CEN Exam Flashcards on Pulmonary Embolism

Questions and Answers

Which component of the critical incident stress management process took place?

Crisis intervention

Defusing

Follow-up

Debriefing (correct)

An infant with a history of hydrocephalus presents with a bulging anterior fontanel, vomiting, poor feeding, and irritability. What condition do these clinical manifestations likely represent?

Meningococcemia

Malrotation with volvulus

Pyloric stenosis

Ventriculoperitoneal shunt malfunction (correct)

What will be the priority diagnostic assessment for a 68-year-old woman presenting with fatigue, nausea, and a history of smoking?

Coagulation panel

Electrocardiogram (correct)

Complete blood count with differential

Depression screening

What is considered prior to the transport of a multiple trauma patient by helicopter?

Chest tube is placed Signup and view all the answers

Which one of the following is a significant risk factor for a patient wanting to attempt suicide?

History of past attempts Signup and view all the answers

What possible cause of pelvic pain is assessed for first in a 21-year-old female presenting to the ED?

Ectopic pregnancy Signup and view all the answers

Which statement indicates the patient understands the discharge instructions after a laceration closed with wound glue?

I should look for redness or drainage. Signup and view all the answers

Which of the following statements about the difference between diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome is true?

The patient with diabetic ketoacidosis presents with ketones in the urine and the patient with hyperosmolar hyperglycemic syndrome does not. Signup and view all the answers

What is positive end-expiratory pressure with ventilation?

Signup and view all the answers

A patient presents to the ED following an incident with an acid splash to the eye. What is the nurse's first priority?

Irrigation Signup and view all the answers

A 22-year-old patient presents with upper respiratory symptoms and nausea following chemotherapy. What is the nurse's priority?

Protective isolation Signup and view all the answers

What eye injury does the patient with the sensation of something in the eye most likely have?

Corneal abrasion Signup and view all the answers

In compensated shock, what physiological response increases serum sodium?

Renin-angiotensin-aldosterone system (RAAS) Signup and view all the answers

What does the nurse's assessment of loss of peripheral vision and redness of the affected eye indicate?

Acute angle glaucoma Signup and view all the answers

Which clinical presentation is most consistent with pancreatitis?

Epigastric pain that radiates to the back Signup and view all the answers

What is the indication for activated charcoal administration?

Carbamazepine overdose Signup and view all the answers

Which intervention is appropriate for acute lithium toxicity?

Hemodialysis Signup and view all the answers

Which segment of the neurological system determines the level of alertness in a patient with diffuse axonal injury?

Reticular activating system Signup and view all the answers

What is the first intervention appropriate for the nurse once a neonate has been delivered?

Thoroughly dry the neonate Signup and view all the answers

Which response indicates understanding of discharge instructions for COPD patients?

I need to get the pneumococcal vaccine. Signup and view all the answers

What procedure does the emergency nurse anticipate for a patient with poor chest rise during ventilation?

Tracheostomy Signup and view all the answers

A patient presents with disorientation and memory impairment. What psychosocial emergency might this indicate?

Delirium Signup and view all the answers

In patients with asthma, what is the severity classification for a peak expiratory flow of 48% of personal best?

Moderate Signup and view all the answers

Which phase of disaster preparedness relates to upgrading an antiquated electrical system?

Mitigation Signup and view all the answers

What symptoms does a patient experiencing transient ischemic attacks (TIAs) exhibit?

Transient ischemic attacks Signup and view all the answers

A 37-year-old female presents with vaginal bleeding and cramping. What is the most likely cause?

Uterine fibroids Signup and view all the answers

Wernicke-Korsakoff syndrome is characterized by which clinical manifestations?

Ataxia, mental confusion, and ophthalmoplegia Signup and view all the answers

What type of gastrointestinal disorder is indicated by stomach pain that is relieved with antacids?

Duodenal ulcer Signup and view all the answers

Which immunoglobulin is responsible for Type 1 allergic responses?

IgE Signup and view all the answers

Using a 5-level triage system, which acuity level is assigned to a patient with fever and a history of HIV?

Acuity Level 2 (emergent) Signup and view all the answers

What type of shock is indicated by low blood pressure and decreased consciousness in an 84-year-old patient?

