DISASTER NSG PRACTICE QUESTIONS

Shai Lagmay ───୨ৎ── BSN 4-2 What priority is key in a lood response?
A. Evacuation
What action is priority in a mass casualty incident? B. Rescue
A. Triage C. Medical aid
B. Evacuation D. Communication
C. Documentation
D. Resource allocation https://www.proprofs.com/quiz-school/story.php?
title=mjaxmze5mwsy7e

Which sign indicates radiation exposure? ─────────────────୨ৎ─────────────────

A. Hair loss 1. You’re working as a triage nurse during a disaster situation.
B. Cough Based on the triage color code tags placed on each of the
C. Bruising wounded, which tag color represents the wounded who have
D. Fever the highest priority of being treated irst?*
A. Green
What is the initial step in disaster management? B. Yellow
C. Red
A. Preparedness D. Black
B. Response
C. Recovery 2. A catastrophic disaster has occurred 5 miles from the
D. Mitigation hospital you are working in. The hospital’s disaster plan is
activated and the wounded are brought to the hospital. You’re
Which resource is most crucial during an evacuation? helping triage the survivors. One of the wounded is able to
A. Food walk around and has minor lacerations on the arms, hands,
B. Water chest, and legs. You would place what color tag on this
C. Shelter survivor?*
D. Transport A. Red
B. Yellow
What symptom requires immediate attention post-disaster? C. Green
A. Anxiety D. Black
B. Headache
C. Dehydration 3. Which statement below is INCORRECT about the yellow
D. Chest pain triage tag color in regards to a disaster situation?*
A. A survivor with this tag color is seen after patients
Which agency provides disaster response updates? with the green tag color.
A. FEMA B. A survivor with this tag color can have treatment
B. CIA delayed for an hour or less.
C. FDA C. A survivor with this tag color has serious injuries
D. USPS that could eventually lead to the compromise of breathing,
circulation, or mental status, especially if treatment is
What method is best for sterilizing water? delayed more than an hour or so.
A. Filtration D. A survivor with this tag color has second priority
B. Boiling for treatment of injuries.
C. Chemicals
D. UV light 4. For the next 7 questions, use the START method for adults to
help triage the wounded that have been involved in a disaster
Which injury is common in earthquakes? situation. Each question will give you details on what you have
A. Laceration assessed and you will need to use those details to help you
B. Fracture assign a color tag to the individual: The wounded victim is
C. Burn unable to walk, has respiratory rate of 40, capillary re ill is 6
D. Frostbite seconds, and can’t follow simple commands. The wounded
victim is assigned what tag color?*
What is essential to assess in chemical exposure? A. Green
A. Allergy history B. Red
B. Prior exposure C. Yellow
C. Symptoms D. Black
D. Vaccination history

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5. While triaging the wounded from a disaster, you note that 2. Nurse Kelly is assessing a child brought to the emergency
one of the wounded is not breathing, radial pulse is absent, department after ingesting an unknown amount of children's
capillary re ill >2 seconds, and does not respond to your chewable vitamins at an unknown time. The child is alert and
commands. What color tag is assigned?* shows no symptoms. Which piece of information should Nurse
A. Green Kelly immediately report to the physician?
B. Red A. The child has a history of multiple treatments for toxic
C. Yellow ingestions.
D. Black B. The children's chewable vitamins contain iron.
C. The child experienced nausea and vomited once at home.
6. The wounded victim is unable to walk, has respiratory rate D. The child has a history of being treated for accidental
of 12, capillary re ill is 8 seconds, and is unresponsive. The injuries.
wounded victim is assigned what tag color?*
A. Green 3. Nurse Jane is caring for an intoxicated patient presenting
B. Red with slurred speech, mild confusion, and uncooperative
C. Yellow behavior. The patient is not providing a clear history but
D. Black admits to recent alcohol consumption. What should Nurse
Jane's priority action be?
7. The wounded victim is unable to walk, has respiratory rate A. Administer naloxone (Narcan) 2–4 mg as ordered.
of 19, capillary re ill of one second, and is able to obey your B. Contact the family to gather more history and baseline
commands. The wounded victim is assigned what tag color?* information.
A. Green C. Administer IV luids with supplemental thiamine as ordered.
B. Red D. Obtain an order for a blood alcohol level.
C. Yellow
D. Black 4. Nurse Sam is caring for a patient who was involved in a one-
car rollover accident and presents with multiple injuries. To
8. The wounded victim is unable to walk, respiratory rate is ensure appropriate trauma care, Nurse Sam must prioritize the
absent but when airway is repositioned breathing is noted. The following interventions. What steps should he take, in order?
wounded victim is assigned what tag color?* A. Assess for external bleeding, check airway patency,
A. Green administer pain medication, and evaluate neurological status.
B. Red B. Control external bleeding, administer pain medication,
C. Yellow assess for breathing issues, and check circulation.
D. Black C. Check airway patency, assess breathing, control any external
bleeding, and check circulation.
9. The wounded victim is unable to walk, respiratory rate is D. Administer pain medication, assess for breathing issues,
absent and when airway is repositioned breathing is still check airway patency, and evaluate circulation.
absent. The wounded victim is assigned what tag color?*
A. Green 5. Nurse Avery responds to an emergency call in the ED waiting
B. Red room where an elderly patient is found lying on the loor. She
C. Yellow must quickly assess and intervene to provide life-saving
D. Black measures. What is the correct order of actions she should
follow?
10. The wounded victim is able to walk and obey commands. A. Call for help, check the patient’s pulse, begin chest
The wounded victim is assigned what tag color?* compressions, and give rescue breaths.
A. Green B. Check the patient’s airway, begin chest compressions, give
B. Red rescue breaths, and call for help.
C. Yellow C. Call for help, check for responsiveness, begin chest
D. Black compressions, and open the patient’s airway.
• D. Check for responsiveness, call for help, check the patient’s
https://www.registerednursern.com/disaster-triage-nursing- airway, and give rescue breaths.
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1. The nursing manager is forming a committee to tackle the
issue of violence against emergency department (ED) staff. To
ensure all perspectives are considered, which combination of
employees would be the most appropriate for this task?
A. Experienced registered nurses and paramedics.
B. Registered nurses, LPN/LVNs, and nursing assistants.
C. A representative from every group of ED personnel.
D. ED physicians and charge nurses.

