Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Certified Emergency Nurse Exam > CEN FLASHCARDS > Flashcards

CEN FLASHCARDS

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards
1
Q

Treatment for cocaine OD for A.C.S.?

A

Nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Positive for ethylene glycol toxicity in urine?

A

Calcium oxalate crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Patient loses 30% of blood volume. What happens?

A

Shunting to increase end organ perfusion. VASOCONSTRICTION
INCREASE PERIPHERAL VASCULAR RESISTANCE INCREASE PRELOAD
INCREASE CARDIAC OUTPUT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Classic triad for CARDIOGENIC SHOCK?

A

Tachypnea / Distended Neck Veins / Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Recommended bolus with blood products in pediatrics?

A

10ml / kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Life threatening emergency caused by edema above the vocal cords. Rapid onset of high fever. Sore throat. Mouth breathing, drooling, and tripod positioning.

A

Acute Epiglottitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Psychotic situation that’s a symptom of schizophrenia?

A

Paranoia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Implied consent

A

Unable to give consent but needs life saving measures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Expressed consent

A

Written or oral agreement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Involuntary consent

A

Patient refuses but police or MD deem it necessary.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Informed consent

A

Full understanding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Excess A.D.H. causes what kind of electrolyte imbalance?

Puts the patient at high risk for developing _______ which leads to ________.

A

Hyponatremia

Cerebral edema which leads to seizure activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What’s the opposite of Excess A.D.H.?

A

Diabetes Insipidus (suppression of A.D.H.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Can be a life threatening condition if infection spreads to deeper tissues like skull base, cranial nerves, and even coratid artery. Usually starts at the ear. Whose at risk?

A

Malignant otitis externa

Elderly and immunocompromised patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of stool with peptic ulcers?

A

Tarry stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Foul smelling fatty stools

A

Pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of stools with Ulcerative Colitis?

A

Bloody diarrhea stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of stools with I.B.S.?

A

Large frequent stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Right Atrial Hypertrophy EKG changes

A

Leads 2 and 3 has peaked P waves, more than 2.5mm in height.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Left Atrial Hypertrophy EKG changes

A

Broad notched P waves in V1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Recommended treatment to lower b/p with chronic HTN?

Decrease by ____to____% over what time frame?

A

20-30% over 2-3 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define Q-wave? Type of deflection? Appears after _____. Height?

A

Negative deflection
Comes after P wave
Deeper than 1/3 QRS height or longer than 0.04 seconds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What to watch for with unknown amount of Tricyclic Antidepressant (Elavil) ingested?

A

Cardiovascular status because it causes prolonged PR, QT, widened QRS, and eventually leads to v-tach.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Most common dysrhythmia of a patient that has suffered electric shock?

A

v-fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What’s the palpation systolic pressure for

Coratid, Femoral, and Radial pulse?

A

CORATID 60mmhg
FEMORAL 70mmhg
RADIAL 80mmhg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

GSW arrives to ED. During the assessment and documentation the nurse would do what with
forceps, clothes, wounds, and gun powder.

A

Place plastic over the teeth to not damage the bullet.
Place clothes in clean paper bag, seal, and label.
Document as wound; not entrance and exit.
Scrape gun powder onto clean paper and place into envelope, seal, and label.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

2 days after patient is in car crash they c/o flashes of light, floaters in peripherals, or looking through cob webs, what do you do?

A

Shield the eyes and obtain ophthalmology consult.

DETACHED RETINA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

You decrease the K in a patient in renal failure. What are the EKG changes to show the treatment worked?

A

Shortened PR interval
Decreased T save height
Increased HR
Shortened QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

COPD characteristics of fingers, type of breathing, expiratory phase does what?

A

Clubbing
Prolonged Expiratory Phase
Purse lipped breathing to aid in exhalation r/t permanent over-distention of alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Patient has been to the ER 4 times in the past 2 months w/ asthma flare ups at night. Bronchiodilators given with the ABG reading Bicarb of 30mEq & PaCo2 50mmhg. What’s the problem?

A

Gastroesophageal Reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pt with tension pneumo needs what before what?

A

Needle thoracentesis (treatment) before CXRAY (diagnostics).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

The purpose of a water seal chamber in a chest tube drainage system is to ……

A

allow air out of the chest but not let air into it. Once the air is expelled from the chest the chamber shouldn’t bubble. If it does then there is an air leak. Start at the chamber and work your way towards the patient in order to trouble shoot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Critical Incident Stress Debriefing (CISD) sessions should commence with in what time frame of the event?

A

1-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Partial seizure

A

Facial grimace or lip smacking (specific body part).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Absence (Petite Mal)

A

children 4-12, abrupt LOC, last about 15 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Tonic Clonic (Grand Mal)

A

Sudden LOC, major muscle group movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Status Epilepticus

A

Series of consecutive seizures or a single one that doesn’t respond to treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Damage to which area of the central cord will result in loss of voluntary movement?

A

Anterior Corticospinal Tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Complication with Diphtheria and why? How to diagnose?

