Chapter 16: First Aid, Emergency Care, and Disaster Management
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. What do changes in cardiopulmonary resuscitation (CPR) techniques as recommended by the
American Heart Association (AHA) include?
a.
Compress the chest 100 times a minute.
b.
Depress the chest at least1 inch.
c.
Before compressions, administer three strong breaths.
d.
Elevate the patient’s hips.
2. Standing in a fast-food line, the person in front, while munching on a cookie, begins to cough
heavily, takes deep inspirations, and waves his arms around wildly. What should be the
nurse’s first action?
a.
Start rescue breathing as quickly as possible.
b.
Start chest compressions as quickly as possible.
c.
Perform abdominal thrusts.
d.
Do nothing at this point as long as air is exchanged.
3. What is the initial intervention for an unconscious patient who is not breathing according to
one-person CPR principles, as taught and practiced by professional nurses?
a.
Lift the jaw to clear the airway.
b.
Call for assistance.
c.
Start chest compressions.
d.
Remove patient clothing to visualize the chest.
4. While ambulating, a patient gasps and drops to the floor unconscious with no pulse or
respiration. When is the nurse aware that brain cells begin to die?
a.
1 minute
b.
2 minutes
c.
3 minutes
d.
4 minutes
5. A nurse comes upon a traffic accident. One passenger is lying on the ground by an open door.
What should the nurse assess for first?
a.
Uncontrolled bleeding
b.
Circulation, airway, and breathing (CAB)
c.
Abdominal deep wounds
d.
Level of consciousness (LOC) and orientation
6. A nurse follows the protocol of SAMPLE when speaking to a victim of a fall in the parking
lot of the hospital. What does the P stand for?
a.
Pills taken today
b.
Personal physician
c.
Past illnesses
d.
Preference for emergency transportation
7. What instructions should the nurse provide for immediate treatment for epistaxis?
a.
“Stand still, lean your head back so that the blood won’t get all over everything,
and pinch your nose shut for at least 10 minutes.”
b.
“Stand still, lean your head forward, and pinch your nose tightly for at least 10
minutes.”
c.
“Sit down on a solid surface, lean your head forward to let the blood run out, and
then pinch your nose closed for at least 30 minutes.”
d.
“Sit down on a solid surface, lean your head forward so you don’t choke on the
blood, and pinch your nose shut for at least 10 minutes.”
8. Which condition may complicate the assessment of an older adult patient with a suspected
head injury?
a.
Sensory deficits
b.
Slowed metabolism
c.
Preexisting cerebral dysfunction
d.
Decreased pulmonary function
9. A nurse is called on to assist a neighbor who needs first aid. What should the nurse know is
the legal responsibility for this action?
a.
Is legally bound to help in any way possible
b.
Is expected to demonstrate the same skill, knowledge, and care that would be
provided by other nurses in the same community with the same credentials
c.
Has no legal responsibilities outside the hospital setting and would be held
accountable for nothing
d.
Can legally perform any aid skill, even those not allowed the nurse in the hospital
10. A nurse comes upon a traffic accident where injured, unconscious people are lying on the
highway. What should the nurse be aware of regarding the sanctioning of first-aid
interventions in this scenario?
a.
Good Samaritan Act
b.
Emergency Care Doctrine
c.
Fifth Amendment
d.
Liability Protection against Malpractice Act
11. What will the nurse giving discharge instructions to a patient who is severely allergic to insect
stings caution the patient to do?
a.
Wear bright colors to repel insects.
b.
Apply perfume liberally as a protection.
c.
Dress in sleeveless, easily removable garments.
d.
Obtain an emergency treatment kit.
12. A patient is admitted to the emergency department after having been bitten on the hand by a
black widow spider. Which nursing intervention should the nurse initiate?
a.
Monitor for respiratory distress.
b.
Wrap the hand in a warm compress.
c.
Seat the patient upright in a chair.
d.
Elevate the patient’s hand above his or her heart.
13. A nurse who is assisting victims of an automobile collision has already placed a towel secured
with a belt on a bleeding leg wound. What action should the nurse take when the towel
becomes saturated?
a.
Do nothing.
b.
Remove the towel and use the belt as a tourniquet.
c.
Remove the towel and place the victim’s jacket over the wound and secure it.
d.
Reinforce the towel with the victim’s jacket.
14. An accident victim comes to the emergency department with an open chest wound. What
should the nurse apply to the wound?
a.
Occlusive dressing taped on four sides
b.
Tight Ace wrap
c.
No dressing of any sort
d.
Vented dressing, taped on three sides
15. A homeless person is brought to the emergency department after having been found asleep on
a park bench under a layer of snow. He has a rectal temperature of 95° F. Which additional
symptoms should the nurse anticipate?
a.
Diminished breath sounds and inadequate chest expansion
b.
Shivering, decreased heart rate, and increased blood pressure (BP)
c.
Confusion, increased hunger, and hypertension
d.
Decreased irregular heart and respiratory rates and decreased BP
16. A mother brings in her 2-year-old who has ingested gasoline 1 hour earlier. What should the
nurse implement following the initial assessment?
a.
