Chapter 68: Emergency and Disaster Nursing

Chapter 68: Emergency and Disaster Nursing

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. During the primary assessment of a victim of a motor vehicle collision, the nurse determines that the patient has an unobstructed airway. Which action should the nurse take next?

a.	Palpate extremities for bilateral pulses.
b.	Observe the patient’s respiratory effort.
c.	Check the patient’s level of consciousness.
d.	Examine the patient for any external bleeding.

 

 

ANS:  B

Even with a patent airway, patients can have other problems that compromise ventilation, so the next action is to assess the patient’s breathing. The other actions are also part of the initial survey but assessment of breathing should be done immediately after assessing for airway patency.

 

DIF:    Cognitive Level: Apply (application)           REF:               1630

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

2. During the primary survey of a patient with severe leg trauma, the nurse observes that the patient’s left pedal and posterior tibial pulses are absent and the entire leg is swollen. Which action will the nurse take next?

a.	Send blood to the lab for a complete blood count.
b.	Assess further for a cause of the decreased circulation.
c.	Finish the airway, breathing, circulation, disability survey.
d.	Start normal saline fluid infusion with a large-bore IV line.

 

 

ANS:  D

The assessment data indicate that the patient may have arterial trauma and hemorrhage. When a possibly life-threatening injury is found during the primary survey, the nurse should immediately start interventions before proceeding with the survey. Although a complete blood count is indicated, administration of IV fluids should be started first. Completion of the primary survey and further assessment should be completed after the IV fluids are initiated.

 

DIF:    Cognitive Level: Analyze (analysis)                                  REF:   1630

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Physiological Integrity

 

3. After the return of spontaneous circulation following the resuscitation of a patient who had a cardiac arrest, therapeutic hypothermia is ordered. Which action will the nurse include in the plan of care?

a.	Initiate cooling per protocol.
b.	Avoid the use of sedative drugs.
c.	Check mental status every 15 minutes.
d.	Rewarm if temperature is below 91° F (32.8° C).

 

 

ANS:  A

When therapeutic hypothermia is used postresuscitation, external cooling devices or cold normal saline infusions are used to rapidly lower body temperature to 89.6° F to 93.2° F (32° C to 34° C). Because hypothermia will decrease brain activity, assessing mental status every 15 minutes is not done at this stage. Sedative drugs are given during therapeutic hypothermia.

 

DIF:    Cognitive Level: Apply (application)           REF:               1634

TOP:   Nursing Process: Planning               MSC:  NCLEX: Physiological Integrity

 

4. A patient who is unconscious after a fall from a ladder is transported to the emergency department by emergency medical personnel. During the primary survey of the patient, the nurse should

a.	obtain a complete set of vital signs.
b.	obtain a Glasgow Coma Scale score.
c.	attach an electrocardiogram monitor.
d.	ask about chronic medical conditions.

 

 

ANS:  B

The Glasgow Coma Scale is included when assessing for disability during the primary survey. The other information is part of the secondary survey.

 

DIF:    Cognitive Level: Apply (application)           REF:               1632

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Physiological Integrity

 

5. A 19-yr-old patient is brought to the emergency department (ED) with multiple lacerations and tissue avulsion of the left hand. When asked about tetanus immunization, the patient denies having any previous vaccinations. The nurse will anticipate giving

a.	tetanus immunoglobulin (TIG) only.
b.	TIG and tetanus-diphtheria toxoid (Td).
c.	tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only.
d.	TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap).

 

 

ANS:  D

For an adult with no previous tetanus immunizations, TIG and Tdap are recommended. The other immunizations are not sufficient for this patient.

 

DIF:    Cognitive Level: Apply (application)           REF:               1634

TOP:    Nursing Process: Planning         MSC:   NCLEX: Health Promotion and Maintenance