EMERGENCY DEPARTMENT RN A Test (answered Summer 2022) all answered correct!

What is the proper procedure for testing visual acuity? 2) Test the affected eye first, then the unaffected eye with corrective lenses when available A 22-year-old man with sickle cell disease is brought into the ED by Campus Police from his local university. He is complaining of increasing pain to his bilateral lower extremities, consistent with his past sickle cell pain crisis. Which intervention would you expect the provider to order? oral hydrocodone. TPA would be contraindicated for which of the following patients? WRONG 1) 67 year old with symptom onset 3 hours ago A 24 year old female, who has recently received methotrexate for a tubal pregnancy, presents to the ED with severe abdominal pain. What would be the PRIORITY nursing intervention? Prepare for OR A 3 year old boy with a history of hydrocephalus with a cerebral shunt arrives to the ED with a fever of 102.0°F, an enlarged abdomen, tachycardia and hypotension. The patient is mildly lethargic, however is cooperative with the ED staff. Immediate treatment for this child should include: BOTH WRONG 1) Removal of the shunt 2) Draining the shunt When caring for a patient who has received a massive blood transfusion, monitoring which of the following lab results is a top priority? ionized calcium level. What medication would you anticipate administering to a six month old having an active tonic-clonic seizure? BOTH WRONG 1) Phenobarbital 2)Phenytoin Patient presents to the ED with a snake bite that occurred 30 minutes ago. The snake was identified as a poisonous rattlesnake. What medication would you expect the physician to order for this patient? CroFab Crotalidae Polyvalent Immune Fab (Ovine) A 26 year old male with a history of asthma presents to the ED with dyspnea, audible expiratory wheezes, substernal retractions, accessory muscle use, with BP-145/72, HR -26, RR-32, O2 Sat 88% on room air. What is the FIRST treatment of choice for this patient? Give albuterol and atrovent nebulizer with oxygen A 40-year-old man presents to the ED with shortness of breath and a headache, after being sprayed by pesticides while working on a farm. What is the FIRST nursing intervention? Decontaminate the patient according to hospital procedure Four patients are being transported to the ED after a severe collision between a train and two motor vehicles. Which of the following patients should be triaged for FIRST treatment? 26-year-old with respiratory distress and open chest wound A 53 year old female with a history of sarcoidosis presents to the ED after being rescued by firefighters from her burning apartment. She is currently alert and oriented, BP-115/78, HR-110, RR- 24, T-100.4 F, oxygen saturation 97% on room air. She is currently only complaining of a headache and her carboxyhemoglobin is 13%. What is the MOST appropriate nursing intervention? Place on high-flow non-rebreather Upgrade to remove ads Only $35.99/year A 28 year old, obsterical patient presents at 38 weeks gestation status post motor vehicle collision. Upon arrival via EMS, you note she is on a backboard and c-collar is in place. What is the immediate nursing intervention for this patient? Place patient in left tilt position A 36 year old male presents to the ED with an amputated hand. What should you do FIRST? Apply direct pressure to extremity Of the following patients, which one needs referral to the closest burn center? Partial-thickness and full-thickness burns involving the genitalia or perineum What are three signs of cardiac tamponade? Hypotension, bradycardia, muffled heart sounds An 11-year-old female is brought to the emergency department with complaints of excessive sleeping, headache, sore throat and swollen neck glands. The patient has no complaints of pain. On exam, you note a pink rash on her torso. Her mother states that her appetite has decreased over the last week. What is the most likely diagnosis Mononucleosis An 88 year old male transferred to the ED from a nursing home with a chief complaint of being unable to void for the past 12 hours. He has a history of prostate cancer. Which of the following nursing interventions should be performed FIRST? Insert urinary catheter Which of the following would be a primary complication of a bowel obstruction? Dehydration A 32-year-old woman recently diagnosed with multiple sclerosis presents to the ED with several days of upper respiratory infection and now progressively weakened lower extremities, and vertigo. What is the FIRST line of treatment for this patient? Methylprednisolone 1 g IV daily Which of the following elevated lab values supports the diagnosis of congestive heart failure (CHF)? BNP A patient presents with blurry vision, seeing floaters and flashes of light. These are symptoms of Retinal Detachement Upgrade to remove ads Only $35.99/year A 53-year-old female with a history of Addison's disease due to an autoimmune disorder presents with fatigue, generalized weakness, nausea, vomiting, and abdominal pain. Which of the following is consistent with an adrenal crisis? Hypotension Your patient has presented to the emergency department with pneumonia. You also note an allergy to penicillin. Which of the following medications would you question if ordered by the physician? Ceftriaxone A 55-year-old man presents with left-sided chest pain that began 30 minutes ago during sexual intercourse. The pain radiates to his left shoulder. Upon initial history intake you learn that he has taken a phosphodiesterase inhibitor (Viagra) for erectile dysfunction. His ECG is concerning for STEMI. Which of the following medication orders should you question if ordered by the provider? Nitroglycerin A 26-year-old woman presents with severe eye pain, photophobia, and the sensation of sand in her right eye. She is a contact lens wearer and states that she frequently leaves them in overnight. Which of the following is indicated for this patient? Slit lamp exam using fluorescein staining A 28-year old male patient presents with severe dysuria and white, foul smelling drainage from his penis. The symptoms have lasted about one month and have become progressively worse over the last few days. On exam, the patient is noted to have a petechial rash to his bilateral upper extremities. The patient's signs and symptoms are consistent with which of the following? Disseminated gonorrhea Which of the following would be the FIRST fluid of choice for a patient in hypovolemic shock secondary to hemorrhaging? PRBCs RhoGAM would be administered to a pregnant patient for which of the following reasons To prevent an RH- negative mother from forming antibodies to RH- positive fetal blood A pediatric patient was brought in by EMS for seizure activity. The patient is post ictal on arrival. During assessment, the patient begins to have convulsions with body stiffening, jerking motions of legs and arms, loss of consciousness and loss of bladder control. What is your PRIORITY nursing intervention? Lay patient on side to avoid injury and protect airway A 54 yr old male with a history of non-insulin dependent diabetes, presents to the ED with new onset of confusion, weakness, lethargy and nausea with frequent large volume urine output. Vital signs are BP-102/54, HR-115, RR-12, T- 97.4 and oxygen saturation is 97% on room air. Blood glucose is 725 mg/dl. pH is 7.40. What diagnosis would you expect to see for this patient? Hyperosmolar hyperglycemic state Your patient arrives hypotensive and tachycardic after a motorcycle collision. His pelvis is unstable upon palpation and a portable pelvic film reveals an open book pelvic fracture. What immediate intervention should you expect? Pelvic sheeting or placement of a commercial pelvic binder