Emergency nursing care

PRELIMINARY QUIZ 1

MATCHING TYPE. 10pts

A. absence of fever

B. larger molecules, like gel

C. small molecules, provide immediate fluid resuscitation

D. widening of blood vessels

E. vomiting of blood

F. Bicarbonate

G. narrowing of blood vessel

H. Magnesium Sulfate

I. also known as hives

J. medical term for a heart rate over 100 beats per minute

1. hematemesis 6. tachycardia

ANSWER: E ANSWER: J
2. colloid 7. urticaria

ANSWER: B ANSWER: I
3. apyrexial 8. HCO3

ANSWER: A ANSWER: F
4. vasoconstriction 9. vasodilation

ANSWER: G ANSWER: D
5. crystalloid 10. MgSO4

ANSWER: C ANSWER: H
 EMERGENCY NURSING CARE
PRELIMINARY QUIZ 2

1. Aqueous solutions of mineral salts or other water-soluble molecules. The most commonly used fluid is normal saline, a
solution of sodium chloride.

ANSWER:

2. The occurrence of intestinal blockage in the absence of an actual physical obstruction

ANSWER: PARALYTIC ILEUS

3. A temporary loss of consciousness usually related to insufficient blood flow to the brain.

ANSWER: SYNCOPE

4. Bleeding from the nose

ANSWER: EPISTAXIS

5. Gas in or from the stomach or intestines, produced by swallowing air or by bacterial fermentation

ANSWER: FLATUS

6. A homogeneous noncrystalline substance consisting of large molecules or ultramicroscopic particles of one substance
dispersed through a second substance

ANSWER: COLLOID

7. A condition in which the airways narrow and swell and may produce extra mucus. This can make breathing difficult
and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath

ANSWER: ASTHMA

8. Medicines that are widely used to relieve pain, reduce inflammation, and bring down a high temperature (ACRONYM)

ANSWER: NSAIDS

9. Inflammation of the pancreas

ANSWER: PANCREATITIS

10. Occurs when the appendix becomes inflamed and filled with pus

ANSWER: APPENDICITIS
 EMERGENCY NURSING CARE
PRELIMINARY EXAMINATION

1. When a patient has lost a lot of blood due to ANSWER: STABILIZE THE PATIENT'S LIFE-
hematemesis, the following Intravenous fluids can be THREATENING CONDITION
initiated for fluid resuscitation EXCEPT.
9. What is the priority nursing acre in emergency nursing?
ANSWER: DEXTROSE
ANSWER: AIRWAY
2. Earliest sign of hypovolemic shock is?
10. In conducting a primary survey on a trauma patient,
ANSWER: INCREASE PULSE RATE which of the following is considered one of the priority
elements of the primary survey?
3. The drug of choice in the treatment of anaphylaxis is?
ANSWER: BRIEF NEUROLOGIC ASSESSMENT
ANSWER: EPINEPHRINE
11. Which of the following is the priority care?
4. The healthcare provider is caring for a patient with a
diagnosis of hemorrhagic pancreatitis. The patient's ANSWER: ESTABLISH AIRWAY
central venous pressure (CVP) reading is 2, blood
pressure is 90/50, lung sounds are clear, and jugular 12. An experienced traveling nurse has been assigned to
veins are flat. Which of these actions is most appropriate work in the ED; however, this is the nurse's first week
for the nurse to take? on the job. Which area of the ED is the most appropriate
assignment for the nurse?
ANSWER: INCREASE THE IV INFUSION RATE
ANSWER: AMBULATORY OR FAST TRACK
5. Which type of shock is associated with low blood CLINIC
levels?
13. From the management given below, which should be
ANSWER: HYPOVOLEMIC SHOCK given highest priority?

6. Is a life-threatening problem that affects people with ANSWER: CONTROL BLEEDING

diabetes. It occurs when the body starts breaking down
fat at a rate that is much too fast. 14. A hypersensitive reaction that occurs in seconds S/S
respiratory, itching, edema, decrease in blood pressure,
ANSWER: DIABETIC KETOACIDOSIS (DKA) vasodilation.