Prepare to administer syrup of ipecac.
b.
Turn the patient on his or her stomach to induce vomiting.
c.
Prepare to administer Milk of Magnesia.
d.
Prepare to administer bowel lavage and cathartics.
17. While at the local pool on an extremely hot day, a nurse is called on to care for a woman who
has evidently developed heat exhaustion. What is the initial nursing care for this person?
a.
Obtain vital signs.
b.
Move the patient into an air-conditioned or shaded area.
c.
Give her several glasses of ice water.
d.
Cover her with a wet towel.
18. A patient comes to the emergency department with an evisceration after a knife attack. What
is the best nursing intervention related to the exposed bowel?
a.
Gently replace the bowel into the abdominal cavity.
b.
Place a sterile wrapped sandbag on the abdomen to prevent further evisceration.
c.
Place the patient in a high Fowler position to allow the bowel to drop back into the
abdominal cavity.
d.
Cover the bowel with a moist saline dressing.
19. A patient visits the industrial nurse after an accident on the factory floor, which has amputated
three toes. What is the most effective nursing intervention for the amputated toes?
a.
Rinsing with normal saline and placing on a sterile towel
b.
Placing toes as they are on ice in a sterile container
c.
Placing the unwrapped toes in a saline bath
d.
Placing the saline-wrapped toes in a plastic bag in a saline bath
20. Six hours after a beach picnic on a hot afternoon, a young man enters the emergency
department with nausea and vomiting, headache, and diarrhea. On interview, the patient says
that he ate potato salad and tuna fish sandwiches. What should the nurse suspect is the
causative organism for these symptoms?
a.
Clostridium botulinum
b.
Clostridium perfringens
c.
Salmonella
d.
Staphylococcus aureus
21. A child is brought to the emergency department with several deep dog bites on her legs. After
cleaning the wounds, what should the nurse be primarily concerned with ascertaining?
a.
The whereabouts of the dog
b.
The status of tetanus inoculation
c.
The rabies status of the animal
d.
The child’s allergy to the rabies vaccine
22. A patient is brought to the emergency department having had a rock chip embedded in the
right eye. What should be the nurse’s initial action?
a.
Turn the patient to the left side and prepare to remove the chip.
b.
Flush the right eye with normal saline.
c.
Keep the patient flat.
d.
Cover both eyes.
23. A hospital visitor cuts herself on the arm and is bleeding profusely. What should be the
immediate treatment by the nurse?
a.
Call any physician and immediately send the visitor to the emergency department.
b.
Apply direct pressure to the arm with sterile dressing.
c.
Take the visitor’s blood pressure and pulse.
d.
Immobilize the injured arm and send the visitor immediately to the emergency
department.
24. A young man is staggering out of a partially closed doorway to a garage, where a car is
running inside. He speaks slowly in a very low voice, telling the nurse that he fell asleep in
the car with the engine running. What is the immediate nursing diagnosis and action?
a.
Impaired gas exchange. Ask the person to lie flat right where he is; begin rescue
breathing. If the nurse sees anyone else, the nurse should ask the individual to call
someone who knows CPR.
b.
Impaired gas exchange resulting from the inhalation of carbon monoxide. Lead the
patient away from the garage and call for help. Stay with the patient and
continually assess level of consciousness and respirations.
c.
Impaired circulatory perfusion resulting from sulfur dioxide poisoning. Have the
patient lie flat. Keep the patient still and call for help.
d.
Impaired gas exchange. Have the patient breathe deeply and continually into a
brown paper bag. Assess pulse, respirations, and color of conjunctiva. Check the
patient’s pockets for a cell phone to call 9-1-1.
25. What should the emergency department nurse anticipate on the initial assessment of a patient
with carbon monoxide poisoning?
a.
Blood pressure will be low.
b.
Oxygen saturation will be low.
c.
Mucous membranes will be blue.
d.
Respirations will be less than 10 breaths/min.
COMPLETION
26. A nurse in the emergency department knows that tissue damage has probably occurred in a
person with hypothermia when a rectal temperature of _____ is assessed.
27. A nurse has assessed the patient with a left-sided head injury and records this information:
decreasing level of consciousness; slow pupillary response on the right side; blood pressure,
167/80 mm Hg; previous blood pressure, 160/72 mm Hg; and gradually increasing respiratory
and pulse rates. The nurse is aware that these assessments are indicators of _____.
28. Assessment of a burn victim leads a nurse to suspect an inhalation injury. The observation that
should indicate such an injury would be _____.
29. When a nurse notes paradoxical respiration in a patient in the emergency department who fell
off some scaffolding, the nurse applies _____ to the ribs.
OTHER
30. How should a nurse intervene for a patient with a perforation of the right eye? (Place the
interventions in the appropriate sequence.) (Separate the letters with a comma and space: A,
B, C, D.)
A. Cover the right eye with an eye shield.
B. Place the patient in a Fowler position.
C. Clean around the right eye.
D. Cover the left eye with a light occlusive dressing.
E. Darken the room.