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NCLEX: Prioritization, Delegation, And Assignment 5th Edition > Emergency & Disasters > Flashcards

Emergency & Disasters Flashcards

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1
Q

Donning or Doffing

Hand Hygine
Inner gloves
Shoe covers
Gown
N95
Respirator
Hood
Outer gloves
Face shield
Inspection (self and trained observer)
ROM
Hand Hygine

A

Donning

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2
Q

Donning or doffing

Hand Hygine
Shoe covers
Outer gloves
Inspect Inner gloves
Face shield
Hand Hygine
Remove hood
Hand Hygine
Remove gown
Hand Hygine
Inner gloves
Hand Hygine
Apply new gloves
Remove N95
Hand Hygine
Disinfect shoes
Hand Hygine
Remove gloves
Hand Hygine
Inspect by self & trained observer

A

Doffing

Yea, right

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3
Q

Primary survey of trauma client, what is one of the priority actions that would be performed first

  1. Obtain complete set VS
  2. Palpate & ausculate the abdomen
  3. Perform brief neurological assessment
  4. Check pulse ox
A
  1. Perform brief neurological assessment

LOC & pupil reaction (Primary Survey)
VS, assess abdomen, pulse ox (Secondary Survey)

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4
Q

56 enters triage area with left-sided chest pain, diaphoresis, dizziness. What is priority action

  1. Initiate ECG monitoring
  2. Notify the emergency depth HCP
  3. Admin oxygen via nasal canula
  4. Draw blood and establish IV access
A
  1. Admin oxygen via nasal canula

Goal: Increase myocardial oxygenation.

No prescription needed for emergency oxygen

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5
Q

0.45% Blood Alcohol Content BAC
what is the priority

  1. Cognition
  2. Addiction
  3. Gas exchange
  4. Functional ability
A
  1. Gas exchange
    0.45 = resp depression, stupor,coma
    0.30 = altered perception/ double vision
    0.20 = reduced motor skills & slurred speech
    0.05 = euphoria & decreased inhibitions
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6
Q

Older adult laying on floor in ER triage

Put in order

  1. Perform the chin lift or jaw thrust maneuver
  2. Establish unresponsiveness
  3. Initiate CPR
  4. Call for help and active code team
  5. Instruct UAP to get crash cart
A
  1. Establish unresponsiveness
  2. Call for help and active code team
  3. Perform the chin lift or jaw thrust maneuver
  4. Initiate CPR
  5. Instruct UAP to get crash cart
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7
Q

Which client represents a group that is most at risk for being vulnerable to tetanus

  1. Child helps with farm work and sustained scratches while feeding animals
  2. Newborn infant delivered in ED, mother had no prenatal care
  3. Older adult who lives alone and sustained a minor cut while cleaning the basement
  4. Young adult who works in auto repair shop sustained deep cut on metal edge.
A
  1. Older adult who lives alone and sustained a minor cut while cleaning the basement

Older adults are less likely to be vaccinated.

Tetanus occurs from minor wound contaminated by wood, metal, organic materials & don’t recieve medical attention.

Children are likely to be vaccinated due to school.

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8
Q

Care of client who was sexually assaulted, which task is most appropriate for LPN to perform.

  1. Assessing immediate emotional state and physical injuries
  2. Collecting hair samples, saliva specimens, scraping below finger nails
  3. Providing emotional support & supportive communication
  4. Ensuring the chain of custody of Evidence is maintained
A
  1. Providing emotional support & supportive communication

Other tasks are for RN

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9
Q

Frostbite interventions Put in correct order

  1. Apply loose, sterile, bulky dressing
  2. Give pain meds
  3. Remove client from cold environment
  4. Immerse the feet in warm water. 105 - 115°
  5. Monitor for compartment syndrome
A
  1. Remove client from cold environment
  2. Give pain meds
  3. Immerse the feet in warm water. 105 - 115°
  4. Apply loose, sterile, bulky dressing
  5. Monitor for compartment syndrome
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10
Q

Discharge for a woman who was treated for contusions & bruises sustained from an episode of domestic violence. Priority intervention

  1. Encourage client to go to safer house
  2. Make referral to counseling
  3. Advise client about contacting polic
  4. Make appointment to follow up on injuries
A
  1. Encourage client to go to safer house

Safety

NCLEX wants to know what your going to do not who you refer them to.

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11
Q

ED, client reports ab pain, N/V, fever. Abdomen is distended, rigid & board like with rebound tenderness.

Nurse notices this client is to be discharged with a follow up appointment in the AM.

