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PROPHECY EMERGENCY DEPARTMENT RN A| 68 Questions and Answers 2025 What is the proper procedure for testing visual acuity? Correct Ans- The proper procedure for testing visual acuity is based on the usage of the Snellen test which has letters or symbols. The letters are arranged in rows and columns in the chart and they have different sizes. A 22-year-old man with sickle cell disease is brought into the ED by Campus Police from his local university. He is complaining of increasing pain to his bilateral lower extremities, consistent with his past sickle cell pain crisis. Which intervention would you expect the provider to order? Correct Ans- IV Fluids Normal Saline TPA would be contraindicated for which of the following patients? Correct Ans- 80 year old diagnosed with stroke 2 weeks ago A 24 year old female, who has recently received methotrexate for a tubal pregnancy, presents to the ED with severe abdominal pain. What would be the PRIORITY nursing intervention? Correct Ans- Prepare to go to the OR
A 3 year old boy with a history of hydrocephalus with a cerebral shunt arrives to the ED with a fever of 102.0°F, an enlarged abdomen, tachycardia and hypotension. The patient is mildly lethargic, however is cooperative with the ED staff. Immediate treatment for this child should include: Correct Ans- Antibiotics and IV Fluids When caring for a patient who has received a massive blood transfusion, monitoring which of the following lab results is a top priority? Correct Ans- Ionized Calcium Level What medication would you anticipate administering to a six month old having an active tonic-clonic seizure? Correct Ans- Ativan Patient presents to the ED with a snake bite that occurred 30 minutes ago. The snake was identified as a poisonous rattlesnake. What medication would you expect the physician to order for this patient? Correct Ans- CroFab Crotalidae Polyvalent Immune Fab (Ovine) A 26 year old male with a history of asthma presents to the ED with dyspnea, audible expiratory wheezes, substernal retractions,
A 28 year old, obsterical patient presents at 38 weeks gestation status post motor vehicle collision. Upon arrival via EMS, you note she is on a backboard and c- collar is in place. What is the immediate nursing intervention for this patient? Correct Ans- Place patient in left tilt position A 36 year old male presents to the ED with an amputated hand. What should you do FIRST? Correct Ans- Apply direct pressure to extremity Of the following patients, which one needs referral to the closest burn center? Correct Ans- Partial-thickness and full-thickness burns involving the genitalia or perineum What are three signs of cardiac tamponade? Correct Ans Sharp pain in the chest. ...
Trouble breathing or breathing rapidly. Fainting, dizziness or lightheadedness. Changes in skin color, especially going pale, gray or blue-tinted skin. Heart palpitations (where you become unpleasantly aware of your heartbeat). Fast pulse. An 11-year-old female is brought to the emergency department with complaints of excessive sleeping, headache, sore throat and swollen neck glands. The patient has no complaints of pain. On exam, you note a pink rash on her torso. Her mother states that her appetite has decreased over the last week. What is the most likely diagnosis Correct Ans- Mononucleosis An 88 year old male transferred to the ED from a nursing home with a chief complaint of being unable to void for the past 12 hours. He has a history of prostate cancer. Which of the following nursing interventions should be performed FIRST? Correct Ans- Insert urinary catheter Which of the following would be a primary complication of a bowel obstruction? Correct Ans- Dehydration A 32-year-old woman recently diagnosed with multiple sclerosis presents to the ED with several days of upper respiratory infection
shoulder. Upon initial history intake you learn that he has taken a phosphodiesterase inhibitor (Viagra) for erectile dysfunction. His ECG is concerning for STEMI. Which of the following medication orders should you question if ordered by the provider? Correct Ans- Nitroglycerin A 26-year-old woman presents with severe eye pain, photophobia, and the sensation of sand in her right eye. She is a contact lens wearer and states that she frequently leaves them in overnight. Which of the following is indicated for this patient? Correct Ans- Slit lamp exam using fluorescein staining A 28-year old male patient presents with severe dysuria and white, foul smelling drainage from his penis. The symptoms have lasted about one month and have become progressively worse over the last few days. On exam, the patient is noted to have a petechial rash to his bilateral upper extremities. The patient's signs and symptoms are consistent with which of the following? Correct Ans- Disseminated gonorrhea Which of the following would be the FIRST fluid of choice for a patient in hypovolemic shock secondary to hemorrhaging? Correct Ans- PRBCs
RhoGAM would be administered to a pregnant patient for which of the following reasons Correct Ans- To prevent an RH- negative mother from forming antibodies to RH- positive fetal blood A pediatric patient was brought in by EMS for seizure activity. The patient is post ictal on arrival. During assessment, the patient begins to have convulsions with body stiffening, jerking motions of legs and arms, loss of consciousness and loss of bladder control. What is your PRIORITY nursing intervention? Correct Ans- Lay patient on side to avoid injury and protect airway
Ans- There is progressive deterioration in cognition and/or behavior without altered consciousness Which of the following fractures is highly associated with child abuse? Correct Ans- Spiral leg fracture of the tibia in an 8 month old You enter a patient's room and notice the chest tube has become dislodged from the patient's chest and is hanging off the bed. The primary intervention is to: Correct Ans- Cover the chest tube site with 4x dressing and taping only 3 sides of the dressing An 18 year old female presents to ED unresponsive via private car. Her friends state that she has overdosed on hydrocodone. BP- 80/40, HR- 58, RR- 8, O2 sat 86% on room air. You expect an order for which of the following medications? Correct Ans- Naltrexone (Narcan) A patient with a tension pnuemothorax should have a needle decompression catheter placed Correct Ans- IN the 2nd intercostal space, midclavicular line
