What is the current recommended dose of intravenous or intraosseous epinephrine in adult patients with cardiac arrest?
10 mg every 10 minutes
1 mg every 3-5 minutes
1 mg every 7 minutes
0.1 mg every 2 minutes
1 mg every 3-5 minutes
A patient with a traumatic brain injury (TBI) is MOST likely to suffer from what condition?
Diabetes mellitus
Cerebral palsy
Diabetes Insipidus
Myxedema coma
Diabetes Insipidus
A patient presents after sustaining a roll-over motor vehicle accident. They are complaining of pain around the mid-upper back. On your initial triage assessment, you find that patient has preserved motor function below L5 but is suffering from a loss of sensory function. The assessment findings are consistent with:
Posterior cord syndrome
Central cord syndrome
Anterior cord syndrome
Autonomic syndrome
Posterior cord syndrome
A patient arrives with acute onset of central chest pain. The patient is tachycardic and tachypneic and appears very anxious and restless. What would be the MOST important initial intervention for this patient?
Obtain electrocardiogram
Administer nitroglycerin
Administer oxygen
Obtain venous blood gas
IDK, but its not administer nitroglycerin or obtain electrocardiogram!!
A patient who is 27 weeks pregnant presents with painless bright red vaginal bleeding. What condition correlates with the presenting symptoms?
Abruptio placenta
Placenta Previa
Ectopic pregnancy
Premature rupture of membranes (PROM)
Placenta Previa
What is a common assessment finding in a patient with a tension pneumothorax?
Petechial chest rash
Distended neck veins
Equal chest wall expansion
Flattened neck veins
Distended Neck Veins
A patient presents with a two-day history of fever, cough, mild shortness of breath (SOB), sore throat, myalgia, and new onset of loss of taste and smell. What is the patient MOST likely suffering from?
Giardia
Microsporidia
COVID 19
Tuberculosis
COVID 19
The deficiency of anti-diuretic hormone (ADH) can lead to what endocrine disorders?
Diabetes Insipidus
Diabetes Mellitus
Adrenal Insufficiency
Syndrome of inappropriate secretion of ADH (SIADH)
Diabetes Insipidus
A patient presents after an intentional overdose of propranolol approximately 2 hours ago. The patient has severe hypotension and bradycardia. IV fluids and vasopressors are initiated. What nursing assessment findings indicate the treatment has been effective?
Decreasing pulse pressure
Decreasing central venous pressure
Increasing serum glucose
Increasing serum cortisol
Increasing serum glucose
A patient presents with acute onset of chest pain and goes into cardiac arrest immediately upon arrival. What is a possible reversible cause of cardiac arrest?
Hypervolemia
Alkalosis
Hyperthermia
Tension Pneumothorax
Tension Pneumothorax
Which of the following represent categories utilized to triage patients during a mass casualty incident (MCI)?
Green, orange, black, purple
Green, blue, red, black
Red, black, pink, yellow
Green, yellow, red, black
Green, yellow, red, black
A 22-year old female who is 8 weeks pregnant presents with a sudden onset of left lower abdominal pain and vaginal bleeding. The patient’s family member stated that she had a syncopal episode shortly after that. What is the MOST likely diagnosis for her?
Ruptured appendix
Placenta previa
Abruptio placenta
Ruptured ectopic pregnancy
Ruptured ectopic pregnancy
A patient with a history of chronic alcohol use is brought in with possible esophageal varices. What medication is used to stop upper gastrointestinal (GI) bleeding in patients with this condition?
Octreotide (Sandostatin®)
Acetaminophen (Tylenol®)
Warfarin (Jantoven®)
Ibuprofen (Motrin®)
Octreotide (Sandostatin)
A patient has sustained multiple traumatic injuries after a fall from a height. What is considered an important component of the primary survey assessment?
Complete set of vital signs
Neurological assessment
Head to toe assessment
Patients allergy history
Neurological Assessment
What do you anticipate is the BEST indicator of adequate hydration in an adult patient with 30% body surface area burn during initial fluid resuscitation?
Blood pressure of 110/60 mm Hg
Urine output of 0.5 mL/kg/hr
Central venous pressure of 25 mm Hg
Urine output of 0.2 mL/kg/hr
Urine output 0.5mL/kg/hr
What staff member would you ask to accompany you when transporting an intubated patient to imaging for a CT?