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6. Nurse Sam is working in the triage area of the emergency 11. Nurse Jenna, an experienced traveling nurse, has just
department when four patients arrive at the desk started her irst week in a new emergency department (ED).
simultaneously. In what order should Nurse Sam prioritize Although skilled, she is still getting oriented to this speci ic ED
these patients for assessment? environment. Which area would be the most appropriate for
1. A 25-year-old male, ambulatory but dazed, with a head her assignment?
wound that is already bandaged. A. Pediatric medicine team.
2. An irritable infant presenting with fever, petechiae, and B. Trauma team.
neck stiffness. C. Ambulatory or fast track clinic.
3. A 35-year-old jogger with a twisted ankle, a palpable D. Triage.
pedal pulse, and no visible deformity.
4. A 50-year-old female experiencing moderate abdominal 12. Nurse Carla is assessing a 25-year-old college student who
pain and occasional vomiting. presents with anxiety, tingling sensations, palpitations, and
A. 2, 1, 4, 3 chest tightness. She observes rapid, deep breathing and carpal
B. 2, 3, 1, 4 spasms, indicating possible hyperventilation. What should be
C. 2, 1, 4, 3 Nurse Carla's priority action?
D. 2, 1, 3, 4 A. Instruct the student to breathe into a paper bag.
B. Administer supplemental oxygen.
7. Nurse Taylor is assessing a patient who has suffered multiple C. Notify the physician immediately.
traumatic injuries. As she prioritizes her assessment indings, D. Request an order for an anxiolytic medication.
which observation indicates the most critical and life-
threatening condition? 13. Nurse David is receiving a patient transported by EMS with
A. A visible deformity in a lower extremity. severe chest pain. As the patient is moved to the emergency
B. Diminished bowel sounds. stretcher, Nurse David notices that the patient is unresponsive,
C. A trachea that is deviated. not breathing, and has no pulse. He needs to delegate tasks
D. Presence of blood in the urine. quickly to the nursing assistant. Which task is appropriate for
the nursing assistant to perform?
8. Nurse Jenna is assessing a patient who has presented with a A. Assisting with bag-valve mask ventilation.
cat bite on the left hand. While gathering information, she B. Placing the de ibrillator pads.
discovers that the cat's immunizations are current, but the C. Helping with oral intubation.
patient cannot recall the date of their last tetanus shot. What D. Performing chest compressions.
should Nurse Jenna identify as the priority nursing diagnosis?
A. Impaired Skin Integrity related to the presence of puncture 14. Nurse Jamie is preparing to assist with the care of a 35-
wounds. year-old patient who has been experiencing continuous seizure
B. Ineffective Health Maintenance related to uncertainty of activity for the past 45 minutes, indicating status epilepticus.
immunization history. Given the patient's history and current condition, which
C. Risk for Impaired Mobility due to possible tendon injury. medication does Nurse Jamie anticipate the physician will
D. Risk for Infection related to organisms commonly associated order?
with cat bites. A. Intravenous Carbamazepine.
B. Intravenous Magnesium sulfate.
9. Nurse Brian is caring for a prisoner with a history of alcohol C. Intravenous Lorazepam (Ativan).
abuse who has been in police custody for 48 hours. The patient D. Oral Phenytoin and Carbamazepine.
is now exhibiting signs of delirium tremens with
disorientation, hallucinations, and hyper-reactivity. What 15. Nurse Carla is managing an unexpected death in the
should be the priority nursing diagnosis for this patient? emergency department and needs to delegate tasks to the
A. Risk for Other-Directed Violence related to hallucinations. nursing assistant. Which task is most appropriate for the
B. Risk for Injury related to seizures. nursing assistant to handle?
C. Risk for Situational Low Self-esteem related to police A. Escort the family to a private area.
custody. B. Assist with post-mortem care.
D. Risk for Nutritional De icit related to chronic alcohol abuse. C. Accompany the organ donor specialist to speak with the
family.
10. Nurse Brian is caring for a patient who has suffered a D. Help the family gather the patient's belongings.
chainsaw injury, resulting in the amputation of the irst and
second digits. He is determining which tasks to delegate to the 16. Nurse Emma is providing discharge instructions to a
LPN/LVN. Which task is appropriate to assign to the LPN/LVN? woman who has been treated for contusions and bruises after
A. Wrap the amputated digits in sterile gauze moistened with experiencing domestic violence. As she plans her care, what
saline. should be Nurse Emma's priority intervention for the patient?
B. Gently cleanse the amputated digits with Betadine solution. A. Provide a referral for counseling services.
C. Store the amputated digits in a solution of sterile normal B. Encourage contacting the police for support.
saline. C. Help arrange transportation to a safe house.
D. Place the amputated digits directly into an ice slurry. D. Schedule a follow-up appointment for her injuries.

