End Term Nursing Exam – Emergency, Trauma
& Disaster | High-Yield Questions A+ Graded
Answers
Patients at risk for airway compromise - ✔✔•Saliva, bloody secretions, vomitus, laryngeal
trauma, dentures, facial trauma, fractures, and the tongue can obstruct the airway.
•Patients at risk for airway compromise include those who have seizures, near-drowning,
anaphylaxis, foreign body obstruction, or cardiopulmonary arrest.
Maintain airway - ✔✔•least to most invasive method
-Open airway
-Suction and/or remove foreign body
-Insert nasopharyngeal/oropharyngeal airway
-Provide endotracheal intubation
•If unable to intubate because of airway obstruction, an emergency cricothyroidotomy or
tracheotomy is performed.
Primary Survey: breathing - ✔✔-Assess work of breathing
•Rate
•Depth
•Effort
•Equal rise and fall
-Assess for dyspnea, cyanosis paradoxical/asymmetric chest wall movement,
decreased/absent breath sounds, retractions
•Many conditions, including fractured ribs, pneumothorax, penetrating injury, allergic
reactions, pulmonary emboli, and asthma attacks, cause breathing alterations.
•Breathing - Emergency Actions - ✔✔•Life-threatening conditions, such as tension
pneumothorax and flail chest, can severely and quickly compromise ventilation.
, -Administer O2
-Bag-valve-mask (BVM) ventilation with 100% O2 and intubation for life-threatening
conditions
-Monitor patient response
Primary Survey• Circulation - ✔✔-Skins signs
-Pulses
•Check central pulse (peripheral pulses may be absent because of injury or vasoconstriction).
-Capillary refill
•If a pulse is felt, assess the quality and rate. Assess the skin for color, temperature, and
moisture. Altered mental status and delayed capillary refill (longer than 3 seconds) are the
most significant signs of shock. Take care when evaluating capillary refill in cold environments
because cold delays refill.
•Circulation - Emergency Actions - ✔✔-Chest compressions
-IV/IO access - large bore if volume concerns
-Initiate aggressive fluid resuscitation using normal saline or lactated Ringer's solution if
indicated
•Insert intravenous (IV) lines into veins in the upper extremities unless contraindicated, such
as in a massive fracture or an injury that affects limb circulation.
•Apply direct pressure to any obvious bleeding sites with a sterile dressing.
•Obtain blood samples for typing to determine ABO and Rh group.
Primary Survey: Disability - ✔✔•measured by patient's level of consciousness
-AVPU
•A = alert
•V = responsive to voice
•P = responsive to pain
& Disaster | High-Yield Questions A+ Graded
Answers
Patients at risk for airway compromise - ✔✔•Saliva, bloody secretions, vomitus, laryngeal
trauma, dentures, facial trauma, fractures, and the tongue can obstruct the airway.
•Patients at risk for airway compromise include those who have seizures, near-drowning,
anaphylaxis, foreign body obstruction, or cardiopulmonary arrest.
Maintain airway - ✔✔•least to most invasive method
-Open airway
-Suction and/or remove foreign body
-Insert nasopharyngeal/oropharyngeal airway
-Provide endotracheal intubation
•If unable to intubate because of airway obstruction, an emergency cricothyroidotomy or
tracheotomy is performed.
Primary Survey: breathing - ✔✔-Assess work of breathing
•Rate
•Depth
•Effort
•Equal rise and fall
-Assess for dyspnea, cyanosis paradoxical/asymmetric chest wall movement,
decreased/absent breath sounds, retractions
•Many conditions, including fractured ribs, pneumothorax, penetrating injury, allergic
reactions, pulmonary emboli, and asthma attacks, cause breathing alterations.
•Breathing - Emergency Actions - ✔✔•Life-threatening conditions, such as tension
pneumothorax and flail chest, can severely and quickly compromise ventilation.
, -Administer O2
-Bag-valve-mask (BVM) ventilation with 100% O2 and intubation for life-threatening
conditions
-Monitor patient response
Primary Survey• Circulation - ✔✔-Skins signs
-Pulses
•Check central pulse (peripheral pulses may be absent because of injury or vasoconstriction).
-Capillary refill
•If a pulse is felt, assess the quality and rate. Assess the skin for color, temperature, and
moisture. Altered mental status and delayed capillary refill (longer than 3 seconds) are the
most significant signs of shock. Take care when evaluating capillary refill in cold environments
because cold delays refill.
•Circulation - Emergency Actions - ✔✔-Chest compressions
-IV/IO access - large bore if volume concerns
-Initiate aggressive fluid resuscitation using normal saline or lactated Ringer's solution if
indicated
•Insert intravenous (IV) lines into veins in the upper extremities unless contraindicated, such
as in a massive fracture or an injury that affects limb circulation.
•Apply direct pressure to any obvious bleeding sites with a sterile dressing.
•Obtain blood samples for typing to determine ABO and Rh group.
Primary Survey: Disability - ✔✔•measured by patient's level of consciousness
-AVPU
•A = alert
•V = responsive to voice
•P = responsive to pain
