An Emergency Test

1.	Thanks For this test Mindy When doing a rapid ABC assessment, which following statement is not true:
		a.	The airway is patent when speech is clear and no noise is associated with breathing.
		b.	Breathing is effective when the skin is pale and capillary refill is >2 seconds.
		c.	If breathing is not effective, consider administering oxygen and placing an assistive device.
		d.	Circulation is effective when the radial pulse is present and the skin is warm and dry.
2.	When identifying the patient, do not include:
		a.	What is the patient's name?
		b.	What is the patient's age and sex?
		c.	What is the patient's insurance carrier?
		d.	What is the name of the patient's current physician?
3.	Which of the following would be a nursing diagnosis not appropriate for a patient with a breathing emergency?
		a.	Ineffective airway clearance
		b.	Impaired gas exchange
		c.	Activity intolerance
		d.	Unilateral neglect
4.	When using the mnemonic AVPU to evaluate a patient's level of consciousness, which following statements is not true:
		a.	A is for alert and signifies that the patient is alert, awake, responsive to voice, and oriented to person, time, and place.
		b.	V is for verbal and signifies that the patient responds to voice and is fully oriented to person, time, and place.
		c.	P is for pain and signifies that the patient does not respond to voice, but does respond to a painful stimulus such as a squeeze to the hand.
		d.	U is for unresponsive and signifies that the patient does not respond to painful stimuli.
5.	Which following statement does not usually indicate respiratory distress:
		a.	Flaring nostrils and head bobbing.
		b.	Use of accessory muscles and leaning forward in a tripod position
		c.	Decreased level of consciousness
		d.	Speaking full sentences
6.	You walk into an ED room and see a 3-year-old child with her parents. The child is sitting forward, leaning on both arms. You notice she is drooling with croaking sounds on inspiration. Which of the following would you do?
		a.	Get the child undressed and prepare for examination.
		b.	Take vital signs including an oral temperature.
		c.	Send the parents from the room.
		d.	Allow the child to rest in position of comfort and prepare for possible intubation.
7.	Which following statement about asthma is not true:
		a.	Intrinsic asthma is asthma due to a known allergen or environmental factor.
		b.	Status asthmaticus is an obstruction that lasts days or weeks.
		c.	Symptoms may include bronchospasms with wheezes and a prolonged expiratory phase.
		d.	Peak flow rates are essential before and after each bronchodilator treatment to determine the effectiveness of the therapy.
8.	All of the following statements about autotransfusion are correct except:
		a.	Autotransfusion is indicated for a patient with a tension pneumothorax.
		b.	A basic autotransfusion device is attached to a chest tube and the filtered returned blood is infused intravenously.
		c.	Autotransfusion from other sites such as the abdomen places the patient at increased risk for bacterial contamination.
		d.	Autotransfusion is indicated for a patient with hemothorax and hypotension.
9.	Which following statement about bradycardia is false:
		a.	Bradycardia is a slow rhythm.
		b.	Bradycardia is the most common arrhythmia in critically ill children.
		c.	Bradycardia in children is usually a symptom of hypoxia.
		d.	Bradycardia in children is usually a sign of hyperventilation.
10.	All of the following statements about assessment of the lungs are true except:
		a.	Crackles (rales) are most common in dependent lobes and are caused by fluid.
		b.	Ronchi are heard over the trachea and bronchi and are caused by bronchospasms that narrow the airway.
		c.	Wheezes can be heard over all lung fields and are caused by bronchospasms that narrow the airway.
		d.	Pleural friction rub is heard over the lateral lung fields with the patient upright and is caused by inflamed pleura.
11.	All of the following statements about congestive heart failure are true except:
		a.	CHF is a fluid overload brought about by an inadequate heart pump.
		b.	The most common cause of right ventricular failure is left ventricular failure.
		c.	Some early signs of left ventricular failure (forward failure) are tachypnea, orthopnea, and systemic vascular engorgement.
		d.	Symptoms of right ventricular failure (backward failure) may include peripheral edema and hepatosplenomegaly.
12.	For the management of congestive heart failure, all the following statements are true except:
		a.	Oxygen is used to maintain sufficient oxygenation to body tissue by keeping the saturation greater then or equal to 94%.
		b.	A diuretic such as Lasix is given to reduce fluid preload.
		c.	An inotropic medication such as morphine is given to increase the pumping action of the heart.
		d.	A blood pressure–reducing medication such as nitroglycerine is given to decrease afterload.
13.	All the following statements about chronic obstructive pulmonary disease (COPD) are true except:
		a.	High-flow oxygen therapy may prevent the necessity for intubation.
		b.	A common sign of COPD is a barrel chest from hyperinflation and overdistention of alveoli.
		c.	Most COPD patients are dependent on hypoxic drive to maintain adequate ventilation.
		d.	Pursed-lip breathing slows expiration and prevents collapse of lung units.
14.	All the following statements about croup are true except:
		a.	A low-grade fever and barking or brassy cough with inspiratory stridor caused by partial upper-airway obstruction characterizes croup.
		b.	Aspirin is given as an antipyretic.
		c.	Early signs of respiratory failure are hypoxemia, restlessness, tachypnea, and tachycardia.
		d.	Medical management of croup may include cool, humid mist and hydration.
15.	Endotracheal tube placement is confirmed by all of the following except:
		a.	First listen over the stomach for sounds of rushing air.
		b.	If nothing is heard in stomach, auscultate both lungs to confirm placement and equality.
		c.	Final tube placement is confirmed by portable chest x-ray.
		d.	Hyperventilate with an ambu bag to see if abdomen enlarges.
16.	Which of the following is not true about oxygen delivery devices:
		a.	A nasal cannula delivers 4% oxygen per liter.
		b.	A simple mask delivers 6–10 liters, equal to 100% oxygen.
		c.	A Venturi mask delivers variable oxygen at 24% to 50%.
		d.	High-flow oxygen delivery is the first priority when a trauma patient is pale, diaphoretic, and hypoventilating.
17.	All of the following statements about pneumonia are true except:
		a.	Pneumonia is always caused by a bacterial infection.
		b.	Symptoms may include fever, pleuritic chest pain, productive cough, and tachypnea.
		c.	Medical management includes identification of the infecting organism and appropriate antimicrobial therapy.
		d.	One percent of Americans will have pneumonia during their lifetime.
18.	Which following statement about pulmonary embolus (PE) is false?
		a.	A PE causes obstruction of arterial pulmonary blood flow to the distal lung, resulting in ischemia and infarction of the lung.
		b.	Symptoms include sudden onset of dyspnea, chest pain, and sinus tachycardia.
		c.	White blood cell count is always elevated.
		d.	Medical management includes intravenous heparin.
19.	Which of following statements about spontaneous pneumothorax is false?
		a.	A pneumothorax is the collapse of a lung.
		b.	Symptoms may include sudden sharp chest pain and dyspnea.
		c.	The typical size chest tube for an adult is a #40 French and it may be clamped when needed.
		d.	Complications include hemothorax or cardiovascular compromise.
20.	Which following statement about sputum color is false?
		a.	Yellow sputum signifies white blood cells that are the major component of pus.
		b.	Green sputum signifies production of an enzyme caused by stagnant pus cells.
		c.	Rust, red, and brown sputum signifies red blood cells in the sputum.
		d.	Green sputum is caused from the breakdown of red blood cells.