Medical Emergencies: Trauma, Neurological, and Cardiac Cases, Exams of Nursing

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CRN PRACTICE QUESTIONS with

Answers 2024

Which of the following are the most appropriate clinical use of opioids? Analgesic, anti-tussive, anti-diarrheal Analgesic, anti-tussive, emetic Analgesic, sedatives, adjunct to psychotic therapy Analgesic, hypnotic, anti-diarrheal \ n ✔Analgesic, anti-tussive, anti-diarrheal What is the drug of choice for the treatment of anaphylaxis? Corticosteroids Antihistamines Epinephrine Bronchodilators \ n ✔Epinephrine Which is not associated with epidural hematoma (EDH)? Skull fracture Mostly seen in the elderly Severe mechanism of trauma Lucid interval after initial loss of consciousness \ n ✔Mostly seen in the elderly Which of the following is false about open chest wounds? A chest tube may be inserted The wound can be closed with adhesive gauze There may be a mediastinal shift to the ipsilateral aspect of the wound Open chest wounds may be used to treat empyema \ n ✔There may be a mediastinal shift to the ipsilateral aspect of the wound What skull injury is consistent with Battle sign? Frontal bone Basilar skull Occipital Temporal \ n ✔Basilar skull Which of these must be adhered to according to the Affordable Care Act? Cover recommended preventive services without charging out of pocket costs Provide an opportunity to appeal coverage decisions Guarantee enrollees their choice of primary care provider All of the above \ n ✔All of the above In which patient is insertion of nasal airways contraindicated? Pneumothorax Pleural effusion Ecchymosis behind the ear Perforated stomach \ n ✔Ecchymosis behind the ear Which of the following is the least preferred method of administering IV fluids? Cubital veins

Cephalic veins Subclavian veins Saphenous vein \ n ✔Subclavian veins After a house fire, what is the most important aspect of clinical evaluation? Depth of burn Surface area of burn Inhalation injury Fluid status \ n ✔Inhalation injury Which one of the following oculomotor muscles is not innervated by the third cranial nerve? Medial rectus Lateral rectus Inferior oblique Superior rectus \ n ✔Lateral rectus A child has an isolated closed femur fracture. His hematocrit drops 8 points. Which of the following is the best course of action? A child with a closed femur fracture typically drops 8 points, so do nothing A child with a closed femur fracture typically drops 4 points, so search for other sources Blood loss in long bone and pelvic fractures is proportionately less in children, so do nothing None of the above \ n ✔A child with a closed femur fracture typically drops 4 points, so search for other sources The brother of a patient says he is a physician and wants to see the chart. What should be done? Give them the chart Ask the patient for a written authorization Ask the patient for a verbal authorization Call hospital administration \ n ✔Ask the patient for a written authorization In which situation is an urgent brain CT scan not indicated? Acute closed head injury with right homonymous hemianopsia Acute closed head injury Acute closed head injury with nausea, vomiting, and lethargy A supraorbital, throbbing headache of acute onset, which is exacerbated by light and attempts at visual accommodation \ n ✔A supraorbital, throbbing headache of acute onset, which is exacerbated by light and attempts at visual accommodation Fat embolism is generally associated with which of the following? Mark one answer: Early tachycardia Fever Non palpable petechiae All of the above \ n ✔All of the above

Which of the following is the age group who are the largest consumers of prescription and nonprescription medications in the US? Mark one answer: Patients 20-59 years of age Patients 14 to 19 years of age Patients 65-years-old and older Patients under the age of 14. \ n ✔Patients 65-years-old and older Which of the following is false about inhalation burn injury? Mark one answer: Often associated with elevated levels of carboxyhemoglobin Can be difficult to diagnose in early stages Can be rapidly lead to respiratory failure Best treated by hyperbaric oxygenation \ n ✔Best treated by hyperbaric oxygenation Which is not included in continuing neurological checks following a concussion? Mark one answer: Memory of injury Movement of arms and legs Level of consciousness Orientation \ n ✔Memory of injury What ECG tracing represents the atrial contraction? Mark one answer: P wave R wave T wave U wave \ n ✔P wave What is the initial treatment for hyperkalemia with ECG changes of widened QRS? Mark one answer: Magnesium Insulin Propranolol Calcium \ n ✔Calcium What is the most common cause of fat embolism? Mark one answer: Burns Bone fractures Liver trauma Severe infection \ n ✔Bone fractures Which of the following is a false statement about pulmonary contusion? Mark one answer: Radiographic signs are visible almost immediately after the injury Usually presents with hypoxemia Can take several weeks to resolve The treatment is supportive oxygen therapy \ n ✔Radiographic signs are visible almost immediately after the injury