A

Difficulty breathing and swallowing r/t the GRAY WHITE membrane covering the pharynx and larynx. Diagnostic by throat culture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

List 3 s/s with thyrotoxic crisis. One being more serious than the others. What’s another name for this disorder?

A

Tachydysrhythmias, hyperthermia, and agitation

Thyroid storm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Cardiac arrest r/t 9.3 K. What’s the treatment and why? Most 2 important drugs to give.

A

Calcium to antagonize the toxic effects of K at the myocardial cell membrane.
Albuterol for intracellular shift.
Other drugs like sodium bicarbonate, insulin, D50, and Kayexalate (onset 1-2 hours).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Most common fluid electrolyte imbalance seen in renal failure?

A

Elevated K (LIFE THREATENING)
Decreased NA
Decreased Calcium
Elevated Phosphorus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Most reliable diagnostics for suspected pancreatitis.

A

CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Blunt force trauma, diffuse abdomen tenderness, and pain shoots to the testicles. What organ is injured?

A

Duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Indication that the patient is being paced?

A

Wide complex after the spacer spike, palpable central pulse at 70 beats per minute.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Implantable defib/pacer who develops v-fib, what to do?

A

Difibrillate and avoid placing pads over the pacemaker.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

The time frame for the start of iron overdose symptoms? When does it peak?

A

60 minutes

3-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What does the water chamber do when patient is breathing?

A

Moves up and down. On exhale it may bubble a little r/t lung trying to expand.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

8 hour history of priapism, what’s the priority?

A

Pain meds and then drain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Side effect of Tensilon (given for myasthenia gravis). You need to have ______ at the bedside.

A

BRADYCARDIA

Atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Antidote for thyroid storm? Mortality rate?

A

Propylthiduracil (PTU). High.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Hep A incubation period and can’t work for how many days?

A

15-50 days and can’t work for 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What happens to oxygen level, metabolic state, b/p, blood vessels, and hematocrit level in patient with sickle cell crisis?

A 
Hypoxia
Acidosis
Hypotension
Vasoconstriction
Increase in hematocrit
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Primary complication associated with Addison’s? Why? What 3 meds used to treat?

A

Shock

Cortisol deficiency is life threatening because corticoids are needed for maintenance of blood volume, blood pressure, hemostasis (process which causes bleeding to stop), and glucose.

Steroids, Glucose, and vasopressors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Reye’s syndrome in children is characterized by what lab test? Ranges for Reye’s? 2 Tests in particular.

A

Ammonia, will be greater the 300mg/dl (normal 10-60)

Lactic Acid, will be around 21mmol/L (normal is 0.5-1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Clinical feature of hypercalcemia? EKG? Urination? General feeling, muscle strength, and reflexes?

A

QT shortening with wide T wave.
Polyuria.
Fatigued, decrease strength and reflexes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Ectopic pregnancy given methotrexate, patient teaching?

A

Vaginal bleeding doesn’t occur until patient has normal period.
Pt with ectopic pregnancy is likely to have another one.
Beta-HCG should drop; if not she needs another dose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Incomplete Abortion
Inevitable Abortion
Threatened Abortion
Missed Abortion

A

Incomplete - Heavy vaginal bleeding, abd cramping, retention of SOME POC.
Inevitable - Heavy vaginal bleeding, abd cramping, open cervix but no passage of POC.
Threatened - Vaginal bleeding, mild cramping, closed cervix.
Missed - Death of fetus w/o expulsion, no maternal symptoms, no FHT, no movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Early s/s of hypovolemic shock? Respiratory, Diastolic, LOC?

A

Increase rate and depth
Diastolic increases r/t sympathetic response on peripheral vascular resistance (Vasoconstrict to save vital organs).
Anxiety, restlessness, and confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Residual volume in children vs. elderly.

What is residual volume?

A

DECREASED in children
INCREASED in elderly
Amount of air left in the lungs after exhalation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Corticoid steriods may cause _______ in elderly.

A

Confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Serious side effect in dilantin?

A

Hypotension and Bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Elderly with head injury and gets progressively altered over 3 weeks?

A

Subdural Hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What area of the rhythm is the synch button synching with?

A

R-Waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Patient presents to ED with lacrimation, salivation, n/v, bradycardia after eating blackberries? What is it from? Medication to treat?

A

Organophosphates (Nerve Agent).

Administer atropine sulfate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Treatment of hydrofluoric acid (found in home rust removers)? Antidote? DO NOT apply_____?

A

Calcium Gluconate

Water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

______ ______ are not calculated in the total body surface area.

A

Superficial burns.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

3 S/S of epididymitis?

A

Urethral Discharge
Pain develops gradually
Pain decreases w/ scrotal elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Sounds with obstruction of trachea vs. larynx?

A

Trachea - wheezes

Larynx - hoarseness, aphonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Joint effusion presents with…..

A

Localized pain, warm skin, limited ROM, erythema, joint tenderness, and edema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Early sign vs. late sign of ICP.

