Emergency Room NCLEX Questions & Answers Already
Graded A+
While assessing a client in the emergency department, the nurse identifies that
the client has been raped. Which health care team member should the nurse
collaborate with when planning this client's care?
a. Emergency medicine physician
b. Case manager
c. Forensic nurse examiner
d. Psychiatric crisis nurse
ANS: C
All other members of the health care team listed may be used in the management of
this client's care. However, the forensic nurse examiner is educated to obtain client
histories and collect evidence dealing with the assault, and can offer the counseling and
follow-up needed when dealing with the victim of an assault.
On admission to the emergency department, a client states that he feels like
killing himself. When planning this client's care, it is most important for the nurse
to coordinate with which member of the health care team?
a. Case manager
b. Forensic nurse examiner
c. Physician
d. Psychiatric crisis nurse
ANS: D
The psychiatric crisis nurse interacts with clients and families in crisis. This health care
team member can offer valuable expertise to the emergency health care team, which
also includes the case manager and the physician.
The emergency department team is performing cardiopulmonary resuscitation on
a client when the client's spouse arrives at the emergency department. What
should the nurse do next?
a. Request that the client's spouse sit in the waiting room.
b. Ask the spouse if he wishes to be present during the resuscitation.
c. Suggest that the spouse begin to pray for the client.
d. Refer the client's spouse to the hospital's crisis team.
ANS: B
If resuscitation efforts are still under way when the family arrives, one or two family
members may be given the opportunity to be present during lifesaving procedures. The
other options do not give the spouse the opportunity to be present for the client or to
begin to have closure.
The emergency department nurse is assigned an older adult client who is
confused and agitated. Which intervention should the nurse include in the client's
plan of care?
a. Administer a sedative medication.
b. Ask a family member to stay with the client.
c. Use restraints to prevent the client from falling.
d. Place the client in a wheelchair at the nurses' station.
, ANS: B
Older adults who are confused are at increased risks for falls. Fall prevention includes
measures such as siderails up, reorientation, call light in reach, and, in some cases,
asking the family member, significant other, or sitter to stay with the client to prevent
falls.
An emergency department nurse is transferring a client to the medical-surgical
unit. What is the most important nursing intervention in this situation?
a. Triage the client to determine the urgency of care.
b. Clearly communicate client data to the unit nurse.
c. Evaluate the need for ongoing medical treatment.
d. Perform a thorough assessment of the client.
ANS: B
The emergency nurse needs to be able to triage, assess, and evaluate. However, these
steps have already been carried out in the early phases of the emergency department
(ED) admission. When a client is ready to be transferred from the ED, communication
with staff nurses from the inpatient units is essential. This report should be a concise but
comprehensive report of the client's ED experience.
The nurse manager is assessing current demographics of the facility's
emergency department (ED) clients. Which population would most likely present
to the ED for treatment of a temperature and a sore throat?
a. Older adults
b. Immunocompromised people
c. Pediatric clients
d. Underinsured people
ANS: D
The ED serves as an important safety net for clients who are ill or injured but lack
access to basic health care. Especially vulnerable populations include the underinsured
and the uninsured, who may have nowhere else to go for health care.
The emergency department (ED) nurse is caring for the following clients. Which
client does the nurse prioritize to see first?
a. 22-year-old with a painful and swollen right wrist
b. 45-year-old reporting chest pain and diaphoresis
c. 60-year-old reporting difficulty swallowing and nausea
d. 81-year-old with a respiratory rate of 28 breaths/min and a temperature of 101°
F
ANS: B
A client experiencing chest pain and diaphoresis would be classified as emergent and
would be triaged immediately to a treatment room in the ED. The other clients are more
stable.