Lift team
Respiratory therapist
Physician’s assistant
Nursing assistant
RT
An elderly patient is brought in with new onset of confusion and gradual onset of headache in the last 48hours. The patient states that they had a fall 3 days ago. Based on the history and presenting complaints, what diagnostic test do you anticipate the provider to order?
MRI of the brain
Complete Blood Count
Finger stick blood sugar
CT scan of the brain
CT scan of the brain
A patient arrives with suspected appendicitis. What action, if observed, would require additional training for the unlicensed assistive personnel (UAP)?
The UAP offers the patient a ginger ale.
The UAP allows the patient to move to a position of comfort.
The UAP helps the patient with a bedpan.
The UAP reminds the patient to stay in bed.
The UAP offers the patient a ginger ale.
What laboratory value would you monitor closely if your patient is vomiting coffee-ground emesis?
White blood cells
Serum potasgium
Arterial Blood Gas
Hemoglobin
Hemoglobin
A patient who is 32 weeks pregnant presents with a three-day history of headache and significant swelling of the lower extremities and face. The patient’s vital signs are BP: 160/90, HR: 105/min, RR:19/min, Spo2: 94% on RA, Temp: 97.3 F. What medication do you anticipate the provider to order FIRST?
Furosemide (Lasix)
Magnesium Sulfate
Labetalol (Trandate)
Acetaminophen (Tylenol)
Magnesium Sulfate
You are caring for a patient who has a history of alcohol use and seizures. You suddenly notice the patient becoming diaphoretic, anxious, tachycardic, and has clammy skin. What would you do NEXT?
Check their blood glucose
Turn them on their side
Auscultate their lungs
Administer propranolol
Check their blood glucose
A patient who is 24 weeks pregnant presents with fever and right upper quadrant pain. The patient states that the pain is radiating to the right shoulder blade, and started an hour after having a pizza for lunch. She is tachycardic, tachypneic, and diaphoretic on the initial triage assessment. What is the MOST likely diagnosis for this patient?
Pericarditis
Cholecystitis
Diverticulitis
Pancreatitis
Cholecystitis
A patient presents after falling from a height and fracturing their right tibia and fibula. What symptom would be reported to the provider IMMEDIATELY?
Bounding pulse
Warm extremity
Paresthesia of the foot
Capillary refill pf toes <2 sec
Paresthesia of the foot
You are assisting a novice nurse with a blood draw. You observe the nurse draw the blood, place the specimen tubes in a biohazard bag, and leave the room with the unlabeled specimen tubes. What would you do NEXT?
Don’t confront the nurse, go redraw the labs and label at the bedside.
Do nothing because they can label them anywhere.
Report them to your supervisor.
Re-educate the nurse, then redraw thexabs, use patient identifiers and label at the bedside.
Re-educate
What is the critical goal time from arrival to the ED to CT brain scan based on the American Heart Association stroke recommendations?
10 minutes
25 minutes
45 minutes
60 minutes
25min
A patient presents with sudden onset of aphasia and left-sided weakness for the last 25 minutes. What action would be taken NEXT?
Triage them to the screening area
Complete a thorough triage evaluation, initiate the appropriate stroke resources
Register the patient prior to triage, and collect smoking and drug use history
Activate your department’s code stroke protocol
Activate your deptartment’s code stroke protocol
Your patient’s chest tube dressing has accidentally come off and you are preparing to place a new one. You have a slit drain sponge, 4 x 4 gauzes, tape, scissors, and antiseptic swabs. What else do you need?
Kelly clamp
Petrolatum gauze
Tube connector
Chest drainage system
Petrolatum gauze
What type of medication is used in the emergency care setting to help manage the symptoms of alcohol withdrawal?
Benzodiazepines
Valproic acid
Electrolytes
Thiamine
Benzos
A patient presents to the lobby stating she thinks she is in active labor. Your facility doesn’t have a labor and delivery unit. What is the NEXT action you would take?
Tell the patient she needs to go to the nearest hospital with a labor and delivery unit.
Have an ED provider perform a medical screening exam to determine if she is in active labor.
Call the nearest hospital with a labor and delivery unit to see if they will accept the patient.
Get a wheelchair for the patient and inform her that there will be a 3 hour wait time.
