Emergency Medical Scenarios, Exams of Nursing

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What is the effect of oral glucose? - ANSWER>>Raises blood sugar

A 14 year old male is hot, dry and complaining of nausea and vomiting after mowing the lawn. What should you suspect? - ANSWER>>Heat stroke

What occurs during compression of the inferior vena cava? - ANSWER>>Pregnancy induced hypertension

An unresponsive 32 year old female was pulled from a frozen lake after 3 minutes of submersion. Vital signs are BP 90/70, P 24, R 8. Why is it important to handle her gently while transporting? - ANSWER>>She could convert into V-Fib or V-Tach rythym

A 56 year old male complains of chest pain after shoveling the driveway. He states that his pain was a 9/10, but it is now a 5/10 after rest and taking 2 of his nitroglycerin. Vital signs are BP 100/66, P 87, R 16. What should you do? - ANSWER>>Administer aspirin

A 71 year old female is short of breath and has lower leg pain. She took 2 doses of her prescribed nitroglycerine and 324 mg aspirin 10 minutes ago. Vital signs are BP 160/90, P 88, R 24, SpO2 88%. What should you do? - ANSWER>>Apply oxygen by non-rebreather mask

A 66 year old female has shortness of breath and diffuse back pain. Auscultation of lungs reveal crackles in the bases. Vital signs are BP 170/110 and P 112. What should you do administer? - ANSWER>>Nitroglycerin

An unresponsive 2 day old female is in respiratory distress. Her skin is cyanotic and vital signs are P 184, R 72. What should you do? - ANSWER>>Assist her ventilations

A 22 year old male complains of shortness of breath with diminished lung sounds on the right side. Vital signs are BP 130/90, P 86, R 24. What should you suspect? - ANSWER>>Pneumothorax

An 66 year old female had a syncopal episode while attempting to stand up. She describes a history of COPD, CHF, and gout. Vital signs are BP 96/40, P 56, R 18. What should you suspect? - ANSWER>>Decrease in cerebral blood flow

What is the best protection from contracting a communicable disease from a patient? - ANSWER>>Frequent hand washing

An anxious 55 year old male is severely short of breath and is coughing up pink frothy sputum. He is sitting upright and tells you that his "feet are more swollen than normal." Vital signs are BP 202/112, P 110, R 36 with crackles. What should you do? - ANSWER>>Assist his ventilations with a BVM

A 34 year old male complains that people are "out to hurt me." He thinks you are attempting to kill him with poison gas while applying a non-rebreather mask. What should you do? - ANSWER>>Explain the benefits of oxygen

What condition is caused by twisting of the spermatic cord, resulting in a sudden onset of severe scrotal pain? - ANSWER>>Testicular torsion

How should you treat asystole in a patient? - ANSWER>>Provide chest compressions

A 45 year old female had a return of spontaneous circulatoin (ROSC) after 10 minutes in cardiac arrest. She is unresponsive. Vital signs are BP 96/40, P 88, R 18, SpO2 74%. What should you do? - ANSWER>>Position her in a recovery position and apply high-flow oxygen

A 16 year old boy tells you that he "caught" his 40 year old mother "holding a handful of sleeping pills" The son explains that she is depressed, and he is convinced that she meant to kill herself. She is extremely agitated and is refusing treatment. What should you do? - ANSWER>>Request law enforcement assistance to transport the patient

A 27 year old pregnant female is complaining of extreme bouts of thirst, nausea and urination. What should you suspect? - ANSWER>>Gestational diabetes

A 34 year old female complains of an open sore on her leg that will not go away. She says that she cut her leg while shaving in the shower at her local gym 2 weeks ago. Her doctor prescribed antibiotics, but nothing has changed. What should you suspect? - ANSWER>>MRSA

What risk factor may cause the development of an esophageal varice? - ANSWER>>Cirrhosis

What abdominal complaint is MOST concerning? - ANSWER>>A sudden, tearing pain

What medical term describes wheals on the skin during an allergic reaction? - ANSWER>>Urticaria

What gland joins the nervous system with the endocrine system? - ANSWER>>Hypothalamus

You assisted a 46 year old female with her prescribed nitroglycerin. She is now light-headed and feels dizzy. What should you do? - ANSWER>>Position her supine