7. A 67-year-old patient who has fallen from a ladder is ANSWER: ANAPHYLAXIS

transported to the emergency department by ambulance.
The patient is unconscious on arrival and accompanied 15. One of the Issues of Emergency Nursing Care is when a
by family members. During the primary survey of the patient was brought to ER unconscious with no family
patient, the nurse should. members, the nurse should do which of the following?

ANSWER: OBTAIN A GLASGOW COMA SCALE ANSWER: DOCUMENT STATUS AND NO FAMILY
SCORE. MEMBERS

8. Which of the following is the nurse’ initial job in the

ER?
 EMERGENCY NURSING CARE
MIDTERM QUIZ 1

1. Which of the following is NOT a physical finding 5. Which of the following is NOT a physical finding
criterion to place an adult patient into the MAJOR to place an adult patient into the MAJOR
TRAUMA category? TRAUMA category?

* OPEN SKULL FRACTURE ANSWER: SYSTOLIC BP LESS THAN 80

* GCS LESS THAN 13. 6. Which of the following is NOT a mechanism of

injury criterion that would place an adult patient
* PULSE LESS THAN 50
into the MAJOR TRAUMA category?
* SUSPECTED FLAIL CHEST
ANSWER: FALL GREATER THAN 3 TIMES
ANSWER: ALL OF THE ABOVE ARE THE PATIENT'S HEIGHT
PHYSICAL FINDINGS INDICATIVE OF MAJOR
TRAUMA 7. For a patient showing signs and symptoms of
hypoperfusion, the correct height to lift the foot
2. A patient falling into the Adult Major Trauma end of the backboard is___ inches.
protocol should be transported to the nearest
designated trauma center. However, patients falling ANSWER: 8-12
into this category MUST be transported to the
nearest Emergency department if which of the 8. Which of the following patients is NOT considered
following occurs? high risk according to the major trauma protocol?

* THE PATIENT HAS AN UNMANAGEABLE ANSWER: AGE GREATER THAN 50

AIRWAY. 9. Which of the following is NOT a physical finding
* AN ONLINE MEDICAL CONTROL to place an adult patient into the MAJOR
PHYSICIAN SO DIRECTS TRAUMA category?
ANSWER: Amputation of the thumb
* THE PATIENT IS IN CARDIAC ARREST 10. According to NYS Trauma Protocol, an adult head
injury patient must be hyperventilated at 20
ANSWER: ALL OF THE ABOVE ARE
breaths/minute if the GCS is less than 8, AND
CORRECT.
active seizures or WHICH OF THE FOLLOWING
3. Accidents are: are present ?

ANSWER: PREVENTABLE & COSTLY ANSWER: FIXED OR ASYMMETRIC PUPILS

4. Collision resulting in ___ inches of intrusion into

the passenger compartment is an MOI indicative
of Major Trauma

ANSWER: 12
 EMERGENCY NURSING CARE
MIDTERM QUIZ 2

Match the following and select the correct answer from the given below:

A. TRAUMA team leader

B. AIRWAY provider

C. Examiner 1

D. Examiner 2

E. Trauma Nurse

F. Trauma Scribe

G. Other people in the room

1. Establishing an airway. 8. Person in charge. Takes report.

ANSWER: B ANSWER: A

2. Records events, orders, physical findings

ANSWER: F 9. Position at the head of the bed

3. Position at the foot of the bed ANSWER: B

ANSWER: A 10. Behind the team leader

4. Laboratory technician ANSWER: F

ANSWER: G 11. Trauma EMT

5. Assessing GCS. Performing head exam ANSWER: G

ANSWER: B 12. Obtains first manual BP. Places monitors

6. Patient’s right. Performs fast ultrasound exam ANSWER: E

ANSWER: C 13. Patients left. Assist in exposing the patient

7. Patient’s left. Assist with IV access ANSWER: D

ANSWER: E 14. Performs secondary survey

ANSWER: D ANSWER: C

15. Breathing and circulatory assessment

EMERGENCY NURSING CARE

MIDTERM EXAMINATION

1. A 40-year-old man was standing near a building ANSWER: DOING ONLY WHAT IAM TRAINED
when it exploded. He has multiple injuries TO DO
including a depressed skull fracture, severe burns,
and an impaled object in his abdomen. His head 6. In the United States, the leading cause of death for
injury was most likely caused by people younger than 44 years old is which of the
_______________ blast injuries. following?

