PNC Emergency Procedures & Response 2 — Questions and Answers
Question 1: A parish nurse arrives at a church event where a 68-year-old man is unresponsive and not breathing normally. After calling 911, what is the next priority action?
- Administer oxygen via nasal cannula
- Begin chest compressions at 100-120 per minute (Correct answer)
- Perform a head-tilt chin-lift and give two rescue breaths first
- Check blood glucose level
Correct answer: Begin chest compressions at 100-120 per minute
Current AHA guidelines emphasize compression-first CPR (C-A-B sequence), so high-quality chest compressions at 100-120/min are initiated immediately after activating EMS.
Question 2: During a heat emergency at an outdoor church picnic, which sign most clearly distinguishes heat stroke from heat exhaustion?
- Profuse sweating
- Altered mental status or loss of consciousness (Correct answer)
- Muscle cramps in the legs
- Nausea and dizziness
Correct answer: Altered mental status or loss of consciousness
Heat stroke is characterized by central nervous system dysfunction (confusion, loss of consciousness) and is a life-threatening emergency unlike heat exhaustion.
Question 3: A congregation member with a known bee allergy is stung and develops hives, throat tightening, and hypotension. The parish nurse should first:
- Apply a cold compress to the sting site
- Administer diphenhydramine orally
- Use the member's epinephrine auto-injector and call 911 (Correct answer)
- Elevate the affected limb and monitor vital signs
Correct answer: Use the member's epinephrine auto-injector and call 911
Anaphylaxis with systemic symptoms requires immediate epinephrine (first-line treatment) and activation of EMS regardless of initial improvement.
Question 4: A parish nurse witnesses a child fall from a climbing structure and suspects a cervical spine injury. While awaiting EMS, she should:
- Flex the child's neck to open the airway if needed
- Maintain inline spinal stabilization and minimize movement (Correct answer)
- Place the child in recovery position immediately
- Encourage the child to sit up slowly to assess consciousness
Correct answer: Maintain inline spinal stabilization and minimize movement
Suspected cervical spine injury requires manual inline stabilization to prevent secondary cord injury until EMS arrives with proper immobilization equipment.
Question 5: When using an AED on a victim who has a transdermal medication patch on the chest, the parish nurse should:
- Apply the AED pad directly over the patch to maximize contact
- Remove the patch with a gloved hand before placing pads (Correct answer)
- Place the pad 2 inches below the patch and continue
- Withhold AED use until the patch degrades
Correct answer: Remove the patch with a gloved hand before placing pads
Transdermal patches can block pad contact or cause burns during defibrillation and should be removed with gloved hands before AED pad placement.
Question 6: A diabetic congregation member becomes confused, diaphoretic, and tremulous during a Bible study. Her blood glucose reads 48 mg/dL. She is conscious and able to swallow. The parish nurse should:
- Administer 1 mg glucagon intramuscularly
- Give 15-20 grams of fast-acting carbohydrate orally (Correct answer)
- Have her drink a full glass of regular soda immediately
- Call 911 and withhold food until EMS arrives
Correct answer: Give 15-20 grams of fast-acting carbohydrate orally
The '15-15 rule' for mild-to-moderate hypoglycemia directs giving 15 grams of fast-acting carbohydrate, then rechecking glucose in 15 minutes.
Question 7: A parish nurse is managing a community health fair when a visitor suddenly has a tonic-clonic seizure. Which action is the priority?
- Restrain the person's limbs to prevent injury
- Insert a padded tongue blade to protect the airway
- Clear the area of hard objects and time the seizure (Correct answer)
- Administer sublingual nitroglycerin to reduce cerebral pressure
Correct answer: Clear the area of hard objects and time the seizure
During a seizure, the nurse should protect the person from environmental hazards, position on the side if possible, and document seizure duration to report to EMS.
PNC Emergency Procedures & Response 2
A parish nurse arrives at a church event where a 68-year-old man is unresponsive and not breathing normally.
After calling 911, what is the next priority action?