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MSN Exam for Emergencies

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1. You are the advise comfort in an necessity division (ED) and must commit two staff members to hide the triage area. Which team is the most divert for this commitment?

  1. An tardy exercitation comfort and an skilled LPN/LVN
  2. An skilled LPN/LVN and an inskilled RN
  3. An skilled RN and an inskilled RN
  4. An skilled RN and a nursing auxiliary
2. You are is-sueing in the triage area of an ED, and indecent endurings path the triage desk at the stubbornselfsame period. List the command in which you gain assess these endurings.
  1. An ambulatory, scared 25-year-old manful behindcited a timeliness a bandaged transferership hurt
  2. An fault-finding infant behindcited a timeliness a ferment, petechiae, and nuchal rigidity
  3. A 35-year-old jogger behindcited a timeliness a distorted ankle, having pedal pulse and no abnormity
  4. A 50-year-old femanful behindcited a timeliness steady abdominal abstinence and interrupted vomiting
  • _____, _____, _____, _____
3. In conducting a principal reconnoitre on a trauma enduring, which of the forthcoming is considered one of the initiative elements of the principal reconnoitre?
  1. Complete set of vivacity-sustaining signs
  2. Palpation and auscultation of the abdomen
  3. Brief neurologic impost
  4. Initiation of pulse oximetry
4. A 56-year-old enduring introduces in triage behindcited a timeliness left-sided chest abstinence, diaphoresis, and dizziness. This enduring should be previousitized into which designation?
  1. High indeferrible
  2. Urgent
  3. Non-urgent
  4. Emergent

5. The physician has commanded cautiousing measures for a branch behindcited a timeliness ferment who is likely to be dismissd when the region ends down. Which of the forthcoming would be divert to commission to the nursing auxiliary?

  1. Assist the branch to transport exterior investment.
  2. Advise the committer to use acetaminophen instead of aspirin.
  3. Explain the demand for cautious clears.
  4. Prepare and straightforward a tepid bath.
6. It is the summer period, and endurings behindcited a timeliness signs and symptoms of fever-connected complaint introduce in the ED. Which enduring demands economy earliest?
  1. An senile single complains of dizziness and syncope behind ultimateing in the sun for separate hours to light a parade
  2. A marathon runner complains of keen leg cramps and sea-sickness. Tachycardia, diaphoresis, pallor, and infirmity are observed.
  3. A previously vigorous residencemaker noises spiritless air circumstanceser for days. Tachypnea, hypotension, tire, and lavish diaphoresis are observed.
  4. A residenceless single, unsatisfactory prosperer, introduces behindcited a timeliness altered immaterial standing, unsatisfactory muscle coordination, and hot, dry, ashen husk. Duration of scylla is hidden.
7. You corcorrespond to a wheedle for succor from the ED abideing space. Thither is an senile enduring mendacious on the foot. List the command for the operations that you must chattels.
  1. Perproduce the chin raise or jaw push maneuver.
  2. Establish unresponsiveness.
  3. Initiate cardiopulmonary action (CPR).
  4. Call for succor and activate the regularity team.
  5. Instruct a nursing auxiliary to get the clash cart.
  • _____, _____, _____, _____, _____
8. The necessity medical utility (EMS) has delighted a enduring behindcited a timeliness keen chest abstinence. As the enduring is material transmitted to the necessity stretcher, you silence unresponsiveness, stop of brisk, and no evident pulse. Which administration is divert to commission to the nursing auxiliary?
  1. Chest contractions
  2. Bag-valve hide zephyr
  3. Assisting behindcited a timeliness vocal intubation
  4. Placing the defibrillator pads
9. An disturbed 24-year-old garden novice complains of tingling sensations, palpitations, and chest stretch. Deep, speedy b facilitate and carpal spasms are silenced. What initiative nursing operation should you catch?
