NURS 4526 EXAM 2026 COMPREHENSIVE
STUDY GUIDE WITH VERIFIED SOLUTIONS
◉How do you assess E1- Environment? Answer: - No fire, no wire,
no gas, no glass, no rugs/drugs or thugs
- Assessed before entering the room
◉How do you assess A - Airway & Alertness? Answer: - AVPU (Alert,
Verbal stimuli, Painful stimuli, Unresponsive)
- GCS
--eyes - 4
- motor - 6
- verbal - 5
- ex. 10 T - pt has tube so unable to assess verbal response
- high level of interrelatability
- unconscious pt: tongue rolls back and obstructs airway (GSC >8)
- Is patient speaking in full sentences?
- C spine precautions (C4 above - respiratory injury;
C4 below - paraplegia)
- Turn pt like a log or use collar to protect sc
,◉If airway is compromised... Answer: Perform from least to most
invasive:
- Head tilt, chin lift
- Jaw thrust: rescuer uses forearms to stabilize pt head and then
applies pressure w index fingers to push jaw forward
- Suctioning, removal of foreign bodies, inserting an airway to induce
gagging
- Endotracheal intubation
- Rapid sequence intubation - preferred procedure to secure an
unprotected airway in the ED
- With suspected SC injury, cervical spine must be stabilized during
airway assessment
- Ensure your room has working oxygen and suction at all times
- SC trauma -> only use jaw thrust
◉How do you assess B - Breathing? Answer: - No distress in face
- Eye brows not raised
- Eyes not open widely
- Nostrils not flared
- Mouth not open or pursed
- No visible accessory muscle use
- No noises of distress
, - Abnormal sounds: wheezing- high pitched whistling sound on
expiration, crackles - alveoli forcefully open (fine or coarse crackles)
◉What to do if breathing is unstable ? Answer: - Reposition client
- Unstable: start HIGH FLOW oxygen and titrate to maintain oxygen
saturation
- Monitor client's response through observation, auscultation and
oxygen saturation
- Importance of the room being ready
- Oxygen dissociation curve: ex. partial pressure changes (SPO2 not
always reliable)
◉what are interventions for unstable breathing? Answer: -
positioning
- coached breathing
- oxygen
- bronchodilators
- intubation & ventilation (RSI)
◉How do you assess C- Circulation? Answer: Central Skin Colour,
Temperature and moisture
STUDY GUIDE WITH VERIFIED SOLUTIONS
◉How do you assess E1- Environment? Answer: - No fire, no wire,
no gas, no glass, no rugs/drugs or thugs
- Assessed before entering the room
◉How do you assess A - Airway & Alertness? Answer: - AVPU (Alert,
Verbal stimuli, Painful stimuli, Unresponsive)
- GCS
--eyes - 4
- motor - 6
- verbal - 5
- ex. 10 T - pt has tube so unable to assess verbal response
- high level of interrelatability
- unconscious pt: tongue rolls back and obstructs airway (GSC >8)
- Is patient speaking in full sentences?
- C spine precautions (C4 above - respiratory injury;
C4 below - paraplegia)
- Turn pt like a log or use collar to protect sc
,◉If airway is compromised... Answer: Perform from least to most
invasive:
- Head tilt, chin lift
- Jaw thrust: rescuer uses forearms to stabilize pt head and then
applies pressure w index fingers to push jaw forward
- Suctioning, removal of foreign bodies, inserting an airway to induce
gagging
- Endotracheal intubation
- Rapid sequence intubation - preferred procedure to secure an
unprotected airway in the ED
- With suspected SC injury, cervical spine must be stabilized during
airway assessment
- Ensure your room has working oxygen and suction at all times
- SC trauma -> only use jaw thrust
◉How do you assess B - Breathing? Answer: - No distress in face
- Eye brows not raised
- Eyes not open widely
- Nostrils not flared
- Mouth not open or pursed
- No visible accessory muscle use
- No noises of distress
, - Abnormal sounds: wheezing- high pitched whistling sound on
expiration, crackles - alveoli forcefully open (fine or coarse crackles)
◉What to do if breathing is unstable ? Answer: - Reposition client
- Unstable: start HIGH FLOW oxygen and titrate to maintain oxygen
saturation
- Monitor client's response through observation, auscultation and
oxygen saturation
- Importance of the room being ready
- Oxygen dissociation curve: ex. partial pressure changes (SPO2 not
always reliable)
◉what are interventions for unstable breathing? Answer: -
positioning
- coached breathing
- oxygen
- bronchodilators
- intubation & ventilation (RSI)
◉How do you assess C- Circulation? Answer: Central Skin Colour,
Temperature and moisture