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17. Nurse Hannah is working in the emergency department 21. Nurse Taylor is assessing multiple patients in the
during a hot summer day when several patients present with emergency department who are experiencing acute abdominal
symptoms of heat-related illness. She must prioritize care pain. She must prioritize them according to the urgency of their
based on the severity of their conditions. Which patient should conditions. How should Nurse Taylor rank the severity of these
Nurse Hannah attend to irst? cases?
A. A marathon runner with severe leg cramps, nausea, rapid 1. A 35-year-old male with severe, cramping abdominal
heart rate, sweating, pallor, and weakness. pain and diarrhea two hours after eating.
B. An elderly individual feeling dizzy and faint after standing in 2. An 11-year-old boy with low-grade fever, left lower
the sun for several hours. quadrant pain, nausea, and no appetite for the past 2
C. A homemaker with a broken air conditioner, breathing days.
rapidly, with low blood pressure, fatigue, and heavy sweating. 3. A 40-year-old female with left upper quadrant pain,
D. A homeless person with altered mental status, poor vomiting bile, and worsening symptoms over the past
coordination, and hot, dry, ashen skin, with an unknown week.
duration of heat exposure. 4. A 56-year-old male with a pulsating abdominal mass and
sudden, pressure-like pain in the abdomen and lank.
18. Nurse Alex is reviewing disaster preparedness protocols at A. 4, 3, 2, 1
her hospital, focusing on scenarios involving natural disasters B. 4, 2, 3, 1
or bioterrorism. As part of her responsibilities, what is her C. 2, 4, 1, 3
primary role in preparing for such incidents? D. 2, 4, 3, 1
A. Making ethical decisions about personal exposure to
hazardous substances. 22. Nurse Riley is overseeing a patient who experienced a near-
B. Understanding the procedures for reporting to the CDC. drowning event and is working alongside the healthcare team.
C. Familiarity with the facility's emergency response plan. She needs to delegate certain tasks to the LPN/LVN while
D. Recognizing the signs and symptoms of potential ensuring patient safety. Which of the following tasks is the
bioterrorism agents. most appropriate for her to assign to the LPN/LVN?
A. Developing a care plan based on the patient’s ongoing status.
19. Nurse Jenna is providing care to a patient who has B. Assessing the patient’s respiratory status and breath sounds.
sustained frostbite on both feet. To prevent further damage and C. Monitoring vital signs and reporting any abnormalities to the
alleviate discomfort, she needs to follow the appropriate steps RN.
in order. What should she do irst? D. Administering IV medications to manage the patient’s
1. Apply a loose, sterile, bulky dressing to the affected feet. condition.
2. Administer pain-relieving medication.
3. Move the patient away from the cold environment. 23. Nurse Alex is conducting a primary survey on a trauma
4. Immerse the feet in warm water, with a temperature patient who just arrived in the emergency department. He
between 100°F and 105°F (40.6°C to 46.1°C). needs to focus on the essential steps to quickly assess life-
A. 3, 2, 4, 1 threatening conditions. Which of the following should be one of
B. 3, 4, 2, 1 his priority actions?
C. 3, 2, 1, 4 A. Performing a brief neurological evaluation.
D. 3, 1, 2, 4 B. Obtaining a full set of vital signs.
C. Starting pulse oximetry monitoring.
20. Nurse Jenna is handling telephone triage when a patient D. Palpating and listening to the abdomen.
calls after being stung by a honey bee. The patient reports pain
and localized swelling but denies any signs of respiratory 24. Nurse Alex is assisting in the emergency intubation of a
distress or anaphylaxis. What should Nurse Jenna instruct the patient. After the procedure, Alex must verify the placement of
patient to do? the endotracheal tube and ensure it is secure. What is the
A. Call 911. correct order of steps to accomplish this?
B. Apply a cool compress. 1. Obtain a chest x-ray order to con irm tube placement.
C. Remove the stinger by scraping. 2. Secure the tube to keep it in position.
D. Take an oral antihistamine. 3. Listen to the chest while assisting with ventilation.
4. Check for equal and bilateral breath sounds.
A. 3, 4, 2, 1
B. 3, 2, 4, 1
C. 2, 3, 4, 1
D. 4, 3, 2, 1

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 25. Nurse Emily is preparing a child for IV conscious sedation
before the repair of a facial laceration. During this process,
certain situations arise that may require immediate
1. C
communication with the physician. Which information should 2. B
Nurse Emily report to the physician right away? 3.
4.
C
C
A. The child becomes upset and removes the IV. 5.
6.
C
A
B. The parent requests more information about IV conscious 7. C
8. D
sedation. 9. B
10. A
C. The parent is unsure about the child’s tetanus immunization 11. C
12. A
status. 13. D
D. The parent declines the use of IV conscious sedation. 14.
15.
C
B
16. C
17. D
26. Nurse Kelly is assessing a teenager who arrived in the 18. C
19. A
emergency department after being poked in the abdomen with 20. C
21. B
a stick. The patient is alert, but his clothes are covered in blood, 22. C
23. A
and his friends are hysterically explaining what happened. 24. A
Which comment should Nurse Kelly prioritize irst? 25.
26.
D
C
A. "The stick was really dirty and covered with mud." 27.
28.
C
B
B. "He's a diabetic, so he needs attention right away." 29. A
30. B
C. "He pulled the stick out just now because it was hurting
him." https://www.rnpedia.com/practice-exams/medical-and-
D. "There was a lot of blood and we used three bandages." surgical-nursing-exams/msn-exam-emergencies/
27. As the charge nurse in the emergency department, Nurse
Linda needs to ensure that the triage area is staffed with the ─────────────────୨ৎ─────────────────
most appropriate team to handle complex and time-sensitive The nurse is the irst responder after a tornado has destroyed
assessments. Which team should she assign to manage the many homes in the community. Which victim should the nurse
triage area? attend to irst?
A. An experienced RN and a nursing assistant. 1. A pregnant woman who exclaims, "My baby is not moving."
B. An advanced practice nurse and a skilled LPN/LVN. 2. A child who is complaining, "My leg is bleeding so bad, I am
C. An experienced RN and a newly licensed RN. afraid it is going to fall off!"
D. An experienced LPN/LVN and a newly licensed RN. 3. A young child standing next to an adult family member who
is screaming, "I want my mommy!"
28. Nurse Sarah is working in triage when a 56-year-old patient 4. An older victim who is sitting next to her husband sobbing,
arrives complaining of left-sided chest pain, sweating, and "My husband is dead. My husband is dead."
dizziness. Considering the symptoms, Nurse Sarah must
quickly determine the appropriate triage category for this The community health nurse is working with disaster relief
patient. How should she prioritize this case? after a tornado. The nurse assists in inding safe housing for
A. Non-urgent. survivors, providing support to families, organizing counseling,
B. Emergent. and securing physical care when needed. Which level of
C. High urgency. prevention does the nurse exercise?
D. Urgent. 1. Primary level of prevention
2. Secondary level of prevention
29. A 24-year-old patient presents to the emergency 3. Tertiary level of prevention
department with a suspected spinal cord injury after a motor 4. Quaternary level of prevention
vehicle accident. Which intervention should the nurse
implement irst? The nurse in the hospital emergency department is noti ied by
A. Place the patient on a irm surface to maintain spinal emergency medical services that several victims who survived
alignment. a plane crash will be transported to the hospital. Victims are
B. Provide a detailed explanation of procedures to reduce suffering from cold exposure because the plane plummeted
anxiety. and was submerged in a local river. What is the initial action of
C. Administer pain medication to relieve discomfort. the nurse?
D. Insert a urinary catheter to monitor urine output. 1. Call the nursing supervisor to activate the agency disaster
plan.
30. Nurse Laura is managing the care of a sexual assault victim 2. Supply the triage rooms with bottles of sterile water and
and is assigning tasks to the team. Which task is most normal saline.
appropriate for the LPN/LVN to handle? 3. Call the intensive care unit to request that nurses be sent to
A. Assess immediate emotional state and physical injuries. the emergency department.
B. Provide emotional support and supportive communication. 4. Call the laundry department, and ask the department to send
C. Collect hair samples, saliva swabs, and scrapings beneath as many warm blankets as possible to the emergency
ingernails. department.
D. Ensure that the "chain of custody" is maintained.
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The nurse is reviewing the manual of disaster preparedness The nurse from a medical unit is called to assist with care for
and response for the annual hospital disaster drill. The nurse clients coming into the hospital emergency department during
reads that which are functions of the American Red Cross an external disaster. Using principles of triage during a disaster,
(ARC) as opposed to the Federal Emergency Management the nurse should attend to the client with which problem irst?
Agency (FEMA) in the United States? Select all that apply. 1. Fractured tibia
1. Provide monetary relief. 2. Penetrating abdominal injury
2. Provide crisis counseling. 3. Bright red bleeding from a neck wound
3. Identify and train personnel. 4. Open massive head injury in deep coma
4. Issue presidential declarations.
5. Deploy National Guard troops. The nurse is the irst responder at the scene of a train accident.
6. Handle inquiries from families. Which victim should the nurse attend to irst?
1. A victim experiencing excruciating pain
The community health nurse is preparing to teach personnel 2. A victim experiencing moderate anxiety
and family preparedness for disasters to a group of parents of 3. A victim experiencing airway obstruction
school-age children. Which items should the nurse plan to 4. A victim experiencing altered level of consciousness
include in disaster preparedness? Select all that apply.
1. Flashlight The nurse in charge of a nursing unit is asked to select the
2. Supply of batteries hospitalized clients who can be discharged so that hospital
3.Battery-operated radio beds can be made available for victims of a community disaster.
4. Extra pair of eyeglasses Select the clients who can be safely discharged. Select all that
5. 4-week supply of water apply.
6. 4-week supply of nonperishable food 1. A client with dyspnea
2. A client experiencing sinus rhythm
The nurse is the irst responder at the scene of a 6-car crash on 3. A client receiving oral anticoagulants
a highway. Which victim should the nurse attend to irst? 4. A client with chronic atrial ibrillation
1. A victim experiencing dyspnea 5. A client experiencing third-degree heart block
2. A victim experiencing confusion 6. A client who has not voided since before surgery
3. A victim experiencing tachycardia
4. A victim experiencing intense pain The nurse is the irst responder at the scene of a train accident.
Which victim should the nurse attend to irst?
The nurse in charge of a nursing unit is asked to select the 1. A middle-aged man with 1 foot trapped under the wreckage
hospitalized clients who can be discharged so that hospital 2. A crying teenager who is holding pressure on an arm
beds can be made available for victims of a community disaster. laceration
Which clients can be safely discharged? Select all that apply. 3. A young woman who appears dazed and confused and is
1. A client with chest pain shivering
2. A client with a Holter monitor 4. A screaming middle-aged woman looking frantically for her
3. A client receiving oral antibiotics husband
4. A client experiencing sinus rhythm
5. A client newly diagnosed with atrial ibrillation Which client should the emergency department triage nurse
6. A client experiencing third-degree heart block who requires classify as emergent?
a pacemaker 1. A client with a displaced fracture who is crying
2. A client with a simple laceration and soft tissue injury
The nurse in charge of a nursing unit is asked to select those 3. A client with crushing substernal pain who is short of breath
hospitalized clients who can be discharged so that hospital 4. A client with a temperature of 101°F (38.3°C) with a
beds can be made available for victims of a community disaster. productive cough
Which clients can be safely discharged? Select all that apply.
1. The client with heart failure (HF) who has bilateral rhonchi https://quizlet.com/510707729/nur213-nclex-questions-triage-
2. The client who 24 hours earlier gave birth to her second emergency-preparedness- lash-cards/
child by caesarean delivery ─────────────────୨ৎ─────────────────
3. The 48-hour postoperative client who has undergone an
ileostomy because of ulcerative colitis A hospital responds to a local mass casualty event. Which ac on
4. The client with peritonitis caused by a ruptured appendix should the nurse supervisor take to prevent sta post-trauma c
who is febrile with a temperature of 102°F (38.9°C) stress disorder during a mass casualty event?
5. The 2-day postoperative client who has undergone total knee a. Provide water and healthy snacks for energy throughout the
replacement and is ambulating with a walker event.
6. The 3-day postoperative client who has undergone coronary b. Schedule 16-hour shi s to allow for greater rest between shi s.
artery bypass grafting and is ready for rehabilitation c. Encourage counseling upon deac va on of the emergency
response plan.
d. Assign sta to di erent roles and units within the medical
facility.