A

Early- decreased LOC

Late- widened pulse pressure / low HR / Dilated nonreactive pupils.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Body position for ICP? List 2.

A

Supine with neutral body position.

Reverse Trendelenberg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

CVP monitoring ranges? Where does it measure from? What’s it for?

A

8-12mmhg

Measures pressure in the Rt. Atrium.

Gives estimation of the fluid volume in the vascular system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Pt. vomiting every 30-40 minutes would put them in ______ ______ and ______ as an electrolyte imbalance.

A

Metabolic Alkalosis (loss of potassium, chloride, and hydrogen ions)

Hypokalemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Pt’s discharge instructions for mononucleosis. List 3. What organ do you need to be concerned about? Symptoms last? Return to ER if?

A

No heavy lifting related to splenomegaly; may cause splenic bleeding.

Pt may have fever for 10-14 days, as well as sore throat, diarrhea, and earache.

Return to ER if increased abd pain, SOB, cough, chest pain, and increase fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Lap belt injury from MVC will be at risk for (ADULT)?

A

Rupture of the colon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Discharge instructions with acute prostatitis?

A

Increase fluids to assist in bacteria elimination.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Drug treatment for preclampsia? Watch for what side effect?

A

Respiratory rate needs to be closely monitored. Muscle weakness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Greatest concern in a patient with a chemical burn to the eye?

A

Altered visual sensory perception.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

STD discharge
Trichomoniasis
Gonorrhea
Candidiasis

A

Trichomoniasis = Gray or Greenish

Gonorrhea = Yellow

Candidiasis = Thick and White (Cheese Like)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Kehr’s sign? Injury to what organ?

A

Left shoulder pain r/t irritation by the diaphragm; found in splenic injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

NSR and the pt’s ICD goes off, what is the treatment?

A

Place magnet over it to turn it off.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Organism associated with respiratory infections?

A

Streptococcus Pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Organism associated with puncture wound of the foot while wearing a rubber soled shoe?

A

Pseudomonas Aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Injured the central cord that’s responsible for proprioception, fine touch. Which part?

A

Posterior Tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q 
Spinal Cord injury assessment
C 2,3,4
C 5,6,7
L 2,3,4
L 4,5
S 3,4,5
A

C 2,3,4 Diaphragm (Needs to be placed on vent)
C 5,6,7 Extension / Flexion of arms
L 2,3,4 Extension / Flexion of legs
L 4,5 Flexion of foot / Extension of toes
S 3,4,5 Anal sphincter tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Diagnostic for posterior wall MI?

A

EKG to the back of the patient.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

ST elevation in

Inferior Wall MI
Anterior Wall MI
Lateral Wall MI

A

Inferior - II, III, AVF

Anterior Septal - v1 -v4

Lateral - v4, v5, Lead 1, AVL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Why administer beta blockers to STEMI pt?

A

Reduce mortality and morbidity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Characterized by alternating euphoric moods with depressive moods?

A

Bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Characterized by bizarre behaviors, hallucinations, and an inability to care for self or function well in a social environment.

A

Schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Colorimetric exhale CO2 detector colors and what do they mean?

A

Purple or Beige = Placement is questionable. If it yields a purple color on inspiration and stays purple on expiration it is most likely in the esophagus (when adequate perfusion is present).

Yellow = It’s in place.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

A nurse may delegate a task if the other person has the appropriate _____, ______, ______, and ______.

A

License
Education
Experience
Competency

94
Q

Characterized by nightmares, hyper vigilance (watchfulness), hallucinations, and generalized anxiety.

A

PTSD

95
Q

Describe the HALO sign and what is it indicative of?

A

Drainage from ear placed on filter paper where it separates into two distinct rings.
Basilar Skull Fracture

96
Q

Serotonin Syndrome characteristics?

A

Confusion, agitation, hyperreflexia, hyperthermia, and diaphoresis.

97
Q

ACE Inhibitor side effects?

A

Angioedema is the most concerning but cough is one also.

98
Q

Fears at what ages….
Birth to toddler
Preschooler
Adolescence

A

Stranger and parental separation.

Bodily mutilation, insides leaking out, the dark, pain, and the unknown.

Loss of control and change in body image.

99
Q

Bradycardia in pediatric patient is defined as _____?

A

Slower than the lowest expected rate for the child’s age.

100
Q

High speed MVC patient sustained an injury to the abdomen.
RUQ - What’s injured? List 3.
LUQ - What’s injured? List 5
Retro-peritoneal Area - What’s injured?

A

RUQ - Liver, ascending colon,and spleen.

LUQ - Pancreas, small intestine, transverse & descending colon, stomach. 50% MORTALITY RATE!!!!

Retro-peritoneal - Kidneys.

101
Q

Pt is pregnant and has headache, swelling of ankles, elevated blood pressure, FINE RED LINE RASH on the pt’s abdomen. What is it?

A

s/s of HELLP (hemolysis, elevated liver enzymes, low platelets)

102
Q

Respiratory Acidosis ABG?

