Nokea
A backcountry skier has been airlifted to the ED after becoming lost and developing hypothermia and frostbite. How should the nurse best manage the patient's frostbite?
- A. Immerse affected extremities in water slightly above normal body temperature.
- B. Immerse the patient's frostbitten extremities in the warmest water the patient can tolerate.
- C. Gently massage the patient's frozen extremities in between water baths.
- D. Perform passive range-of-motion exercises of the affected extremities to promote circulation.
Correct Answer: A
Rationale: Immersion in 37-40°C water safely rewarms frostbitten extremities. Hotter water risks burns, and massage or exercises cause further tissue damage.
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A triage nurse is talking to a patient when the patient begins choking on his lunch. The patient is coughing forcefully. What should the nurse do?
- A. Stand him up and perform the abdominal thrust maneuver from behind.
- B. Lay him down, straddle him, and perform the abdominal thrust maneuver.
- C. Leave him to get assistance.
- D. Stay with him and encourage him, but not intervene at this time.
Correct Answer: D
Rationale: A forcefully coughing patient may dislodge the obstruction, so the nurse should stay and encourage without intervening unless obstruction worsens. Abdominal thrusts are for complete obstruction.
A patient is brought to the ER in an unconscious state. The physician notes that the patient is in need of emergency surgery. No family members are present, and the patient does not have identification. What action by the nurse is most important regarding consent for treatment?
- A. Ask the social worker to come and sign the consent.
- B. Contact the police to obtain the patient's identity.
- C. Obtain a court order to treat the patient.
- D. Clearly document LOC and health status on the patient's chart.
Correct Answer: D
Rationale: Documenting the patient's unconscious state and critical condition justifies emergency treatment without consent. Social workers can't sign, police contact delays care, and court orders are too slow.
A patient with multiple trauma is brought to the ED by ambulance after a fall while rock climbing. What is a responsibility of the ED nurse in this patient's care?
- A. Intubating the patient
- B. Notifying family members
- C. Ensuring IV access
- D. Delivering specimens to the laboratory
Correct Answer: C
Rationale: Ensuring IV access is a key ED nursing role for administering fluids or medications. Intubation is for specialized providers, family notification is not a nurse's role, and specimen delivery is handled by others.
The ED nurse admitting a patient with a history of depression is screening the patient for suicide risk. What assessment question should the nurse ask when screening the patient?
- A. How would you describe your mood over the past few days?
- B. Have you ever thought about taking your own life?
- C. How do you think that your life is most likely to end?
- D. How would you rate the severity of your depression right now on a 10-point scale?
Correct Answer: B
Rationale: Directly asking about suicidal thoughts is essential for risk assessment in depression. Mood, life expectancy, or severity ratings are less specific for suicide screening.
A 13-year-old is being admitted to the ED after falling from a roof and sustaining blunt abdominal injuries. To assess for internal injury in the patient's peritoneum, the nurse should anticipate what diagnostic test?
- A. Radiograph
- B. Computed tomography (CT) scan
- C. Complete blood count (CBC)
- D. Barium swallow
Correct Answer: B
Rationale: CT scans effectively detect intraperitoneal injuries from blunt trauma. Radiographs are less detailed, CBC indicates blood loss but not location, and barium swallow is irrelevant.