A 20 year old male complains of nausea and headache after working on his car in the garage. Vital signs are BP 130/90, P 76, R 16. What should you suspect? - ANSWER>>CO poisoning

Lifeguards have rescued an unconscious 42 year old near-drowning victim from the water. What should be your most important treatment for this patient? - ANSWER>>Establish and maintain C-spine immobilization

A 26 year old male has Kussmaul's respirations. He has a diabetic alert bracelet. What should you suspect? - ANSWER>>Diabetic ketoacidosis (DKA)

A 46 year old male complains of difficulty breathing and a productive cough. He states that his cough began about 2 weeks ago. Lung sounds reveal coarse rhonchi in all fields. His skin color is ashen and he is diaphoretic. What should you do? - ANSWER>>Don an N95 mask

Possible splenic injury or ectopic pregnancy can have referred left shoulder pain called? - ANSWER>>Kehr's

Which of the following is NOT part of the Cincinnati Stroke Test? - ANSWER>>Ability to walk

A 32 year old male is presents with difficulty breathing. He has bilateral inspiratory and expiratory wheezing. Vital signs are BP 120/80, P 89, R 32, SpO2 93%. What should you suspect? - ANSWER>>Asthma

A 22 year old male working at a factory has recently inhaled a poison. After ensuring scene safety, what should you do? - ANSWER>>Move the patient to an area outside

A 19 year old male hides in his closet and thinks that aliens are coming to abduct him. What should you do? - ANSWER>>Acknowledge his fears as real

A 47 year old male has a ROSC after 10 min of CPR, but remains unconscious. How should you transport him? - ANSWER>>Left-lateral recumbent

What can unequal pupils indicate? - ANSWER>>Head injury

A 20 year old male has been exposed to cold temperatures for an unknown period of time. Where should you assess his skin temperature? - ANSWER>>Abdomen

How is nitroglycerin spray administered? - ANSWER>>Sublingually

A 58 year old unconscious male has a return of spontaneous circulation (ROSC) after 10 minutes of CPR and 3 shocks from an AED. Vital signs are BP 90/60, P 54, R 4. What should you do? - ANSWER>>Assist his ventilations with a BVM

A 51 year old male with a history of COPD is having difficulty breathing. Vital signs are BP 136/74, R 22, P 100, SpO2 95%. What should you do? - ANSWER>>Administer oxygen by non- rebreather mask

A 21 year old female was lost in the woods for several hours. The ambient temperature is 25 degrees Fahrenheit. She is lethargic and confused. The skin on her hands is waxy and white. What should you do? - ANSWER>>Gently wrap the patient in several dry blankets

What is the most common communicable disease contracted by blood-borne pathogen exposure? - ANSWER>>Hepatitis B

An elderly patient has left-sided heart failure. What lung sounds should you suspect to hear? - ANSWER>>Crackles

A 84 year old female becomes unconscious while eating her breakfast. Her home-care nurse states that she was "fine one minute and then complained of a bad headache" before losing consciousness. Vital signs are 178/120, P 62, R 10 and irregular. What should you suspect? - ANSWER>>Hemorrhagic stroke

What is the primary action of insulin? - ANSWER>>Facilitate glucose transport into cells

A 45 year old male has chest pain. What should you determine before administering a dose of nitroglycerin? - ANSWER>>His blood pressure

You have assisted with the administration of an Albuterol inhaler. The patient's heart rate begins to increase. What should you do? - ANSWER>>Obtain an additional set of vitals and transport to the hospital

A 32 year old male has ingested an unknown quantity of gasoline in an attempt to kill himself. What should you do? - ANSWER>>Apply high-flow oxygen and transport immediately

You are called to a bar for a 52 year old male who has slurred speech and difficulty sitting upright. He is unable to follow your commands and refuses to leave the bar. Which of the following should you consider LAST? - ANSWER>>Alcohol intoxication

A 64 year old male is unresponsive. Bystanders tell you he has been down for 10-15 minutes and resuscitation efforts have not been attempted. What should you do? - ANSWER>>Assess a carotid pulse

A systolic blood pressure is less than 90. What should this indicate? - ANSWER>>Hypotension

Which type of shock presents itself with respiratory distress, crackles and chest pain? - ANSWER>>Cardiogenic

A 87 year old female has bilateral rales. What should you suspect? - ANSWER>>Pulmonary edema

A 24 year old female complains of a sudden onset of lower quadrant abdominal pain. She is pale and has a rapid, weak pulse. What should you ask her? - ANSWER>>"Are you sexually active?"