Have an ED provider preform a MSE
A patient is brought in with a history of a head-on motor vehicle accident. The patient was not wearing a seat belt and was traveling at 120 mph with the deployment of an airbag. They complain of severe lower abdominal and hip pain. A secondary trauma survey reveals an unstable hip on lateral compression. What would be a PRIORITY intervention in managing this patient?
Application of pelvic blinder
Initiation of massive transfusion protocol
Administration of IV fluids
Insertion of second IV line
Application of a pelvic binder
You exit your patient’s room and as you walk away you hear a thud. Upon inspection, you find your patient on the floor. What would you do FIRST?
Assess the patient for injury.
Call the familv.
Get assistance.
Notify the charge nurse.
Assess the pt for injury
A patient is brought in for a potential overdose of heroin. What is the PRIORITY nursing intervention?
Administering normal saline fluids
Maintaining airway and breathing
Starting an IV line
Administering naloxone
Maintaining airway and breathing.
You see a fellow nurse placing an opioid medication in their pocket rather than administering it as ordered. What would you do NEXT?
Don’t say anything.
Tell another coworker.
Confront your coworker.
Tell your immediate supervisor.
Tell your immediate supervisor
A patient is being treated in a hyperbaric oxygen chamber for carbon monoxide poisoning. What measurement is the BEST indicator of treatment success?
Pulse oximetry
Vital signs
Pulse pressure
O
Arterial blood gas
ABG
A patient presents with a facial burn with significant facial swelling and acute respiratory distress. Based on a 1-4 triage acuity scale with 1 being most critical, what is the appropriate category based on the
patient presentation?
1
2
3
4
1
A patient presents with an episode of hypertensive crisis, a blood pressure of 220/118, and the provider has put in the order for nitroprusside. What demonstrates that the treatment has been effective?
Systolic blood pressure reaches 160 mm Hg
Systolic blood pressure reaches 210 mm Hg
Patients states that he no longer has chest pain
Oxygen saturation increased from 94% to 99%
SBP reaches 160
You want to implement the new evidence-based practice guidelines in managing patients to prevent falling on your unit. What provides the STRONGEST evidence for interventions?
Systematic reviews
Retrospective study
Single randomized control trial
Observational study
Systematic reviews
A patient is brought in after being struck by lightning during a heavy thunderstorm. What would be the PRIORITY intervention for this patient upon arrival?
Measuring urine output
Monitoring cardiac rhythm
Cleaning of the burn wounds
Obtaining chest x-ray
Monitoring cardiac rhythm
A patient presents with a history of acute urinary retention. An indwelling catheter is placed and the patient is sent for an ultrasound scan. The imaging confirms benign prostatic hyperplasia as the cause of urinary retention. What medication do you anticipate the provider to order?
Tamsulosin (Flomax®)
Vasopressin
Phenylephrine (Omidria®)
Methoxamine (Vasoxy|®)
Flomax
The life-threatening and rare complication of hypothyroidism is known as:
Pheochromocytoma
Adrenal crisis
Thyroid storm
Myxedema coma
Myxedema
A new nurse observes their preceptor giving the incorrect dosage of a medication to a patient. Implementing the ethical principle veracity, what action would the new nurse take?
Keep the information confidential to avoid repercussions from the preceptor.
Inform the charge nurse about what happened and document it.
Since the patient was not harmed, do not report the incident.
Tell only the patient about the incident and have them decide what to do.
Inform the charge nurse about what happened and document it.
Your patient has just had a paracentesis during which 5 liters of fluid were removed. Which assessment is the PRIORITY?
Palpate for tenderness
Blood pressure
Observation of puncture site
Signs of infection
Blood pressure
What symptom is commonly seen in patients with alcohol withdrawal?
Tachycardia
Hypotension
Bradycardia
Hypothermia
Tachycardia
A patient’s family has decided to withdraw life-sustaining treatment. When communicating with the family of the patient, what reassurance would you provide?
Life support is essential in the patient’s quality of life.
Efforts will be made to make the patient comfortable.
That the patient lived a full and complete life.
Substantial amounts of pain medication will be provided.
Efforts with be made to make the patient comfortable.
During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided?
Coronary artery bypass
notropic iffusion
Percutaneous intervention
Continuous renal replacement therapy
Inotropic infusion
You accidentally administered epinephrine 1:1000 intravenous push for a patient suffering from a severe anaphylactic reaction. You recognize this as a near-miss event and report this:
Internally, per policy through the defined incident reporting system
Externally, to the state board of nursing through the website
Externally, to state board of pharmacy through the website
Since it was a near miss reporting is not necessary
Internally, per policy through the defined incident reporting system.