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 A client who is hospitalized with burns a er losing the family A nurse wants to become involved in community disaster
home in a re becomes angry and screams at a nurse when dinner preparedness and is interested in helping set up and sta rst aid
is served late. How should the nurse respond? sta ons or community acute care centers in the event of a
a. Do you need something for pain right now? disaster. Which organiza on is the best t for this nurses
b. Please stop yelling. I brought dinner as soon as I could. interests?
c. I suggest that you get control of yourself. a. The Medical Reserve Corps
d. You seem upset. I have me to talk if you'd like. b. The Na onal Guard
c. The health department
A nurse is eld-triaging clients a er an industrial accident. Which d. A Disaster Medical Assistance Team
client condi on should the nurse triage with a red tag?
a. Dislocated right hip and an open fracture of the right lower leg A nurse wants to become part of a Disaster Medical Assistance
b. Large contusion to the forehead and a bloody nose Team (DMAT) but is concerned about maintaining licensure in
c. Closed fracture of the right clavicle and arm numbness several di erent states. Which statement best addresses these
d. Mul ple fractured ribs and shortness of breath concerns?
a. Deployed DMAT providers are federal employees, so their
An emergency department (ED) charge nurse prepares to receive licenses are good in all 50 states.
clients from a mass casualty within the community. What is the b. The government has a program for quick licensure ac va on
role of this nurse during the event? wherever you are deployed.
a. Ask ED sta to discharge clients from the medical-surgical units c. During a me of crisis, licensure issues would not be the
in order to make room for cri cally injured vic ms. governments priority concern.
b. Call addi onal medical-surgical and cri cal care nursing sta to d. If you are deployed, you will be issued a temporary license in
come to the hospital to assist when vic ms are brought in. the state in which you are working.
c. Inform the incident commander at the mass casualty scene
about how many vic ms may be handled by the ED. A er a hospitals emergency department (ED) has e ciently
d. Direct medical-surgical and cri cal care nurses to assist with triaged, treated, and transferred clients from a community
clients currently in the ED while emergency sta prepare to disaster to appropriate units, the hospital incident command
receive the mass casualty vic ms. o cer wants to stand down from the emergency plan. Which
ques on should the nursing supervisor ask at this me?
The hospital administra on arranges for cri cal incident stress a. Are you sure no more vic ms are coming into the ED?
debrie ng for the sta a er a mass casualty incident. Which b. Do all areas of the hospital have the supplies and personnel
statement by the debrie ng team leader is most appropriate for they need?
this situa on? c. Have all ED sta had the chance to eat and rest recently?
a. You are free to express your feelings; whatever is said here stays d. Does the Chief Medical O cer agree this disaster is under
here. control?
b. Let's evaluate what went wrong and develop policies for future
incidents. A family in the emergency department is overwhelmed at the loss
c. This session is only for nursing and medical sta , not for of several family members due to a shoo ng incident in the
ancillary personnel. community. Which interven on should the nurse complete rst?
d. Let's pass around the wri en policy compliance form for a. Provide a calm loca on for the family to cope and discuss
everyone. needs.
b. Call the hospital chaplain to stay with the family and pray for
A nurse is caring for a client whose wife died in a recent mass the deceased.
casualty accident. The client says, "I cant believe that my wife is c. Do not allow visi ng of the vic ms un l the bodies are
gone and I am le to raise my children all by myself." How should prepared.
the nurse respond? d. Provide privacy for law enforcement to interview the family.
a. Please accept my sympathies for your loss.
b. I can call the hospital chaplain if you wish. An emergency department charge nurse notes an increase in sick
c. You sound anxious about being a single parent. calls and bickering among the sta a er a week with mul ple
d. At least your children s ll have you in their lives. trauma incidents. Which ac on should the nurse take?
a. Organize a pizza party for each shi .
A nurse cares for clients during a community-wide disaster drill. b. Remind the sta of the facility's sick-leave policy.
Once of the clients asks, "Why are the individuals with black tags c. Arrange for cri cal incident stress debrie ng.
not receiving any care?" How should the nurse respond? d. Talk individually with sta members.
a. To do the greatest good for the greatest number of people, it is
necessary to sacri ce some.
b. Not everyone will survive a disaster, so it is best to iden fy
those people early and move on.
c. In a disaster, extensive resources are not used for one person at
the expense of many others.
d. With black tags, volunteers can iden fy those who are dying
and can give them comfort care.