A

PH Low, PaCO2 High (Indicates respiratory issue), HCO3 High (Compensated for increase PaCO2).

103
Q

Respiratory Alkalosis ABG?

A

PH High, PaCO2 Low

104
Q

Metabolic Acidosis ABG?

A

PH Low, PaCO2 Low to Normal, HCO3 Low

105
Q

Metabolic Alkalosis ABG?

A

PH High, PaCO2 Normal, HCO3 high

106
Q

What is a Pneumomediastinum?
Cause?
S/S?
Treatments?

A

Air in the mediastinum (space between lungs).
Occurs in rapid ascent altitude changes.
Chest pain beneath the sternum and progressive dyspnea.
Remove mediastinal gas via mediastinoscopy, thoracostomy, and percutaneous drainage.

107
Q

Medication for treatment of pericarditis?

A

Indocin (NSAIDS)

108
Q

Subjective s/s of pregnancy induced hypertension?

List 4.

A

Visual changes / Headache / Right sided upper abd. pain / Decreased urination.

109
Q

Methotrexate given to ectopic pregnant patient. What,s the patient education of med and situation? Return if ______, _______, and ______.

A

Folic acid antagonist that prevents duplication of the fetal cells. Serum HCG levels should drop as the pregnancy fails to develop.

Dizzy, Pallor, or Increased HR.

110
Q

Diet for GERD?

A

Small frequent meals.

111
Q

Diet for Gastric Ulcer?

A

Bland low fiber diet.

112
Q

———-Physical characteristics of a child———
Blood = How much can a child lose before s/s of hypotension?

Body Surface = Body surface r/t body weight? Extra and Intracellular volume ratio?

Respiratory = In relation to inhalation of toxic substances?

A

Children can lose 25% of blood volume before s/s of hypotension.

Greater body surface in proportion to body weight, and they have a higher extra and intracellular fluid volume ratio.

Increase respiratory rate puts them at risk for inhaling more toxic substances.

113
Q 
Childhood immunizations time frame
HIB (influenza B)
Hep B
DTap
MMR
A

HIB - Immediately after birth.
Hep B - Immediately, 4 weeks, 16 weeks, 24 weeks (six months)
DTap - 2 months, 4 months, 6 months
MMR - 12 months, 4-6 years old.

114
Q

Medication commonly used for schizophrenia?

A

Respiradal

115
Q

Pt is on coumadin, falls, and ends up with subdural hematoma. What’s the treatment?

A

200 to 500ml of FFP to return clotting factors back to normal.

116
Q

——–Heart Sounds——–
S3 - Condition - Cause

S4 - Condition - Cause

Split S1 - Condition -

A

S3 - CHF - Excess fluid remains in the ventricle at the end of systole. The new blood entering the chamber interacts with the residual fluid that causes S3 sound.

S4 - CAD & Hypertension - From a forceful atrial contraction in presystole.

Split S1 - BBB & Aortic Stenosis

117
Q

Flow of the heart and start at the superior vena cava and end with the aorta.

A

superior vena cava - rt atrium - tricuspid - rt ventricle - pulmonary valve - pulmonary artery for oxygenation - pulmonary veins - lt atrium - mitral valve - lt ventricle - aortic valve - aorta

118
Q

Left side heart failure

Cause and Symptom

A

Blood backs up into the pulmonary system, causing dyspnea.

119
Q

Right side heart failure

Cause and Symptom

A

Blood backs up into the systemic vasculature giving s/s of JVD, Peripheral Edema, and Hepatomegaly.

120
Q

Organism seen in cat bites?

A

Pasteurella Multocida

121
Q 
--------Meneires Disease--------
Nature?
How often are the symptoms?
How long the episodes last?
Symptom that differentiates it form vertigo?
A

Episodic
Several times a week or month
Duration of 2 - 8 hours
Vertigo has unilateral hearing loss along with N/V

122
Q

Most common consequence w/ trauma of a pregnant patient?

Rx. treatment?

Place the patient in what position?

A

Preterm labor contractions 5/t the releasing of prostaglandins from cellular damage, which stimulates the uterus.

Treatment is tocolysis (Magnesium) to stop the contractions. Fluid replacement.

Place the patient in lateral tilt position.

123
Q

HCO3 normal ranges?

Too low or high means what?

A

22-26 meq/L
Lower than 22 = acidosis
Higher than 26 = alkalosis
(Same as the PH)

124
Q

PaCO2 normal ranges?

Too low or high means what?

A

35 - 45 mmhg
Lower than 35 Alkalosis
Higher than 45 Acidosis
A level greater than 45 could be indicative of hyperventilation.

125
Q 
Base Excess (BE) normal ranges?
Too low or high means what?
A

-2 to +2 mEq/L
Indicates the amount of excess bicarbonate is in the system and how well the body is trying to compensate or correct itself.
Lower than -3 is Metabolic Acidosis
Higher than +3 is Metabolic Alkalosis

126
Q

List 3 diagnosis of when to use the hyperbaric chamber?

