Nokea
A patient arrives at the emergency department with complaints of being bitten by a cat. Which of the following parameters should the nurse assess? (Select all that apply.)
- A. Septic arthritis
- B. Hypotension
- C. Osteomyelitis
- D. Tenosynovitis
- E. Cyanosis
Correct Answer: A,C,D
Rationale: Cat bites carry a high risk of infection, leading to septic arthritis, osteomyelitis, and tenosynovitis due to deep tissue penetration. Hypotension and cyanosis are not typically associated unless systemic infection develops later.
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A patient who is unconscious after a fall from a ladder is transported to the emergency department by family members. During the primary survey of the patient, which of the following actions should the nurse implement?
- A. Assess the patient's vital signs
- B. Attach a cardiac electrocardiogram (ECG) monitor
- C. Obtain a Glasgow Coma Scale score
- D. Ask about chronic medical conditions
Correct Answer: C
Rationale: The Glasgow Coma Scale score assesses neurological disability during the primary survey, prioritizing evaluation of consciousness in an unconscious trauma patient. Vital signs and medical history are part of the secondary survey.
After spending the previous weekend camping out with friends, a patient presents to the emergency department (ED) and is diagnosed with flaccid ascending paralysis. Based upon this information, the nurse concludes that the patient has been bitten by which of the following?
- A. Spider
- B. Wasp
- C. Tick
- D. Snake
Correct Answer: C
Rationale: Flaccid ascending paralysis developing 5-7 days after tick exposure is characteristic of tick paralysis, caused by a neurotoxin from wood or dog ticks. Removal of the tick typically reverses symptoms within 48-72 hours.
A patient arrives in the emergency department (ED) a few hours after taking '20-30' acetaminophen (Tylenol) tablets. Which of the following actions will the nurse plan to take?
- A. Give N-acetylcysteine
- B. Discuss the use of chelation therapy
- C. Have the patient drink large amounts of water
- D. Administer oxygen using a non-rebreather mask
Correct Answer: A
Rationale: N-acetylcysteine is the antidote for acetaminophen overdose, preventing liver damage by restoring glutathione levels. Chelation therapy, water dilution, and oxygen are not appropriate treatments for acetaminophen toxicity.
A patient's family members are in the patient room when the patient has a cardiac arrest and emergency personnel start resuscitation measures. Which of the following actions should the nurse take first?
- A. Have the family wait outside the patient room with a designated staff member to provide emotional support
- B. Keep the family in the room and assign a member of the team to explain the care given and answer questions
- C. Ask the family members about whether they would prefer to remain in the patient room or wait outside the room
- D. Advise the family members that patients are comforted by having family members present during resuscitation efforts
Correct Answer: C
Rationale: Assessing family preferences first respects their emotional needs and informs subsequent actions. Some families benefit from staying, while others prefer to leave, and this decision guides whether to provide support in or out of the room.
The nurse is assessing a patient admitted to the emergency department (ED) with a broken arm and facial bruises and notes multiple bruising in various stages of healing. Which of the following responses by the nurse is most appropriate?
- A. Is someone at home hurting you?
- B. You should not return to your home
- C. Would you like to see a social worker?
- D. I have to report this abuse to the police
Correct Answer: A
Rationale: Multiple bruises in various stages of healing suggest possible abuse. The nurse's initial response should be to assess further by asking about potential abuse sensitively, before taking other actions like reporting or involving social services.