The nurse is performing a painless , noninvasive procedure to measure SaO2. What procedure is it?
A) Incentive spirometry
B) Arterial blood gas measurement
C) Peak flow measurement
D) Pulse oximetry
ANSWER: D

A patient suspected of having aneurysm usually complains of flank pains. This is because the most common site of aneurysm formation is in which segment of the aorta?
A) Abdominal aorta, just below the renal arteries
B) Ascending aorta, around the aortic arch
C) Descending aorta, beyond the subclavian arteries
D) Aortic arch, around the ascending aorta
ANSWER: A

A patient was brought in the emergency room following a vehicular accident. After assessment by the ER physician, cardiac tamponade was diagnosed. You 	would  prepare for which of the following as ordered?
A) Drainage of the pericardial sac
B) IV bolus of diuretics
C) IV bolus of Digitalis
D) Tracheostomy
ANSWER: A
       
What is the  primary objective for putting a patient with myocardial Infarction on absolute bed rest upon admission?
A) Prevent impending shock
B) Lower heart rate and oxygen demand of the heart
C) To maintain vital signs
D) Relieve the anxiety and difficulty of breathing
ANSWER: B

Which of the following types of pain is most characteristics of angina?
A) Knifelike
B) Sharp
C) Shooting
D) Tightness
ANSWER: A

In what situation would a patient maybe in ,who is assessed to have .inspiratory and expiratory stridor ?
A) Experiencing an exacerbation of goiter
B) Is experiencing an acute asthmatic attack
C) Has aspirated a piece of meat
D) Has severe laryngotrachietis
ANSWER: C

For which of the following procedures would the nurse expect to prepare for a patient who has adult respiratory distress syndrome?
A) Endotracheal intubation
B) Chest tube insertion
C) Incentive spirometry
D) Ventilation perfusion scan
ANSWER: A

When caring for a patient experiencing status asthmaticus, which of the following signs should alert the nurse to impending respiratory failure?
A) Audible wheezing
B) Absence of wheezing
C) Crackles during expiration
D) Rhonchi during inspiration 
ANSWER: B

On auscultation, which finding suggests a right pneumothorax?
A) Bilateral inspiratory and expiratory crackles
B) Absence of breath sounds in the right thorax
C) Inspiratory wheezes in the right thorax
D) Bilateral pleural friction rub
ANSWER: B

A patient with asthma has orders for all of the following medications.Which medication should the nurse expect to prepare when the patient shows signs of status asthmaticus?
A) Epinephrine[Adrenaline]
B) Theophylline
C) Erythromycin
D) Cromolyn Sodium
ANSWER: A

After a car accident, a patient is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24-48 hours after the accident, the nurse must monitor the patient closely for which potential complication of a fractured pelvis?
A) Compartment syndrome
B) Fat embolism
C) Infection
D) Volkman's or chronic contracture
ANSWER: B

A nurse is assessing a patient who has thrombophlebitis. Which of the following findings would indicate to the nurse the potential development of a pulmonary embolism?
A) Cheyne Stokes respirations
B) Subcutaneous emphysema
C) Increased somnolence
D) Severe chest pain
ANSWER: D

A patient has had a total abdominal hysterectomy. Which of the following instructions would be important to prevent the development of a deep vein thrombosis(DVT)?
A) Limit intake of fluids
B) Limit activity for two weeks
C) Change positions frequently
D) Massage the incision daily
ANSWER: C

A one month old infant in respiratory distress is brought to the emergency department. Which of the following signs would indicate respiratory distress?
A) Clubbing of fingers and toes
B) Jugular venous distension
C) Nasal flaring and chest retractions
D) Cool clammy, moist skin
ANSWER: C

A patient in the emergency department has multiple fractured ribs and a right sided tension pneumothorax. The nurse would expect to prepare the patient for which of the following procedures?
A) Electrocardiogram
B) Usually catheter placement
C) Chest tube insertion
D) Gastric lavage
ANSWER: C