You are administering haloperidol (Haldol®) to a patient with acute symptoms of Schizophrenia. What changes in the electrocardiogram (ECG) are possible as a result of this medication?
Depressed T wave
O
Prolonged QT interval
Prolonged PR interval
Elevated ST segment
Prolonged QT interval
A patient is brought in with possible foreign body obstruction and respiratory distress. The provider suctions the patient and unsuccessfully tries to insert an endotracheal tube (ETT). What type of procedure would you anticipate NEXT?
Placement of laryngeal mask
Tracheostomy
Bronchoscopy
Chest tube insertion
Trach
A patient is complaining of a burning sensation in both eyes with pain, redness, swelling, and purulent discharge. The visual assessment using the Snellen chart reveals no changes in vision. You anticipate that the patient has signs and symptoms of:
Iritis
Conjuntivitis
Retinal detachment
Glaucoma
Conjuntivitis
A patient presents with possible organophosphate toxicity. What would you expect to find upon assessment?
Diaphoresis
Tachycardia
Constipation
Hot and dry skin
Diaphoresis
What is the appropriate intervention for patients with Acute Respiratory Distress Syndrome (ARDS)?
Increasing fluid volume
Mechanical ventilation
Bag mask valve (BMV) ventilation
Administering sedatives
Mechanical ventilation
A patient with a history of advanced-stage leukemia presents with a history of increasing shortness of breath in the last 4 days. The patient is anemic and has multiple bruises on their extremities. What is the MOST likely cause of bruising?
Anemia
Thrombocytopenia
Lymphadenopathy
Septicemia
Thrombocytopenia
What are you MOST likely to see during your initial assessment of a patient with chronic obstructive pulmonary disease (COPD)?
Pursed lip breathing
Absent breath sounds on one side
Fever
Blood tinged sputum
Pursed lip breathing
A patient presents with a 5-day history of runny nose, headache, and productive cough. The patient is unable to speak full sentences, reports having a history of moderate to severe COPD, and has a Sp02
reading of 89%. What intervention do you anticipate implementing FIRST for this patient?
•
Provide oxygen
Obtain venous blood gas (VBG)
Obtain vital signs
Obtain ECG
Provide Oxygen
A patient with dementia has a family member with MPOA, who is unable to be reached. The provider needs a consent signed and allows the patient to sign. What is the MOST appropriate action you would
take?
•
Report the provider to their supervisor.
Do nothing as the form has already been signed.
Call the ethics committee.
Report the provider to the Medical Board.
Report the provider to their supervisor
Under what circumstances can the hospital transfer an unstable patient to another facility and maintain
compliance with the Emergency Medical Treatment and Active Labor Act (EMTALA)?
The patient has no health insurance coverage.
The receiving facility is conducting research on specific disease condition.
The necessary treatment is not available at the current hospital.
The family members are requesting to transfer the patient near to them.
The necessary treatment is not available at the current hospital.
A 35-year-old patient complains of night sweats, low-grade fever, weight loss, and a productive cough
with pink-tinged sputum for 3-4 weeks. They have been staying at a local shelter since they lost their job
6 months ago. What diagnosis is most likely?
Tuberculosis
Influenza
COVID 19
Liver cancer
TB
Which of the following wounds has the highest risk for developing osteomyelitis?
Closed fracture of tibia resulting from trauma
Contusion and bruising to the head from a fall
Puncture wound from stepping on a rusty nail
Laceration of the face from breaking glass
Puncture wound from stepping on a nail
A patient is being treated with an anticoagulant for pulmonary embolism (PE). What patient assessment
finding indicates that a heparin infusion would be stopped IMMEDIATELY?
©
Decreased level of consciousness
Decreased urine output
Increase in blood pressure of 140/85
Increase in temperature to 100.1 F
Decreased level of consciousness
A patient presents with a 1-day history of pain in the right upper abdomen with nausea and vomiting. The
provider suspects that the patient has cholecystitis. What lab value supports the diagnosis?
Elevated amylase
A
Elevated creatinine
Elevated bilirubin
Decreased hemoglobin
Elevated Bilirubin
Acute deficiency of cortisol and aldosterone can lead to what severe life-threatening condition?
