Nursing Board Exam Review Questions in Emergency Part 6/20
1. The nurse is teaching a class on biological warfare. Which information should the nurse include in the
presentation?
a. Contaminated water is the only source of transmission of biological agents.
b. Vaccines are available and being prepared to counteract biological agents.
c. Biological weapons are less of a threat than chemical agents.
d. Biological weapons are easily obtained and result in significant mortality.
2. Which signs/symptoms would the nurse assess in the client who has been exposed to the anthrax bacillus via
the skin?
a. A scabby, clear fluid filled vesicle.
b. Edema, pruritus, and a 2-mm ulcerated vesicle.
c. Irregular brownish-pink spots around the hairline.
d. Tiny purple spots flush with the surface of the skin.
3. The client has expired secondary to smallpox. Which information about funeral arrangements is most important
for the nurse to provide to the clients family?
a. The client must be cremated.
b. Suggest an open casket funeral.
c. Bury the client within 24 hours.
d. Notify the public health department.
4. A chemical exposure has just occurred at an airport. An off-duty nurse, knowledgeable about biochemical
agents, is giving directions to the travelers. Which direction should the nurse provide to the travelers?
a. Hold their breath as much as possible.
b. Stand up to avoid heavy exposure.
c. Lie down to stay under the exposure.
d. Attempt to breathe through their clothing.
5. The nurse is caring for a client in the prodromal phase of radiation exposure. Which signs/symptoms would the
nurse assess in the client?
a. Anemia, leukopenia, and thrombocytopenia.
b. Sudden fever, chills, and enlarged lymph nodes.
c. Nausea, vomiting, and diarrhea.
d. Flaccid paralysis, diplopia, and dysphagia.
6. The off-duty nurse hears on the television of a bioterrorism act in the community. Which action should the
nurse take first?
a. Immediately report to the hospital emergency room.
b. Call the American Red Cross to find out where to go.
c. Pack a bag and prepare to stay at the hospital.
d. Follow the nurse’s hospital policy for responding.
7. Which situation would warrant the nurse obtaining information from a material safety datasheet (MSDS)?
a. The custodian spilled a chemical solvent in the hallway.
b. A visitor slipped and fell on the floor that had just been mopped.
c. A bottle of antineoplastic agent broke on the client’s floor.
d. The nurse was stuck with a contaminated needle in the client’s room.
8. The triage nurse is working in the emergency department. Which client should be assessed first?
a. The 10-year-old child whose dad thinks the child’s leg is broken.
b. The 45-year-old male who is diaphoretic and clutching his chest.
c. The 58-year-old female complaining of a headache and seeing spots.
d. The 25-year-old male who cut his hand with a hunting knife.
9. According to the North Atlantic Treaty Organization (NATO) triage system, which situation would be
considered a level red (Priority 1)?
a. Injuries are extensive and chances of survival are unlikely.
b. Injuries are minor and treatment can be delayed hours to days.
c. Injuries are significant but can wait hours without threat to life or limb.
d. Injuries are life threatening but survivable with minimal interventions.
10. Which statement best describes the role of the medical-surgical nurse during a disaster?
a. The nurse may be assigned to ride in the ambulance.
b. The nurse may be assigned as a first assistant in the operating room.
c. The nurse may be assigned to crowd control.
d. The nurse may be assigned to the emergency department.
RATIONALES
1. Answer: D Rationale: Because of the variety of agents, the means of transmission, and lethality of the agents,
biological weapons, including anthrax, smallpox, and plague, is especially dangerous.
2. Answer: B Rationale: Exposure to anthrax bacilli via the skin results in skin lesions, which cause edema with
pruritus and the formation of macules or papules that ulcerate, forming a 1-3 mm vesicle. Then a painless eschar
develops, which falls off in one (1) to 2 weeks.
3. Answer: A Rationale: Cremation is recommended because the virus can stay alive in the scabs of the body for
13 years.