The physicican evaluates the most recent set of arterial blood gases(ABGs) and orders an increase in the positive end expiratory pressure(PEEP) from 5 cm of H2O to 10 cm of  H2O. Based on this change in therapy, the nurse should anticipate which of the following ABG findings?
A) Decreased PaO2
B) Increased PaO2
C) Decreased  HCO3
D) Increased PaCO2
ANSWER: B

The nurse should be aware that the correct order for physical assessment of the abdomen is
A) Inspect, auscultate, percuss and palpate
B) Inspect, palpate, auscultate and percuss
C) Inspect, percuss, palpate and auscultate
D) Inspect, palpate,percuss and auscultate
ANSWER: A

A patient arrives at the emergency department with a history of fall and a complaint of abdominal pain. Assessment findings are blood pressure 101/68,pulse 116 and regular respirations 24, capillary refill four seconds, and thirst. The nurse assessing the patient should be aware that tese signs and symptoms are indicative of
A) Gall bladder inflammation
B) Intra abdominal hemorrhage
C) Septicemia
D) Cardiogenic shock 
ANSWER: B

The nurse assesses cranial nerve V11 in a pediatric client by which of the following techniques?
A) Gently swab the cornea with sterile cotton tipped applicator
B) Hold the eyes open and turn the head from side to side
C) Place the child's head in the midline position with the head elevated and inject ice water into the ear canal
D) Irrigate the pharynx with a tongue depressor or cotton swab
ANSWER: C

The nurse receives report from an emergency room nurse that a child is being admitted with a C7 spinal cord injury. Based on this information, the nurse prepares to care for a child with which of the following deficits?
A) Quadriplegia with total loss of respiratory function and flaccid paralysis
B) Paraplegia with loss of leg, bowel, and bladder function
C) Quadriplegia  but with gross arm movements and diaphragmatic breathing
D) Paraplegia, arm function intact, loss of some degree of intercostals and abdominal muscles
ANSWER: D

A client is thrown from an automobile during a collision. The nurse knows that the client will be able to maintain gross arm movements and diaphragmatic breathing. If the injury occurs at  what vertebra level?
A) C4
B) C5
C) C3
D) C7
Amswer: B

A client is admitted with a cervical spine injury sustained during a driving accident. When planning this client's care, the nurse should assign the highest priority which nursing diagnosis?
A) Impaired physical mobility
B) Ineffective breathing pattern
C) Sensory perceptual alterations
D) Dressing-grooming self-care deficit
ANSWER: B

After a car accident, a patient is admitted to an acute care facility with multiple traumatic injuries, including a fractured pelvis. For 24-48 hours after the accident, the nurse must monitor the patient closely for which potential complication of a fractured pelvis?
A) Compartment syndrome
B) Fat embolism
C) Infection
D) Volkman's or chronic contracture
ANSWER: B

A postoperative patient is receiving heparin after developing thrombophlebitis, the nurse monitors the patient carefully for adverse effects of heparin, especially bleeding. If the patient starts to exhibit signs of bleeding, the nurse should expect to administer an antidote that is specific for heparin. Which agent fits this description?
A) Vitamin K
B) Protamine Sulfate
C) Thrombin
D) Plasma protein formation 
ANSWER: B

A client has difficulty communicating because of expressive aphasia following cerebrovascular accident. When the nurse asks  how the client is feeling, the spouse ANSWERs for the client. The nurse should 
A) Ask how the spouse knows how the spouse is feeling
B) Acknowledge the spouse but look at the client for a response
C) Instruct the spouse but to let the client ANSWER
D) Return later to speak to the client after the spouse has gone home
ANSWER: B

The nurse is caring for a client with a spinal cord trauma following a motorcycle accident. It is priority for the nurse to monitor for and immediately report which of the following findings?
A) Hypotension
B) Bradycardia
C) Pain
D) Inflammation of the site of the injury
ANSWER: B