What is a hazardous, odorless gas resulting from incomplete combustion? - ANSWER>>Carbon monoxide

Which statement about suicide is correct? - ANSWER>>There is a high correlation between suicide and alcohol use

What condition presents with a fruity, acetone-like odor on the breath? - ANSWER>>Diabetic ketoacidosis (DKA)

A 21 year old male complains of dark colored urine. His eyes and nail beds have a yellow discoloration. He has general weakness and has upper right quadrant discomfort. What should you suspect? - ANSWER>>Hepatitis

Which of the following is a contraindication for Nitroglycerin? - ANSWER>>Hypotension

A 43 year old male complains of a stiff neck, persistent cough, and fever for the past week. He states he has been in and out of homeless shelters for the past 5 months. What should you do?

• ANSWER>>Use gloves, gown, and HEPA mask

What condition is NOT commonly associated with sickle cell anemia? - ANSWER>>Excessive bleeding

What is status epilepticus? - ANSWER>>Two or more continuous seizures

A 70 year old male complains of shortness of breath and has wheezing. Vitals signs are BP 126/90, P 74, R 22, SpO2 92%. What should you do? - ANSWER>>Apply oxygen by nasal cannula at 2 lpm

A 26 year old female is supine and only responding to voice with unintelligible gurgling noises. Her husband tells you she is an epileptic. She had a seizure during which he was able to gently assist her to the ground. What should you do? - ANSWER>>Roll the patient onto her side and suction the airway

How does the blood flow through the heart? - ANSWER>>Right atrium to right ventricle to lungs to left atrium to left ventricle

What should you do when the automated external defibrillator (AED) performs its rhythm analysis? - ANSWER>>Remain clear of the patient

When administering nitroglycerin to a patient with angina, to which structures are you hoping to alleviate ischemia? - ANSWER>>Coronary arteries

A 62 year old female complains of chest pain and shortness of breath. She is extremely anxious. Vital signs are BP 80/56, P 118, R 24 with crackles, SpO2 87%. What is the most likely cause? - ANSWER>>Cardiogenic shock

A 3 year old male has inspiratory wheezes. After assisting wth his inhaler you now hear both inspiratory and expiratory wheezing. What should you do? - ANSWER>>Document the respiratory improvement

Which of the following is NOT a sign of heatstroke? - ANSWER>>Diaphoresis

Which of the following is NOT a definitive sign of death? - ANSWER>>Absence of breath sounds

What symptom would a person who overdosed on barbiturates have? - ANSWER>>Sluggish movements

A 57 year old female complains of difficulty breathing. She has jugular vein distension (JVD), pedal edema and fatigue. What chamber of the heart should you suspect is weakened? - ANSWER>>Right ventricle

A euphoric patient states that she can save the world while sitting on the roof of her house. What should you suspect? - ANSWER>>Neurosis

A 33 year old male has respirations of 22 per minute. How should you administer oxygen to him? - ANSWER>>Non-rebreather mask at 15 lpm.

Which of the following is a common side effect of nitroglycerin? - ANSWER>>Hypotension

Where are the first electrical impulses stimulating the heart located? - ANSWER>>Right atrium

An apneic 79 year old female is found lying unconscious on the floor. Vital signs are P 45, R 0. What should you do? - ANSWER>>Provide ventilations with a BVM

A 56 year old male complains of "squeezing" chest pain after doing yard work. He states the pain has subsided slightly with rest. What should you do? - ANSWER>>Administer aspirin

Where does the electrical impulse in the heart begin? - ANSWER>>SA node

After assisting your patient with the self-administration of their prescribed metered-dose inhaler medication, what should you do? - ANSWER>>Gather an additional set of vital signs

A 60 year old female has a history of type 2 diabetes and complains of nausea and weakness. You notice a sharp, fruity odor on her breath. What should you suspect? - ANSWER>>Diabetic ketoacidosis

