Psychosocial
A 4 year old child is brought to the ED after falling out of a tree is awake, but fearful. Past medical records indicate the child has experienced multiple instances of injury. An appropriate first action for the nurse would be what?
A. tell the parents that abuse is suspected.
B. immediately report the suspicion of abuse to the proper authorities.
C. discuss with the ED physician the possibility of child neglect.
D. recognize that all children are accident prone.
C. Discuss with the ED physician the possibility of child neglect.
A middle aged patient presents to the ED with complaint of fever and in no acute distress. Vitals: HR 122, RR 20, SpO2 95%, BP 118/58, and temp 101.9F. Medical history: HIV positive, taking antiviral meds. Using a 5-level triage system, this patient should be triaged as which acuity level?
A. Level 3 (urgent)
B. Level 1 (resuscitation/life-threatening)
C. Level 2 (High risk/emergent)
D. Level 4 (nonurgent)
C. Level 2 (High risk/emergent)
Damage to the epithelial layer of the cornea causing uptake of fluorescein dye is most likely caused by what?
A. hyphema
B. traumatic irits
C. corneal abrasion
D. chemical burn
C. corneal abrasion
A splint has been placed on a fractured upper extremity. The patient continues to have 10/10 pain despite administration of IV narcotics. Which of the following conditions is the most likely cause of this patient's unrelieved pain?
A. Torn ligaments
B. A history of substance abuse
C. Compartment syndrome
D. Excessive blood loss
C. Compartment syndrome
Which of the following foreign bodies is most likely to cause a tissue reaction leading to infection?
A. Bullets
B. Wooden splinters
C. Glass shards
D. Metal needles
B. Wooden splinters
The priority for a patient who verbalizes sucidal thoughts is to what?
A. determine if they have a past medical history of depression.
B. determine if they have a supportive spouse.
C. ascertain if the patient has a plan to kill himself.
D. identify recent diagnosis of a chronic condition
C. ascertain if the patient has a plan to kill himself.
An age-specific consideration for the pediatric patient with sickle cell disease is that:
A. prophylactic splenectomy should be scheduled.
B. the frequency of attacks decreases with age.
C. vaccinations are not routinely recommended.
D. the incidence of ischemic stroke is increased.
D. the incidence of ischemic stroke is increased.
The term for blood in the anterior chamber of the eye is what?
A. anterior uveitis
B. hyphema
C. detached retina
D. chemosis
B. hyphema
A boxer's fracture is a fracture of what?
A. distal 5th metacarpal
B. distal 5th phalanx
C. proximal 5th metacarpal
D. proximal 5th phalanx
A. distal 5th metacarpal
Which of the following complications is a consequence of landing on the pavement after a motorcycle crash.
A. Tattooing
B. Contusions
C. Avulsions
D. Lacerations
A. Tattooing
During an assessment for a patient with a work-related back injury the patient admits to a pattern of promiscuous sexual behavior, repeated substance abuse, and a history of sleeping only 2 hours in the past 48 hours. The patient also describes having episodes of lethargy, lack of motivation, decreased energy, and no appetite. The nurses suspects which of the following conditions?
A. schizoaffective disorder
B. disorganized schizophrenia
C. major depressive disorder
D. bipolar disorder
D. bipolar disorder
A semiresponsive, elderly patient is admitted to the ED with the following findings: finger stick glucose is 380 mg/dL, serum osmolality is 330 mOsm/kg, and the pH is 7.2. Kussmaul respirations are noted. The nurse would suspect:
A. syndrome of inappropriate antidiuretic hormone (SIADH)
B. diabetic ketoacidosis (DKA)
C. thyroid storm
D. hyperosmolar hyperglycemic nonketotic coma (HHNC)
B. diabetic ketoacidosis (DKA)
Trauma resulting in hoarseness, pain with swallowing, stridor, or hemoptysis most likely indicates which of the following?
A. Ludwig's angina
B. Tracheobronchial injury
C. Fractured larynx
D. Pneumomediastinum
C. Fractured larynx
Assessment of a patient with a Colles' fracture should include evaluation of which of the following?
A. Peroneal
B. Ulna
C. Radial
D. Median
C. Radial
A patient with an open fracture to the forearm that was placed in a cast 2 weeks prior now presents with pain, fever, and a foul odor coming from the cast. Fingers are edematous and cold. Which of the following is suspected when cast removal reveals tissue sloughing and a foul-smelling odor?
A. Clostridium gangrene
B. Cast syndrome
C. Nerve damage
D. Volkmann's contracture
A. Clostridium gangrene
According to the Mental Health Triage Scale, which of the following patients would be categorized as emergent?
A. A patient with suicidal ideations, accompanied by a friend.
B. A patient with signs and symptoms of paranoia.
C. A patient exhibiting extreme agitation.
D. A chronic psychiatric patient requesting emergent medication refill.
C. A patient exhibiting extreme agitation.
Which of the following electrolyte abnormalities would you expect to find in a patient in adrenal crisis?
A. Hyperglycemia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
C. Hyperkalemia
Which of the following statements made by a patient diagnosed with Bell's palsy indicates successful discharge teaching?
A. "I will apply a cold compress to the side of my face 4 times a day."
B. "I will use artificial tears only when I notice my eye burning or stinging."
C. "I will wear sunglasses anytime I go outside."
D. "I will need to take steroids for the rest of my life."
C. "I will wear sunglasses anytime I go outside."
To confirm radial nerve function, children with elbow fractures are typically asked to perform the following:
A. peace sign
B. thumbs-up sign
C. tight fist
D. OK sign
B. thumbs-up sign
Which of the following statements regarding treatment applies to a patient who sustained a large laceration to the lower leg after slipping on rocks in a riverbed?
A. The laceration needs to be treated aggressively because bacteria are associated with fresh water and streams.
B. Antimicrobials are not required for fresh water exposure.
C. Infections of this type wound occur 7 to 10 days after injury.
D. Meticulous irrigation is not required because the wound was cleaned in the stream with the laceration was sustained.
A. The laceration needs to be treated aggressively because bacteria are associated with fresh water and streams.
A psychiatric patient admits to hearing voices telling him to hang himself. The nurse documents that the patient is at risk for suicide based on what?
A. an intolerable feeling of hopelessness
B. command hallucinations
C. overwhelming anxiety
D. specific visual hallucinations
B. command hallucinations
An elderly patient presents with a chief complaint of "not feeling well." The patient has been taking digoxin for 4 months as prescribed with a potassium supplement. The nurse suspects the patient may be digoxin toxic due to:
A. overdosage
B. hyperkalemia
C. decreased renal function
D. decreased cardiac output
C. decreased renal function
An altercation results in multiple facial injuries in which the upper teeth and maxillary arch are moveable when grasped. CT scan of the face reveals a triangular midfacial fracture. This type of fracture is called what?
A. a tripod fracture of the zygoma
B. Le Fort I
C. Le Fort III
D. Le Fort II
D. Le Fort II
Which is the correct method of cane instruction for a patient with an injured right knee?
A. The cane should be used on the right side with the elbow at 90 degrees.
B. The cane should be alternated on different days to avoid overuse of either side.
C. The cane should be used on the left side with the elbow at 30 degrees.
D. The cane should be used on the left side with the elbow at 60 degrees.
C. The cane should be used on the left side with the elbow at 30 degrees.
Sutures placed on the face should be removed within how many days?
A. 7 to 10
B. 5 to 7
C. 3 to 5
D. 10 to 14
B. 5 to 7 days