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 Emergency medical services (EMS) brings a large number of clients 2. Nurse Anna is an experienced travel nurse who was recently
to the emergency department following a mass casualty incident. employed and is assigned to the emergency unit. In her rst week
The nurse iden es the clients with which injuries with yellow of the job, which of the following area is the most appropriate
tags? (SATA) assignment for her?
a. Par al-thickness burns covering both legs A. Triage
b. Open fractures of both legs with absent pedal pulses B. Ambulatory sec on
c. Neck injury and numbness of both legs C. Trauma team
d. Small pieces of shrapnel embedded in both eyes D. Psychiatric care
e. Head injury and di cult to arouse
f. Bruising and pain in the right lower abdomen 3. A client arrives at the emergency department who su ered
mul ple injuries from a head-on car collision. Which of the
A nurse triages clients arriving at the hospital a er a mass following assessment should take the highest priority to take?
casualty. Which clients are correctly classi ed? (SATA) A. Unequal pupils
a. A 35-year-old female with severe chest pain: red tag B. Irregular pulse
b. A 42-year-old male with full-thickness body burns: green tag C. Ecchymosis in the ank area
c. A 55-year-old female with a scalp lacera on: black tag D. A deviated trachea
d. A 60-year-old male with an open fracture with distal pulses:
yellow tag 4. Nurse Kelly, a triage nurse encountered a client who
e. An 88-year-old male with shortness of breath and chest bruises: complained of mid-sternal chest pain, dizziness, and diaphoresis.
green tag Which of the following nursing ac on should take priority?
A. Administer oxygen therapy via nasal cannula
A hospital prepares to receive large numbers of casual es from a B. No fy the physician
community disaster. Which clients should the nurse iden fy as C. Complete history taking
appropriate for discharge or transfer to another facility? (SATA) D. Put the client on ECG monitoring
a. Older adult in the medical decision unit for evalua on of chest
pain 5. A group of people arrived at the emergency unit by a private car
b. Client who had open reduc on and internal xa on of a femur with complaints of periorbital swelling, cough, and ghtness in the
fracture 3 days ago throat. There is a strong odor emana ng from their clothes. They
c. Client admi ed last night with community-acquired pneumonia report exposure to a “gas bomb” that was set o in the house.
d. Infant who has a fever of unknown origin What is the priority ac on?
e. Client on the medical unit for wound care A. Instruct personnel to don personal protec ve equipment
B. Direct the clients to the cold or clean zone for immediate
A hospital prepares for a mass casualty event. Which func ons are treatment
correctly paired with the personnel role? (SATA) C. Immediately remove other clients and visitors from the area
a. Paramedic Decides the number, acuity, and resource needs of D. Measure vital signs and auscultate lung sounds
clients
b. Hospital incident commander Assumes overall leadership for 6. When an unexpected death occurs in the emergency
implemen ng the emergency plan department, which task is the most appropriate to delegate to a
c. Public informa on o cer Provides advanced life support during nursing assistant?
transporta on to the hospital A. Assis ng with postmortem care
d. Triage o cer Rapidly evaluates each client to determine B. Facilitate mee ngs between the family and the organ donor
priori es for treatment specialist
e. Medical command physician Serves as a liaison between the C. Escor ng the family to a place of privacy
health care facility and the media D. Help the family to collect belongings

h ps://quizlet.com/378485103/emergency-disaster-preparedness-nclex- 7. The physician has ordered cooling measures for a child with a
ash-cards/ fever who is likely to be discharged when the temperature comes
─────────────────୨ৎ───────────────── down. Which task would be appropriate to delegate to a nursing
1. Nurse Ejay is assigned to telephone triage. A client called who assistant?
was stung by a honeybee and is asking for help. The client reports A. Prepare and administer a tepid sponge bath
pain and localized swelling but has no respiratory distress or other B. Explain the need for giving cool uids
symptoms of anaphylac c shock. What is the C. Assist the child in removing outer clothing
appropriate ini al ac on that the nurse should direct the client to D. Advise the parent to use acetaminophen (Tylenol) instead of
perform? aspirin
A. Removing the s nger by scraping it
B. Applying a cold compress
C. Taking an oral an histamine
D. Calling 911