ANSWER: TERTIARY ANSWER: VEHICULAR ACCIDENT

2. You’re working as a triage nurse during a disaster 7. Which of the following situations could lead to an
situation. Based on the triage color code tags accident?
placed on each of the wounded, which tag color
represents the wounded who have the highest ANSWER: NOT GETTING A GOOD NIGHT’S
priority of being treated first? REST BEFORE WORK

8. The following are solid organs in the abdomen

ANSWER: RED EXCEPT
3. Severe abrasion injuries can occur when
motorcycle riders are slowed after a collision by ANSWER: STOMACH
road drag. Road drag is most often associated with 9. Whiplash injuries are most common following
which type of motorcycle impact? ___________ impacts

ANSWER: EJECTION ANSWER: REAR-END

4. A catastrophic disaster has occurred 5 miles from 10. Which statement below is INCORRECT about the
the hospital you are working in. The hospital’s yellow triage tag color in regards to a disaster
disaster plan is activated and the wounded are
brought to the hospital. You’re helping triage the ANSWER: A SURVIVOR WITH THIS TAG
survivors. One of the wounded is able to walk COLOR IS SEEN AFTER PATIENTS WITH THE
around and has minor lacerations on the arms, GREEN TAG COLOR.
hands, chest, and legs. You would place what color
tag on this survivor? 11. Safety Signs provide

*INFORMATION ABOUT HAZARDOUS AREAS

ANSWER: GREEN
*CAUTION INFORMATION

*WARNINGS
5. I can help prevent accidents by
ANSWER: ALL OF THE ABOVE 19. While triaging the wounded from a disaster, you
note that one of the wounded is not breathing,
12. Death from a rollover motor vehicle crash is most radial pulse is absent, capillary refill >2 seconds,
often secondary to: and does not respond to your commands. What
color tag is assigned?
ANSWER: EJECTION OF THE PATIENT FROM
THE MOTOR VEHICLE ANSWER: BLACK
13. Kinetic energy is a calculation of 20. The wounded victim is able to walk and obey
commands. The wounded victim is assigned what
ANSWER: SPEED AND FORCE tag color?
14. The wounded victim is unable to walk, respiratory
rate is absent and when airway is repositioned ANSWER: GREEN
breathing is still absent. The wounded victim is 21. Energy of a moving object is which of the
assigned what tag color? following?

ANSWER: BLACK ANSWER: KINETIC ENERGY

15. For the next 7 questions, use the START method for 22. A young male experienced severe blunt chest
adults to help triage the wounded that have been
trauma when his passenger car struck another
involved in a disaster situation. Each question will give
vehicle head-on. During your inspection of the
you details on what you have assessed and you will need
to use those details to help you assign a color tag to the
interior of his vehicle you would most likely find
individual: The wounded victim is unable to walk, has
respiratory rate of 40, capillary refill is 6 seconds, and ANSWER: STEERING WHEEL DEFORMITY
can’t follow simple commands. The wounded victim is
23. A nurse is field-triaging clients after an industrial
assigned what tag color?
accident. Which client condition should the nurse
triage with a red tag?
ANSWER: RED

16. The wounded victim is unable to walk, respiratory ANSWER: MULTIPLE FRACTURED RIBS AND
rate is absent but when airway is repositioned SHORTNESS OF BREATH
breathing is noted. The wounded victim is assigned
24. Most accidents are caused by
what tag color?
ANSWER: PEOPLE
ANSWER: RED
25. The wounded victim is unable to walk, has
17. The wounded victim is unable to walk, has
respiratory rate of 19, capillary refill of one
respiratory rate of 12, capillary refill is 8 seconds,
second, and is able to obey your commands. The
and is unresponsive. The wounded victim is
wounded victim is assigned what tag color?
assigned what tag color?
ANSWER: YELLOW
ANSWER: RED

18. A nurse triages clients arriving at the hospital after

a mass casualty. Which clients are correctly
classified?