What is the intended oxygen saturation when giving COPD patients supplemental oxygen? Mark one answer: 90% 85% 80% 75% \ n ✔90% Which is not usually seen with spinal cord injury? Mark one answer: Neurogenic shock Spinal shock Diuresis and diaphoresis Autonomic dysfunction \ n ✔Diuresis and diaphoresis Release of which of the following is inhibited by tetanus toxin? Mark one answer: Acetylcholine Serotonin GABA Norepinephrine \ n ✔GABA Fat emboli usually do not present with which finding? Mark one answer: Bradycardia Fever Desaturation Petechiae \ n ✔Bradycardia Which of the following is an action of morphine? Mark one answer: Analgesia Gastroparesis Itching All of the above \ n ✔All of the above What is the most common organism isolated from surgical site infections after a clean-contaminated procedure? Mark one answer: Staphylococcus Escherichia coli Streptococcus Peptostreptococcus \ n ✔Escherichia coli What part of the gluteal region is the safest place to give an intramuscular injection? Mark one answer: Inferolateral quadrant Inferomedial quadrant Superolateral quadrant

Superomedial quadrant \ n ✔Superolateral quadrant Which of the following is a component of the simple triage and rapid treatment (START) method? Mark one answer: Respiration Pulse Mental status All of the above \ n ✔All of the above An 18 year old male complains of left shoulder pain and decreased ability to move the arm after a fall at home and on exam the arm is abducted and externally rotated with sensation intact to light touch but resisting any range of motion--his diagnosis? Mark one answer: Anterior glenohumeral dislocation Posterior glenohumeral dislocation Inferior glenohumeral dislocation Acromioclavicular separation \ n ✔Anterior glenohumeral dislocation Which of the following does not affect the efficacy of a neurolytic block? Mark one answer: Concentration of the neurolytic agent Needle size Nerve type Nerve thickness \ n ✔Needle size Which is true of aspiration pneumonia? Mark one answer: Rare occurrence during anesthesia Can occur after head injuries Due to gram-negative organisms Most occur in the left lung \ n ✔Can occur after head injuries Which of the following trauma scenarios will not compromise the airway after endotracheal intubation? Mark one answer: Unrecognized pneumothorax Massive bronchopleural fistula Placement of endotracheal tube in right mainstem bronchus Placement of endotracheal tube 2 cm above the carina \ n ✔Placement of endotracheal tube 2 cm above the carina Which injury is produced by a force that drives the trunk forward while the head lags behind? Mark one answer: Herniated disk Epidural hemorrhage Whiplash Humeral fracture \ n ✔Whiplash

Ventricular fibrillation (VF) is treated the same as which rhythm? Mark one answer: Nonperfusing ventricular tachycardia Atrial tachycardia Asystole None of the above \ n ✔Nonperfusing ventricular tachycardia What is the goal urine output in a 44 year old mildly burnt patient? Mark one answer: 5 ml per hour 10 ml per hour 30 ml per hour 50 ml per hour \ n ✔30 ml per hour Which of the following is most increased with ventricular tachycardia (VT)? Mark one answer: Myocardial infarction (MI) Pulmonary embolism (PE) Sudden death COPD \ n ✔Sudden death If a trauma patient has clear fluid draining from the nose the provider should do which of the following? Mark one answer: Tilt the head back Apply pressure Collect the fluid Insert nasal tampons \ n ✔Collect the fluid Entrapment of which nerve is a common complication of a Smith fracture? Mark one answer: Radial Ulnar Median Lower brachial plexus \ n ✔Median Select the best example of an interaction covered by Good Samaritan Acts. Mark one answer: Patrons who perform the Heimlich maneuver on a child choking on candy and is unable to speak On duty EMTs who assist a women in early labor while in a grocery store A physician who regularly volunteers at a community center A licensed practitioner who renders care to a patient in a patient care setting \ n ✔Patrons who perform the Heimlich maneuver on a child choking on candy and is unable to speak Battle sign is due to what type of skull injury? Mark one answer: Frontal bone Basilar skull