An intubated patient becomes extremely agitated and the ventilator begins to alarm. What should you do FIRST? Correct Ans- Check the ventilator tubing for disconnection Which of the following is a responsibility of the nurse collecting forensic evidence during the care of a sexual assault patient? Correct Ans- Maintaining the evidence chain of custody A 26 year old male presents to the ED with an alcohol level of 225 mg/dl. The patient also consumed an unmeasured amount of benzodiazepines, is positive for THC and opiates. An eye witness states that the patient also consumed bleach while intoxicated. What is the next most important step to take in order to ensure proper treatment for this patient? Correct Ans- Call the Poison Control Center for toxic ingestion recommendations A 38 week pregnant patient presents to the ED in active labor. The patient states she has not had any prenatal care. The fetal heart rate is assessed to be 85 beats per minute. What is the PRIORITY nursing intervention? Correct Ans- Have the patient lay on her left side and place patient on high flow oxygen A patient arrives to the ED intubated and decompressed on the left side status post gunshot wound to the chest. During the primary
Your patient is intubated and sedated with extensive second and third degree burns after being pulled from a house fire. You note the patient's core temp to be 94 F. Which of the following interventions should you implement immediately? Correct Ans- Application for forced-air warming system and warmed fluids An 8 year old boy presents to the ED with fever for the last 6 hours. Which of the following assessment findings would cause the MOST concerns? Correct Ans- Petechial rash on the trunk An 83-year old woman presents to the ED triage with shortness of breath, generalized fatigue and weakness. Her daughter says her symptoms are similar to what she experienced several months ago from a urinary tract infections. There are no beds immediately available in the ED. Her vital signs BP- 127/70, HR-65, RR- 16, T-99 F, O sat 100% RA. Which of the following diagnostic tests is MOST important to obtain during triage? Correct Ans- ECG A 25-year old female presents to the ED via ambulance for evaluation of erratic behavior. She was found acting bizarrely and speaking loudly in a public park. The patient is irritable, displays pressured speech, and flight of ideas. She is hyperactive and pacing around the room. The patient's presentation is most consistent with: Correct Ans- Mania
Your patient fell 15 feet of a roof landing chest first onto a barrel. He is complaining of shortness of breath and shoulder pain. When assessing his lung sounds anteriorly, you auscultate bowel wounds in the chest. Based on this assessment, which of the following injuries would you suspect? Correct Ans- Ruptured diaphragm You have a bariatric patient that was involved in an MVC. The patient was in the driver's side, restrained by seatbelt, and airbag deployed. The patient is responsive upon arrival and complains of pain to the left arm. The patient has seatbelt marks across the chest. What is your priority assessment for this patient? Correct Ans- Assess the patient for signs of possible airway and respiratory compromise A 38-year old man with a history of schizophrenia arrives at this emergency department reporting that he is being monitored and plotted against by his neighbors through his television. He appears mildly agitated and suspicious. He reports he has blocked the people working against him by putting aluminum foil over TV and over the doors and windows. He left his apartment because he suddenly feared they would retaliate. This patient is demonstrating which of the following psychotic symptom? Correct Ans- Persecutory delusions
including hypotension, bradypnea, loss of reflexes and decreased urinary output. Which of the following is the antidote used to treat magnesium toxicity? Correct Ans- Calcium gluconate IV Which of the following statements from a patient exhibits a good understanding of discharge instructions after being diagnosed with trichomoniasis and given a prescription for metronidazole? Correct Ans- I will avoid alcohol consumption while taking my medication Hypoparathyroidism tends to cause which of the following electrolyte imbalance? Correct Ans- Hypocalcemia A 48-year old woman presents to the ED with nausea, vomiting, RUQ, and a fever (T-101 F). The physician states that she has a positive Murphy's sign. Considering these symptoms and assessment findings, the patient is MOST likely experiencing: Correct Ans- Cholecystitis What would you anticipate as part of the plan of care for a patient diagnosed with pancreatitis? Correct Ans- Maintain NPO status Interpret the acid-base abnormality: ph 7.56, PaCO2- 24 mm Hg, HCO3 - 23 mEq/L,PO2 93 Correct Ans- Respiratory alkalosis
A 79 year old male from a nursing home presents to the ED with complaints of severe diarrhea ongoing for more than 3 days. C- difficile is suspected. Education for visitors should include: Correct Ans- Wash hands with soap and water You are delegating wound care to a licensed practical nurse. The LPN states she has never performed this type of wound care before. What component of delegation have you neglected? Correct Ans- Competency A 46-year old patient presents with complaint of palpitations beginning 1 hour prior to presentation. He reports excessive caffeine intake over the past 24 hours. A 12-lead EKG has been contained and shows a narrow complex tachycardia at a rate of 200 BPM. His skin is cool and clammy. The patient's blood pressure is 110/50. The physician has attempted vagal maneuvers with the patient by asking him to bear down without effect. An intravenous line has been established. What is the NEXT priority intervention? Correct Ans- Place defibrillator/pacing electrode pads on his chest and prepare to administer adenosine 50 year old Female (JVD and muffled heart sounds) Correct Ans- Cardiac tamponade 68 lbs x 2.2 = 30.9kg (20 ml / kg) Correct Ans- 618 ml/ hr