4. Answer: B Rationale: Standing up will avoid heavy exposure the chemical will sink toward the floor or ground.
5. Answer: C Rationale: The prodromal phase (presenting symptoms) of radiation exposure occurs 48± 72 hours
after exposure and the signs/symptoms are nausea, vomiting, diarrhea, anorexia, and fatigue. Higher exposures
of radiation signs/symptoms include fever, respiratory distress, and excitability.
6. Answer: D Rationale: The nurse should follow the hospitals policy. Many times nurses will stay at home until
decisions are made as to where the employees should report.
7. Answer: A Rationale: The MSDS provides chemical information regarding specific agents, health information,
and spill information for a variety of chemicals. It is required for every chemical that is found in the hospital.
8. Answer: B Rationale: The triage nurse should see this client first because these are symptoms of a myocar- dial
infarction, which potentially life is threatening.
9. Answer: D Rationale: This is called the immediate category. Individuals in this group can progress rapidly to
expectant if treatment is delayed.
10. Answer: D Rationale: New settings and atypical roles for nurses may be required during disasters; medicalsurgical nurses can provide first aid and be required to work in unfamiliar settings.
Nursing Board Exam Review Questions in Emergency Part 5/20
1. Which intervention is the most important for the nurse to implement when performing mouth-to-mouth
resuscitation on a client who has pulseless ventricular fibrillation?
a. Perform the jaw thrust maneuver to open the airway.
b. Use the mouth to cover the client’s mouth and nose.
c. Insert an oral airway prior to performing mouth to mouth.
d. Use a pocket mouth shield to cover client’s mouth.
2. The nurse is teaching CPR to a class. Which statement best explains the definition of sudden cardiac death?
a. Cardiac death occurs after being removed from a mechanical ventilator.
b. Cardiac death is the time that the physician officially declares the client dead.
c. Cardiac death occurs within one (1) hour of the onset of cardiovascular symptoms.
d. The death is caused by myocardial ischemia resulting from coronary artery disease.
3. Which statement explains the scientific rationale for having emergency suction equipment available during
resuscitation efforts?
a. Gastric distention can occur as a result of ventilation.
b. It is needed to assist when intubating the client.
c. This equipment will ensure a patent airway.
d. It keeps the vomitus away from the health-care provider.
4. Which equipment must be immediately brought to the client’s bedside when a code is called for a client who
has experienced a cardiac arrest?
a. A ventilator.
b. A crash cart.
c. A gurney.
d. Portable oxygen.
5. The nursing administrator responds to a code situation. When assessing the situation, which role must the
administrator ensure is performed for legal purposes and continuity of care of the client?
a. A person is ventilating with an ambu bag.
b. A person is performing chest compressions correctly.
c. A person is administering medications as ordered.
d. A person is keeping an accurate record of the code.
6. The nurse in the emergency department has admitted five (5) clients in the last two (2) hours with complaints
of fever and gastrointestinal distress. Which question would be most appropriate for the nurse to ask each client
to determine if there is a bioterrorism threat?
a. ³Do you work or live near any large power lines?
b. ³Where were you immediately before you got sick?
c. ³Can you write down everything you ate today?
d. ³What other health problems do you have?
7. The health-care facility has been notified that an alleged inhalation anthrax exposure hasoccurred at the local
post office. Which category of personal protective equipment (PPE) wouldthe response team wear?
a. Level A
b. Level B
c. Level C
d. Level D
8. The nurse is teaching a class on bioterrorism and is discussing personal protective equipment (PPE). Which
statement is the most important fact that must be shared with the participants?
a. Health-care facilities should keep masks at entry doors.
b. The respondent should be trained in the proper use of PPE.
c. No single combination of PPE protects against all hazards.
d. The EPA has divided PPE into four levels of protection
9. The nurse is teaching a class on bioterrorism. What is the scientific rationale for designating specific area for
decontamination?
a. Showers and privacy can be provided to the client in this area.
b. This area isolates the clients who have been exposed to the agent.
c. It provides a centralized area for stocking the needed supplies.
d. It prevents secondary contamination to the health-care providers.