A 59 year old female missed her weekly renal dialysis appointment. She is feeling weak and unable to care for herself. What should you suspect? - ANSWER>>Fluid overload

A 57 year old male complains of chest pain. He is slightly pale, but warm and dry. He has a 20 year cardiac history and is taking metoprolol. Vital signs are BP 86/64, P 84, R 22. What should you do? - ANSWER>>Administer 324 mg aspirin

A 14 year old male is recovered from a 30F pond after falling through the ice 10 minutes ago. How should he be moved to the ambulance? - ANSWER>>Gently on a backboard

An unrestrained 47 year old female is in cardiac arrest after car crash on the freeway. She has been pulseless for 20 minutes and CPR was withheld. What should you do? - ANSWER>>Start CPR and contact medical control to terminate efforts

What is the normal rate of breathing for an adult? - ANSWER>>12 to 20 breaths per minute

A 19 year old male complains of sudden difficulty breathing on his right side after sneezing vigorously. He has diminished breath sounds on his right side. What should you suspect? - ANSWER>>Spontaneous pneumothorax

Which structure contains the vocal cords? - ANSWER>>Larynx

How many vertebrae make up the cervical spine? - ANSWER>>Seven

What gland secretes chemical substances directly into the blood and is also called a ductless gland? - ANSWER>>Endocrine

What are the structures that branch off from the trachea called? - ANSWER>>Bronchi

A 35 year old man is pulseless and apneic. He was found in a lake after falling through the ice. His wife says he left the house 3 hours ago. What should you do? - ANSWER>>Provide chest compressions

A 36 year old male and his 34 year old wife complain of severe headaches, confusion, and dizziness. He also complains of chest pain. Both are short of breath. What type of poisoning should you suspect? - ANSWER>>Carbon monoxide

At a mass gathering several hundred people suddenly began to experience severe salivation, lacrimation, urination, and vomiting. What should you do? - ANSWER>>Set up a command post and ensure scene safety

A 26 year old male underwent a recent surgery. He has fever, altered mental status, and decreased urine output. What should you suspect? - ANSWER>>Septic shock

How many times faster does heat loss occur during water immersion as compaired to air exposure? - ANSWER>>

Which of the following capillary refill times is considered normal? - ANSWER>>2 seconds

You have completed your initial assessment of a ten year old unresponsive medical patient. How should you start your focused assessment? - ANSWER>>A rapid physical exam

What condition can present with paranoia, delusions, and auditory hallucinations? - ANSWER>>Schizophrenia

What does the "O" in the OPQRST mnemonic stand for? - ANSWER>>Onset

What type of procedure does a patient with chronic renal failure undergo? - ANSWER>>Renal dialysis

What environmental emergency is life-threatening? - ANSWER>>Heat stroke

A 45 year old male has fallen down a flight of stairs. He is unresponsive and has diminished breath sounds bilaterally with subcutaneous emphysema around the base of his neck. What should you suspect? - ANSWER>>Fractured treachea

A 65 year old male complains of circumferential burns around his hands and wrists. His homecare nurse says that he burned himself while helping cook dinner that evening. What should you suspect? - ANSWER>>Abuse

An 84 year old man is in cardiac arrest in the passenger seat of a vehicle following a single car crash. The driver tells you that his passenger had complained of chest pain prior to the car crash. What should you do? - ANSWER>>Start CPR and call for additional ambulances

A 6 year old male with sudden onset stridor and drooling is seated upright. His skin is hot and he is lethargic to respond. Vital signs are BP 80/54, P 140, RR 32. What should you do? - ANSWER>>Transport in fowler's position

What is the name of the leaf shaped valve that prevents food from entering the trachea? - ANSWER>>Epiglottis

A 21 year old male was involved in a motor vehicle collision. He has a puncture wound to the neck that is actively bleeding. What should you apply? - ANSWER>>A gloved hand for direct pressure

Why do patients with cardiac compromise have chest pain? - ANSWER>>There is not enough oxygen to the heart

A 22 year old female complains of body aches, severe headache and blurred vision. She admits to having large amounts of alcohol the night before. What diagnosis you should consider LAST?

• ANSWER>>Hangover

Which of the following MOST accurately defines an allergic reaction? - ANSWER>>An exaggerated immune system response to any substance