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 8. You are preparing a child for IV conscious seda on before the 14. A 5-year-old client was admi ed to the emergency unit due to
repair of a facial lacera on. What informa on should you the inges on of an unknown amount of chewable vitamins for
report immediately to the physician? children at an unknown me. Upon assessment, the child is alert
A. The child suddenly pulls out the IV and with no symptoms. Which of the following informa on should
B. The parent is not sure regarding the child's tetanus be reported to the physician immediately?
immuniza on status A. The child was nauseated and vomited once at home
C. The parent wants informa on about the IV conscious seda on B. The child has been treated several mes for toxic substance
D. The parent's refusal of the administra on of the IV seda on inges on
C. The vitamin that was ingested contains iron
9. The emergency medical service has transported a client with D. The child has been treated mul ple mes for injuries caused by
severe chest pain. As the client is being transferred to the accidents
emergency stretcher, you note unresponsiveness, cessa on of
breathing, and unpalpable pulse. Which of the following task is Skip 15
appropriate to delegate to the nursing assistant?
A. Assis ng with the intuba on 16. The following clients are presented with signs and symptoms
B. Placing the de brillator pads of heat-related illness. Which of them needs to be a ended rst?
C. Doing chest compressions A. A rela vely healthy homemaker who reports that the air
D. Ini a ng bag valve mask ven la on condi oner has been broken for days and who manifest fa gue,
hypotension, tachypnea, and profuse swea ng.
10. The nursing manager decides to form a commi ee to address B. An elderly person who complains of dizziness and syncope
the issue of violence against ED personnel. Which combina on of a er standing in the sun for several hours to view a parade.
employees would be best suited to ful ll this assignment? C. A homeless person who is a poor historian; has altered mental
A. ED physicians and charge nurses status, poor muscle coordina on, and hot, dry ashen skin; and
B. RNs, LPNs, and nursing assistants whose dura on of heat exposure is unknown.
C. Experienced RNs and experienced paramedics D. A marathon runner who complains of severe leg cramps and
D. At least one representa ve from each group of ED personnel nausea, and manifests weakness, pallor, diaphoresis, and
tachycardia.
11. A client su ered an amputa on of the rst and second digits in
a chainsaw accident. Which task should be delegated to an LPN/ 17. An anxious female client complains of chest ghtness, ngling
LVN? sensa ons, and palpita ons. Deep, rapid breathing, and carpal
A. Cleansing the amputated digits and placing them directly into spasms are noted. Which of the following priority ac on should
an ice slurry the nurse do rst?
B. Wrapping the cleansed digits in saline-moistened gauze, sealing A. Provide oxygen therapy
in a plas c container, and placing it in icy water B. No fy the physician immediately
C. Gently cleansing the amputated digits and the hand with C. Administer anxioly c medica on as ordered
povidone-iodine D. Have the client breathe into a brown paper bag
D. Cleansing the digits with sterile normal saline and placing it in a
sterile cup with sterile normal saline 18. An intoxicated client comes into the emergency unit with
uncoopera ve behavior, mild confusion, and slurred speech. The
12. A client arrives in the emergency unit and reports that a client is unable to provide a good history but he verbalizes that he
concentrated household cleaner was splashed in both eyes. Which has been drinking a lot. Which of the following is a priority ac on
of the following nursing ac ons is a priority? of the nurse?
A. Examine the client's visual acuity A. Administer IV uid incorporated with Vitamin B1 as ordered
B. Patch the eye B. Administer Naloxone (Narcan) 4 mg as ordered
C. Use Restasis (Allergan) drops in the eye C. Contact the family to get informa on about the client
D. Flush the eye repeatedly using sterile normal saline D. Obtain an order for the determina on of blood alcohol level

13. A client was brought to the emergency department a er 19. A nurse is providing discharge instruc ons to a woman who
su ering a closed head injury and lacera ons around the face due has been treated for contusions and bruises due to domes c
to a hit-run accident. The client is unconscious and has a minimal violence. What is the priority interven on for this client?
response to noxious s muli. Which of the following assessment A. Arranging transporta on to a safe house
ndings if observed a er few hours, should be reported to the B. Advising the client about contac ng the police
physician immediately? C. Making an appointment to follow up on the injuries
A. Drainage of a clear uid from the client's nose D. Making a referral to a counselor
B. Withdrawal of the client in response to painful s muli
C. Bruises and minimal edema of the eyelids
D. Bleeding around the lacera ons

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 20. In the work se ng, what is the primary responsibility of the 8. A 15-year-old male client arrives at the emergency department.
nurse in prepara on for disaster management, that includes He is conscious, coherent, and ambulatory, but his shirt and pants
natural disasters and bioterrorism incidents? are covered with blood. He and his hysterical friends are yelling
A. Being aware of the signs and symptoms of poten al agents of and trying to explain that they were goo ng around and he got
bioterrorism poked in the abdomen with a s ck. Which of the following
B. Making ethical decisions regarding exposing self to poten ally comments should be given rst considera on?
lethal substances A. “The s ck was really dirty and covered with mud.”
C. Being aware of the agency's emergency response plan B. “He pulled the s ck out, just now, because it was hur ng him.”
D. Being aware of what and how to report to the Centers for C. “He’s a diabe c, so he needs a en on right away.”
Disease Control and Preven on D. “There was a lot of blood and we used three bandages.”

1. A 9. A prisoner, with a known history of alcohol abuse, has been in

2. B
3. D
police custody for 48 hours. Ini ally, anxiety, swea ng, and
4. A tremors were noted. Now, disorienta on, hallucina on, and
5. E hyper-reac vity are observed. The medical diagnosis is delirium
6. A
7. C tremens. What is the priority nursing diagnosis?
8. D A. Risk for Injury related to seizures
9. C
10. D
B. Risk for Situa onal Low Self-esteem related to police custody
11. B C. Risk for Nutri onal De cit related to chronic alcohol abuse
12. D D. Risk for Other-Directed Violence related to hallucina ons
13. A
14. C
15. Na 10. In rela on to submersion injuries, which task
16. C is most appropriate to delegate to an LPN/LVN?
17. D
18. A A. Stabilize the cervical spine for an unconscious drowning vic m
19. A B. Talk to a community group about water safety issues
20. C
C. Monitor an asymptoma c near-drowning vic m
D. Remove wet clothing and cover the vic m with a warm blanket
h ps://nurseslabs.com/quizzes/nclex-emergency-nursing-1/
─────────────────୨ৎ───────────────── 11. You are assessing a pa ent who has sustained a cat bite to the
2. In conduc ng a primary survey on a trauma pa ent, which of le hand. The cat is up-to-date immuniza ons. The date of the
the following is considered one of the priority elements of the pa ent’s last tetanus shot is unknown. Which of the following is
primary survey? the priority nursing diagnosis?
A. Brief neurologic assessment A. Impaired Skin Integrity related to puncture wounds
B. Client's allergy history B. Ine ec ve Health Maintenance related to immuniza on status
C. Ini a on of pulse oximetry C. Risk for Infec on related to organisms speci c to cat bites
D. Complete set of vital signs D. Risk for Impaired Mobility related to poten al tendon damage