A nurse is triaging clients in the emergency department. Which client complaint
would the triage nurse classify as nonurgent?
a. Chest pain and diaphoresis
b. Decreased breath sounds due to chest trauma
c. Left arm fracture with palpable radial pulses
d. Sore throat and a temperature of 104° F
Graded A+
While assessing a client in the emergency department, the nurse identifies that
the client has been raped. Which health care team member should the nurse
collaborate with when planning this client's care?
a. Emergency medicine physician
b. Case manager
c. Forensic nurse examiner
d. Psychiatric crisis nurse
ANS: C
All other members of the health care team listed may be used in the management of
this client's care. However, the forensic nurse examiner is educated to obtain client
histories and collect evidence dealing with the assault, and can offer the counseling and
follow-up needed when dealing with the victim of an assault.
On admission to the emergency department, a client states that he feels like
killing himself. When planning this client's care, it is most important for the nurse
to coordinate with which member of the health care team?
a. Case manager
b. Forensic nurse examiner
c. Physician
d. Psychiatric crisis nurse
ANS: D
The psychiatric crisis nurse interacts with clients and families in crisis. This health care
team member can offer valuable expertise to the emergency health care team, which
also includes the case manager and the physician.
The emergency department team is performing cardiopulmonary resuscitation on
a client when the client's spouse arrives at the emergency department. What
should the nurse do next?
a. Request that the client's spouse sit in the waiting room.
b. Ask the spouse if he wishes to be present during the resuscitation.
c. Suggest that the spouse begin to pray for the client.
d. Refer the client's spouse to the hospital's crisis team.
ANS: B
If resuscitation efforts are still under way when the family arrives, one or two family
members may be given the opportunity to be present during lifesaving procedures. The
other options do not give the spouse the opportunity to be present for the client or to
begin to have closure.
The emergency department nurse is assigned an older adult client who is
confused and agitated. Which intervention should the nurse include in the client's
plan of care?
a. Administer a sedative medication.
b. Ask a family member to stay with the client.
c. Use restraints to prevent the client from falling.
d. Place the client in a wheelchair at the nurses' station.
, ANS: B
Older adults who are confused are at increased risks for falls. Fall prevention includes
measures such as siderails up, reorientation, call light in reach, and, in some cases,
asking the family member, significant other, or sitter to stay with the client to prevent
falls.
An emergency department nurse is transferring a client to the medical-surgical
unit. What is the most important nursing intervention in this situation?
a. Triage the client to determine the urgency of care.
b. Clearly communicate client data to the unit nurse.
c. Evaluate the need for ongoing medical treatment.
d. Perform a thorough assessment of the client.
ANS: B
The emergency nurse needs to be able to triage, assess, and evaluate. However, these
steps have already been carried out in the early phases of the emergency department
(ED) admission. When a client is ready to be transferred from the ED, communication
with staff nurses from the inpatient units is essential. This report should be a concise but
comprehensive report of the client's ED experience.
The nurse manager is assessing current demographics of the facility's
emergency department (ED) clients. Which population would most likely present
to the ED for treatment of a temperature and a sore throat?
a. Older adults
b. Immunocompromised people
c. Pediatric clients
d. Underinsured people
ANS: D
The ED serves as an important safety net for clients who are ill or injured but lack
access to basic health care. Especially vulnerable populations include the underinsured
and the uninsured, who may have nowhere else to go for health care.
The emergency department (ED) nurse is caring for the following clients. Which
client does the nurse prioritize to see first?
a. 22-year-old with a painful and swollen right wrist
b. 45-year-old reporting chest pain and diaphoresis
c. 60-year-old reporting difficulty swallowing and nausea
d. 81-year-old with a respiratory rate of 28 breaths/min and a temperature of 101°
F
ANS: B
A client experiencing chest pain and diaphoresis would be classified as emergent and
would be triaged immediately to a treatment room in the ED. The other clients are more
stable.
A nurse is triaging clients in the emergency department. Which client complaint
would the triage nurse classify as nonurgent?
a. Chest pain and diaphoresis
b. Decreased breath sounds due to chest trauma
c. Left arm fracture with palpable radial pulses
d. Sore throat and a temperature of 104° F