A

Decompression sickness
Air of Gas Embolism
Carbon Monoxide Poisoning

127
Q

May need rabies shot if bit from _____, _____. _____, and _____.

A

raccoon, skunks, foxes, and bats.

128
Q

———-Reye’s Syndrome——–
List two most important organs affected.
Hallmark finding?

A

Found in children that have been given aspirin that previously had a viral infection.

2 organs that are affected is the liver and brain (encephalopathy, cerebral edema)

Hallmark finding is an ammonia levels greater than 300 in children.

129
Q

Normal findings of CSF?
RBC

Spinal fluid pressure

WBC

Glucose

A

RBC - 0, If the RBC count is elevated suspect traumatic spinal tap or subarachnoid bleed.

Spinal fluid pressure - 50-200mm/h2o; High pressure could indicate intracranial hypertension or cerebral edema.

WBC - 0-5mm3; High indicates infection

Glucose - 50-75 / 100ml ; Decreased levels are associated w/ bacteria in spinal fluid.

130
Q

A child’s circulating blood volume?

A

80ml/kg

131
Q

An infant’s circulating blood volume?

A

90ml/kg

132
Q

An adult’s circulating blood volume?

A

70ml/kg

133
Q

Post transplant patient should not take _________ herb because they may experience transplant rejection.

A

St. John’s Wart

134
Q

Adverse effects of urecholine (bethanechol)? What is it used for?

A

Polyuria, diarrhea, abd cramping, hypotension, and increased salivation.

Used in the treatment of GERD, increases sphincter pressure and facilitates gastric emptying.

135
Q 
Suture removal days and body parts?
Upper or lower ext. without joint involvement?
Face?
Scalp?
Knee or Joint?
A

Upper or lower ext. 7-10 days.
Face 3-5 days.
Scalp 5-8 days.
Knee or Joint 12-14 days.

136
Q

Colle’s fracture? What bones are involved?

A

“fork” deformity. Combined fracture of the radius and ulnar forming a “hump” deformity.

137
Q

Most common fractures of ______ and ______ when landing on feet from high fall.

A

Calcaneous and lumbosacral compression fracture.

138
Q

EKG changes for WPW?

Treatment?

Explain the electrical conduction issue in the heart.

A

Shortened PR Interval and Widened QRS complex with DELTA wave (looks like an upwards ski slope coming right after the P wave).

Ablation, if critical pt may need synchronized cardioversion.

Extra electrical conduction pathway causing electrical signal to arrive at the ventricle too soon.

139
Q

Hyphema is usually caused by_____.

Describe it.

A

Trauma.

Blood suspended in the anterior chamber of the iris.

140
Q

Patient is in sickle cell crisis, list 2 tests done and their values.

A

LDH Lactate Dehydrogenase 75-220 U/L
Reticulocyte Count 2-20%
Retic % .50-2.0%

141
Q

Edema to the conjunctiva and pertains to the superficial portion of the eye.

A

Chemosis

142
Q

Difference between Infarction vs. Ischemia?

EKG differences?

A

Ischemia left untreated leads to infarct.
T-wave depression is indicative of the ischemia.
ST elevation indicates infarction.

143
Q

Classic s/s tracheobrachial injury? List 4?

A
  1. Subcutaneous Emphysema in the neck, face, and suprasternal area.
  2. Tachypnea.
  3. Hemoptysis.
  4. Hoarseness.
144
Q

Sympathomimetric toxidrome s/s, rx. examples?

A

Cool, clammy, dilated pupils, increase heart rate.

Ephedrine in the cold medicine.

145
Q

Cholinergic toxidrome s/s, rx. examples?

A

Bradycardia, hypothermia, tachypnea, and bronchorrhea.

Organophosphates.

146
Q

Anticholinergic toxidrome s/s, rx. examples?

A

Coma, Decreased breath sounds (resp. suppression), flushing, hallucinations, dilated pupil.
All the “ANTI’s” like antihistamines, antipsychotics, antiparkinsonians, antidepressants.

147
Q

Sedative / Hypnotic toxidrome s/s, rx. examples?

A

Decrease CNS functions, apnea is major concern.

GHB, Barbituates, Anticonvulsants, Ethanol.

148
Q

Hypokalemia on monitor shows? List 3?

A

ST depression
Bradycardia
Prolonged PR interval

149
Q

What’s the treatment for Black Widow Spider Bite?

A

Muscle Relaxant related to it being a neurotoxin.

150
Q

What’s the treatment for Jellyfish sting?

A

Apply vinegar.

151
Q

What’s the treatment for Brown Recluse Spider?

A

Give Dapsone.

152
Q

Ammonia Hydroxide causes?

A

Corrosive alkaline that can cause severe necrosis to esophagus on contact.

153
Q

Sulfuric Acid causes?

A

Necrosis of the stomach.

154
Q

Lithium Carbonate causes?

A

Heavy metal that damages CNS.

155
Q

Paint thinner causes?

