Question 1

While at a public park,a nurse encounters a person immediately after a bee sting.The person's lips are swollen,and wheezes are audible.Which action should the nurse take first?

Accepted Answer

A)   Elevate the site and notify the person's next of kin.
B)   Remove the stinger with tweezers and encourage rest.
C)   Administer diphenhydramine (Benadryl)  and apply ice.
D)   Administer an EpiPen from the first aid kit and call 911. D

Question 2

A provider prescribes a rewarming bath for a client who presents with partial-thickness frostbite.Which action should the nurse take prior to starting this treatment?

Accepted Answer

A)   Administer intravenous morphine.
B)   Wrap the limb with a compression dressing.
C)   Massage the frostbitten areas.
D)   Assess the limb for compartment syndrome. A

Question 3

A provider prescribes diazepam (Valium)to a client who was bitten by a black widow spider.The client asks,"What is this medication for?" How should the nurse respond?

Accepted Answer

A)   "This medication is an antivenom for this type of bite."
B)   "It will relieve your muscle rigidity and spasms."
C)   "It prevents respiratory difficulty from excessive secretions."
D)   "This medication will prevent respiratory failure." B

Question 4

A nurse is teaching a wilderness survival class.Which statements should the nurse include about the prevention of hypothermia and frostbite? (Select all that apply.)

Accepted Answer

A)   "Wear synthetic clothing instead of cotton to keep your skin dry."
B)   "Drink plenty of fluids.Brandy can be used to keep your body warm."
C)   "Remove your hat when exercising to prevent the loss of heat."
D)   "Wear sunglasses to protect skin and eyes from harmful rays."
E)   "Know your physical limits.Come in out of the cold when limits are reached."

Question 5

A nurse teaches a community health class about water safety.Which statement by a participant indicates that additional teaching is needed?

Accepted Answer

A)   "I can go swimming all by myself because I am a certified lifeguard."
B)   "I cannot leave my toddler alone in the bathtub for even a minute."
C)   "I will appoint one adult to supervise the pool at all times during a party."
D)   "I will make sure that there is a phone near my pool in case of an emergency."

Question 6

On a hot humid day,an emergency department nurse is caring for a client who is confused and has these vital signs: temperature 104.1° F (40.1° C),pulse 132 beats/min,respirations 26 breaths/min,blood pressure 106/66 mm Hg.Which action should the nurse take?

Accepted Answer

A)   Encourage the client to drink cool water or sports drinks.
B)   Start an intravenous line and infuse 0.9% saline solution.
C)   Administer acetaminophen (Tylenol)  650 mg orally.
D)   Encourage rest and re-assess in 15 minutes.

Question 7

An emergency department nurse cares for a middle-aged mountain climber who is confused and exhibits bizarre behaviors.After administering oxygen,which priority intervention should the nurse implement?

Accepted Answer

A)   Administer dexamethasone (Decadron) .
B)   Complete a mini-mental state examination.
C)   Prepare the client for computed tomography of the brain.
D)   Request a psychiatric consult.

Question 8

An emergency department nurse assesses a client admitted after a lightning strike.Which assessment should the nurse complete first?

Accepted Answer

A)   Electrocardiogram (ECG) 
B)   Wound inspection
C)   Creatinine kinase
D)   Computed tomography of head

Question 9

A nurse teaches a client who has severe allergies to prevent bug bites.Which statements should the nurse include in this client's teaching? (Select all that apply.)

Accepted Answer

A)   "Consult an exterminator to control bugs in and around your home."
B)   "Do not swat at insects or wasps."
C)   "Wear sandals whenever you go outside."
D)   "Keep your prescribed epinephrine auto-injector in a bedside drawer."
E)   "Use screens in your windows and doors to prevent flying insects from entering."

Question 10

An emergency department nurse plans care for a client who is admitted with heat stroke.Which interventions should the nurse include in this client's plan of care? (Select all that apply.)

Accepted Answer

A)   Administer oxygen via mask or nasal cannula.
B)   Administer ibuprofen, an antipyretic medication.
C)   Apply cooling techniques until core body temperature is less than 101° F.
D)   Infuse 0.9% sodium chloride via a large-bore intravenous cannula.
E)   Obtain baseline serum electrolytes and cardiac enzymes.

Question 11

While on a camping trip,a nurse cares for an adult client who had a drowning incident in a lake and is experiencing agonal breathing with a palpable pulse.Which action should the nurse take first?

Accepted Answer

A)   Deliver rescue breaths.
B)   Wrap the client in dry blankets.
C)   Assess for signs of bleeding.
D)   Check for a carotid pulse.

Question 12

A provider prescribes Crotalidae Polyvalent Immune Fab (CroFab)for a client who is admitted after being bitten by a pit viper snake.Which assessment should the nurse complete prior to administering this medication?

Accepted Answer

A)   Assess temperature and for signs of fever.
B)   Check the client's creatinine kinase level.
C)   Ask about allergies to pineapple or papaya.
D)   Inspect the skin for signs of urticaria (hives) .

Question 13

After teaching a client how to prevent altitude-related illnesses,a nurse assesses the client's understanding.Which statement indicates the client needs additional teaching?

Accepted Answer

A)   "If my climbing partner can't think straight, we should descend to a lower altitude."
B)   "I will ask my provider about medications to help prevent acute mountain sickness."
C)   "My partner and I will plan to sleep at a higher elevation to acclimate more quickly."
D)   "I will drink plenty of fluids to stay hydrated while on the mountain."

Question 14

A nurse is providing health education at a community center.Which instructions should the nurse include in teaching about prevention of lightning injuries during a storm? (Select all that apply.)

Accepted Answer

A)   Seek shelter inside a building or vehicle.
B)   Hide under a tall tree.
C)   Do not take a bath or shower.
D)   Turn off the television.
E)   Remove all body piercings.F) Put down golf clubs or gardening tools.

Question 15

A nurse assesses a client admitted with a brown recluse spider bite.Which priority assessment should the nurse perform to identify complications of this bite?

Accepted Answer

A)   Ask the client about pruritus at the bite site.
B)   Inspect the bite site for a bluish purple vesicle.
C)   Assess the extremity for redness and swelling.
D)   Monitor the client's temperature every 4 hours.

Question 16

A nurse assesses a client recently bitten by a coral snake.Which assessment should the nurse complete first?

Accepted Answer

A)   Unilateral peripheral swelling
B)   Clotting times
C)   Cardiopulmonary status
D)   Electrocardiogram rhythm

Question 17

An emergency department nurse moves to a new city where heat-related illnesses are common.Which clients does the nurse anticipate being at higher risk for heat-related illnesses? (Select all that apply.)

Accepted Answer

A)   Homeless individuals
B)   Illicit drug users
C)   White people
D)   Hockey players
E)   Older adults

Question 18

A nurse plans care for a client admitted with a snakebite to the right leg.With whom should the nurse collaborate?

Accepted Answer

A)   The facility's neurologist
B)   The poison control center
C)   The physical therapy department
D)   A herpetologist (snake specialist)

Question 19

A client presents to the emergency department after prolonged exposure to the cold.The client is difficult to arouse and speech is incoherent.Which action should the nurse take first?

Accepted Answer

A)   Reposition the client into a prone position.
B)   Administer warmed intravenous fluids to the client.
C)   Wrap the client's extremities in warm blankets.
D)   Initiate extracorporeal rewarming via hemodialysis.

Exam 9: Care of Patients with Common Environmental Emergencies