A client who has been severely beaten is admitted to the emergency department. The nurse suspects a basilar skull fracture after assessing;
A) Racoon's eyes and Battle's sign
B) Nuchal rigidity and kernig's sign
C) Motor loss in the lungs
D) Pupillary change
ANSWER: A

Which of the following instructions should be given to the family to ensure safety of a patient who recently began experiencing periodic grand mal seizures?
A. Place a torque blade in the patient's  mouth during a seizure
B. Physically restrain the patient during the seizure
C. Remove sharp objects in the patient's immediate environment
D. Call the emergency medical squad when each seizure begins
ANSWER: C

The nurse should inform a client with seizure disorder to avoid which of the following?
A) Excess noise 
B) Stress
C) Infections
D) A high chocolate intake
ANSWER: D

After a plane crash, a client is brought to the emergency department with severe burns and respiratory difficulty. The nurse helps to secure a patient airway and attends to the client's immediate needs, then prepares to perform a neurologic assessment because the client is unstable and in critical condition, this examination must be brief but should include
A) Evaluation of the corneal reflex response
B) Examination of the fundus of the eye
C) Assessment of the client's gait
D) Examination of the bowel and bladder functions
ANSWER: A

If a client experienced a cerebrovascular accident, that damage the hypothalamus, the nurse would anticipate that the client has problems with which of the  following?
A) A body temperature control
B) Balance and equilibrium
C) Visual acuity
D) Thinking and reasoning
ANSWER: A

The nurse caring for a patient who has subarachnoid hemorrhage should be aware that an increasing intracranial pressure is manifested by which of the following?
A) A widening pulse pressure
B) An increase heart rate
C) A decrease in blood pressure
D) A decrease body temperature  
ANSWER: A

A 50 year old male was brought   the ER. He is alert and has complained of vomiting and headache after onset of left sided weaknes. He has a history of Diabetes Mellitus and blood pressure is 150/90 mm Hg .Using the Siriraj scoring, the total score is +4. What is the score interpretation?
A) Most likely hemorrhage
B) Equivocal result [CT scan  needed]
C) Most likely infarction
D) Most probably cerebral arteriospasm
ANSWER: A

A client is admitted with a cervical spine injury sustained during a driving accident. When planning this client's care, the nurse should assign the highest priority which nursing diagnosis?
A) Impaired physical mobility
B) Ineffective breathing pattern
C) Sensory perceptual alterations
D) Dressing-grooming self-care deficit
ANSWER: B

The nurse receives report from an emergency room nurse that a child is being admitted with a C7 spinal cord injury. Based on this information, the nurse prepares to care for a child with which of the following deficits?
A) Quadriplegia with total loss of respiratory function and flaccid paralysis
B) Paraplegia with loss of leg, bowel, and bladder function
C) Quadriplegia  but with gross arm movements and diaphragmatic breathing
D) Paraplegia, arm function intact, loss of some degree of intercostals and abdominal muscles
ANSWER: D

The nurse assesses cranial nerve V11 in a pediatric client by which of the following techniques?
A) Gently swab the cornea with sterile cotton tipped applicator
B) Hold the eyes open and turn the head from side to side
C) Place the child's head in the midline position with the head elevated and inject ice water into the ear canal
D) Irrigate the pharynx with a tongue depressor or cotton swab.
ANSWER: C

A patient suspected of having aneurysm usually complains of flank pains. This is because the most common site of aneurysm formation is in which segment of the aorta?
A) Abdominal aorta, just below the renal arteries
B) Ascending aorta, around the aortic arch
C) Descending aorta, beyond the subclavian arteries
D) Aortic arch, around the ascending aorta
ANSWER: A

In caring for a patient with vasovagal syncope, the nurse should know that the  associated temporary loss of consciousness is not often related to:
A) Vestibular dysfunction
B) Sudden vascular fluid shifting
C) Postural hypotension
D) Bradyrhythmia
E) Shock
ANSWER: E)

When assessing a patient for the potential development of hypovolemic shock, which of the following manifestations would the nurse most likely see first?
A) Nervousness and apprehension
B) Decreased urinary output
C) Systolic blood pressure below 90 mm Hg
D) Hypoventilation and tachycardia
ANSWER: A

A physician has written all of the following orders for a patient who has a diagnosis of septic shock. Which order should be carried first?
A) Obtain blood culture
B) Initiate antibiotic therapy
C) Insert indwelling catheter
D) Apply antiembolism stockings
ANSWER: A
.