  1. Notify the physician forthwith.
  2. Administer suppleimmaterial oxygen.
  3. Have the novice mete into a tract bag.
  4. Obtain an command for an anxiolytic medication.
10.An skilled traveling comfort has been commited to is-sue in the ED; thus-far, this is the comfort’s earliest week on the job. Which area of the ED is the most divert commitment for the comfort?
  1. Trauma team
  2. Triage
  3. Ambulatory or fats trace clinic
  4. Pediatric salve team
11.A sad committer brings a branch to the ED for vestibule an hidden completionity of branchren’s cheweffectual vitamins at an hidden period. The branch is currently watchful and asymptomatic. What notification should be forthbehind a timeliness reputed to the physician?
  1. The ingested branchren’s cheweffectual vitamins inclose hale.
  2. The branch has been treated separate periods for ingestion of toxic materials.
  3. The branch has been treated separate periods for adventitious injuries.
  4. The branch was sea-sicknessted and vomited unintermittently at residence.
12.In caring for a dupe of sexual attack, which administration is most divert for an LPN/LVN?
  1. Assess contiguous tender propound and corporeal injuries
  2. Collect hair samples, saliva swabs, and scrapings adown fingernails.
  3. Provide tender stay and stayive despatch.
  4. Ensure that the “manacle of keeping” is maintained.
13.You are caring for a dupe of frostbite to the feet. Attribute the forthcoming mediations in the improve command.
  1. Apply a flowing, barren, large verbiage.
  2. Give abstinence medication.
  3. Remove the dupe from the apathetic environment.
  4. Immerse the feet in thermal inspire 100o F to 105o F (40.6o C to 46.1o C)
  • _____, _____, _____, _____
14.A enduring sustains an disramification of the earliest and cooperate digits in a manaclesaw surroundings. Which administration should be commissiond to the LPN/LVN?
  1. Gently purify the amputated digits behindcited a timeliness Betadine separation.
  2. Place the amputated digits instantly into ice slurry.
  3. Wrap the amputated digits in barren gauze moistened behindcited a timeliness memorable.
  4. Store the amputated digits in a separation of barren typical memorable.
15.A 36-year-old enduring behindcited a timeliness a truth of rapines and medication submission of phenytoin (Dilantin) and carbamazepine (Tegretol) is brought to the ED by the MS singlenel for repetitive rapine disembodiment that started 45 minutes previous to look. You prepare that the physician gain command which offal for standing epilepticus?
  1. PO phenytoin and carbamazepine
  2. IV lorazepam (Ativan)
  3. IV carbamazepam
  4. IV magnesium sulfate
16.You are preparing a branch for IV sensible sedation previous to relit of a facial shield. What notification should you forthbehind a timeliness noise to the physician?
  1. The committer is unsure encircling the branch’s tetanus immunization standing.
  2. The branch is balancethrow and pulls out the IV.
  3. The committer declines the IV sensible sedation.
  4. The committer wants notification encircling the IV sensible sedation.
17.An stupefied enduring introduces behindcited a timeliness slurred discourse, gentle laziness, and uncooperative demeanor. The enduring is a unsatisfactory folinferior but admits to “drinking a few on the weekend.” What is the initiative nursing operation for this enduring?
  1. Obtain an command for a race alcohol resemblingize.
  2. Contact the producerage to gain affixed truth and baseline notification.
  3. Administer naloxone (Narcan) 2 – 4 mg as commanded.
  4. Administer IV clear stay behindcited a timeliness suppleimmaterial thiamine as commanded.
18.When an unlocked-for dissolution transfer-places in the ED, which of the forthcoming administrations is most divert to commission to the nursing auxiliary?
  1. Escort the producerage to a attribute of solitude.
  2. Go behindcited a timeliness the organ donor specialist to converse to the producerage.
  3. Assist behindcited a timeliness postmortem economy.
  4. Assist the producerage to infer belongings.
19.Following necessity endotracheal intubation, you must realize tube attributement and enclose the tube. List in command the steps that are claimd to chattels this administration?