Occipital Temporal wing \ n ✔ How is frostbite treated? Mark one answer: Rewarming the area with a heating blanket Place affected part in tepid water Allowing the extremity to warm on it's own Wrapping the part and exposing to a heat source \ n ✔Place affected part in tepid water Heat stroke is a serious condition that can have end-organ damage. Which of the following are not considered possible complications of heat stroke? Mark one answer: Rhabdomyolysis Disseminated intravascular coagulation Permanent neurologic defects All of the above are possible complications of heat stroke \ n ✔All of the above are possible complications of heat stroke Which of the following is true regarding a medical provider passing a motor vehicle accident? Mark one answer: No moral obligation to render assistance Legal obligation to assist and malpractice can result if duty neglected No legal obligation to assist None of the above \ n ✔No legal obligation to assist What is being assessed when urine specific gravity is measured? Mark one answer: Concentration pH Urine sodium Urine albumin \ n ✔Concentration When resuscitating a patient with hemorrhagic shock following penetrating trauma, what is the goal? Mark one answer: Keep blood pressure on the low side Restore blood pressure to normal Restore blood pressure to just 40 mmHg above normal Restore blood pressure so that there is urine output \ n ✔Restore blood pressure to normal What is the minimal score on the Glasgow coma scale? Mark one answer: 0 3 8 15 \ n ✔ 3

A 4-month-old child is dropped and hits her head. What ist the best indicator of serious brain injury? Mark one answer: The parent says that the child was pale and diaphoretic for a few seconds after the fall Child has one episode of emesis The child has incessant crying The child has hypotension \ n ✔The child has hypotension How is exhalation achieved in a patient undergoing cardiopulmonary resuscitation? Mark one answer: The pressure of cardiac compressions Bilateral chest wall pressure after each delivered breath Normal relaxation of the chest Upward sub-xiphoid pressure applied every 2-4 minutes during CPR \ n ✔Normal relaxation of the chest Why would a patient with a head injury be instructed to avoid the valsalva maneuver? Mark one answer: Prevention of hemorrhoids Possibility of causing decrease in ICP Possibility of causing increased ICP Prevention of tinnitus \ n ✔Possibility of causing increased ICP Which is not a manifestation of a blood transfusion reaction? Mark one answer: Hypotension Tachycardia Back pain Muscle rigidity \ n ✔Muscle rigidity Which of the following is not descriptive of magnet hospitals? Mark one answer: Excellent patient outcomes delivered by nurses Nurses have a high level of job satisfaction High staff nurse turnover rate Appropriate grievance resolution \ n ✔High staff nurse turnover rate A patient is found unconscious after a fire in his bedroom. He is found to have severe burns around his face. What is the first aspect of treatment? Mark one answer: Tetanus toxoid Cover the wound Airway Obtain blood work \ n ✔Airway Which medication is not usually given to patients with severe penicillin allergy? Mark one answer:

Doxycycline Ceftriaxone Clindamycin Erythromycin \ n ✔Ceftriaxone In which patient is bag mask ventilation LEAST difficult? Mark one answer: Facial hair Lack of teeth History of sleep apnea BMI of less than 17 \ n ✔BMI of less than 17 A 18-year-old male sustains a right femur fracture and a cerebral concussion in a motor vehicle accident. His initial blood pressure is 75/50 mmHg with a pulse of 90 beats per minute. After giving him 2 liters of Ringer lactate he stabilizes, but the blood pressure falls when he is seen in the emergency room. Which of the following would be the cause of suspected hypotension in this patient? Mark one answer: Subdural hematoma Undiagnosed facial fracture Ruptured spleen 10% pneumothorax \ n ✔Ruptured spleen Which of the following is the best example of documenting a chain of evidence? Mark one answer: Properly labeling an observed urine sample of a suspected impaired driver for the police, personally handing it to the arresting officer, and getting a receipt Properly documenting in a medical record including dates, signatures, and making sure mistakes are lined out, initialed, and dated Documenting vaginal fluids in a rape case where obtained, labeled, initialed, and sent to the lab Properly recording all medications and treatments in the medical record \ n ✔Properly labeling an observed urine sample of a suspected impaired driver for the police, personally handing it to the arresting officer, and getting a receipt Which ECG wave represents the depolarization of the right and left ventricles? Mark one answer: P wave QRS complex T wave Q wave \ n ✔QRS complex A patient is on droplet precaution. What personal protective equipment is needed if working within 3 feet of the patients? Mark one answer: Mask Mask and eye protection Mask, eye protection, and gloves Mask, eye protection, gloves, and gown \ n ✔Mask and eye protection

In a patient with a suspected cervical injury, what maneuver can protect the airway? Mark one answer: Head tilt Jaw thrust Chin lift Neck extension \ n ✔Jaw thrust