Septic Signup and view all the answers

What gastrointestinal emergency is indicated by abdominal pain and rigid abdomen in a vehicle crash victim?

Peritonitis Signup and view all the answers

What condition is associated with a patient who has been defibrillated but remains unresponsive?

Pulseless electrical activity Signup and view all the answers

What injury is indicated by a patient feeling pain in the heel after a jump?

Achilles tendon rupture Signup and view all the answers

What injury is described by skin being peeled away, exposing underlying structures?

Avulsion Signup and view all the answers

What statement by a patient with asthma indicates understanding of discharge instructions?

I'm going to wash my bed linen once a week in hot water. Signup and view all the answers

Which statement indicates understanding of side effects of phenazopyridine?

My urine will have an orange discoloration. Signup and view all the answers

What ocular emergency is associated with an irregular pupil after trauma to the eye?

Iritis Signup and view all the answers

What is the highest priority intervention for a patient feeling guilty and sad with decreased appetite?

Performing a suicide risk assessment Signup and view all the answers

What advanced directive allows a family member to sign a consent form for a sedated patient?

Durable power of attorney for healthcare Signup and view all the answers

What pathophysiologic process does bruising and muffled heart tones indicate in a motor vehicle collision victim?

Low pulse pressure Signup and view all the answers

What is the most common inherited bleeding disorder?

Von Willebrand Signup and view all the answers

What complication is the most common risk for all puncture wounds?

Abscess Signup and view all the answers

In a patient with vaginal bleeding and open cervical os, what type of spontaneous abortion likely occurred?

Inevitable abortion Signup and view all the answers

Procalcitonin blood test is ordered for what condition?

Sepsis Signup and view all the answers

What is the highest priority for a patient with sore throat, fever, and swollen lymph nodes?

Airway protection Signup and view all the answers

Which gastrointestinal disorder is a female patient at risk for with right upper quadrant pain and bloating?

Cholecystitis Signup and view all the answers

What does rest relieving chest pain indicate?

Stable angina Signup and view all the answers

What type of gastrointestinal disorder is indicated by severe epigastric pain and retching after alcohol abuse?

Mallory-Weiss syndrome Signup and view all the answers

What stage pressure ulcer includes partial thickness skin loss?

Stage 2 Signup and view all the answers

What component of cardiac output does the Frank-Starling law apply to?

Preload Signup and view all the answers

What is an early sign of increasing intracranial pressure in a head injury patient?

Nausea and vomiting Signup and view all the answers

What medication should be administered next for a patient who is unresponsive with involuntary movements despite midazolam?

Lorazepam Signup and view all the answers

What statement indicates understanding of methotrexate administration for a stable ectopic pregnancy?

I can't administer this medication. I'm pregnant. Signup and view all the answers

What discharge instruction is included for a patient with Bell's palsy?

Instill artificial tears during the day Signup and view all the answers

What assessment finding might indicate meningeal irritation?

Nuchal rigidity Signup and view all the answers

What should be included in a critical incident process after a mass casualty incident?

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Which of the following statements made by a patient would lead the nurse to conclude that the patient understands risk factors for pulmonary embolism?

While on a long flight, I should get up and walk to stretch my legs every hour. Signup and view all the answers

Which statement made by a patient indicates an understanding of discharge instructions for pelvic inflammatory disease?

I will be at increased risk for ectopic pregnancy. Signup and view all the answers

Based on the assessment, which injury does the nurse suspect in a patient with severe left upper quadrant pain after a bicycle collision?

Ruptured diaphragm Signup and view all the answers

What does the nurse suspect in a patient with chest pain and an abnormal Q wave on the ECG?

An old infarction Signup and view all the answers

What immediate action will the nurse expect to promote safety for a patient with increased aggression and homicidal threats?

Place in a seclusion room Signup and view all the answers

Which diagnostic testing will the nurse expect as the highest priority for a patient with shortness of breath and a recent MVC?

Computed tomographic pulmonary angiography Signup and view all the answers

What is the highest priority intervention for a family presenting with fever, muscle pain, and bruising after traveling to Sierra Leone?

Notify infection prevention Signup and view all the answers

Which scenario is most consistent with a patient presenting with moon face, buffalo hump, and hirsutism?

