Which dysrhythmia would be identified on an ECG/EKG six-second
strip by a heart rate of 76 and a PR interval of 0.24?
a.sinus tachycardia
b.first-degree atrioventricular block
c.sinus bradycardia
d.junctional escape rhythm - Precise Answer ✔✔B: First-degree
atrioventricular block is diagnosed partially by an EKG showing a PR
interval of greater than 0.20 seconds.
Which blood test may indicate infection or inflammation and would
need to be used as part of the clinical picture with diagnosing and
treating abdominal pain?
a.white blood cell (WBC) count of 5.0
b.hematocrit (HCT) of 45
c.WBC count of 28.0
d.blood sugar (BS) of 74 - Precise Answer ✔✔C: An elevated WBC
count would be indicative of infection or inflammation. The WBC count
of 5.0 is normal. The HCT and BS levels listed would also be considered
within normal limits.
,A 30-year-old man comes to the emergency department with the acute
onset of left flank pain radiating to the groin. Microscopic hematuria is
present on urinalysis. What is the most likely diagnosis?
a.ureteral calcium oxalate calculus
b.ureteral cystine calculus
c.testicular torsion
d.cystitis - Precise Answer ✔✔A: Ureteral calculi are a quite common
cause of acute emergency evaluation, usually causing flank pain with
radiation to the back and/or groin. About 75% of these are calcium
oxalate or phosphate; less common are struvite, uric acid, or cystine
calculi. While KUB or ultrasound may show the stone, helical CT is
now the preferred diagnostic method. Additional workup includes CBC,
chemistry panel, urinalysis, and straining of urine to catch a passed stone
for chemical analysis. Nursing attention should be directed to
intravenous hydration with input and output recording and narcotic or
narcotic plus NSAID (e.g., ketorolac) administration for pain. Some
patients may be discharged with analgesics and instructions for
hydration and calculus capture. Testicular torsion is most common in
adolescents and usually presents with testicular and groin pain with
abdominal radiation; increasing pain by lifting the scrotum to the level
of the pubic symphysis causes exacerbation of the pain (Prehn sign).
Cystitis may be infectious or drug-induced, but cystitis usually causes
dysuria and pyuria and shows positive urine cultures.
Which of the following is NOT appropriate for screening for domestic
violence by the emergency department nurse?
a.asking if the person has been hit, kicked, or otherwise hurt by someone
in the past year; if so, by whom
, b.asking, "Do you feel safe in your present relationship?"
c.avoid asking about intimate person violence if the patient is in the
emergency department for a medical ailment, not trauma
d.asking if there is a partner from a previous relationship that makes the
individual feel unsafe - Precise Answer ✔✔C: Domestic violence,
nearly always perpetrated against women, is a major problem confronted
by the emergency nurse. Screening for possible cases should include
answers A, B and D. Interestingly, victims of intimate partner violence
often present with a medical ailment, not trauma. These include back,
abdominal, or pelvic pain, headaches, urinary infections, sexually
transmitted disease, or symptoms consistent with posttraumatic stress
disorder (PTSD). Sometimes evidence of old trauma such as healing
fractures or cosmetically concealed bruises may point toward the
presence of domestic violence. Many victims will deny it but sometimes
compassionate questioning in a private setting will elicit a positive
response. The nurse may then offer advice, refer to a social agency or
shelter, or ask for a consultation by the hospital social worker.
A patient is intubated and on mechanical ventilation. The ventilator
alarm rings and the airway pressure is found to be elevated. Possible
causes include the following EXCEPT:
a.endotracheal tube obstruction with sputum
b.pneumothorax
c.bronchospasm
d.cuff leak - Precise Answer ✔✔D: Mechanical ventilation requires
diligent observation of the patient and ventilator by the emergency
nurse. Modern ventilators usually come with alarms that indicate high or
low airway pressure. High pressure may be caused by endotracheal tube
obstruction with sputum or kinks or inadvertent endobronchial
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