10. The triage nurse in a large trauma center has been notified of an explosion in a major chemical manufacturing
plant. Which action should the nurse implement first when the clients arrive at the emergency department?
a. Triage the clients and send them to the appropriate areas.
b. Thoroughly wash the clients with soap and water and then rinse.
c. Remove the clients clothing and have them shower.
d. Assume the clients have been decontaminated at the plant.
Nursing Board Exam Review Questions in Emergency Part 5/20(ANSWER KEY)
1. Answer: D Rationale: Nurses should protect themselves against possible communicable disease, such as HIV,
hepatitis, or any types of sexually transmitted disease.
2. Answer: C Rationale: Unexpected death occurring within1 hour of the onset of cardiovascular symptoms is the
definition of sudden cardiac death.
3. Answer: A Rationale: Gastric distention occurs from over ventilating clients. When compressions are
performed, the pressure will cause vomiting that could be aspirated into the lungs.
4. Answer: B Rationale: The crash cart is the mobile unit that has the defibrillator and all the medications and
supplies needed to conduct a code.
5. Answer: D Rationale: The chart is a legal document and the code must be documented in the chart and provide
information that may be needed in the intensive care unit.
6. Answer: B Rationale: The nurse should take note of any unusual illness for the time of year or clusters of clients
coming from a single geographical location who all exhibit signs/symptoms of possible biological terrorism.
7. Answer: A Rationale: Level A protection is worn when the highest level of respiratory, skin, eye, and mucous
membrane protection is required. In this situation of possible inhalation of anthrax, such protection is required.
8. Answer: C Rationale: The health-care providers are not guaranteed absolute protects. The nurse should take
note of any unusual illness for the time of year or clusters of clients coming from a single geographical location
who all exhibit signs/symptoms of possible biological terrorism. Ion, even with all the training and protective
equipment.
9. Answer: D Rationale: Avoiding cross contamination is a priority for personnel and equipment²the fewer
number of people exposed, the safer the community and area.
10. Answer: C Rationale: This is the first step. Depending on the type of exposure, this step alone can remove
large portion of exposure.
Nursing Board Exam Review Questions in Emergency Part 4/20
1. The nurse is planning a program for clients at a health fair regarding the prevention and early detection of
cancer of the pancreas. Which self-care activity should the nurse teach that is an example of primary nursing care?
a. Monitor for elevated blood glucose at random intervals.
b. Inspect the skin and sclera of the eyes for a yellow tint.
c. Limit meat in the diet and eat a diet that is low in fats.
d. Instruct the client with hyperglycemia about insulin injections.
2. The client diagnosed with cancer of the pancreas is being discharged to start chemotherapy in the HCP office.
Which statement made by the client indicates the client understands the discharge instructions?
a. ³I will have to see the HCP every day for six (6) weeks for my treatments.
b. ³I should write down all my questions so I can ask them when I see the HCP.
c. ³I am sure that this is not going to be a serious problem for me to deal with.
d. ³The nurse will give me an injection in my leg and I will get to go home.
3. The nurse caring for a client diagnosed with cancer of the pancreas writes the collaborative problem of ³altered
nutrition. Which intervention should the nurse include in the plan of care?
a. Continuous feedings via PEG tube.
b. Have the family bring in foods from home.
c. Assess for food preferences.
d. Refer to the dietitian.
4. The client is taken to the emergency department with an injury to the left arm. Which action should the nurse
take first?
a. Assess the nail beds for capillary refill time.
b. Remove the client’s clothing from the arm.
c. Call radiology for a STAT x-ray of the extremity.
d. Prepare the client for the application of a cast.
5. The nurse finds the client unresponsive on the floor of the bathroom. Which action should thenurse implement
first?
a. Check the client for breathing.
b. Assess the carotid artery for a pulse.
c. Shake the client and shout.
d. Call a code via the bathroom call light.