Which of the following findings, if identified in a patient with hypovolemic shock, should indicate to the nurse that the treatment is having the desired effect? 
A) Central venous pressure of 4 mm Hg
B) Pulse oximeter reading of 98 percent
C) Urine output of 50 ml per hr
D) Temperature of  37 degree centigrade
ANSWER: C

A patient is receiving treatment for hypovolemic shock. Which of the following findings would indicate that the treatment has been successful?
A) Heart rate, 100 to 120 beats per minute
B) Central venous pressure four to six cm of H2O
C) Capillary refill time, eight seconds
D) Urine output, 210 ml in eight hours
ANSWER: B

A nurse should assess a postoperative patient for which of the following early manifestations of hypovolemic shock
A) Hypotension
B) Restlessness
C) Oliguria
D) Dyspnea
ANSWER: B

Which of the following measures is important for a nurse to include in the care of a patient who has septic shock?
A) Promoting ambulation
B) Restricting dietary protein
C) Limiting sensory stimulation
D) Increasing fluid intake
ANSWER: D


A patient was brought to the emergency unit of the hospital where you were on duty. A 10 inches laceration in his scalp caused profused bleeding. He is hypotensive, tachycardic with a rapid pulse. Based on this assessment, how would you classify his blood loss?
A) Blood loss of 15 percent
B) Blood loss of 25 percent
C) Blood loss of 35 percent
D) Blood loss of  45percent
ANSWER: B

The client who was taking penicillin for a wound, suddenly developed urticaria bronchoconstriction, vasodilation laryngeal edema. What drug is a priority to administer to this patient?
A) Atropine sulfate
B) Epinephrine
C) Hydrocortisone
D) Motilium
ANSWER: E


What type of anaphylactic reaction did the above mentioned client display?
A) Delayed hypersensitivity reaction
B) Anaphylactic reaction
C) Immune complex reaction
D) Cytolytic reaction
ANSWER: B

Blood loss  may cause hypovolemia. You can quickly assess volume depletion in  a patient by which of the following?
A) Measuring the quantity and specific gravity of her urine output
B) Taking her blood pressure first supine then sitting position; noting any changes
C) Comparing the patient's weight with her weight on her last admission
D) Administering the oral water test
ANSWER: B

A client who has been severely beaten is admitted to the emergency department. The nurse suspects a basilar skull fracture after assessing;
A) Racoon's eyes and Battle's sign
B) Nuchal rigidity and kernig's sign
C) Motor loss in the lungs
D) Pupillary change
ANSWER: A

Emergency medical technicians transport a 28 year old iron worker to the emergency department. They  tell the nurse" He fell from a two story bulding. He has a large contusion on his left chest and a hematoma in the left parietal area. He has a compound fracture of his left femur and he's comatose. We intubated him and he's maintaining an arterial saturation of 92percent by pulse oximeter with a manual resuscitation bag" . Which intervention by the nurse has the highest priority?
A) Assessing the left leg
B) Assessing the pupils
C) Placing the patient in trendelenberg position
D) Assessing level of consciousness
ANSWER: A

The term _____ describes a drowning event where a patient is pronounced dead within 24 hours of the event.
A) drowning 
B) submersion 
C) water rescue
D) drowning related death
ANSWER: A

Death that occurs 24 hours after a drowning is called a
A) drowning..
B) submersion. 
C) water rescue
D) drowning-related death
ANSWER: D

If a swimmer may have been involved in a diving accident or may have been struck by a boat, water skier, surfboard, or another object, the EMT should suspect
A) spinal injury..
B) air embolism. 
C) ARDS
D) hypothermia
ANSWER: A

