NUR 213 Test 4 Ch.1
1. Which statement by the student nurse indicates effective learning about the functions and
utilization of trauma centers?
A. "Clients requiring advanced life support should be sent to a level II trauma center."
B. "Most injured clients requiring urgent treatment should be sent to a level I trauma center."
C. "Clients requiring stabilization with major injuries should be sent to a level III trauma
center."
D. "Clients requiring full continuum of trauma services should be sent to a level IV trauma
center.
Answer
C
2. Which client would the nurse provide care for first based on priority of condition and
findings?
Client A- Cardiomyopathy, lower extremities swollen, Weight gain
Client B- PAD, Painful cramping in hip region, Weakness and numbness in leg Client C- Aortic
Aneurysm, Breathing difficulty, Chest pain
Client D- Chest Trauma, Breathing difficulty, Coughing up blood
Answer
Client D
3. Which action would be priority for a client diagnosed with major depression who is
experiencing psychotic features and who says, "All of my relatives have been killed because I've
been sinful and need to be punished"?
A. Protecting the client against any suicidal impulses
B. Supporting the client's interest in the outside world
C. Helping the client manage the concern for family members
D. Reassuring the client that past behaviors are not being punished
Answer
A
4. Which nursing goal would be priority for an adolescent who has a history of fighting,
stealing, vandalizing property, running away from home, and has been suspended from school
repeatedly?
A. Preventing violence
B. Encouraging insight
C. Supporting self-esteem
D. Promoting social interaction
Answer
A
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, 5. Which priority parameter would the nurse assess when caring for an older adult client with a
neurocognitive disorder who demonstrates disorientation and numerous unmanageable
behaviors?
A. Orientation to time, place, and person
B. Ability to perform daily activities without assistance from others
C. Stressors that appear to precipitate the client's disruptive behavior
D. Cognitive impairments until complete adjustments are accomplished
Answer
C
6. When notified of a client en route to the emergency department after sus- taining a gunshot
wound to the chest, which action is the nurse ' s priority
when preparing for the client' s arrival?
A. Reserve an operating room.
B. Organize equipment for a tracheotomy.
C. Prepare equipment for chest tube insertion.
D. Arrange for a portable chest x-ray examination.
Answer
C
7. The emergency department nurse would provide immediate care based on priority to the
client with which condition?
A. Second-degree burns
B. Blunt abdominal trauma
C. Closed fracture of the right arm
D. Repeated tonic-clonic seizures
Answer
D
8. Which action would the nurse take first for a client with blunt abdominal trauma?
A. Ensure a patent airway.
B. Monitor the level of consciousness.
C. Infuse warm normal saline solution.
D. Maintain client warmth using blankets.
Answer
A
9. Which client would the triage nurse provide care to first based on condition? Client A- Severe
respiratory distress
Client B- Chest pain resulting from trauma Client C- Hip fracture in older client
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