RPN Emergency Response 4

Question 1

A patient is brought to the ED after being found unresponsive. The nurse notes a respiratory rate of 6 breaths/min and constricted pupils. Which medication should the nurse prepare FIRST?

Accepted Answer

Naloxone 0.4–2 mg IV/IM/IN

Answer

Miosis and respiratory depression are hallmarks of opioid toxicity; naloxone rapidly reverses opioid-induced CNS and respiratory depression.

Question 2

A patient in the ED is diagnosed with hypertensive emergency with a blood pressure of 220/130 mmHg and confusion. The nurse should anticipate the blood pressure being lowered by no more than:

Accepted Answer

25% in the first hour

Answer

Overly rapid blood pressure reduction in hypertensive emergency can cause cerebral ischemia; the goal is a maximum 25% reduction in the first hour.

Question 3

A patient with a penetrating abdominal wound has an evisceration. The nurse's CORRECT intervention is to:

Accepted Answer

Cover the evisceration with moist sterile saline gauze and do not reinsert

Answer

Eviscerated organs should be covered with moist sterile saline gauze to prevent drying and ischemia, and never pushed back in, as this risks contamination and vascular compromise.

Question 4

A nurse is performing a primary survey on a trauma patient. Using the ABCDE approach, which assessment occurs BEFORE evaluating breathing?

Accepted Answer

Airway with cervical spine protection

Answer

In the ABCDE trauma primary survey, Airway with simultaneous cervical spine protection is the very first assessment and intervention priority.

Question 5

A patient presents with a serum potassium of 6.8 mEq/L and peaked T-waves on ECG. The FIRST intervention to protect the heart is to administer:

Accepted Answer

Calcium gluconate IV

Answer

Calcium gluconate IV is given first in severe hyperkalemia to stabilize the cardiac membrane and prevent lethal dysrhythmias before other measures lower serum potassium.

RPN - Registered Practical Nurse Practice Test

RPN - Registered Practical Nurse Practice Test

RPN Emergency Response 4