Patient with severe chronic asthma who has been on prednisone for years. Signup and view all the answers

What condition would be suspected in a patient with vital signs showing labored breathing, cyanosis, and absent breath sounds on the right?

Tension pneumothorax Signup and view all the answers

What is the most common cause of cardiogenic shock?

Myocardial infarction Signup and view all the answers

The disease most commonly associated with the catarrhal, paroxysmal and convalescent stages is best treated with which classification of medications?

Macrolide antibiotics Signup and view all the answers

Which anxiety disorder is a patient exhibiting with dizziness, fear of dying, and hot flashes?

Panic attack Signup and view all the answers

What type of headache is experienced by a patient with a reddened right eye and facial flushing?

Cluster Signup and view all the answers

What is the most responsible task performed by an emergency nurse to ensure the chain of custody is followed?

Limit the number of people with access to the evidence Signup and view all the answers

Which orthopedic condition is the result of elevated uric acid levels?

Gouty arthritis Signup and view all the answers

What would the nurse expect to take place for a patient exhibiting hallucinations and delusions?

Medical clearance Signup and view all the answers

What intervention will the nurse perform for a patient preparing for surgery for valvular repair due to endocarditis?

Administer antibiotics Signup and view all the answers

Which neurological condition is likely associated with unsteady gait, weakness, and vision changes?

Multiple sclerosis Signup and view all the answers

What is the risk for a patient who has experienced a severe electrical injury?

Arrhythmias Signup and view all the answers

Which heart block is associated with a lengthening PR interval until a QRS complex is dropped?

Second degree type I Signup and view all the answers

Which of the following interventions would be appropriate for a patient diagnosed with renal calculi?

Administer antiemetics Signup and view all the answers

What assessment can the nurse do to further determine the cause of a patient's acute symptoms after taking nitroglycerin?

Take a blood pressure on the other arm Signup and view all the answers

Which medication will the nurse expect to give to a patient diagnosed with diabetes insipidus?

Vasopressin Signup and view all the answers

What condition is described by a 56-year-old patient with fatigue, bloating, pitting edema, and prominent neck veins?

Right-sided heart failure Signup and view all the answers

What type of research study is an emergency nurse conducting when interviewing staff nurses about emotional states and patient outcomes?

Qualitative study Signup and view all the answers

Which complication is associated with orbital wall fractures?

Ocular entrapment Signup and view all the answers

What intervention is used to manage seasonal affective disorder?

Vitamin D supplements Signup and view all the answers

Which of the following would be indicative of Alzheimer's disease?

Gradual onset of memory loss and aphasia Signup and view all the answers

What is the best way to promote a successful family presence practice?

Have administrative support Signup and view all the answers

What will the nurse anticipate as the next intervention for a patient in ventricular tachycardia with no pulse?

Defibrillation Signup and view all the answers

What is a late sign of intussusception?

Currant jelly-like stools Signup and view all the answers

What respiratory problem should the nurse anticipate in a patient with a history of heart failure and recent pneumonia treatment who presents with respiratory symptoms?

Pleural effusion Signup and view all the answers

Which assessment indicates exclusion criteria for receiving tissue plasminogen activator (tPA) in a patient with a stroke?

BP 190/110 mm Hg Signup and view all the answers

What genitourinary emergency is suggested by a 16-year-old patient experiencing severe pain in the left groin after playing football in cold weather?

Testicular torsion Signup and view all the answers

Which disorder does the nurse suspect in a 3-year-old boy with bruising, minor respiratory illness history, and laboratory findings of low platelet count?

Idiopathic thrombocytopenia purpura Signup and view all the answers

What type of spinal cord injury is suspected in a patient with loss of movement on one side and sensation on the opposite side after a knife wound?

Brown-Séquard syndrome Signup and view all the answers

This activity, where a community hospital emergency department uses key performance indicators (KPI) to identify improvements, is a component of what?

Quality improvement Signup and view all the answers

Which assessment finding will be most concerning in a patient with chronic bronchitis and shortness of breath?

A respiratory rate of 10 breaths/min Signup and view all the answers

What condition is suspected in a patient presenting with flu-like symptoms after being bitten by a bat?

Rabies Signup and view all the answers

In a 74-year-old patient who fell and was on the floor for a prolonged period, what clinical manifestation should be assessed for?