  1. Obtain an command for a chest x-ray to muniment tube attributement.
  2. Secure the tube in attribute.
  3. Auscultate the chest during proped zephyr.
  4. Confirm that the met sounds are resembling and bilateral.
  • _____, _____, _____, _____
20.A teenager arrives by secret car. He is watchful and ambulatory, but this shirt and pants are hideed behindcited a timeliness race. He and his hysterical friends are yelling and obscure to illustrate that that they were goofing encircling and he got poked in the abdomen behindcited a timeliness a adhere. Which of the forthcoming comments should be bestown earliest motive?
  1. “Thither was a lot of race and we used three bandages.”
  2. “He pulled the adhere out, impartial now, accordingly it was hurting him.”
  3. “The adhere was truly insignificant and hideed behindcited a timeliness mud.”
  4. “He’s a diabetic, so he demands economy just far.”
21.A vassal, behindcited a timeliness a distinguishn truth of alcohol affront, has been in police keeping for 48 hours. Initially, eagerness, excretion, and tremors were silenced. Now, disorientation, hallucination, and hyper-redisembodiment are observed. The medical idiosyncrasy is malice tremens. What is the initiative nursing idiosyncrasy?
  1. Risk for Damnification connected to rapines
  2. Risk for Other-Directed Rape connected to hallucinations
  3. Risk for Situational Low Self-esteem connected to police keeping
  4. Risk for Nutritional Deficit connected to constant alcohol affront
22.You are commited to telephone triage. A enduring who was stung by a spiritless honey bee wheedles for notice, noises abstinence and localized swelling, but denies any respiratory disturb or other systemic signs of anaphylaxis. What is the operation that you should straightforward the wheedleer to chattels?
  1. Call 911.
  2. Remove the stinger by scraping.
  3. Apply a cautious contract.
  4. Take an vocal antihistamine.
23.In ratio to submersion injuries, which administration is most divert to commission to an LPN/LVN?
  1. Talk to a class assemblage encircling inspire protection conclusions.
  2. Stabilize the cervical spine for an unsensible drowning dupe.
  3. Remove wet investment and hide the dupe behindcited a timeliness a thermal blanket.
  4. Monitor an asymptomatic near-drowning dupe.
24.You are assessing a enduring who has sustained a cat bite to the left agency. The cat is up-to-limit immunizations. The limit of the enduring’s ultimate tetanus shot is hidden. Which of the forthcoming is the initiative nursing idiosyncrasy?
  1. Risk for Infection connected to organisms favoring to cat bites
  2. Impaired Husk Integrity connected to poke hurts
  3. Ineffective Health Maintenance connected to immunization standing
  4. Risk for Impaired Mobility connected to possible tendon impairment
25.These endurings introduce to the ED repining of clever abdominal abstinence. Prioritize them in command of cruelty.
  1. A 35-year-old manful repining of keen, intermittent cramps behindcited a timeliness three results of inspirey diarrhea, 2 hours behind eating
  2. A 11-year-old boy behindcited a timeliness a low-grade ferment, left inferior quadrant pity, sea-sickness, and anorexia for the elapsed 2 days
  3. A 40-year-old femanful behindcited a timeliness steady left conspicuous quadrant abstinence, vomiting narrow completionitys of yellow bile, and worsening symptoms balance the elapsed week
  4. A 56-year-old manful behindcited a timeliness a pulsating abdominal magnitude and abrupt aggression of constraining-like abstinence in the abdomen and flank behindcited a timelinessin the elapsed hour
  • _____, _____, _____, _____
26.The nursing aggravateseer decides to produce a committee to discourse the conclusion of rape aggravate ED singlenel. Which co-operation of employees is best suited to aim this commitment?
  1. ED physicians and advise comforts
  2. Experienced RNs and skilled paramedics
  3. RNs, LPN/LVNs, and nursing auxiliarys
  4. At last one procuratorial-to-others from each assemblage of ED singlenel
27.In a multiple-trauma dupe, which impost finding signals the most relevant and vivacity-threatening circumstances?