ANSWER: A 35 YEAR OLD FEMALE WITH

SEVERE CHEST PAIN:RED TAG
 Emergency nursing care
PRE-FINAL QUIZ 1

1. The following are the three methods of transfer EXCEPT?

ANSWER: LOG ROLL

2. A mild reduction in the oxygen supply to the brain that occurs with changes in body position and may cause them to
feel light headed or faint when rising suddenly is termed as

ANSWER: ORTHOSTATIC HYPOTENSION

3. The person transporting the patient is responsible for ensuring the following EXCEPT?

ANSWER: THAT THE PATIENT IS UNSTABLE DURING THE TRANSPORT

4. What is a gait belt used for?

ANSWER: TRANSFER BELT THAT SHOULD VE USED WHEN ASSISSTING PATIENTS WHO ARE
WEAK OR UNSTEADY

5. A common cause of falls and accidents

ANSWER: WHEELCHAIR TRANSFER

6. The following are the 4 steps in wheelchair transfer. Which should be done first?

ANSWER: LOWERING THE BED TO THE LEVEL OF THE WHEEL CHAIR SEAT AND ELEVATING THE
HEAD OF THE BED

7. What should you do with a person who has had a stroke?

ANSWER:

8. Who should not be transferred by a wheelchair, but a stretcher transfer?

ANSWER: PATIENTS WHO CANNOT STAND OR WALK SINCE AN ACCIDENT, SURGERY,

STROKE OR HEART ATTACK.

9. When patients are moved from one place to another in the hospital, wheeled transport is _________ :

ANSWER: REQUIRED

10. How are active infants and toddlers often transported?

ANSWER: IN THEIR CRIBS
 EMERGENCY NURSING CARE
PRE-FINAL QUIZ 2

ASSAULT TRUE

- Unlawfully placing a person in fear of - The patient has the right to refuse treatment.
immediate bodily harm.
GOOD SAMARITAN LAW
SCOPE OF PRACTICE
- Law enacted in 1959 to protect from liability
- Actions and care that EMTs are legally "persons licensed who in good faith render
allowed to perform by the state in which they emergency care at the scene of an emergency
provide emergency medical care for civil damages as a result of any acts or
omissions.
BATTERY
IMPLIED CONSENT
- Unlawfully touching a person example,
providing treatment without consent. - Instructions written in advance which specifies
treatment should the patient become
DO NO HARM unconscious or unable to make decisions.
- A basic principle of emergency care is which Answer
of the following?
CONSENT
FALSE - Permission to render care
- A DNR or “do not resuscitate” order means “
FALSE
do not treat
- The nurse can also determine the cause of
APPLIED RESEARCH death.
- The purpose of this research is to find an
COMPETENT
immediate solution to an existing problem
- Refers to the right of the patient to make
INVOLUNTARY CONSENT decisions about his or her health
- This type of consent applies to patient who are
IMPLIED CONSENT
mentally ill, in behavioral crisis or
developmentally delayed Answer - This type of consent applies to patient who are
unconscious or incapable of making an
EXPRESSED CONSENT informed decision Answer
- This type of research is performed without
specific purpose in mind
 EMERGENCY NURSING CARE
PRE-FINAL EXAMINATION
ANSWER: B

MATCHING TYPE: 6pts

A. NON-URGENT MOVE 1. When preparing for a transfer, what is the first

B. BODY MECHANICS thing that must be done?

C. CRITICAL CARE TRANSPORT ANSWER: CHECK THE NURSING SERVICE

AND OBTAIN THE CHART
D. SLIDER BOARD

E. URGENT MOVE
2. When checking the patient's chart what must be
verified first?
F. CRITICAL CARE PATIENT
ANSWER: CORRECT PATIENT
 The transport of a patient from an emergency
department, critical care unit, or incident scene during 3. The following are preparation for transport within
which the patient receives the same level of care as was a facility EXCEPT:
provided in the hospital or originating facility.
A. IS THE PATIENT STABLE ENOUGH FOR
ANSWER: C TRANSPORT
 A strong sheet of smooth plastic large enough to support
B. DO YOU HAVE AN ADEQUATE O2
the patients body with handholds cut into the edges
SUPPLY
ANSWER: D C. EQUIPMENT (MASK, AMBU BAG 10CC
 Patient move that can be made if speed is not priority SYRINGE)

ANSWER: NONE OF THE ABOVE

ANSWER: A

 Any patient who experiences an actual or potential life-

4. If the patient is on the floor or ground and the
threatening illness or injury that requires continual EMT-B has decided that an emergency move is
monitoring and care by a specially trained physician, appropriate, the patient can be moved by
registered nurse, or paramedic.
ANSWER: PULLING ON HIS/HER CLOTHING
ANSWER: F IN THE NECK AND SHOULDER AREA.