Cushing syndrome
Diabetes Insipidus.
Adrenal Crisis
Myxedema coma
Adrenal Crisis
A patient who is suspected of having hyperkalemia is MOST likely to have what ECG changes?
•
Tall, peaked T waves
T wave inversion
Prolonged QT interval
ST-segment elevation
Tall, peaked T wave
What type of diet would a patient with diverticulitis follow?
High residual diet
High fiber diet
Low sugar diet
High calorie diet
IDK, but its not High residual or Low sugar!!
A confused patient is trying to grasp at their IV with their right hand. Which is the LEAST restrictive
measure to maintain patient safety?
2-point restraint on right arm and left leg
Safety “mitt” for both hands
2-point restraints on upper limbs
Safety “mitt” for right hand only
Safety “mitt” for right hand only
A patient is frustrated at the length of time they have been waiting to be triaged. They start to yell obscenities and threaten you with violence. Why would this incident be reported to your supervisor?
The patient is responsible for their actions even though they are ill
You have the right to personal safety at work
As no physical injury actually occurred, no further action is necessary
This type of behavior is expected and accepted in the ED
You have a right to personal safety at work
A patient who is 8 weeks pregnant presents to triage with vaginal bleeding and lower abdominal pain. RhoGAM will be given for which situation?
Father is negative
Father is positive
Mother is positive
Mother is Rh negative
Mother is Rh negative
An adult patient who is 70 kg has a full-thickness burn over 30% of their body surface area. What is the anticipated fluid replacement for a patient in the first 8 hours is based on the Parkland formula?
4200 mL
4800 mL
6300 mL
8400 mL
4200 mL
Your patient’s chest tube dressing has accidentally come off and you are preparing to place a new one. You have a slit drain sponge, 4 x 4 gauzes, tape, scissors, and antiseptic swabs. What else do you need?
Petrolatum gauze
You want to implement the new evidence-based practice guidelines in managing patients to prevent falls on your unit. What provides the STRONGEST evidence for interventions?
Systematic reviews
Upon triage of a patient, they state that they have suicidal ideation with intent. What would you do NEXT?
Institute suicide precautions.
Which of the following wounds has the highest risk for developing osteomyelitis?
Puncture wound from stepping on a rusty nail
What type of diet would a patient with diverticulitis follow?
High fiber diet
Answer is NOT high residual diet
An elderly patient is brought in with new onset of confusion and gradual onset of headache in the last 48 hours. The patient states that they had a fall 3 days ago. Based on the history and presenting complaints, what diagnostic test do you anticipate the provider to order?
CT scan of the brain
What medication is used in reversing the effects of opioid overdose?
Naloxone (Narcan®)
What are you MOST likely to see during your initial assessment of a patient with chronic obstructive pulmonary disease (COPD)?
Pursed lip breathing
Under what circumstances can the hospital transfer an unstable patient to another facility and maintain compliance with the Emergency Medical Treatment and Active Labor Act (EMTALA)?
The necessary treatment is not available at the current hospital.
The life-threatening and rare complication of hypothyroidism is known as:
Myxedema coma
A patient presents with acute onset of chest pain and goes into cardiac arrest immediately upon arrival. What is a possible reversible cause of cardiac arrest?
Tension Pneumothorax
A patient presents with an episode of hypertensive crisis, a blood pressure of 220/118, and the provider has put in the order for nitroprusside. What demonstrates that the treatment has been effective?
Systolic blood pressure reaches 160 mm Hg
A patient arrives with suspected appendicitis. What action, if observed, would require additional training for the unlicensed assistive personnel (UAP)?
The UAP offers the patient a ginger ale.
You see a fellow nurse placing an opioid medication in their pocket rather than administering it as ordered. What would you do NEXT?
Tell your immediate supervisor.
You are administering haloperidol (Haldol®) to a patient with acute symptoms of Schizophrenia. What changes in the electrocardiogram (ECG) are possible as a result of this medication?
Prolonged QT interval
A patient presents with a 5-day history of runny nose, headache, and productive cough. The patient is unable to speak full sentences, reports having a history of moderate to severe COPD, and has a SpO2 reading of 89%. What intervention do you anticipate implementing FIRST for this patient?
