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An emergency department nurse moves to a new city where heat-related illnesses are common. Which clients does the nurse anticipate being at higher risk for heat-related illnesses? (Select all that apply.)
- A. Homeless individuals
- B. Illicit drug users
- C. White people
- D. Older adults
- E. Construction workers
Correct Answer: A,B,D,E
Rationale: Homeless individuals, illicit drug users, older adults, and construction workers are at higher risk due to exposure, impaired thermoregulation, or physical exertion. White people are not specifically at higher risk compared to other groups.
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A nurse teaches a community class about ways to decrease the risk of lightning injuries. Which instructions should the nurse include? (Select all that apply.)
- A. Seek shelter in a building or enclosed vehicle.
- B. Hide under a tall tree.
- C. Do not take a bath or shower.
- D. Turn off the television.
- E. Remove all body piercings.
- F. Put down golf clubs or gardening tools.
Correct Answer: A,C,D,F
Rationale: Seeking shelter, avoiding water, turning off electronics, and putting down conductive tools reduce lightning injury risk. Hiding under a tall tree increases risk, and body piercings do not significantly affect lightning strike likelihood.
A nurse is teaching a wilderness survival class. Which statements should the nurse include about the prevention of hypothermia and frostbite? (Select all that apply.)
- A. Wear synthetic clothing instead of cotton to keep your skin dry.
- B. Drink plenty of fluids. Brandy can be used to keep your body warm.
- C. Remove your hat when exercising to prevent the loss of heat.
- D. Layer clothing to trap heat effectively.
- E. Know your physical limits. Come in out of the cold when limits are reached.
Correct Answer: A,D,E
Rationale: Synthetic clothing wicks moisture, layering traps heat, and knowing physical limits prevents overexposure. Alcohol like brandy causes heat loss, and removing a hat during exercise increases heat loss, both of which are incorrect.
An emergency department nurse plans care for a client who is admitted with heat stroke. Which interventions should the nurse include? (Select all that apply.)
- A. Administer oxygen via mask or nasal cannula.
- B. Administer ibuprofen, an antipyretic medication.
- C. Apply cooling techniques until core body temperature is less than 101°F.
- D. Infuse 0.9% sodium chloride via a large-bore intravenous cannula.
- E. Obtain baseline serum electrolytes and cardiac enzymes.
Correct Answer: A,D,E
Rationale: Heat stroke requires oxygen therapy, IV fluids, and baseline lab tests. Cooling should continue until the core temperature is around 102°F, not 101°F. Antipyretics like ibuprofen are ineffective for heat stroke.
A provider prescribes a rewarming bath for a client who presents with partial-thickness frostbite. Which action should the nurse take prior to starting this treatment?
- A. Administer intravenous morphine.
- B. Wrap the limb with a compression dressing.
- C. Massage the frostbitten areas.
- D. Assess the limb for compartment syndrome.
Correct Answer: A
Rationale: Rapid rewarming in a water bath is recommended for frostbite, but it causes severe pain. Administering IV morphine prior to treatment is essential for pain management. Wrapping with a compression dressing or massaging the area can cause further tissue damage, and assessing for compartment syndrome is not the priority before rewarming.
A nurse assesses a client recently bitten by a coral snake. Which assessment should the nurse complete first?
- A. Unilateral peripheral swelling
- B. Clotting times
- C. Cardiac rhythm
- D. Electrocardiogram rhythm
Correct Answer: C
Rationale: Coral snake venom is neurotoxic, causing ascending paralysis and respiratory compromise. Assessing cardiac rhythm is critical to detect early signs of systemic effects. Swelling and clotting issues are more associated with pit viper bites, and ECG rhythm is redundant with cardiac rhythm.