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The major physiologic insult which occurs in a near drowning victim is which of the following?
a. hypothermia
b. pneumonia
c. dysrhythmia
d. hypoxemia Correct Answer: Hypoxemia
rationale: The central clinical event in all near drowning victims is hypoxia caused by laryngospasm
and asphyxia.
A 40 yr old male involved in a house fire presents to the emergency department with dyspnea, sooty
sputum, and a brassy cough. He is conscious, and 100% oxygen via non-rebreather reservoir mask
is being administered. The priority nursing diagnosis for this patient is?
a. fluid volume deficit
b. impaired gas exchange
c. airway clearance ineffective
d. pain Correct Answer: Airway clearance ineffective
Rationale: Potential for edema and obstruction of the airway. If the airway is not patent, you will be
unable to ventilate and oxygenate the patient.
Management of an orbital blowout fracture includes:
a. pressure eye patch
b. anterior nasal packing for orbital support
c. topical anesthetic
d. Delayed surgical intervention Correct Answer: delayed surgical intervention
rationale: delayed until swelling subsides
A 24 yr old male sustains a high pressure injection injury to his hand from an industrail pain gun
sprayer. THe index finger is discolored and swollen with decreased mobility and numbness distally.
The patient complains of pain throughout the hand and numbness to the first fingertip with decreased
mobility. Priority treatment of the affected hand includes:
a. icing and elevating the extremity
b. soaking the hand in warm saline
c. asking physician to perform a digital block on injured finger
d. Preparing the patient for surgical debridement with possible fasciotomy Correct Answer: Preparing
the patient for debridement with possible fasciotomy
rationale: Immediate treatment to relieve pressure within th edigit is key with an injection injury.
Tissue ischemia and necrosis progress rapidly with swelling and decreased circulation.
A four yr old girl has a 2 day history of a rash. The rash is pruritic was first noted on the neck and has
now spread to the chest and back. THe neck lesions are crusted over, but the chest lesions are tiny
vescicles on a pink base. According to the father, the child is somewhat less active, but had no