Provide oxygen
A patient who is 24 weeks pregnant presents with fever and right upper quadrant pain. The patient states that the pain is radiating to the right shoulder blade, and started an hour after having a pizza for lunch. She is tachycardic, tachypneic, and diaphoretic on the initial triage assessment. What is the MOST likely diagnosis for this patient?
Cholecystitis
A patient arrives with acute onset of central chest pain. The patient is tachycardic and tachypneic and appears very anxious and restless. What would be the MOST important initial intervention for this patient?
Administer oxygen
Answer is NOT Obtain electrocardiogram
A patient is being treated with an anticoagulant for pulmonary embolism (PE). What patient assessment finding indicates that a heparin infusion would be stopped IMMEDIATELY?
Decreased level of consciousness
We have an expert-written solution to this problem!
A new nurse observes their preceptor giving the incorrect dosage of a medication to a patient. Implementing the ethical principle veracity, what action would the new nurse take?
Inform the charge nurse about what happened and document it.
What is the appropriate intervention for patients with Acute Respiratory Distress Syndrome (ARDS)?
Mechanical ventilation
What is a common assessment finding in a patient with a tension pneumothorax?
Distended neck veins
What is the current recommended dose of intravenous or intraosseous epinephrine in adult patients with cardiac arrest?
1 mg every 3-5 minutes
What type of medication is used in the emergency care setting to help manage the symptoms of alcohol withdrawal?
Benzodiazepines
A patient who is 27 weeks pregnant presents with painless bright red vaginal bleeding. What condition correlates with the presenting symptoms?
Placenta Previa
A patient who is 32 weeks pregnant presents with a three-day history of headache and significant swelling of the lower extremities and face. The patient’s vital signs are BP: 160/90, HR: 105/min, RR: 19/min, Spo2: 94% on RA, Temp: 97.3 F. What medication do you anticipate the provider to order FIRST?
Labetalol (Trandate®)
You are assessing a patient who had an altercation involving a clenched fist injury. You notice that his right hand is swollen significantly with pain and bruising. What would you be MOST concerned about for the patient?
Rheumatoid arthritis
Loss of function
Osteomyelitis
Active bleeding
A patient with a history of advanced-stage leukemia presents with a history of increasing shortness of breath in the last 4 days. The patient is anemic and has multiple bruises on their extremities. What is the MOST likely cause of bruising?
Thrombocytopenia
A patient presents with a facial burn with significant facial swelling and acute respiratory distress. Based on a 1-4 triage acuity scale with 1 being most critical, what is the appropriate category based on the patient presentation?
1
A patient is brought in after being struck by lightning during a heavy thunderstorm. What would be the PRIORITY intervention for this patient upon arrival?
Monitoring cardiac rhythm
A patient is being treated in a hyperbaric oxygen chamber for carbon monoxide poisoning. What measurement is the BEST indicator of treatment success?
Arterial blood gas
What do you anticipate is the BEST indicator of adequate hydration in an adult patient with 30% body surface area burn during initial fluid resuscitation?
Urine output of 0.5 mL/kg/hr
A patient with a traumatic brain injury (TBI) is MOST likely to suffer from what condition?
Answer is NOT myxedema coma
Answer is NOT Cerebral palsy
A patient with a history of chronic alcohol use is brought in with possible esophageal varices. What medication is used to stop upper gastrointestinal (GI) bleeding in patients with this condition?
Octreotide (Sandostatin®)
A patient is brought in for a potential overdose of heroin. What is the PRIORITY nursing intervention?
Maintaining airway and breathing
Your patient has just had a paracentesis during which 5 liters of fluid were removed. Which assessment is the PRIORITY?
Blood pressure
During cardiogenic shock what temporary intervention might be ordered to improve perfusion until definitive treatment is provided?
Inotropic infusion
What laboratory value would you monitor closely if your patient is vomiting coffee-ground emesis?
Hemoglobin
A patient has sustained multiple traumatic injuries after a fall from a height. What is considered an important component of the primary survey assessment?
Neurological assessment
A patient presents after falling from a height and fracturing their right tibia and fibula. What symptom would be reported to the provider IMMEDIATELY?
Paresthesia of the foot
A 22-year old female who is 8 weeks pregnant presents with a sudden onset of left lower abdominal pain and vaginal bleeding. The patient’s family member stated that she had a syncopal episode shortly after that. What is the MOST likely diagnosis for her?
