CEN-Practice Questions And Answers Graded A

CEN-Practice Questions And Answers
Graded A
The major physiologic insult which occurs in a near drowning victim is which of the
following?
a. hypothermia
b. pneumonia
c. dysrhythmia
d. hypoxemia - Hypoxemia
rationale: The central clinical event in all near drowning victims is hypoxia caused by
laryngospasm and asphyxia.
A 40 yr old male involved in a house fire presents to the emergency department with
dyspnea, sooty sputum, and a brassy cough. He is conscious, and 100% oxygen via
non-rebreather reservoir mask is being administered. The priority nursing diagnosis for
this patient is?
a. fluid volume deficit
b. impaired gas exchange
c. airway clearance ineffective
d. pain - Airway clearance ineffective
Rationale: Potential for edema and obstruction of the airway. If the airway is not patent,
you will be unable to ventilate and oxygenate the patient.
Management of an orbital blowout fracture includes:
a. pressure eye patch
b. anterior nasal packing for orbital support
c. topical anesthetic
d. Delayed surgical intervention - delayed surgical intervention
rationale: delayed until swelling subsides
A 24 yr old male sustains a high pressure injection injury to his hand from an industrail
pain gun sprayer. THe index finger is discolored and swollen with decreased mobility
and numbness distally. The patient complains of pain throughout the hand and
numbness to the first fingertip with decreased mobility. Priority treatment of the affected
hand includes:
a. icing and elevating the extremity
b. soaking the hand in warm saline
c. asking physician to perform a digital block on injured finger
d. Preparing the patient for surgical debridement with possible fasciotomy - Preparing
the patient for debridement with possible fasciotomy
rationale: Immediate treatment to relieve pressure within th edigit is key with an injection
injury. Tissue ischemia and necrosis progress rapidly with swelling and decreased
circulation.
A four yr old girl has a 2 day history of a rash. The rash is pruritic was first noted on the
neck and has now spread to the chest and back. THe neck lesions are crusted over, but
the chest lesions are tiny vescicles on a pink base. According to the father, the child is
somewhat less active, but had no complaints of pain. Vitals: temp 102.4, heart rate 130,
rr 24, bp 90/50, and child weighs 36 lbs. THe child is examined by the doctor, and father
requests that she be given something for the itching. The child is ready for discharge
and the father is asking when she can return to school.
a. 24 hours after the last fever above 101
b. tomorrow
c. once all the lesions are crusted
d. in 2 weeks - once all the lesions are crusted
rationale: once all the lesions are crusted, the child is no longer contagious.
You recieve a patient from EMS following an explosion at an industrial plant. The patient
has deep partial-thickness burns to his left arm, his entire chest, and entire left leg.
According to the rule of 9's, which percentage of burn do you calculate?
a. 36%
b. 27%
c. 45%
d. 54% - 45%
rationale: left arm=9%, entire chest=18%, entire left leg=18%
Your state senator is in your ER. One of your staff members is seen discussing his care
with a local reporter. Your institution is most likely to face a lawsuit of which of the
following?
a. false imprisonment
b. defamation
c. libel
d. invasion of privacy - invasion of privacy
rationale: involves unwarranted publicity, wrongful intrusion into one'srivte activities, and
publicizing the
Which of the following symptoms may indicate that a patient may have been hit by
lightening?
a. unequal pupils
b. hypertension