A

Petroleum distillate that affects the lung surfaces, causing pneumonitis.

156
Q

CVP Levels for a patient in septic shock. What do the levels need to be?

A

Fluid resuscitation is used to maintain the CVP from 8-12mmhg.

157
Q

Cyanide antidote

A

Amyl Nitrate

158
Q

Organophosphates antidote

A

Atropine

159
Q

Mustard Gas (Vesicants) antidote

A

Dimercaprol

160
Q

Iron poisoning antidote

A

Deferoxamine

161
Q

S/S of carbon monoxide poisoning, list 4?

A

Headache, tachycardia, hypotension, and metabolic acidosis.

162
Q

Used to treat depression?

A

Elavil (Tricyclic Antidepressant)

163
Q

Medication used for bipolar presenting in a manic state?

A

Lithium

164
Q

Advair may cause ________ in the elderly. What type of drug is it?

A

Depressive Symptoms.

Corticosteriods.

165
Q

Associated with emphysema? List 3.

2 are forms of breathing and 1 physical characteristic

A 
Thin limbs (Dyspnea limits eating)
Tripod posture
Pursed lips (self peep)
166
Q

Premedicate with _________ to alleviate increased ICP associated with RSI. Name 3 medications that fall into this catagory.

A

Nondepolarizing blocking agent (pancuronium, vecuronium, and rocuronium).

167
Q

Name example of depolarizing agent.

A

Succs.

168
Q

Describe Myoclonic Seizures

A

No LOSS OF CONSCIOUSNESS!

Sudden muscle contraction that may be generalized or limited to individual muscle groups. Looks like subtle tremors.

169
Q

Describe Generalized siezure

A

No LOSS OF CONSCIOUSNESS!

They stare into space. Minor motor movements such as blinking or nystagmus.

170
Q

Potential complication of solumedrol in a patient with spinal injury? List 5.

A 
Hyperglycemia
Infection
HTN
Low K+
Thrombocytopenia 
GI Bleeding
171
Q

What to think about when patient receives multiple units of PRBCs?
Name two electrolyte imbalances?
After 5 units give______.
After 10 units give______.

A

Hypocalcemia after 5 units because citrate binds with free calcium. The treatment is to give calcium.

Hyperkalemia because lysis of red blood cells releases potassium. The treatment is to put them on the monitor.

Acidosis since blanked blood is 7.1. The treatment is to monitory the heart.

Decreased clotting time after 10 units. The treatment is to administer FFPs.

172
Q

APGAR score, describe

A

Appearance-Blue, Pale, or Pink
Pulse-None, less than 100 or greater than 100
Grimace-None, Weak, or Cries
Activity-None, Some flexion of arms or Both extended
Respiration-None, Weak, or Strong Cry
0-10 scoring system.

173
Q

You should watch for an injury to _____, _____, and _____ if it’s a lap belt injury in children.

A

Lumbar spine fracture, Duodenal, and Pancreatic injuries.

174
Q

Capnography wave form that looks like a shark fin?

What does hyperventilation look like?

A

Bronchospasm. The shape is caused by uneven alveolar emptying as the patient struggles to exhale.
Normal shape but a lower plateau.

175
Q

Most common electrolyte imbalances seen in ARF patients? List 4. Which is the most important?

A

Hyperkalemia (most important)
Hyponatremia
Hypocalcemia
Hyperphosphatemia

176
Q

The 4 classes of hemorrhage.
% lost?
ml lost?
s/s?

A
  1. 15%, 750ml, HR and BP normal.
  2. 15-30%, 750ml-1500ml, 100-120 BPM with BP being normal.
  3. 30-40%, 2000ml, 120-140bpm, Increase in RR, Increase in BUN.
  4. Greater than 40%, above 150 bpm, low BP, coma and cyanosis.
177
Q

Myexedema Coma

Cause, EKG, and Lab values?

A

Occurs with untreated hypothyroidism.
EKG shows bradycardia, prolonged QT intervals, ST segment and T wave changes.
Labs = Increased TSH and Decreased T4; LOW Blood sugar, b/p, HR, and sodium.

178
Q

What’s the cause of Thyroid Storm and what’s the lab values?

A

Undiagnosed and untreated hyperthyroidism.
LOW TSH and HIGH T4.
Opposite of myexedema coma.

179
Q

What’s the cause of inappropriate antidiuretic hormone (ADH)? Electrolyte imbalance? High risk for_______.

A

Occurs when the pituitary gland releases excessive ADH which results in excessive H2O retention causing water intoxication.
Severe hyponatremia, which leads to fluid shifts causing cerebral edema. Puts patient at high risk for seizures.

180
Q

What’s the cause of diabetes insipidus? S/S? Electrolyte imbalance?

A

Suppression of the ADH or the kidney’s ability to concentrate the urine.
S/S are polyuria and polydipsia
The H2O disturbance results in dehydration and hypernatremia.

181
Q

What is found in soil, human and animal intestines?

A

Clostridium Tetani

182
Q

Treatment for ASA overdose?

