment)
Impaired renal or liver function
Bone marrow dysfunction - Anemia, leukopenia or thrombocytopenia
Active GI or Resp disease
-Define compensated Shock - -The body has activated hormonal and chemical
compensatory mechanisms to maintain homeostasis.
Few signs of shock/impaired cardiac output
-Define uncompensated shock - -Compensatory mechanisms begin to fail.
Oxygen supply and demand is imbalanced
Objectively symptomatic
-Define irreversible shock - -Cellular damage and cell death is so profound and permanent
Significant organ damage occurred and death is inevitable
-State the classic symptoms of shock - -Hypotension, cool/clammy extremities,
Tachypnea
Oliguria,
Dysglycemia
Delirium
Elevated lactate (evidence of anaerobic metabolism)