3. A 65-year-old pa ent arrived at the triage area with complaints 13. A 33-year-old pa ent with a history of seizures and medica on
of diaphoresis, dizziness, and le -sided chest pain. This pa ent compliance of phenytoin (Dilan n) and carbamazepine (Tegretol)
should be priori zed into which category? is brought to the ED by the MS personnel for repe ve seizure
A. Non-urgent ac vity that started 45 minutes prior to arrival. You an cipate that
B. Urgent the physician will order which drug for status epilep cus?
C. Emergent A. Phenytoin and Carbamazepine PO
D. High urgent B. Carbamazepine (Tegretol) IV
C. Magnesium sulfate IV
5. In caring for a vic m of sexual assault, which task D. Lorazepam (A van) IV
is most appropriate for an LPN/LVN?
A. Provide emo onal support and suppor ve communica on 14. A client arrived at the emergency department a er su ering
B. Assess immediate emo onal state and physical injuries mul ple physical injuries including a fractured pelvis from a
C. Ensure that the “chain of custody” is maintained vehicular accident. Upon assessment, the client is incoherent,
D. Collect hair samples, saliva swabs, and scrapings beneath pale, and diaphore c. With vital signs as follows: temperature of
ngernails 97°F (36.11° C), blood pressure of 60/40 mm Hg, heart rate of 143
beats/minute, and a respiratory rate of 30 breaths/minute. The
client is mostly su ering from which of the following shock?
A. Distribu ve
B. Hypovolemic
C. Obstruc ve
D. Cardiogenic

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 15. Cole is an emergency nurse who encountered a pa ent who is 2. A
3. C
a suspected carrier of a biologic agent. Which of these if found in 4. Skip
the pa ent is not classi ed as a Category A biologic agent? 5. A
A. Bacillus anthracis (anthrax) 6. Skip
7. Skip
B. Francisella tularensis (tularemia) 8. B
C. Clostridium botulinum toxin (botulism) 9. A
10. C
D. Burkholderia pseudomallei (Melioidosis) 11. C
E. Yersinia pe s (plague) 12. Skip
13. D
14. B
16. A 15-year-old male client was sent to the emergency unit 15. D
following a small lacera on on the forehead. The client says that 16. C
he can’t move his legs. Upon assessment, respiratory rate of 20, 17. C
18. D
strong pulses, and capillary re ll me of less than 2 seconds. 19. D
Which triage category would this client be assigned to? 20. C
A. Red
B. Black h ps://nurseslabs.com/quizzes/nclex-emergency-nursing-2/
C. Yellow ─────────────────୨ৎ─────────────────
D. Green Ques on 1 of 10
E. White Four ambulances arrive to the emergency room. The nurses know
to see which of the following clients rst?
17. An ER nurse is handling a 50-year-old woman complaining of A.Fall o bike with arm deformity, bluish ngers
dizziness and palpita ons that occur from me to me. ECG B.Trauma c leg amputa on, bleeding through gauze
con rms the diagnosis of paroxysmal supraventricular tachycardia. C.Fish hook caught in the lower lip
The client seems worried about it. Which of the following is an D.MVC with neck and back pain and limited ROM
appropriate response of the nurse?
A. “You can be discharged now; this is a probable sign of anxiety.” Ques on 2 of 10
B. “The physician will prescribe you blood-thinning medica ons A nurse is working in a pediatric emergency room and has 4 clients
to lessen the episodes of palpita ons.” that need assessment. The nurse would be accurate in seeing
C. “We’ll need to keep you for further assessment; you may which client rst?
develop blood clots.” A.Epiglo s
D. "You have to stay here for a few hours to undergo blood tests B.Dehydra on
to rule out myocardial infarc on.” C.Fever
D.Fussiness

18. A client was brought to the ED due to an abdominal trauma Ques on 3 of 10

caused by a motorcycle accident. During the assessment, the Which of the following clients should be seen rst?
client complains of epigastric pain and back pain. Which of the A. A client with a foreign body in the throat
following is true regarding the diagnosis of pancrea c injury? B. COPD client with O2 satura on of 88%
A. Redness and bruising may indicate the site of the injury in C. Bleeding abdominal stab wound
blunt trauma D. Heart a ack (STEMI)
B. The client is symptom-free during the early post-injury period
C. Signs of peritoneal irrita on may indicate pancrea c injury Ques on 4 of 10
D. All of the above A nursing student is asking a nurse about priori za on of client
needs. The nurse knows that which of the following client
19. A 20-year-old male client was brought to the emergency symptoms would need to be seen rst?
department with a gunshot wound to the chest. In obtaining a A. Altered mental status with fever
history of the incident to determine possible injuries, the nurse B. Headache with photophobia
should ask which of the following? C. 28 week pregnant woman with bilateral leg swelling
A. "How long ago did the incident occur?" D. Finger swelling over rings that can't be removed
B. "What was the ini al rst aid done?"
C. "Where did the incident happen?" Ques on 5 of 10
D. "What direc on did the bullet enter into the body?" There are 4 pediatric clients si ng in the wai ng room of the
emergency department. A bed becomes available and the triage
20. When a ending a client with a head and neck trauma nurse knows to take back the client with which of the following
following a vehicular accident, the nurse’s ini al ac on is to? rst?
A. Provide oxygen therapy A. A fever of 105 F
B. Ini ate intravenous access B. Acute asthma exacerba on; O2 satura on of 100% on room air
C. Immobilize the cervical area C. An open fracture; no hemorrhage noted
D. Do oral and nasal suc oning D. Epistaxis

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 Ques on 6 of 10 2. During the primary survey of a pa ent with severe leg trauma,
There has been a bombing at the conven on center downtown. the nurse observes that the pa ent’s le pedal and posterior bial
The nurse is working in the emergency department and has been pulses are absent, and the en re leg is swollen. Which ac on will
no ed that approximately 58 clients are on the way to the the nurse take next?
hospital facility. Which clients will be given the highest priority? a. Send blood to the lab for a complete blood count.
A. Clients with life-threatening yet survivable injuries b. Assess further for a cause of the decreased circula on.
B. Ac vely dying clients c. Finish the airway, breathing, circula on, disability survey.
C. Clients requiring life support d. Start normal saline uid infusion with a large-bore IV line.
D. All children under 2
3. A er the return of spontaneous circula on following the
Ques on 7 of 10 resuscita on of a pa ent who had a cardiac arrest, therapeu c
There are four clients that the nurse is priori zing in order of hypothermia is prescribed. Which ac on will the nurse include in
importance. Of the following clients, which client should the nurse the plan of care?
see rst? a. Ini ate cooling per protocol.
A.Failure to thrive and pressure ulcers b. Avoid the use of seda ve drugs.
B. Anxiety disorder and the feeling of an elephant on the chest c. Check mental status every 15 minutes.
C. Arm abscess who is fussy d. Rewarm if temperature is below 91° F (32.8° C)
D. Right lower quadrant pain with sudden pain relief
4. A pa ent who is unconscious a er a fall from a ladder is
Ques on 8 of 10 transported to the emergency department by emergency medical
A client presents to the emergency department with complaints of personnel. What should the nurse do during the primary survey of
chest pain. What is the priority for the nurse? the pa ent?
A. Get an EKG a. Obtain a complete set of vital signs.
B. Get vital signs b. Check a Glasgow Coma Scale score.
C. Visually assess the client c. A ach an electrocardiogram monitor.
D. Ask the client if they have had a cough d. Ask about chronic medical condi ons

