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An 83-year-old patient is brought in by ambulance from a long-term care facility. The patient's symptoms are weakness, lethargy, incontinence, and a change in mental status. The nurse knows that emergencies in older adults may be more difficult to manage. Why would this be true?
- A. Older adults may have an altered response to treatment.
- B. Older adults are often reluctant to adhere to prescribed treatment.
- C. Older adults have difficulty giving a health history.
- D. Older adults often stigmatize their peers who use the ED.
Correct Answer: A
Rationale: Older adults may have atypical presentations or altered treatment responses, complicating emergency management. Nonadherence, history difficulties, or stigmatization are not primary issues.
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A patient is brought to the ED by two police officers. The patient was found unconscious on the sidewalk, with his face and hands covered in blood. At present, the patient is verbally abusive and is fighting the staff in the ED, but appears medically stable. The decision is made to place the patient in restraints. What action should the nurse perform when the patient is restrained?
- A. Frequently assess the patient's skin integrity.
- B. Inform the patient that he is likely to be charged with assault.
- C. Avoid interacting with the patient until the restraints are removed.
- D. Take the opportunity to perform a full physical assessment.
Correct Answer: A
Rationale: Frequent skin integrity checks prevent injury from restraints. Legal charges are not the nurse's role, interaction should continue, and a full assessment may be unsafe while combative.
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 nurse observes that the family members of a patient who was injured in an accident are blaming each other for the circumstances leading up to the accident. The nurse appropriately lets the family members express their feelings of responsibility, while explaining that there was probably little they could do to prevent the injury. In what stage of crisis is this family?
- A. Anxiety and denial
- B. Remorse and guilt
- C. Anger
- D. Grief
Correct Answer: B
Rationale: The family's blame and sense of responsibility indicate remorse and guilt, a stage of crisis where individuals process feelings of fault. This is distinct from anxiety, anger, or grief.
The nurse is caring for a patient admitted with a drug overdose. What is the nurse's priority responsibility in caring for this patient?
- A. Support the patient's respiratory and cardiovascular function.
- B. Provide for the safety of the patient.
- C. Enhance clearance of the offending agent.
- D. Ensure the safety of the staff.
Correct Answer: A
Rationale: Supporting respiratory and cardiovascular function is the priority in drug overdose to sustain life. Safety and agent clearance are important but secondary.
A patient is admitted to the ED complaining of abdominal pain. Further assessment of the abdomen reveals signs of peritoneal irritation. What assessment findings would corroborate this diagnosis? Select all that apply.
- A. Ascites
- B. Rebound tenderness
- C. Changes in bowel sounds
- D. Muscular rigidity
- E. Copious diarrhea
Correct Answer: B,C,D
Rationale: Rebound tenderness, altered bowel sounds, and muscular rigidity indicate peritoneal irritation. Ascites and diarrhea are not specific to this condition.