  1. A deviated trachea
  2. Gross abnormity in a inferior extremity
  3. Decreased bowel sounds
  4. Hematuria
28.A enduring in a one-car rollbalance introduces behindcited a timeliness multiple injuries. Prioritize the mediations that must be rooted for this enduring.
  1. Secure/start two large-bore IVs behindcited a timeliness typical memorable
  2. Use the chin raise or jaw push regularity to public the airway.
  3. Assess for gratuitous respirations
  4. Give suppleimmaterial oxygen per hide.
  5. Obtain a bountiful set of vivacity-sustaining signs.
  6. Remove enduring’s investment.
  7. Insert a Foley catheter if not contraindicated.
  • _____, _____, _____, _____, ____, ____, ____

29.In the is-sue setting, what is your principal trust in preparing for affliction administration that includes probeffectual afflictions or bioterrorism incidents?

  1. Knowledge of the agency’s necessity defense delineation
  2. Awareness of the signs and symptoms for possible agnets of bioterrorism
  3. Knowledge of how and what to noise to the CDC
  4. Ethical sentence-making encircling exposing stubborn to possiblely calamitous materials
30.You are giving disadvise instructions to a dame who has been treated for contusions and bruises sustained during an result of domiciliary rape. What is your initiative mediation for this enduring?
  1. Transportation arrangements to a secured house
  2. Referral to a counselor
  3. Advise encircling contacting the police
  4. Follow-up Nursing Assignment for injuries
Answers
  1. ANSWER C – Triage claims at last one skilled RN. Pairing an skilled RN behindcited a timeliness inskilled RN stipulates opportunities for mentoring. Tardy exercitation comforts are adapted to chattels triage; thus-far, their utilitys are usually claimd in other areas of the ED. An LPN/LVN is not adapted to chattels the steady enduring impost or sentence making. Pairing an skilled RN behindcited a timeliness a nursing auxiliary is the cooperate best non-interference, accordingly the auxiliary can gain vivacity-sustaining signs and prop in transporting.
  2. ANSWER B, A, D, C – An fault-finding infant behindcited a timeliness ferment and petechiae should be prefer assessed for other meningeal signs. The enduring behindcited a timeliness the transferership hurt demands affixed truth and impost for intracranial constraining. The enduring behindcited a timeliness steady abdominal abstinence is disagreeable, but not transient at this subject-matter. For the ankle damnification, medical evaluation can be tardy 24 – 48 hours if inevitable.
  3. ANSWER C – A illiberal neurologic impost to singleize resemblingize of sensibleness and scholar reoperation is sever of the principal reconnoitre. Life-sustaining signs, impost of the abdomen, and foundation of pulse oximetry are considered sever of the cooperateary reconnoitre.
  4. ANSWER D – Chest abstinence is considered an emergent initiative, which is defined as possiblely vivacity-threatening. Patients behindcited a timeliness indeferrible initiative demand texture behindcited a timelinessin 2 hours of triage (e.g. kind stones). Non-indeferrible circumstancess can abide for hours or equeffectual days. (High indeferrible is not spiritlessly used; thus-far, in 5-tier triage systems, High indeferrible endurings drop betwixt emergent and indeferrible in provisions of the period lapsing previous to texture).
  5. ANSWER A – The nursing auxiliary can prop behindcited a timeliness the disunion of the exterior investment, which apportions the fever to expend from the branch’s husk. Advising and explaining are instruction administrations that are the trust of the RN. Tepid baths are not usually chattelsed accordingly of possible for reverberate and quivering.
  6. ANSWER D – The residenceless single has symptoms of fever tickle, a medical necessity, which increases facilitate for brain impairment. Senile endurings are at facilitate for fever syncope and should be educated to repose in cautious area and fly coming low tops. The runner is having fever crams, which can be managed behindcited a timeliness repose and clears. The housewife is experiencing fever want, and administration includes clears (IV or committereral) and cautiousing measures. The prognosis for rectification is amiable.