6. Which behavior by the unlicensed assistive personnel who is performing cardiac compression son an adult
client during a code warrants immediate intervention by the nurse?
a. Has one hand on the lower half of the sternum above the xiphoid process.
b. Performs cardiac compressions and allows for rescue breathing.
c. Depresses the sternum 0.5 to one (1) inch during compressions.
d. Requests to be relieved from performing compressions because of exhaustion.
7. Which is the most important intervention for the nurse to implement when participating in code?
a. Elevate the arm after administering medication.
b. Maintain sterile technique throughout the code.
c. Treat the client’s signs/symptoms; do not watch the monitor.
d. Be sure to provide accurate documentation of what happened in the code.
8. The CPR instructor is explaining what an automated external defibrillator (AED) does to students in a CPR
class. Which statement best describes an AED?
a. It analyzes the rhythm and shocks the client in ventricular fibrillation.
b. The client will be able to have synchronized cardioversion with the AED.
c. It will keep the health-care provider informed of the client’s oxygen level.
d. The AED will perform cardiac compressions on the client.
9. The nurse is caring for clients on a medical floor. Which client is most likely to experience sudden cardiac
death?
a. The 84-year-old client exhibiting uncontrolled atrial fibrillation.
b. The 60-year-old client exhibiting asymptomatic sinus bradycardia.
c. The 53-year-old client exhibiting ventricular fibrillation.
d. The 65-year-old client exhibiting supraventricular tachycardia.
10. Which health-care team member referral should be made when a code is being conducted ona client in a
community hospital?
a. The hospital chaplain.
b. The social worker.
c. The respiratory therapist.
d. The director of nurses.
Nursing Board Exam Review Questions in Emergency Part 4/20(ANSWER KEY)
1. Answer: C Rationale: Limiting the intake of meat and fats in the diet would be an example of primary
interventions. Risk factors for the development of cancer of the pancreas are cigarette smoking and eating a highfat diet that is high in animal protein. By changing these behaviors the client could possibly prevent the
development of cancer of the pancreas. Other risk factors include genetic predisposition and exposure to industrial
chemicals.
2. Answer: B Rationale: The most important person in the treatment of the cancer is the client. Research has
proved that the more involved a client becomes in his or her care, the better the prognosis. Clients should have a
chance to ask all the questions that they have.
3. Answer: D Rationale: A collaborative intervention would be to refer to the nutrition expert, the dietitian.
4. Answer: A Rationale: The nurse should assess the nail beds for the capillary refill time. A prolonged time
(greater than three seconds) indicates impaired circulation to the extremity.
5. Answer: C Rationale: This is the first intervention the nurse should implement after finding the client
unresponsive on the floor.
6. Answer: C Rationale: The sternum should be depressed 1.5 to 2 inches during compressions to ensure adequate
circulation of blood to the body; therefore, the nurse needs to correct the assistant.
7. Answer: C Rationale: This is the most important intervention. The nurse should always treat the client based
on the nurse’s assessment and data from the monitors; an intervention should not be based on data from the
monitors without the nurse assessment.
8. Answer: A Rationale: This is the correct statement explaining what an AED does when used in a code.
9. Answer: C Rationale: Ventricular fibrillation is the most common dysrhythmia associated with sudden cardiac
death; ventricular fibrillation is responsible for 65% to 85% of sudden cardiac deaths.
10. Answer: A Rationale: The chaplain should be called to help address the client’s family or significant others.
A small community hospital would not have a 24-hour on-duty pastoral service.