A condition in which the stomach fills with water, enlarging the abdomen to the point that it interferes with the ability to inflate the lungs, is called
A) hydrothorax..
B) water in the lungs
C) distended pleura
D) gastric distention
ANSWER: C

As a guideline, the EMT should attempt resuscitation on any pulseless, nonbreathing patient who has been submerged in _____ water, even if the drowning has been longer than 30 minutes.
A) warm 
B) cold
C) fresh
D) salt
ANSWER: B

60. All of the following are signs and symptoms of arterial gas embolism except
A) dizziness..
B) delayed onset.
C) chest pain
D) ndifficulty breathing
ANSWER: B

If you suspect that a patient has a spine injury, maintain in-line stabilization and then secure the patient to a backboard before
A) evaluating breathing.
B) starting CPR
C) starting rescue breathing
D) removing from water
ANSWER: D

Signs and symptoms of barotrauma include all of the following except
A) xtreme dizziness..
B) palpitations
C) nausea
D) disorientation
ANSWER: B

Decompression sickness may occur up to _____ following a dive.
A) 2 days 
B) 72 hours 
C) one week
D) two weeks
ANSWER: B

The most important factor in determining whether EMTs enter the water to rescue a patient is
A) the quality of their equipment.
B) their training.
C) the depth of the water.
D) their ability to use a rowboat
ANSWER: B

All of the following are forms of barotrauma except one:
A) pnemothorax
B) mask squeeze
C) air embolism
D) the bends
E) ear squeeze
ANSWER: D

In which of the following conditions has it been proved that there is increased risk of death or severe injury from scuba diving?
A) asthma
B) diabetes
C) epilepsy
D) pregnancy
E) none of the above
ANSWER: E

Which of the following conditions would be the most prohibitive of participating in scuba diving?
A) history of asthma, diver on medication
B) a history of epilepsy, diver on medication
C) insulin-dependent diabetes
D) blebs or "bullae" seen on chest xray, diver has no symptoms
E) an episode of the bends two months earlier, treated in a hyperbaric chamber with no residual defects
ANSWER: D

Which of the following conditions would be the most prohibitive of participating in scuba diving?
A) a history of asthma, diver on medication
B) a history of epilepsy, diver on medication
C) insulin dependent diabetes
D) blebs or "bullae" seen on chest x-ray, diver has no symptoms
E) an episode of the bends two months earlier, treated in a hyperbaric chamber with no residual defect
ANSWER: D

The main importance of a Patent ForamenOvale for scuba divers is that it may increase the risk of:
A) developing venous nitrogen bubbles
B) developing arterial air bubbles
C) letting nitrogen bubbles get to the brain
D) letting arterial air bubbles get to the brain
E) none of the above
ANSWER: D

Shallow water blackout in free or breath-hold divers is due to:
A) Build-up of CO2 from staying under water too long.
B) Lack of oxygen near the end of the dive.
C) Running out of compressed air near the surface.
D) A combination of a, b, and c
E) None of the above.
ANSWER: B

A scuba diver is inhaling compressed air that is 5 times the density of air at sea level. She is at what depth?
A) 99 feet.
B) 132 feet.
C) 165 feet.
D) Can't determine without knowing the air tank's residual air pressure.
E) Depends on her frequency of breathing [whether she is taking partial or full inhalations]
ANSWERs: B

A scuba diver ascends rapidly from 20 foot depth, where she has been for 15 minutes on her only dive of the day. Potential hazard(s) from a rapid ascent in this case include:
A) Air embolism
B) Decompression sickness [bends]
C) Both
D) Neither
ANSWER: A

After a plane crash, a client is brought to the emergency department with severe burns and respiratory difficulty. The nurse helps to secure a patient airway and attends to the client's immediate needs, then prepares to perform a neurologic assessment because the client is unstable and in critical condition, this examination must be brief but should include
A) Evaluation of the corneal reflex response
B) Examination of the fundus of the eye
C) Assessment of the client's gait
D) Examination of the bowel and bladder functions
ANSWER: A

