Lewis ATI Med Surg 12th edition Chapter 21: Emergency and
Disaster Nursing Key Exam Guide Questions and Integral
solution version 2025/2026
1. Family members are in the patient's room when the patient has a cardiac arrest and
the staff start resuscitation measures. Which action would the nurse take first?
a. Keep the family in the room and assign a staff member to explain the care given and
answer questions.
b. Ask the family to wait outside the patient's room with a staff member to provide
emotional support.
c. Ask the family members whether they would prefer to remain in the patient's room or
wait outside the room.
d. Tell the family members that patients are comforted by having family members
present during resuscitation efforts. - correct answer ANS: C
Although many family members and patients report benefits from family presence
during resuscitation efforts, the nurse's initial action would be to determine the
preference of these family members. the other actions may be appropriate, but this will
depend on what is learned when assessing family preferences.
2. A patient who has deep human bite wounds on the left hand is being treated in the
urgent care center. Which action will the nurse plan to take?
a. Prepare to administer rabies immune globulin.
b. Assist the health care provider with suturing the wounds.
c. Teach the patient about the use of prophylactic antibiotics.
d. Keep the wounds dry until the health care provider can assess them - correct
answer ANS: C
Because human bites of the hand frequently become infected, prophylactic antibiotics
are usually prescribed to prevent infection. To minimize infection, deep bite wounds on
the extremities are left open. Rabies immune globulin might be used after an animal
bite. Initial treatment of bite wounds includes copious irrigation to help clean out
contaminants and microorganisms.
3. The urgent care center protocol for tick bites includes the following actions. Which
action will the nurse take first when caring for a patient with a tick bite?
a. Use tweezers to remove any remaining ticks.
b. Check the vital signs, including temperature.
c. Give doxycycline (Vibramycin) 100 mg orally.
d. Obtain information about recent outdoor activities - correct answer ANS: A
, Because neurotoxic venom is released as long as the tick is attached to the patient, the
initial action would be to remove any ticks using tweezers or forceps. the other actions
are also appropriate, but the priority is to minimize venom release.
Which interventions will thenurse plan for a comatose patient who will have targeted
temperature management/therapeutic hypothermia? (Select all that apply.)
a. Assist with endotracheal intubation.
b. Insert an indwelling urinary catheter
c. Begin continuous cardiac monitoring.
d. Prepare to give sympathomimetic drugs.
e. Obtain a prescription for patient restraints - correct answer ANS: A, B, C
Cooling can produce dysrhythmias, so the patient's heart rhythm would be continuously
monitored, and dysrhythmias treated if necessary. Bladder catheterization and
endotracheal intubation are needed during cooling. Sympathomimetic drugs tend to
stimulate the heart and increase the risk for fatal dysrhythmias such as ventricular
fibrillation. Patients receiving therapeutic hypothermia are comatose, so restraints are
not indicated.
The emergency department (ED) nurse is starting targeted temperature
management/therapeutic hypothermia in a patient who has been resuscitated after a
cardiac arrest. Which actions in thehypothermia protocol can be delegated to an
experienced licensed practical/vocational nurse (LPN/VN)? (Select all that apply.)
a. Evaluate changes in heart rhythm.
b. Insert a urinary catheter to drainage.
c. Assess neurologic status every 2 hours.
d. Place cooling blankets above and below patient.
e. Attach rectal temperature probe to cooling blanket control panel - correct answer
ANS: B, D, E
Experienced LPN/VNs have the education and scope of practice to implement
hypothermia measures (e.g., cooling blanket, temperature probe) and insert a urinary
catheter under the supervision of a registered nurse (RN). Assessment of neurologic
status and evaluating changes in heart rhythm require RN-level education and scope of
practice.
