Chapter 11: Care of Patients with Common Environmental Emergencies

Chapter 11: Care of Patients with Common Environmental Emergencies

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. While the nurse is visiting the community pool, an adult swimmer is pulled out of the pool, unconscious and cyanotic. What is the priority action of the nurse?

a.	Begin chest compressions.
b.	Move from the pool area.
c.	Give two rescue breaths.
d.	Check for a carotid pulse.

 

 

ANS:  C

The highest priority is to maintain ventilatory support until the victim can breathe on his or her own. The other options are important, but maintaining the airway and breathing are always priority.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Medical Emergencies) MSC:           Integrated Process: Nursing Process (Implementation)

 

2. The nurse working at a first aid booth during a summer marathon sees several runners. Which runner should be seen first? A runner who:

a.	Has fallen several times
b.	Is fatigued
c.	Thinks he has the flu
d.	Has tachypnea

 

 

ANS:  A

Hot, dry skin, tachycardia, tachypnea, and hypotension are signs of heat stroke. A marathon runner who has fallen several times may have a thermal injury to the brain, causing loss of coordination. Mental status changes from thermal injury to the brain include confusion, bizarre behavior, seizures, and even coma. The nurse should prioritize the client with potential thermal brain injury over the other clients.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Medical Emergencies) MSC:           Integrated Process: Nursing Process (Planning)

 

3. The nurse is working at a first aid booth for a spring training game on a hot day. A spectator comes in, reporting that he is not feeling well. Vital signs are temperature 104.1° F (40.1° C), pulse 132 beats/min, respirations 26 breaths/min, and blood pressure 106/66 mm Hg. He trips over his feet as the nurse leads him to a cot. What is the priority action of the nurse?

a.	Encourage drinking of cool water or sports drinks.
b.	Sponge the victim with cool water and remove his shirt.
c.	Administer Tylenol (acetaminophen), 650 mg orally.
d.	Encourage rest, and reassess in 15 minutes.

 

 

ANS:  B

The spectator shows signs of heat stroke, which is a medical emergency. The spectator should be transported to the emergency department as quickly as possible. The nurse should take actions to lower his body temperature in the meantime by removing his shirt and sponging his body with cool water. Lowering body temperature by drinking cool fluids or taking acetaminophen is not as effective in an emergency situation. The client needs to be cooled quickly and is a priority for treatment.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Medical Emergencies) MSC:           Integrated Process: Nursing Process (Implementation)

 

4. The emergency department nurse assesses a client in extreme pain with an apparent snakebite of the leg. Vital signs are stable. What is the priority action of the nurse?

a.	Call the regional poison control center.
b.	Administer IV pain medication.
c.	Place a tourniquet around the leg.
d.	Apply an immobilization splint.

 

 

ANS:  D

Treatment involves immobilization to minimize the spread of venom. A tourniquet should not be used because it impairs arterial blood flow. Pain medication should be administered and collaboration with the regional poison control center begun after the leg is immobilized.

 

DIF:    Cognitive Level: Application/Applying or higher               REF:   N/A

TOP:   Client Needs Category: Physiological Integrity (Physiological Adaptation—Medical Emergencies) MSC:           Integrated Process: Nursing Process (Implementation)