Ques on 9 of 10 5. A 19-yr-old pa ent is brought to the emergency department

A er receiving report on four clients the emergency room nurse (ED) with mul ple lacera ons and ssue avulsion of the le hand.
should see the client with which of the following diagnosis rst? When asked about tetanus immuniza on, the pa ent denies
A. Liver failure and now has petechiae having any previous vaccina ons. What should the nurse
B. Chronic back pain 8/10 an cipate giving?
C. Ovarian cyst a. Tetanus immunoglobulin (TIG) only
D. Celluli s that is now itchy b. TIG and tetanus-diphtheria toxoid (Td)
c. Tetanus-diphtheria toxoid and pertussis vaccine (Tdap) only
Ques on 10 of 10 d. TIG and tetanus-diphtheria toxoid and pertussis vaccine (Tdap)
A client is brought into the trauma bay a er being stabbed in the
abdomen with a 12 inch knife. The blade is s ll present in the 6. A pa ent who has experienced blunt abdominal trauma during
client. The client is complaining of severe abdominal pain and is a motor vehicle collision reports increasing abdominal pain. What
restless. A er comple ng the ini al survey, which of the following topic will the nurse plan to teach the pa ent?
is the next thing the nurse should do? a. Peritoneal lavage
A. Remove the knife b. Abdominal ultrasonography
B. Stabilize the knife c. Nasogastric (NG) tube placement
C. Intubate the client d. Magne c resonance imaging (MRI)
D. Insert a chest tube
7. A pa ent with hypotension and an elevated temperature a er
h ps://quizlet.com/538463468/0404-triage- ash-cards/ working outside on a hot day is treated in the emergency
─────────────────୨ৎ───────────────── department (ED). Which pa ent statement indicates to the nurse
1. During the primary assessment of a vic m of a motor vehicle that discharge teaching has been e ec ve?
collision, the nurse determines that the pa ent has an a. “I’ll take salt tablets when I work outdoors in the summer.”
unobstructed airway. Which ac on should the nurse take next? b. “I should take acetaminophen (Tylenol) if I start to feel too
a. Palpate extremi es for bilateral pulses. warm.”
b. Observe the pa ent’s respiratory e ort. c. “I need to drink extra uids when working outside in hot
c. Check the pa ent’s level of consciousness. weather.”
d. Examine the pa ent for any external bleeding. d. “I’ll move to a cool environment if I no ce that I’m feeling
confused”

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 8. A 22-yr-old pa ent who experienced a drowning accident in a 15. The following interven ons are part of the emergency
local pool, but now is awake and breathing spontaneously, is department (ED) protocol for a pa ent who has been admi ed
admi ed for observa on. Which assessment will be most with mul ple bee s ngs to the hands. Which ac on should the
important for the nurse to take during the observa on period? nurse take rst?
a. Auscultate heart sounds. a. Apply ice packs to both hands.
b. Palpate peripheral pulses. b. A empt to remove the pa ent’s rings.
c. Check mental orienta on. c. Apply calamine lo on to itching areas.
d. Auscultate breath sound d. Give diphenhydramine (Benadryl) 50 mg PO.

9. When requested to plan the response to the poten al use of 1. B

smallpox as a biological weapon, what should the emergency 2. D
department (ED) nurse manager expect to obtain? 3. A
4. B
a. Vaccine 5. D
b. Atropine 6. B
c. An bio cs 7. C
d. Whole blood 8. D
9. A
10. D
10. Which nding indicates that the nurse should discon nue 11. B
ac ve rewarming of a pa ent admi ed with hypothermia? 12. A
a. The pa ent begins to shiver. 13. B
b. The BP decreases to 86/42 mm Hg. 14. C
15. B
c. The pa ent develops atrial brilla on.
d. The core temperature is 94° F (34.4° C). https://www.brainscape.com/ lashcards/nclex-emergency-and-disaster-
nursing-9859308/packs/17027328
11. When assessing an older pa ent admi ed to the emergency ─────────────────୨ৎ─────────────────
department (ED) with a broken arm and facial bruises, the nurse
observes several addi onal bruises in various stages of healing. https://www.icn.ch/sites/default/ iles/inline- iles/
Which statement or ques on by the nurse should be rst? ICN_Disaster-Comp-Report_WEB.pdf
a. “You should not go home.”
b. “Do you feel safe at home?” https://www.studocu.com/ph/document/eastern-samar-
c. “Would you like to see a social worker?” state-university/disaster-nursing/disaster-nursing-nclex/
d. “I need to report my concerns to the police.” 43273401
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12. A pa ent arrives in the emergency department (ED) several
hours a er taking “25 to 30” acetaminophen (Tylenol) tablets.
Which ac on will the nurse plan to take?
a. Give N-acetylcysteine.
b. Discuss the use of chela on therapy.
c. Start oxygen using a non-rebreather mask.
d. Have the pa ent drink large amounts of water.

13. A triage nurse in a busy emergency department (ED) assesses

a pa ent who reports 7/10 abdominal pain and states, “I had a
temperature of 103.9° F (39.9° C) at home.” What should be the
nurse’s rst ac on?
a. Give acetaminophen (Tylenol).
b. Assess the pa ent’s current vital signs.
c. Ask the pa ent to provide a clean-catch urine for urinalysis.
d. Tell the pa ent that it may be 1 to 2 hours before seeing a
health care provider

14. The emergency department (ED) triage nurse is assessing four

vic ms involved in a motor vehicle collision. Which pa ent has the
highest priority for treatment?
a. A pa ent with no pedal pulses
b. A pa ent with an open femur fracture
c. A pa ent with paradoxical chest mo on
d. A pa ent with bleeding facial lacera ons

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