Nokea
A patient is admitted to the ED after being involved in a motor vehicle accident. The patient has multiple injuries. After establishing an airway and adequate ventilation, the ED team should prioritize what aspect of care?
- A. Control the patient's hemorrhage.
- B. Assess for cognitive effects of the injury.
- C. Splint the patient's fractures.
- D. Assess the patient's neurologic status.
Correct Answer: A
Rationale: Controlling hemorrhage restores cardiac output, a priority after airway and ventilation. Neurologic assessment and fracture splinting follow, and cognitive effects are assessed later.
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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.
A 23-year-old woman is brought to the ED complaining of stomach cramps, nausea, vomiting, and diarrhea. The care team suspects food poisoning. What is the key to treatment in food poisoning?
- A. Administering IV antibiotics
- B. Assessing immunization status
- C. Determining the source and type of food poisoning
- D. Determining if anyone else in the family is ill
Correct Answer: C
Rationale: Identifying the source and type of food poisoning guides specific treatment, such as fluid replacement or antitoxins. Antibiotics are rarely needed, and immunization or family illness are secondary.
A patient is brought by friends to the ED after being involved in a motor vehicle accident. The patient sustained blunt trauma to the abdomen. What nursing action would be most appropriate for this patient?
- A. Ambulate the patient to expel flatus.
- B. Place the patient in a high Fowler's position.
- C. Immobilize the patient on a backboard.
- D. Place the patient in a left lateral position.
Correct Answer: C
Rationale: Immobilization on a backboard is necessary until spinal injury is ruled out in blunt trauma. Ambulation, Fowler's, or lateral positions risk worsening undiagnosed spinal injuries.
A nurse is caring for a patient who has been the victim of sexual assault. The nurse documents that the patient appears to be in a state of shock, verbalizing fear, guilt, and humiliation. What phase of rape trauma syndrome is this patient most likely experiencing?
- A. Reorganization phase
- B. Denial phase
- C. Heightened anxiety phase
- D. Acute disorganization phase
Correct Answer: D
Rationale: The acute disorganization phase of rape trauma syndrome involves shock, fear, guilt, and humiliation. Denial, heightened anxiety, and reorganization occur in different stages.
A patient is being treated for bites that she suffered during an assault. After the bites have been examined and documented by a forensic examiner, the nurse should perform what action?
- A. Apply a dressing saturated with chlorhexidine.
- B. Wash the bites with soap and water.
- C. Arrange for the patient to receive a hepatitis B vaccination.
- D. Assess the patient's immunization history.
Correct Answer: B
Rationale: Washing bites with soap and water after forensic documentation prevents infection. Chlorhexidine dressings, hepatitis B vaccination, or immunization history are not immediate priorities.