ENPC exam answers : NURS MISC

1. Which of the following would be an abnormal finding in a patient with glomerulonephritis? Clear urine There is a decrease in urine output for patient's with glomerulonephritis. Urine would be concentrated and dark brown/tea-colored. Decreased energy Hypertension Nausea, vomiting 2. A 3-year-old is brought to the emergency department with a 2-day history of a runny nose, lowgrade fever, and a "barky" cough at night. The caregiver tells the emergency department nurse the coughing is getting worse. The child is awake and alert, with stridor. The nurse should anticipate which of the following? Administration of nebulized epinephrine Moderate to severe croup is treated with dexamethasone and nebulized epinephrine. Delivery of humidified oxygen Bag-valve-mask ventilations Suctioning secretions from the oropharynx 3. The neurosurgeon has decided to perform an invasive procedure in the emergency department to monitor the intracranial pressure on a 5-year-old patient. The family does not speak English and has identified their religion as Muslim. Which of the following interventions is most supportive of the family? Allow the extended to family members to serve as interpreters during the procedure. Dedicate a healthcare team member to be with the family during the procedure. Allowing caregivers to remain with the pediatric patient is more supportive in this situation. Allow family members to serve as interpreters during the procedure Provide access to nondenominational clergy in a quiet area 4. Which of the following patient presentations should increase suspicion of potential child maltreatment? Right radial spiral fracture in a 10-year-old practicing martial arts Bruising to the left ear of a newborn from sleeping on his side Any bruise in a nonexploratory location in children younger than 4 years and any bruising in a child younger than 4 months (TEN-4) are cause for suspicion of abuse. Closed greenstick wrist fracture in a 4 year old who fell off his bicycle Bruises in various stages of healing to the lower extremities of a 2-year-old 5. A 14-year-old high school student who was pitching for his baseball team was hit in the chest by the ball and had a sudden cardiac arrest. Of the following, which is the most likely cause of the cardiac arrest? Aortic Dissection Commotio cordis Commotio cordis occurs when the chest is struck during the refractory period of the cardiac conduction cycle, resulting in a ventricular dysrhythmia or asystole. This type of injury usually occurs in recreational sports such as baseball or ice hockey. Pericardial Tamponade Blunt Aortic Injury 6. A 12-year-old who was recently started on anti-psychotic medication for schizophrenia is brought to the emergency department with severe muscle rigidity and hyperthermia. These symptoms are most likely caused by which of the following? Ecstasy overdose Neuroleptic malignant syndrome These are classic symptoms of neuroleptic malignant syndrome, which is a rare reaction to antipsychotic medications. Serotonin syndrome Nicotine overdose 7. Which of the following patients should be evaluated first? A 3-year-old with a dislodged gastrostomy tube A 12-year-old with left shoulder pain after a handlebar injury An 18-month-old with bilious emesis Bilious emesis in an 18-month-old is always considered an emergent symptom indicative of a life-threatening bowel obstruction. A 3-month-old with periods of inconsolable crying 8. Which of the following tasks can the nurse do to decrease adverse medication events? Obtain the patient's weight in kilograms This is the preferred measurement for medication calculations for pediatric and adult patients. Verifying the patient dose during shift report at nursing station Dual confirmation of a hard to read order Confirming patient's attending provider 9. Acute chest syndrome, stroke, and splenic sequestration are complications of which of the following diseases? Mononucleosis Hemophilia Sickle cell anemia These are all complications of sickle cell anemia. Acute rheumatic fever 10. During the assessment of a 16-year-old male patient, the ED nurse identifies him as a potential sex trafficking victim. The trauma informed approach to care emphasizes certain principles in caring for these types of patients. Which of the following care principles has the highest priority? Empowerment, voice and choice Physical and psychological safety Create an environment where patients feel safe, both physically and psychologically. Increase awareness of the patient’s interpersonal interactions with others to screen for risk of harm. Prioritize the patient being in a safe location. Peer support Trustworthiness and transparency 11. A 6-month-old is brought to the emergency department for a recurrent respiratory infection. When gathering a history from the caregiver, the emergency nurse learns that, in addition to the respiratory symptoms, the infant has had fatty stools. The emergency nurse should be concerned about which of the following disease processes?