Answer is NOT Abruptio placenta
You exit your patient’s room and as you walk away you hear a thud. Upon inspection, you find your patient on the floor. What would you do FIRST?
Assess the patient for injury.
A patient is brought in with possible foreign body obstruction and respiratory distress. The provider suctions the patient and unsuccessfully tries to insert an endotracheal tube (ETT). What type of procedure would you anticipate NEXT?
Tracheostomy
A patient presents with a 1-day history of pain in the right upper abdomen with nausea and vomiting. The provider suspects that the patient has cholecystitis. What lab value supports the diagnosis?
Elevated bilirubin
You are assisting a novice nurse with a blood draw. You observe the nurse draw the blood, place the specimen tubes in a biohazard bag, and leave the room with the unlabeled specimen tubes. What would you do NEXT?
Re-educate the nurse, then redraw the labs, use patient identifiers and label at the bedside.
A patient presents with a two-day history of fever, cough, mild shortness of breath (SOB), sore throat, myalgia, and new onset of loss of taste and smell. What is the patient MOST likely suffering from?
COVID 19
A patient is brought in with a history of a head-on motor vehicle accident. The patient was not wearing a seat belt and was traveling at 120 mph with the deployment of an airbag. They complain of severe lower abdominal and hip pain. A secondary trauma survey reveals an unstable hip on lateral compression. What would be a PRIORITY intervention in managing this patient?
Application of pelvic blinder
A patient presents with possible organophosphate toxicity. What would you expect to find upon assessment?
Diaphoresis
What symptom is commonly seen in patients with alcohol withdrawal?
Tachycardia
A patient presents after sustaining a roll-over motor vehicle accident. They are complaining of pain around the mid-upper back. On your initial triage assessment, you find that patient has preserved motor function below L5 but is suffering from a loss of sensory function. The assessment findings are consistent with:
Answer is NOT Anterior cord syndrome
Answer is NOT central cord syndrome
You are caring for a patient who has a history of alcohol use and seizures. You suddenly notice the patient becoming diaphoretic, anxious, tachycardic, and has clammy skin. What would you do NEXT?
Answer is NOT Turn them on their side
Answer is NOT Administer propranolol
A confused patient is trying to grasp at their IV with their right hand. Which is the LEAST restrictive measure to maintain patient safety?
Safety “mitt” for right hand only
A patient’s family has decided to withdraw life-sustaining treatment. When communicating with the family of the patient, what reassurance would you provide?
Efforts will be made to make the patient comfortable.
A patient is frustrated at the length of time they have been waiting to be triaged. They start to yell obscenities and threaten you with physical violence. Why would this incident be reported to your supervisor?
You have the right to personal safety in the work environment.
A patient who is 8 weeks pregnant presents to triage with vaginal bleeding and lower abdominal pain. RhoGAM will be given for which situation?
Mother is Rh negative
What is the critical goal time from arrival to the ED to CT brain scan based on the American Heart Association stroke recommendations?
25 minutes
The deficiency of anti-diuretic hormone (ADH) can lead to what endocrine disorders?
Answer is NOT Adrenal Insufficiency
Answer is NOT Syndrome of inappropriate secretion of ADH (SIADH)
A patient presents after an intentional overdose of propranolol approximately 2 hours ago. The patient has severe hypotension and bradycardia. IV fluids and vasopressors are initiated. What nursing assessment findings indicate the treatment has been effective?
Answer is NOT Increasing serum cortisol
An adult patient who is 70 kg has a full-thickness burn over 30% of their body surface area. What is the anticipated fluid replacement for a patient in the first 8 hours is based on the Parkland formula?
4200 mL
A patient with dementia has a family member with MPOA, who is unable to be reached. The provider needs a consent signed and allows the patient to sign. What is the MOST appropriate action you would take?
Report the provider to their supervisor
A patient presents after an intentional overdose of propranolol approximately 2 hours ago. The patient has severe hypotension and bradycardia. IV fluids and vasopressors are initiated. What nursing assessment findings indicate the treatment has been effective?
Increasing serum cortisol
Increasing serum glucose
Decreasing pulse pressure
Decreasing central venous pressure
A patient presents with a partial thickness burn to the anterior portion of the chest. Based on the rule of nine estimations, what is the patient’s estimated total body surface area burned?
18%