  7. ANSWER B, D, A, C, E – Organize unresponsiveness earliest. (The enduring may own drunreserved and sustained a younger damnification.) If the enduring is unresponsive, get succor and own someone originate the regularity. Performing the chin raise or jaw push maneuver publics the airway. The comfort is then under obligation for starting CPR. CPR should not be interrupted until the enduring recovers or it is singleized that daring efforts own been unencumbered. A clash cart should be at the plight when the regularity team arrives; thus-far, basic CPR can be chattelsively chattelsed until the team arrives.
  8. ANSWER A – Nursing auxiliarys are trained in basic cardiac vivacity stay and can chattels chest contractions. The use of the bag-valve hide claims exercitation and usually a respiratory therapist gain chattels this administration. The comfort or the respiratory therapist should stipulate PRN propance during intubation. The defibrillator pads are plainly marked; thus-far, attributement should be done by the RN or physician accordingly of the possible for husk impairment and electrical arcing.
  9. ANSWER C – The enduring is hyperventilating cooperateary to eagerness, and b facilitate into a tract bag gain apportion reb facilitate of carbon dioxide. Also, hopeful lazy b facilitate gain succor. Other textures such as oxygen and medication may be demanded if other causes are verified.
  10. ANSWER C – The firm trace clinic gain trade behindcited a timeliness proportionately permanent endurings. Triage, trauma, and pediatric salve should be staffed behindcited a timeliness skilled comforts who distinguish the hospital routines and policies and can speedyly lodge equipment.
  11. ANSWER A – Hale is a toxic material that can transfer to magnitudeive hemorrhage, coma, horrify, and hepatic want. Deferoxame is an depression that can be used for keen cases of hale poisoning. Other notification demands affixed exploration, but gain not shift the contiguous feature testing or texture delineation.
  12. ANSWER C – The LPN/LVN is chattelsual to bestow-ear and stipulate tender stay for her endurings. The other administrations are the trust of an RN or, if conducive, a SANE (sexual attack comfort examiner) who has accepted inoculation to assess, infer and securedguard deposition, and economy for these dupes.
  13. ANSWER C, B, D, A – The dupe should be transportd from the apathetic environment earliest, and then the rewarming order can be rooted. It gain be abstinenceful, so bestow abstinence medication previous to immersing the feet in thermaled inspire.
  14. ANSWER C – The simply improve mediation is C. the digits should be gently purifyd behindcited a timeliness typical memorable, unreserved in barren gauze moistened behindcited a timeliness memorable, and attributed in a tractile bag or incloseer. The incloseer is then attributed on ice.
  15. ANSWER B – IV Lorazepam (Ativan) is the offal of excellent for standing epilepticus. Tegretol is used in the administration of generalized tonic-clonic, nonproduction or qualified cast rapines, but it does not end in an IV produce. PO (per os) medications are indivert for this necessity top. Magnesium sulfate is bestown to manage rapines in toxemia of pregnancy.
  16. ANSWER C – Committer frown is an absolute contraindication; for-this-reason, the physician must be notified. Tetanus standing can be discourseed succeeding. The RN can restart the IV and stipulate notification encircling sensible sedation; if the committer quiet notsatisfied, the physician can bestow prefer notification.
  17. ANSWER D – The enduring introduces behindcited a timeliness symptoms of alcohol affront and thither is a facilitate for Wernicke’s syndrome, which is caused by a thiamine imperfection. Multiples offal affront is not uncommon; thus-far, thither is rush in the scrutiny that suggests an anodyne balancedose that claims naloxone. Affixed notification or the results of the race alcohol resemblingize are sever of the completion texture delineation but should not stay the contiguous texture.
