PROPHECY EMERGENCY DEPARTMENT RN A TEST QUESTIONS AND ANSWERS GRADED A+.

What is the proper procedure for testing visual acuity? Correct ans - *BOTH WRONG* 1) Test the affected eye first, then the unaffected eye without corrective lenses 2) Test the unaffected eye first, then the affected 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? Correct ans - *BOTH WRONG* 1) Oral hydrocodone 2) Intravenous acetaminophen TPA would be contraindicated for which of the following patients? Correct ans - 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? Correct ans - *BOTH WRONG* 1) Administer pain medication and fluids as ordered 2) Prepare for a pelvic exam and assess for vaginal bleeding 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: Correct ans - *BOTH WRONG* 1) Removal of the shunt 2) Draining the shunt This study source was downloaded by from CourseH on :10:34 GMT -05:00 When caring for a patient who has received a massive blood transfusion, monitoring which of the following lab results is a top priority? Correct ans - *BOTH WRONG* 1) B-type natriuretic peptide 2) Hematocrit count What medication would you anticipate administering to a six month old having an active tonic-clonic seizure? Correct ans - *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? Correct ans - 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? Correct ans - 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? Correct ans - 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? Correct ans - 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? Correct ans - Place on high-flow non-rebreather 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. This study source was downloaded by from CourseH on :10:34 GMT -05:00 What is the immediate nursing intervention for this patient? Correct ans - Place patient in left tilt position A 36 year old male presents to the ED with an amputated hand. What should you do FIRST? Correct ans - Apply direct pressure to extremity Of the following patients, which one needs referral to the closest burn center? Correct ans - Partial-thickness and full-thickness burns involving the genitalia or perineum What are three signs of cardiac tamponade? Correct ans - Hypertension, 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 Correct ans - 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? Correct ans - Insert urinary catheter Which of the following would be a primary complication of a bowel obstruction? Correct ans - 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? Correct ans - Methylprednisolone 1 g IV daily Which of the following elevated lab values supportsthe diagnosis of congestive heart failure (CHF)? Correct ans - BNP A patient presents with blurry vision, seeing floaters and flashes of light. These are symptoms of Correct ans - Retinal Detachement 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? Correct ans - Hypotension Your patient has presented to the emergency department with pneumonia. You also note an allergy to penicillin. Which of the followingmedications This study source was downloaded by from CourseH on :10:34 GMT -05:00 would you question if ordered by the physician? Correct ans - 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 followingmedication orders should you question if ordered by the provider? Correct ans - 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? Correct ans - 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? Correct ans - Disseminated gonorrhea Which of the following would be the FIRST fluid of choice for a patient in hypovolemic shock secondary to hemorrhaging? Correct ans - PRBCs RhoGAM would be administered to a pregnant patient for which of the following reasons Correct ans - 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? Correct ans - 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,RR12, 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? Correct ans - 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 This study source was downloaded by from CourseH on :10:34 GMT -05:00 open book pelvic fracture. What immediate intervention should you expect? Correct ans - Pelvic sheeting or placement of a commercial pelvic binder A nurse is at end of their shift and has been dealing with a difficult and unruly patient. The nurse threatens to place the patient in restraints without justification. Thisis an example of: Correct ans - Assault Your patient is an 84-year-old man who presents to the ED with increasing forgetfulness, restlessness, and anxiety, which has become progressively worse over the past 2 months. The patient feels well and is independent with his ADLs but will forget where he placed things. The head CT, labs and ECG are all normal. The diagnosis is likely dementia. Which of the following is correct about dementia? Correct ans - There is progressive deterioration in cognition and/or behavior without altered consciousness Which of the following fractures is highly associated with child abuse? Correct ans - Spiral leg fracture of the tibia in an 8 month old You enter a patient's roomand notice the chest tube has become dislodged from the patient's chest and is hanging off the bed. The primary intervention is to: Correct ans - Cover the chest tube site with 4x4 dressing and taping only 3 sides of the dressing An 18 year old female presents to ED unresponsive via private car. Her friends state that she has overdosed on hydrocodone.BP- 80/40, HR- 58, RR8, O2 sat 86% on room air. You expect an order for which of the following medications? Correct ans - Naltrexone (Narcan) A patient with a tension pnuemothorax should have a needle decompression catheter placed Correct ans - IN the 2nd intercostal space, midclavicular line