Nurse reexamine and client is worse.
What should the nurse do first

  1. Contact supervisor Nurse & express concerns
  2. Express findings & concerns to HCP
  3. Discharge client but stress importance of follow up
  4. Follow discharge orders and write incident report.
A
  1. Express findings & concerns to HCP

If HCP refuses contact supervisor nurse & write incident report

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12
Q

Wernicke encephalopathy what will be prescribed initially

  1. Glucagon IV
  2. Naltrexone IM
  3. Thiamine IV
  4. Naloxone IV
A
  1. Thiamine IV

Wernicke encephalopathy manifesting as confusion, nystagmus, and abnormal ocular movements.
CAN BE REVERSED WITH THIAMINE

Glucagon = hypoglycemia
Naltrexone = Helps alcoholics & drug addicts not use
Naloxone = opiod OD (Narcan)

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13
Q

Most appropriate for UAP when an unexpected death occurs in ED

  1. Escorting family to a place of privacy
  2. Accompanying organ donors specialist to talk to family
  3. Assist with postmortem care
  4. Helping the family collect belongings
A
  1. Assist with postmortem care

Lots of Turning, Lifting, Cleaning involved in this process.

In cases of questionable deaths belongings are retained for evidence

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14
Q

Most accurate bedside verification that an Endotracheal Tube is placed correctly

  1. Visualize movement of Thoracic cage.
  2. Ausculate the chest during assisted ventilation
  3. Confirm breath sounds are equal & bilateral
  4. Check exhaled CO² levels with capnography
A
  1. Check exhaled CO² levels with capnography
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15
Q

Client detoxing from alcohol is at risk for this serious medical condition _____

The following meds maybe prescribed. Describe what they are used for.

Chlordiazepoxide _____
Phenytoin ______
Thiamine ______
Haloperidol ______

A

Seizures

Chlordiazepoxide (Benzo) Relax
Phenytoin Antiseizure
Thiamine Corrext underlying nutritional problems
Haloperidol Psychotic Symptoms

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16
Q

Heat stroke 105 Temp, confused, bizarre behavior, BP 85/60, HR 130, RR 40. Which should be assigned to LPN

  1. Rectal probe measure core body temp.
  2. Administer aspirin or another Antipyretic
  3. Insert indwelling catheter
  4. Assess resp effort, hemodynamics, mental status
A
  1. Insert indwelling catheter

Aspirin or Antipyretics won’t lower his body temp. (It’s not a fever)

UAP = Rectal probe

17
Q

Most severe

  1. 35 male severe intermittent cramps with 3 episodes of watery diarrhea 2 hrs after eating
  2. 11 boy low grade fever, right lower quadrant tenderness, nausea, Anorexia 2-days
  3. 23 woman, dizziness, severe left quadrant pain states possibly pregnant
  4. 50 woman gnawing midepigadtric pain that is worse between meals or during night.
A
  1. 23 woman, dizziness, severe left quadrant pain states possibly pregnant. RISK ECTOPIC PREGNANCY

11 boy possible appendicitis

35 male food poisoning = Self limiting

Woman midepigastric pain = possible ulcer

18
Q

Car crash. Which is the priority

  1. Deviated trachea
  2. Unequal pupils
  3. Ecchymosis flank area
  4. Irregular apical pulse
A
  1. Deviated trachea

ABC

19
Q

Put interventions in order. Roll over car crash

  1. Secure 2 large-bore IV Infuse NS
  2. Use chin lift / Jaw thrust maneuver to open airway
  3. Assess for spontaneous respirations
  4. Give supplemental Ox via mask
  5. Obtain full set vital sign measurement
  6. Remove / cutaway clients clothing
A
  1. Assess for spontaneous respirations
  2. Use chin lift / Jaw thrust maneuver to open airway
  3. Give supplemental Ox via mask
  4. Secure 2 large-bore IV Infuse NS
  5. Obtain full set vital sign measurement
  6. Remove / cutaway clients clothing
20
Q

Biochemical incident Put in Order

  1. Report to Public Health/ CDC per protocol
  2. Decontamination of affected people in seperate area
  3. Protect environment for safety of personnel & nonaffected individuals
  4. Don PPE
    5 Perform triage
A
  1. Protect environment for safety of personnel & nonaffected individuals
  2. Don PPE
  3. Decontamination of affected people in seperate area
    5 Perform triage
  4. Report to Public Health/ CDC per protocol
21
Q

Put in order of which to recieve medical attention.

  1. 52 male cardiac arrest, received CPR for 60 minutes
  2. Firefighter combative behavior & resp stridor
  3. 69 woman full thickness burns to hands and forearms
  4. Teenager crushed leg very swollen anxious tachycardia
  5. 3 yr resp distress burns 70% anterior
  6. 12 yr Wheezing, labored resp, unbelieved by asthma inhaler
A
  1. 12 yr Wheezing, labored resp, unbelieved by asthma inhaler (Albuterol Treatment)
  2. Teenager crushed leg very swollen anxious tachycardia (Swelling suggest hemorrhage)
  3. 69 woman full thickness burns to hands and forearms ( Dressings and pain management)
  4. 3 yr resp distress burns 70% anterior (Prognosis is poor - Comfort Measures)
  5. 52 male cardiac arrest, received CPR for 60 min (He dead)

NCLEX: Prioritization, Delegation, And Assignment 5th Edition (26 decks)

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