 Patient move that should be done quickly yet without 5. Oxygen tank should be checked prior to
any compromise of spinal integrity transportation and make sure that it is

ANSWER: E ANSWER: FULL

 Proper use of the body to facilitate lifting and moving 6. If the patient has fracture of the lower extremity
and to prevent injury what should the nurse do?
ANSWER: DO NOT CAUSE FURTHER ANSWER: BED PAN OR URINAL
INJURIES, STABILIZE FRACTURE AREA
17. What can be used to assist a patient to stand or
7. Position the wheelchair ______ to the patient's bed walk if they cant walk by themselves?

ANSWER: PARALLEL ANSWER: GAIT BELT

8. When lifting a patient you should do all of the 18. Make sure hands of patient are ______during
following EXEPT: transportation

ANSWER: TWIST WHILE YOU LIFT THE ANSWER: INSIDE THE SAFETY RAILS
PATIENT.
19. To assure your own safety when lifting a patient, it
9. When doing a log roll, lean from your hips and is important to

ANSWER: USE YOUR SHOULDER MUSCLES ANSWER: USE YOUR LEGS, NOT YOUR
TO HELP WITH THE ROLL. BACK, TO LIFT.

10. The direct ground lift is an example of aNo ______ 20. Where should the patient's belongings be placed
move for a patient who has no spine injury. during a transfer?

ANSWER: NON-URGENT ANSWER: UNDER THE GURNEY OR BEHIND

WHEELCHAIR
11. With wheels of the wheelchair _____ and footrest
out of the way 21. For patients with spinal trauma or surgery, the
nurse should
ANSWER: LOCKED
ANSWER: ALWAYS PROTECT THE NECK
12. To avoid trauma to a patient with an injured spine,
the best patient-carrying device would be the 22. What are the first and second steps when
transferring a patient with IV or bags attached to
ANSWER: LONG SPINE BOARD. them?
13. Safety side rails are required to be in a up and
ANSWER: BE AWARE OF WHAT YOU ARE
locked position EXCEPT when:
DEALING WITH AND MAKE SURE YOU KEEP
THEM ATTACHED TO THE PATIENT
ANSWER: WHEN PATIENTS ARE
AMBULATORY, CONSCIOUS AND COHERENT 23. What are premature infants transferred in?
14. If the patient had a stroke, where should the nurse
ANSWER: CLOSED INCUBATOR
stand?
24. If you are carrying a patient down stairs, when
ANSWER: STAND ON PATIENT'S WEAK SIDE possible
15. What are infants and toddlers typically transported
ANSWER: USE A STAIR CHAIR INSTEAD OF
in?
A STRETCHER.
ANSWER: CRIBS

16. Examples of things that might have to be

transported with the patient, which is not
necessary?
 EMERGENCY NURSING CARE
FINAL QUIZ 1

IDENTIFY THE PARTS OF THE HEART WHERE BLOOD FLOWS – FROM OXYGEN-POOR BLOOD TO
OXYGEN-RICH BLOOD.

ANSWER

1. INFERIOR VENA CAVA

2. SUPERIOR VENA CAVA
3. RIGHT ATRIUM
4. RIGHT VENTRICLE
5. PULMONARY ARTERIES
6. LUNGS
7. PULMONARY VEINS
8. LEFT ATRIUM
9. LEFT VENTRICLE
10. AORTA
 EMERGENCY NURSING CARE
FINAL QUIZ 2

ARRHYTHMIA ANSWER ?