Nursing Board Exam Review Questions in Emergency Part 3/20
1. A client with multiple injury following a vehicular accident is transferred to the critical care unit. He begins to
complain of increased abdominal pain in the left upper quadrant. A ruptured spleen is diagnosed and he is
scheduled for emergency splenectomy. In preparing the client for surgery, the nurse should emphasize in his
teaching plan the:
a. Complete safety of the procedure
b. Expectation of postoperative bleeding
c. Risk of the procedure with his other injuries
d. Presence of abdominal drains for several days after surgery
2. After you managed to stabilize the respiratory function of your burn patient, your next goal is to prevent this
you have to replace the lost fluid and electrolytes. In starting fluid replacement therapy, the total volume and rate
of IV fluid replacement are gauged by the patient’s response and by the patient’s response and by the resuscitation
formula. In determining the adequacy of fluid resuscitation, it is essential for you to monitor the:
a. urine output
b. blood pressure
c. intracranial pressure
d. cardiac output
3. You are a nurse in the emergency department and it is during the shift that Mr. CT is admitted in the area due
to a fractured skull from a motor accident. You scheduled him for surgery under which classification?
a. Urgent b. Emergent
c. Required
d. Elective
4. Lucky was in a vehicular accident where he sustained injury to his left ankle. In the Emergency room, you
noticed anxious he looks. You establish rapport with him and to reduce his anxiety, you initially:
a. Identify yourself and state your purpose in being with the client
b. Take him to the radiology section for x-ray of affected extremity
c. Talk to the physician for an order of valium
d. Do inspection and palpation to check extent of his injuries
5. The client diagnosed with a mild concussion is being discharged from the emergency department. Which
discharge instruction should the nurse teach the client’s significant other?
a. Awaken the client every two hours.
b. Monitor for increased intracranial pressure.
c. Observe frequently for hypervigilance.
d. Offer the client food every three to four hours.
6. The client diagnosed with Addison’s disease is admitted to the emergency department after a day at the lake.
The client is lethargic, forgetful, and weak. Which intervention should be the emergency department nurse’s first
action?
a. Start an IV with an 18-gauge needle and infuse NS rapidly.
b. Have the client wait in the waiting room until a bed is available.
c. Perform a complete head-to-toe assessment.
d. Collect urinalysis and blood samples for a CBC and calcium level.
7. The nurse caring for a client diagnosed with cancer of the pancreas writes the nursing diagnosis of ³risk for
altered skin integrity related to pruritus.´ which interventions should the nurse implement?
a. Assess tissue turgor.
b. Apply antifungal creams.
c. Monitor bony prominences for breakdown.
d. Have the client keep the fingernails short.
8. The client diagnosed with cancer of the head of the pancreas is two (2) days post pancreatic duodenectomy
(Whipples procedure). Which nursing problem has the highest priority?
a. Anticipatory grieving.
b. Fluid volume imbalance
.c. acute incisional pain.
d. Altered nutrition.
9. The client is diagnosed with cancer of the head of the pancreas. When assessing the patient, which signs and
symptoms would the nurse expect to find?
a. Clay-colored stools and dark urine.
b. Night sweats and fever.
c. Left lower abdominal cramps and tenesmus.
d. Nausea and coffee-ground emesis.
10. The client admitted to rule out pancreatic islet tumors complains of feeling weak, shaky, and sweaty. Which
should be the first intervention implemented by the nurse?
a. Start an IV with D5W. b. Notify the health-care provider.
c. Perform a bedside glucose check.
d. Give the client some orange juice.
Nursing Board Exam Review Questions in Emergency Part 2/20
1 Which nursing intervention would be appropriate when caring for a client who has sustained anelectrical burn?
a. Applying ice to the burned area
b. Flushing the burn area with large amounts of water
c. Monitoring the client with cardiac telemetry
d. Preparing to administer the chemical antidote
2. Eddie, 40 years old, is brought to the emergency room after the crash of his private plane. He has suffered
multiple crushing wounds of the chest, abdomen and legs. It is feared his leg may have to be amputated. When
Eddie arrives in the emergency room, the assessment that assume the greatest priority are:
a. Level of consciousness and pupil size
b. Abdominal contusions and other wounds
c. Pain, Respiratory rate and blood pressured.
d. Quality of respirations and presence of pulses.