  18. ANSWER C – Postmortem economy claims some turning, cleaning, raiseing, etc., and the nursing auxiliary is chattelsual to prop behindcited a timeliness these duties. The RN should catch trust for the other administrations to succor the producerage initiate the grieving order. In cases of scrutinyeffectual dissolution, belongings may be retained for deposition, so the manacle of keeping would own to be maintained.
  19. ANSWER C, D, B, A – Auscultating and confirming resembling bilateral met sounds should be chattelsed in speedy rotation. If the sounds are not resembling or if the sounds are heard balance the mid-epigastric area, tube attributement must be improveed forthwith. Securing the tube is divert age abideing for the x-ray con-over.
  20. ANSWER B – An impaled intent may be providing a tamponade chattels, and disunion can overwhelm abrupt hemodynamic decompensation. Affixed truth including a prefer enacted cognomen of the race waste, profundity of discrimination, and medical truth should be gained. Other notification, such as the uncleanness on the adhere or truth of diabetes, is relevant in the balanceall texture delineation, but can be discourseed succeeding.
  21. ANSWER A – The enduring demonstrates neurologic hyperdisembodiment and is on the tend of a rapine. Enduring protection is the initiative. The enduring demands chlordiazepoxide (Librium) to reduce neurologic nervousness and phenytoin (Dilantin) for rapines. Thiamine and haloperidol (Haldol) gain besides be commanded to discourse the other problems. The other diagnoses are fit but not as contiguous.
  22. ANSWER B – The stinger gain abide to acquit malice into the husk, so quick disunion of the stinger is advised. Cautious contractes and antihistamines can prosper. The wheedleer should be prefer advised encircling symptoms that claim 911 propance.
  23. ANSWER D – The asymptomatic enduring is currently permanent but should be observed for tardy pulmonary edema, cerebral edema, or pneumonia. Instruction and economy of accurate endurings is an RN trust. Removing investment can be commissiond to a nursing auxiliary.
  24. ANSWER A – Cat’s mouths inclose a virulent organism, Pasteurella multocida, that can transfer to septic arthritis or bacteremia. Thither is besides a facilitate for tendon impairment due to learned poke hurts. These hurts are usually not sutured. A tetanus shot can be bestown anteriorly dismiss.
  25. ANSWER D, B, C, A – The enduring behindcited a timeliness a pulsating magnitude has an abdominal aneurysm that may disseverance and he may decompensate abruptly. The 11-year-old boy demands evaluation to administration out appendicitis. The dame demands evaluation for gallbladder problems that show to be worsening. The 35-year-old man has stay poisoning, which is usually stubborn-limiting.
  26. ANSWER D – At last one procuratorial-to-others from each assemblage should be middle accordingly all employees are possible targets fro rape in the ED.
  27. ANSWER A – A deviated trachea is a symptoms of strain pneumothorax. All of the other symptoms demand to be discourseed, but are of lesser initiative.
  28. ANSWER C, B, D, A, E, F, G – For a multiple trauma dupe, divers mediations gain transfer-fix concomitantly as team members prop in the action. Methods to public the airway such as the chin raise or jaw push can be used concomitantly age assessing for gratuitous respirations. However, airway and oxygenation are initiative. Starting IVs for clear action is sever of staying circulation. (EMS gain usually organize at last one IV in the room.) Nursing auxiliarys can be straightforwarded to catch vivacity-supportings and transport investment. Foley catheter is ineviteffectual to closely mentor output.
  29. ANSWER A – In preparing for afflictions, the RN should be informed of the necessity defense delineation. The delineation bestows direction that includes roles of team members, responsibilities, and mechanisms of noiseing. Signs and symptoms of divers agents gain follow spiritless complaints, such as flu-like symptoms. Discussions behindcited a timeliness colleagues and supervisors may succor the single comfort to designation through ethical dilemmas connected to possible peril to stubborn.
  30. ANSWER A – Protection is a initiative for this enduring, and she should not revert to a attribute whither rape could reoccur. The other non-interferences are relevant for the crave signal administration of this economy.

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