1. The nurse is doing the primary survey of an adult who was in a motor vehicle
collision. After the nurse determines that the patient has an unobstructed airway, which
action would the nurse take next?
a. Palpate extremities for bilateral pulses.
b. Observe the patient's respiratory effort.
c. Check the patient's level of consciousness.
d. Examine the patient for external bleeding. - correct answer ANS: B
Disaster Nursing Key Exam Guide Questions and Integral
solution version 2025/2026
1. Family members are in the patient's room when the patient has a cardiac arrest and
the staff start resuscitation measures. Which action would the nurse take first?
a. Keep the family in the room and assign a staff member to explain the care given and
answer questions.
b. Ask the family to wait outside the patient's room with a staff member to provide
emotional support.
c. Ask the family members whether they would prefer to remain in the patient's room or
wait outside the room.
d. Tell the family members that patients are comforted by having family members
present during resuscitation efforts. - correct answer ANS: C
Although many family members and patients report benefits from family presence
during resuscitation efforts, the nurse's initial action would be to determine the
preference of these family members. the other actions may be appropriate, but this will
depend on what is learned when assessing family preferences.
2. A patient who has deep human bite wounds on the left hand is being treated in the
urgent care center. Which action will the nurse plan to take?
a. Prepare to administer rabies immune globulin.
b. Assist the health care provider with suturing the wounds.
c. Teach the patient about the use of prophylactic antibiotics.
d. Keep the wounds dry until the health care provider can assess them - correct
answer ANS: C
Because human bites of the hand frequently become infected, prophylactic antibiotics
are usually prescribed to prevent infection. To minimize infection, deep bite wounds on
the extremities are left open. Rabies immune globulin might be used after an animal
bite. Initial treatment of bite wounds includes copious irrigation to help clean out
contaminants and microorganisms.
3. The urgent care center protocol for tick bites includes the following actions. Which
action will the nurse take first when caring for a patient with a tick bite?
a. Use tweezers to remove any remaining ticks.
b. Check the vital signs, including temperature.
c. Give doxycycline (Vibramycin) 100 mg orally.
d. Obtain information about recent outdoor activities - correct answer ANS: A
, Because neurotoxic venom is released as long as the tick is attached to the patient, the
initial action would be to remove any ticks using tweezers or forceps. the other actions
are also appropriate, but the priority is to minimize venom release.
Which interventions will thenurse plan for a comatose patient who will have targeted
temperature management/therapeutic hypothermia? (Select all that apply.)
a. Assist with endotracheal intubation.
b. Insert an indwelling urinary catheter
c. Begin continuous cardiac monitoring.
d. Prepare to give sympathomimetic drugs.
e. Obtain a prescription for patient restraints - correct answer ANS: A, B, C
Cooling can produce dysrhythmias, so the patient's heart rhythm would be continuously
monitored, and dysrhythmias treated if necessary. Bladder catheterization and
endotracheal intubation are needed during cooling. Sympathomimetic drugs tend to
stimulate the heart and increase the risk for fatal dysrhythmias such as ventricular
fibrillation. Patients receiving therapeutic hypothermia are comatose, so restraints are
not indicated.
The emergency department (ED) nurse is starting targeted temperature
management/therapeutic hypothermia in a patient who has been resuscitated after a
cardiac arrest. Which actions in thehypothermia protocol can be delegated to an
experienced licensed practical/vocational nurse (LPN/VN)? (Select all that apply.)
a. Evaluate changes in heart rhythm.
b. Insert a urinary catheter to drainage.
c. Assess neurologic status every 2 hours.
d. Place cooling blankets above and below patient.
e. Attach rectal temperature probe to cooling blanket control panel - correct answer
ANS: B, D, E
Experienced LPN/VNs have the education and scope of practice to implement
hypothermia measures (e.g., cooling blanket, temperature probe) and insert a urinary
catheter under the supervision of a registered nurse (RN). Assessment of neurologic
status and evaluating changes in heart rhythm require RN-level education and scope of
practice.
1. The nurse is doing the primary survey of an adult who was in a motor vehicle
collision. After the nurse determines that the patient has an unobstructed airway, which
action would the nurse take next?
a. Palpate extremities for bilateral pulses.
b. Observe the patient's respiratory effort.
c. Check the patient's level of consciousness.
d. Examine the patient for external bleeding. - correct answer ANS: B