Dark brown urine Signup and view all the answers

Which condition is described by a patient with ear pain, nausea, vomiting, and tinnitus receiving prescriptions for antibiotics, corticosteroids, and antiemetics?

Labyrinthitis Signup and view all the answers

How will the nurse instruct a patient to apply permethrin cream for a scaly, itchy rash?

From head-to-toe, with a second application one week later Signup and view all the answers

What abnormal assessment finding will the nurse expect in a patient with severe chest pain after using cocaine?

BP 196/110 mm Hg Signup and view all the answers

What is the nurse's priority intervention for a 3-week-old infant with vomiting after eating and laboratory results revealing hypokalemia?

Isotonic crystalloid fluid bolus Signup and view all the answers

Which intervention is used to manage acute respiratory distress syndrome (ARDS) to help maintain open alveoli?

Positive end-expiratory pressure (PEEP) Signup and view all the answers

Study Notes

Pulmonary Embolism Risk Factors

Understanding statement: Walking to stretch legs during long flights reduces risk.

Pelvic Inflammatory Disease Education

Key insight: Increased risk for ectopic pregnancy after infection.

Abdominal Trauma Assessment

Suspicion of injury: Ruptured diaphragm suspected based on symptoms following a bicycle collision.

Electrocardiogram Findings

Interpretation: Abnormal Q wave indicates an old infarction.

Behavioral Emergencies

Safety measure: Placing aggressive patients in a seclusion room to promote safety.

Postoperative Deterioration Concerns

Priority diagnostic test: Computed tomographic pulmonary angiography is critical following recent leg fractures.

Infection Control in Emergency Situations

Immediate action: Notifying infection prevention is essential for suspected Ebola cases.

Endocrine and Metabolic Disorders

Clinical symptoms: Long-term prednisone use linked to Cushing's syndrome features.

Respiratory Distress Indicators

Condition suspected: Tension pneumothorax indicated by absent breath sounds and jugular vein distension.

Cardiogenic Shock Causes

Most common cause: Myocardial infarction listed as a leading cause of cardiogenic shock.

Infectious Disease Treatments

Best treatment: Macrolide antibiotics recommended for specific bacterial infections with distinct disease stages.

Anxiety Disorder Manifestations

Condition identified: Panic attack evidenced by acute fear and physiological symptoms.

Headache Classification

Type identification: Cluster headaches characterized by severe pain and reddened eye.

Chain of Custody in Evidence Handling

Best practice: Limiting access to evidence ensures the integrity of the chain of custody.

Gout Presentation

Associated condition: Gouty arthritis directly linked to elevated uric acid levels.

Psychological Assessment for Acute Patients

Necessary action: Medical clearance required for patients displaying severe hallucinations and delusions.

Surgical Preparation for Endocarditis

Preoperative care: Administering antibiotics is critical prior to valvular repair surgery.

Neurological Disorder Symptoms

Condition correlation: Multiple sclerosis connected to unsteady gait and vision changes.

Risks Following Electrical Injury

Chief concern: Arrhythmias are a significant risk after severe electrical injuries.

ECG Findings and Heart Block Identification

Characteristic of block: Second degree type I heart block involves progressively lengthening PR intervals until a QRS is dropped.

Renal Calculi Management

Recommended intervention: Administering antiemetics for symptom relief in renal calculi cases.

Cardiac Assessment

Assessment focus: Blood pressure on the opposite arm can provide further diagnostic clarity.

Diabetes Insipidus Treatment

Expected medication: Vasopressin indicated for management of diabetes insipidus.

Heart Failure Symptoms

Clinical finding: Right-sided heart failure evidenced by peripheral edema and prominent neck veins.

Quality Improvement in Healthcare

Objective: Key performance indicators to identify opportunities that enhance satisfaction.

Respiratory Concerns in Chronic Conditions

Concerning finding in assessment: A respiratory rate of 10 breaths/min in a patient with chronic bronchitis.

Rabies Exposure Treatment

Suspected illness: Rabies consideration following animal bite with flu-like symptoms.

Post-Fall Assessment in Elderly Patients

Physical finding: Dark brown urine may suggest significant internal injury after prolonged exposure on the floor.

Diagnosed condition: Labyrinthitis characterized by ear pain and associated systemic symptoms.