A

Activated Charcoal

183
Q

Which electrolyte imbalance would you find in a patient in adrenal crisis? List 3. What metabolic state would you find them in?

A

Hypoglycemia r/t low cortisol levels not balancing insulin. Hyponatremia r/t unable to retain NA because of low levels of aldosterone.
Hyperkalemia r/t aldosterone levels dropping causes body to retain K+ and lose NA.
METABOLIC ACIDOSIS

184
Q

What’s the difference between heat stroke and heat exhaustion?

A

Heat stroke - Temp 106, organ damage, dilated fixed pupils, tachypnea, delirium.
Exhaustion - Temp 104, dizzy, Low B/P, oliguria, muscle cramping.

185
Q

Wellen’s syndrome?

A

T wave changes plus a history of anginal chest pain with out serum marker abnormality.

186
Q

Recommended diet for IBS?

A

High fiber diet to decrease cramping and bloating.

187
Q

Blood collection between the dura and the skull?

Fatality%?

A

Epidural

15-20%

188
Q

Pt on Bipap for acute pulmonary edema. What’s the most accurate indicator for improvement? ABG finding?
In what time frame should you see improvement?

A

The PaCO2 will be decreased, and happens with in 1-2 hrs.

189
Q

Example: Feeling on the right side of the body but not the left, and can move the left but not the right.

A

Brown Sequard Syndrome

190
Q

ABG of pregnant patient wound indicate?

Why?

A

Due to increased levels of progesterone it causes the patient to have a low PaCO2. 30-34 mmHg. (35-45 is normal).

191
Q

Hypercalcemia s/s?

A 
Decreased muscle strength
Hyporeflexia
Lethargic
Hypertensive
Confused
Polyuria
192
Q

Most common dysrythmia with inferior wall MI? What artery is affected?

A

Bradycardia r/t infarction of RCA

193
Q

Bowel sounds for small bowel obstruction?

A

Frequent high pitches r/t the force of peristalsis attempting to move bowel contents thru the obstruction.

194
Q

Bowel sounds for Gastroenteritis?

A

Hyperactive bowel sounds r/t hyperperistalsis causing diarrhea along with n/v.

195
Q

Bowel sounds for paralytic ileus?

A

Absent bowel sounds caused by bowel paralysis and decrease in peristalsis.

196
Q

Primary complication associated with bowel obstruction?

A

Dehydration.

197
Q

Core temp 86. Treatment?

A 
ACTIVE CORE REWARMING
Continuous arteriovenous rewarming (CVR)
Warm humidified oxygen
Mechanically warmed fluids
Peritoneal lavage
Bladder irrigation
198
Q

Core temp 95. Treatment?

A

PASSIVE REWARMING
Blankets
Bear Hugger
Remove we clothes

199
Q

Pt falls on out stretched hand and complains of pain and tenderness at the “snuff box” the nurse should expect fracture of the _________ bone.

A

Scaphoid

The fracture may not show up for 2 - 4 weeks.

200
Q

S/S of diptheria?
How is it diagnosed?
What to watch for?

A

HIGHLY contagious disease that produces a systemic toxin.
Causes a gray white membrane that covers the pharynx and larynx. Swelling can make it difficult to swallow or breath.
Diagnosis by throat culture from beneath the membrane or the membrane itself.

201
Q

Autonomic Dysreflexia

A

Spinal cord injury above the T6.
S/S are headache, sweating, HTN, dysrhythmia.
FLUSHING above the level of the injury and COOLNESS below the level of the injury.

202
Q

2 Hours after eating seafood and the patient complains of n/v/d with generalized weakness. What’s the cause?

A

Bacterial food poisoning (RAPID ONSET).

FYI: Heavy metal contamination of fish or shell fish may produce neurological s/s later.

203
Q

Diaphragmatic Injury
Pain where?
Commonly ruptured on ______ side.
Where are the bowel sounds heard?

A

Left shoulder (Kehr’s).
Left side r/t liver protecting the right.
Bowel sounds in the thoracic cavity.

204
Q

What’s the difference between Varicella vaccine (Varivax) & Varicella Zoster Immune Globulin (VZIG)?

A

Varivax is for HEALTHY CHILDREN 12 months -18 years old who haven’t been immunized or who haven’t had the pox.
VZIG is for post exposure prophylaxis of susceptible PREGNANT WOMEN and perinatally exposed NEW BORNS.

205
Q

Type of embolism that is caused by physical trauma such as fracture of long bones, soft tissue trauma, and burns? What are s/s and where?

A

FAT EMBOLISM which presents with petechiae on anterior neck and chest, upper arm, axilla, shoulder, oral mucosa, and even the conjuctiva.
It results from occlusion of dermal capillaries by fat, and increasing capillary fragility.

206
Q

D/C instructions for peak exspiratory flow meter?
How many times do it?
What do the colors mean?