A client with a solar burn of the chest, back and face, and arms is seen in urgent care. The nurse's primary concern should be:
A) Fluid resuscitation
B) Infection
C) Body image
D) Pain management
ANSWER: D

When teaching parents first aid for burns, a nurse should instruct the parents to
A) Cover the burn areas with cotton gauze
B) Apply ice directly to the burned area
C) Coat the burned area lightly with petroleum jelly
D) Immerse the burned area and cool water
ANSWER: D

To which of the following nursing diagnosis would a nurse give priority in caring for a patient who has sustained serious facial and neck burns?
A) Fluid volume deficit
B) Body image disturbance
C) Ineffective thermoregulation
D) Ineffective airway clearance
ANSWER: D

A nurse is instructing a group at the wellness center about first aid treatment for burns. Which of the following instructions would the nurse give to the group?
A) Cover the burned area with butter
B) Apply an antibacterial ointment to the burned area
C) Wrap the burned area with the patients clothes
D) Submerge the burned area in cool water
ANSWER: D

A young child has experienced a minor superficial burn to the forearm. As an immediate measure, a nurse would advise the parent to apply which of the following substances to the affected area?
A) Cool water
B) Antibiotic ointment
C) Hydrogen peroxide
D) Iodine solution
ANSWER: A

To which of the following nursing diagnosis should a nurse give priority in the care of a patient who has sustained severe burns?
A) Hyperthermia
B) Risk of infection
C) Body image disturbance
D) Impaired physical mobility
ANSWER: B

A client with a solar burn of the chest, back and face, and arms is seen in urgent care. The nurse's primary concern should be:
A) Fluid resuscitation
B) Infection
C) Body image
D) Pain management
ANSWER: D

A seven year old child who was in a house fire is being evelauated in the emergency department. The child has no visible burn injurues but vomits undigested food with black particles. Which of the following goals would be given priority in the child's care of plan?
A) Minimize discomfort
B) Conserve urinary output
C) Maintain a patent airway
D) Preserve gastrointestinal function
ANSWER: C


After taking an overdose of Phenobarbital, a client is admitted to the emergency department. The physician prescribes activated charcoal to be administered by mouth immediately. Before administering the dose, the nurse verifies the dosage ordered. What is the usual minimum dose of activated charcoal?
A) 5 g mixed in 250 ml of water
B) 15 g mixed in 250 ml of water
C) 30 g mixed in 250 ml water
D) 60 g mixed in 500 ml of water
Answe: C
   
A 16 year old who is semiconscious is brought to the emergency department after ingesting an unknown quantity of acetaminophen and alcohol. To which of the following actions would a nurse give priority?
A) Inserting a nasogastric tube
B) Obtaining a urine toxicology sample
C) Inducing vomiting
D. Starting an intravenous infusion
ANSWER: D

After successfully performing the Heimlich maneuver on an 18 year old child, a nurse would advise the child's parent to perform which of the following measures?
A) Monitor the child carefully for signs of abdominal bruising
B) Give the child only liquids to drink for the next 24 hours
C) Take the child to a healthcare facility for a thorough examination
D) Check the child's breathing every two hours at night
ANSWER: C

In what situation would a patient maybe  in ,who is assessed to have inspiratory and expiratory stridor ?
A) Experiencing an exacerbation of goiter
B) Is experiencing an acute asthmatic attack
C) Has aspirated a piece of meat
D) Has severe laryngotrachietis
ANSWER: C

You were one of those who responded to a landslide in Mount Diwalwal which involved a hundred victims. In triaging of patients in the area, what color code would you tag a victim who is not ambulatory and can not follow commands?
A) Green
B) Red
C) Black
D) Yellow
ANSWER: B

A client arrives at the emergency room with a painful rash  surrounded by necrotic tissue on his left shoulder. Suspecting an insect bite,this assessment finding  is usually caused by usually a/an:
A) Tick
B) Ant
C) Spider
D) Mosquito
ANSWER: A