Skin Disorders Treatment

Application guideline: Permethrin cream applied from head-to-toe with a follow-up application after one week.

Cocaine Use Complications

Expected vital sign finding: Elevated blood pressure in a patient who used cocaine earlier.

Pediatric Dehydration Management

Priority intervention: Isotonic crystalloid fluid bolus for infants showing signs of dehydration.

ARDS Management

Critical intervention: Implementing positive end-expiratory pressure to maintain open alveoli.

Eye Injury Management

Immediate priority: Eye irrigation necessary following acid splash exposure.

Protective Measures in Immunocompromised Patients

Infection prevention: Protective isolation is essential for a patient post-chemotherapy.

Eye Injury Recognition

Common condition: Corneal abrasion suggested by sensation of a foreign object in the eye.

Shock Physiology

Physiological response: Renin-angiotensin-aldosterone system activation increases sodium during compensated shock.

Acute Glaucoma Symptoms

Condition presentation: Acute angle glaucoma indicated by eye pain, nausea, and loss of peripheral vision.### Abdominal Pain and Conditions
Pain with palpation in the right subcostal area during inspiration may indicate gallbladder issues or hepatobiliary disease.
Diffuse cramping abdominal pain can be associated with gastrointestinal disorders such as irritable bowel syndrome or acute gastroenteritis.
Epigastric pain radiating to the back suggests potential pancreatitis or duodenal ulcer disease.
Dull and constant umbilical pain could relate to appendicitis or mesenteric ischemia.

Medication and Toxicity

Activated charcoal is indicated for overdoses of medications such as Carbamazepine, which can cause toxicity.
Hemodialysis is the preferred intervention for acute lithium toxicity, providing effective clearance of the drug.

Neurological Injuries

The level of alertness in diffuse axonal injury is determined by the reticular activating system, crucial for consciousness and arousal.

Neonatal Care

The first intervention for a delivered neonate is to thoroughly dry the infant, aiding in thermoregulation and stimulating breathing.

Respiratory Health

Patients with chronic obstructive pulmonary disease (COPD) should be educated about the importance of pneumococcal vaccinations to prevent respiratory infections.

Burn Emergencies

In patients with full-thickness (third-degree) burns, an escharotomy may be necessary to relieve pressure and improve ventilation.

Psychological Assessment

Signs of delirium include disorientation and personality changes over a short period, distinguishing it from chronic conditions like dementia.

Asthma Severity

An asthma exacerbation with peak expiratory flow measuring 48% of personal best is categorized as moderate, necessitating treatment adjustments.

Disaster Preparedness

Mitigation involves proactively upgrading antiquated systems, as evidenced by addressing deficiencies in the electrical infrastructure of emergency services.

Stroke Assessment

Symptoms of transient ischemic attacks include sudden weakness and speech difficulty that resolve quickly, requiring rapid evaluation to rule out strokes.

Gynecological Emergencies

Uterine fibroids can cause heavy bleeding and cramping, while open cervical os suggests an inevitable abortion.

Nutritional Disorders

Wernicke-Korsakoff syndrome is marked by ataxia and confusion, often related to long-term alcohol abuse.

Gastrointestinal Disorders

Duodenal ulcers present with pain alleviated by antacids, while Mallory-Weiss syndrome arises from retching leading to esophageal tears.

Immunology

IgE immunoglobulin is crucial for mediating Type 1 allergic responses.

Triage in Emergency Medicine

Patients with potential septic shock exhibit vital signs indicating low blood pressure and altered heart rate, necessitating urgent intervention.

Trauma Management

Velocities in trauma cases and their symptoms, such as extremity injuries, must be evaluated for underlying life-threatening conditions like pericardial tamponade.

Risk Factors for Suicide

A history of past suicide attempts is among the most significant risk factors, requiring careful patient assessment and intervention.

Laceration Care

For patients with laceration repairs using wound glue, it is important to monitor for signs of infection, like redness and drainage.

Diabetic Emergencies

Distinguishing between diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome involves understanding their metabolic processes and patient demographics, with DKA commonly seen in Type 1 diabetes.

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Description

Test your understanding of patient statements related to risk factors for pulmonary embolism with these flashcards. The quiz will help reinforce knowledge essential for nurses to care for patients effectively. Assess your grasp of important concepts related to this critical health condition.