A

Do it 3 times and take the highest of the three.
Under 50% of personal best indicates need for urgent medical attention.
50-70% (Yellow Zone) use rescue inhaler but don’t come to ER.
Green - OK
Yellow - Take inhaler
Red - Seek attention

207
Q

A connective tissue disorder that’s hereditary. These patients are unusually tall with long limbs, fingers, and toes. What’s the most serious manifestations?

A

Morfans.

Heart valves and aortic dissections.

208
Q

Describe malignant hypertension? And complications with it?

A

Sudden increase in blood pressure possibly from missing doses of meds. This is a hypertensive emergency and needs to be addressed immediately. Long term isues could lead to retinopathy, heart failure, renal compromise, and even encephalopathy.

209
Q

Genetic disorder.
RBBB with ST elevation in v1-v3.
AKA sudden unexpected death syndrome.
This is the most common cause of sudden death in young men with known cardiac disease.

A

Brugada syndrome.

210
Q

Neurogenic Shock

A

Loss of sympathetic (voluntary) function below the level of the spinal cord injury.
The unopposed vagal (parasympathetic) stimulus which leads to hypotension and bradycardia r/t vasodilation.
(LOSS OF FUNCTION / HYPOTENSION / BRADYCARDIA)

211
Q

S/S and cause of Rocky Mountain Spotted Fever?

A

Transmitted by Dog and Wood ticks.
NEUROLOGICAL SYMPTOMS
Ataxia, Paralysis of limb, Decrease in reflexes, Parasthesia
Respiratory failure if left on and not treated. Removal of tick and antibiotics ASAP.

212
Q

S/S and cause of Lyme disease?

A 
Caused by a Deer Tick.
EXPANDING BULL'S EYE CIRCLE ON SKIN
Flu like s/s
Menengitis 
Atrioventricular Blocks
Hepatitis
213
Q

Brisk, painless vaginal bleeding.

A

Placenta Previa (P=PAINLESS)

214
Q

Board like Uterus, decreased fetal heart rate.

A

Abruptio Placenta

215
Q

Medication used for major depression, PTSD, OCD, social anxiety, or panic disorder?

A

Zoloft (Selective Serotonin Re-uptake Inhibitor / SSRI)

216
Q 
Red rash that starts at the face, spreads to the trunk, and then ext. 
Rash lasts 2-3 days.
Contagious 1 week prior to outbreak. 
Joint pain. 
Lymph nodes swollen.
A

Rubella

217
Q

Varicella (Chicken Pox)
Presentation on skin?
Where is it located on body?
Symptoms develope about ____ to ____ days after contact with virus.
New spots will appear every day for up to ___ to ___ days.
Red dots to blisters being crusted over takes about ____Days.

A 
Red, raised, and fluid filled lesions (all different stages).
Trunk and face.
14-16
5-7
10
218
Q

Descriptive research

A

Attempts to describe a problem that has not been examined before.

219
Q

Qualitative research

A

The findings are not presented statistically but rather in words through description.

220
Q

Experimental research

A

Involves doing something different to at least one treatment group.

221
Q

Quasi-experimental research

A

Manipulates a variable but can not randomly assign subjects to control group.

222
Q 
Suture removal 
3-5 days
5-7 days
7-10 days
10-14 days
A

3-5 Face, lips, and eyelids
5-7 eyebrow and scalp
7-10 back, chest, arm, hands, thigh
10-14 lower legs, feet, and joints

223
Q

Early signs of ETOH withdrawal? List 2.

A

Insomnia and anxiety

224
Q

Wound botulism infection s/s? What bacteria?

A

caused from clostridium botulinum
descending paralysis
difficulty speaking or swallowing
dilated fixed pupils

225
Q

Increases risk of PID?
Increases risk of UTI?
Both are medical devices.

A

PID-IUD

UTI-Diaphragms

226
Q

Describe La Forte 1,2, & 3

A
  1. Transverse fracture of the maxilla above the upper teeth at the level of the basal floor.
  2. Pyramidal-shaped fracture that involves a triangular segment of the mid portion face and nasal bones.
  3. Complete separation of the cranial attachments from the facial bones, resulting in craniofacial dysjunction.
227
Q

Avoid _____, _____, _____, and _____ herbs when taking aspirin. 4 Gs

A

Garlic
Ginger
Ginseng
Ginkobiloba

228
Q

Most common cause for PEAs? List two.

A

Hypovalemia and Acidosis.

229
Q

Early signs of shock in child vs. late signs.

A

Early - tachycardia, pallor, tachypnea, cool mottled skin, and delayed cap refill.

Late - Bradycardia, hypotension, and lethargy.

230
Q

Which chemical is primarily responsible for alterations in neurotransmitters?

A

Dopamine

231
Q

Which abnormalities are associated with acute adrenal insufficiency?

A

Hypoglycemia
Hyponatremia / hyperkalemic
Hypercalcemia

232
Q

Which abnormalities are associated with depletion of adrenal glucocorticoids (cortisol) and mineralocorticoids (aldosterone).

A

Hypernatremia
Hypokalemia
Hypocalcemia

Certified Emergency Nurse Exam (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions