Emergency Nursing

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions. Remember, there's only one answer to each question.

1.	An emergency patient with Level IV acuity would require immediate marshaling of medical and nursing resources.

2.	Of the two types of migraine headaches, classic migraine is generally more prevalent.

3.	Most migraine conditions begin in adolescence.

4.	Proper diagnosis of migraine headache requires a thorough physical examination followed by lab studies.

5.	Narcotic analgesics are commonly recommended in the management of migraines.

6.	One of the most widely used drugs for the treatment of migraines is Ergotamine, except when a patient experiences migraine headaches more than twice a month.

7.	Because ethanol is distributed throughout the body to all tissues based on their water content, persons with greater body mass can ingest proportionately higher amounts of ethanol and still maintain lower intravascular and body tissue concentrations.

8.	All patients who experience alcohol withdrawal syndrome go through four distinct stages of increasing severity.

9.	Tongue biting and loss of sphincter control are less common in alcohol withdrawal seizures than in idiopathic seizures.

10.	Which of the following statements is true? Seizures can cause hypoglycemia. Hypoglycemia can cause seizures. Both A & B. None of the above.

11.	For a patient with drug overdose, protecting the patient’s airway is the most immediate response of the ED nursing staff.

12.	Use of activated charcoal is the most frequent and effective method for poison control in the ED patient.

13.	If two individuals carrying the sickle-cell trait mate, their children will have a one in four chance of having sickle-cell anemia.

14.	Risk factor for acute myocardial infarction is about the same for men and women.

15.	A person with a normal ECG and cardiac enzymes may still have symptoms of acute myocardial infarction (AMI).

16.	If thrombolytic therapy is administered within the first four to six hours after the onset of chest pain, there is a good potential for reversal or minimalization of myocardial damage in a patient.

17.	Thrombolytic agent streptokinase carries the possibility of allergic reaction because of its “foreign” substance.

18.	Death caused by cocaine toxicity usually occurs from failure of the patient to breathe or from progressive hyperthermia.

19.	The effects of cocaine can be more prolonged or more toxic in people who abuse alcohol and have poor nutritional habits.

20.	A low B.P. is a contraindication for administering intravenous morphine to a patient.

21.	Preexcitation syndrome is ruled out in a young man with no history of coronary heart disease although he may have a history of rapid heartbeats.

22.	All of the following factors contribute to the development of supraventricular tachycardia (SVT): Family history, high caffeine intake, smoking, over-exertion and emotional stress.

23.	If a patient is wheezing, it should be assumed that the patient has asthma.

24.	Asthma attacks are almost never life threatening and are generally assigned triage acuity levels of I or II.

25.	Extreme physical activity is the primary cause of spontaneous pneumothorax.

26.	The classic signs of a moderately sized pulmonary embolus include unexplained dyspnea, tachypnea, tachycardia, and restlessness.

27.	Smoke inhalation is the leading cause of death within the first 24 hours following exposure to fire.

28.	Anyone treated for CO poisoning should routinely be treated for cyanide toxicity as well.

29.	Patients with carboxyhemoglobin levels of 40% or more should be treated with hyperbaric oxygen therapy (HBOT) even if this means transport to another facility.

30.	An elevated serum amylase is exclusively diagnostic of pancreatitis.

31.	Patients who have used excessive alcohol for five to ten years are prone to chronic pancreatitis.

32.	Morphine is the recommended drug to relieve pain in a patient suffering from an attack of pancreatitis.

33.	Any patient presenting with an altered level of consciousness should immediately have a finger stick blood glucose level checked.

34.	Only Type II diabetic patients are at risk for hypoglycemia from their use of insulin.

35.	All of the following factors may be the cause of hypoglycemia in a particular patient: Type and amount of insulin; the sight of administration; diet; and, eating and exercise habits of the patient.

36.	The presence of hyperglycemia alone is sufficient to establish the diagnosis of diabetic ketoacidosis (DKA).

37.	When in doubt about the reason for a patient’s decreased level of consciousness, treat as if it were caused by hyperglycemia and administer 25g of glucose.

38.	In a patient diagnosed with DKA, insulin therapy may have to be continued even after hyperglycemia has been reversed.

39.	Urinary calculi are more likely to occur in persons living in the Southeast or the Southwest than in any other part of the country.

40.	Struvite stone is 3 to 4 times more prevalent in men than in women, whereas calcium oxalate stone occurs more frequently in women than in men.

41.	Uric acid stones are commonly found in men especially Jewish males.

42.	Between the two new procedures for removal of kidney stones, PUL and ESWL, the former is likely to become more popular because of its lower cost.

43.	The use of antibiotics is more common than surgical incision and drainage method of treating abscesses.

44.	The patient who has sustained significant soft tissue injury is a candidate for developing neurovascular compromise.

45.	Attending to a victim of hypothermia, first priority should be to administer pharmacological and electrical therapies in the field.

46.	The definition of hypothermia is a body core temperature that is less than 25 degrees Centigrade.

47.	A victim of hypothermia whose core body temperature does not drop below 90 degree Fahrenheit has a very good chance of complete recovery.

48.	While treating a victim of hypothermia a major complication resulting from active rewarming of a patient is a continued fall in body temperature after rewarming maneuvers have been initiated. This phenomenon occurs with rapid emersion cooling as well as

49.	Bee stings and penicillin are the two major causes of anaphylaxis in humans.

50.	As long as a victim of bee sting shows no systemic symptoms of anaphylaxis, the individual is in no life-threatening emergency.

51.	Testicular torsion and epididymitis have very similar symptoms and both are commonly found in men who are sexually active.

52.	The patient with testicular torsion often has a testis that is in a transverse or horizontal position, while the patient with epididymitis has a testis in a vertical position.

53.	Pelvic inflammatory disease (PID) is a common complication for women resulting from exposure to a sexually-transmitted disease (STD).

54.	According to one long-term study, 25% of all women who had PID were unable to conceive children during the subsequent ten years.

55.	Use of IUD is the most common cause of ectopic pregnancy.

56.	A patient who has a positive beta-HCG and positive intrauterine pregnancy is likely to have an additional ectopic pregnancy.

57.	Primary angle-closure glaucoma is more common than primary open-angle glaucoma.

58.	Every child who presents in an emergency room should be thoroughly examined to rule out possible abuse or neglect, regardless of the complaint.

59.	Most states by law require a report to the appropriate agency only after a definitive diagnosis of child abuse or neglect has been established.

60.	A minor child presented in the emergency room can be hospitalized only with the consent of the parents.

61.	A person who has been abused as a child and may have observed other means of violence in the family is more likely to engage in abuse of the elderly.

62.	An elderly person who is otherwise competent can be hospitalized against his or her wishes for medical treatment.

63.	White females have the highest percentage of completed suicides in the general population.

64.	All of the following characteristics have been known to predispose a patient to object-related suicide attempts (parasuicide): Alcoholic parents Unstable family life History of physical or sexual abuse Financial probl

65.	Patients with bipolar disorder, manic phase, are more at risk for aggressive behavior than other patients with major mental illnesses.

66.	Bipolar disorder is a life-long problem, requiring ongoing psychiatric care and treatment.

67.	Smith’s model includes the following four phases that an aggressive patient goes through: activation, escalation, assault, and recovery and stabilization.

68.	Stress may result in labile BP changes in a patient in which there is a diastolic BP greater than 90 mm Hg in an individual who usually has a diastolic BP less than 90 mm Hg.

69.	If a person shows no adverse symptoms due to high blood pressure there is no need to continue with the drug therapy.

70.	In the United States HBP is equally prevalent among blacks and whites.

71.	An HBP patient who has been prescribed multiple dose therapy is more likely to adhere to the drug regimen than the one who has been prescribed single does therapy.

72.	The greatest challenge in nursing intervention of a patient suffering from high blood pressure lies in the education of the patient about this disease.

73.	The first priority in nursing and medical management of the substance-abuse patient should be to establish a trusting, therapeutic relationship.

74.	T4 cell count below 200 and emergence of opportunistic infections establish the diagnosis of AIDS.

75.	A patient with a positive HIV test does not necessarily have AIDS.

76.	A person who tests positive on ELISA test must undergo Western blot blood test to confirm a diagnosis of HIV.