- A problem with the rate or rhythm of the heartbeat - Corresponds to contraction of myocardial muscle
and is represented by the QRS complex on the
TACHYCARDIA ECG.
- When a heart beats too fast, the condition is called
REPOLARIZATION

BRADYCARDIA - The return of the ions to their previous resting

state, which corresponds with relaxation of the
- When a heart beats too slowly, the condition is
myocardial muscle and is represented by the T
called
wave on the ECG.
PULMONARY CIRCULATION
TRUE
- The term referring to circulation of blood between
- When we sleep our body has a naturally low heart
the heart and the lungs
rate because of reduced automaticity mechanism.
SYSTEMIC CIRCULATION
FALSE
- The term referring to circulation of blood between
- The right atrium receives oxygenated blood from
the heart and body tissues
the superior and inferior vena cava, and from the
coronary veins.
SINOATRIAL NODE

- A specialized myocardial structure that initiates the TRUE

electrical impulses to stimulate contraction
- The left atrium receives the now oxygen-rich blood
(dominant pacemaker).
from the lungs and pumps it into the left ventricle.
ATRIOVENTRICULAR NODE
FALSE
- Primarily an electrical gatekeeper between the atria
- The parasympathetic nervous system prepares your
and ventricles and introduces a delay (slow action
body for physical and mental activity. It makes
potential) between atrial and ventricular excitation,
your heart beat faster and stronger, opens your
allowing for efficient ventricular filling.
airways so you can breathe more easily, and
inhibits digestion.
ANSWER: ?

- After electrical impulse is sent from the (SA) node FALSE

to the (AV) node, this specialized conducting
tissue generates a fast action potential.
- Dyspnea is often the presenting symptom of Acute
Coronary Syndromes (ACSs).
 EMERGENCY NURSING CARE
FINAL EXAMINATION

1. Released into the bloodstream 6 hours after

damage to heart. Can stay in blood stream 1-2
9. sometimes called lockjaw, is a painful
weeks after
condition in which the chewing muscles of the
ANSWER: MYOSIN
jaw become contracted and sometimes
inflamed,
2. More cardiac specific, seen in blood 3-4 hours preventing the mouth from fully opening.
after onset of chest pain.
ANSWER: TRISMUS
ANSWER: CRETININE KINASE (CK-MB)
10. The following are the appropriate management
3. Which of the following diagnosis is related to for epistaxis EXCEPT:
compromised oxygen transport system.
ANSWER: TILT THE HEAD BACKWARD WHILE PINCHING
ANSWER: ACTIVITY INTOLERANCE THE NOSE

4. The diagnosis of anxiety is related to the 11. A 3 year old has a bug lodged in his ear. He is
following factors EXCEPT: screaming and combative. What can you do to
help?
ANSWER: DECREASED CARDIAC OUTPUT
ANSWER: THE FIRST PRIORITY IS TO KILL THE INSECT
5. Infection of the middle ear
12. Rapidly progressive swelling of the floor of
ANSWER: OTITIS MEDIA
the mouth.
6. Region in the anteroinferior part of the nasal
ANSWER: LUDWIGS ANGINA
septum where 4 arteries that supply the nose
anastamose. 13. Oxygen delivery method characterized as a
LOW FLOW DEVICE, add humidity at above
ANSWER: KIESSELBACH'S AREA
4 LPM , Flow Rate of 1-6 lpm , range of 24 -
7. Defined as ear pain 45%

ANSWER: OTALGIA Use for COPD / Hypoxic drive

8. the medical term for swallowing difficulties ANSWER: NASAL CANNULA

ANSWER: DYSPHAGIA 14. has two gaskets left in the partial rebreather to
create a high flow device, is used at a flow rate
of 10, delivering 21% - 100% Fi02, is used in
case of emergency to deliver 100% oxygen
ANSWER: NON-REBREATHER

15. What would the nurse monitor for before

applying oxygen to a COPD patient?

ANSWER: RESPIRATIONS

16. Which patient should be the nurse's first

priority?

ANSWER: A PATIENT WHOSE AIRWAY IS OBSTRUCTED

BY MUCOUS

17. Oxygen should be applied at any point if the

oxygen saturation falls below normal.

ANSWER: TRUE

18. A pt presents to the ER with difficulty

breathing, SOB, chest pain, fatigue and
dizziness. Upon checking the vital signs the
nurse notices that the patient's SPO2 level is
89%. What is the next thing the nurse will do?

ANSWER: APPLY OXYGEN VIA NASAL CANNULA @

2L/MIN

19. The following are safety precautions when

caring for a client who is using oxygen. Which
is not a safety precaution in oxygen therapy?

ANSWER: SIDE RAILS UP

20. Which of the following is not a risk category

for a health care agency?

ANSWER: NONE OF THE AVOVE

 FIRE SAFETY
 HOSPITAL SAFETY
 PATIENT SAFETY