3. An emergency treatment for an acute asthmatic attack is Adrenaline 1:1000 given hypodermically. This is
given to:
a. increase BP
b. decrease mucosal swelling
c. relax the bronchial smooth muscle
d. decrease bronchial secretions
4. Intervention for a pt. who has swallowed a Muriatic Acid includes all of the following except
a. administering an irritant that will stimulate vomiting
b. aspirating secretions from the pharynx if respirations are affected
c. neutralizing the chemical
d. washing the esophagus with large volumes of water via gastric lavage
5. John, 16 years old, is brought to the ER after a vehicular accident. He is pronounced dead on arrival. When his
parents arrive at the hospital, the nurse should
a. ask them to stay in the waiting area until she can spend time alone with them
b. speak to both parents together and encourage them to support each other and express their emotions
freely
c. Speak to one parent at a time so that each can ventilate feelings of loss without upsetting the other
d. ask the MD to medicate the parents so they can stay calm to deal with their son’s death.
6. A nurse is eating in the hospital cafeteria when a toddler at a nearby table chokes on a piece of food and appears
slightly blue. The appropriate initial action should be to
a. Begin mouth to mouth resuscitation
b. Give the child water to help in swallowing
c. Perform 5 abdominal thrusts
d. Call for the emergency response team
7. A client is admitted from the emergency department with severe-pain and edema in the right foot. His diagnosis
is gouty arthritis. When developing a plan of care, which action would have the highest priority?
a. Apply hot compresses to the affected joints.
b. Stress the importance of maintaining good posture to prevent deformities.
c. Administer salicylates to minimize the inflammatory reaction.
d. Ensure an intake of at least 3000 ml of fluid per day.
8. The Heimlich maneuver (abdominal thrust), for acute airway obstruction, attempts to:
a. Force air out of the lungs
b. Increase systemic circulation
c. Induce emptying of the stomach
d. Put pressure on the apex of the heart
9. A nurse is performing CPR on an adult patient. When performing chest compressions, thenurse understands
the correct hand placement is located over the a. upper half of the sternum
b. upper third of the sternum
c. lower half of the sternum
d. Lower third of the sternum
10. John, 16 years old, is brought to the ER after a vehicular accident. He is pronounced dead on arrival. When
his parents arrive at the hospital, the nurse should:
a. ask them to stay in the waiting area until she can spend time alone with them
b. speak to both parents together and encourage them to support each other and express their emotions
freely
c. Speak to one parent at a time so that each can ventilate feelings of loss without upsetting the other
d. ask the MD to medicate the parents so they can stay calm to deal with their son’s death.
Nursing Board Exam Review Questions in Emergency Part 2/20(ANSWER KEY)
1. Answer: C Rationale: Because of the effects of the electrical current on the cardiovascular system, all clients
experiencing electrical burns should be placed on a cardiac monitor. Applying ice is inappropriate for any type of
burn. Only chemical burns should be flushed with large amounts of water. Chemical antidotes may be used for
chemical burns for which an antidote has been identified.
2. Answer: D Rationale: Respiratory and cardiovascular functions are essential for oxygenation. These are top
priorities to trauma management. Basic life functions must be maintained or reestablished
3. Answer: C Rationale: Acute asthmatic attack is characterized by severe bronchospasm which can be relieved
by the immediate administration of bronchodilators. Adrenaline or Epinephrine is an adrenergic agent that causes
bronchial dilation by relaxing the bronchial smooth muscles.
4. Answer: A Rationale: Swallowing of corrosive substances causes severe irritation and tissue destruction of the
mucous membrane of the GI tract. Measures are taken to immediately remove the toxin or reduce its absorption.
For corrosive poison ingestion, such as in muriatic acid where burn or perforation of the mucosa may occur,
gastric emptying procedure is immediately instituted, This includes gastric lavage and the administration of
activated charcoal to absorb the poison. Administering an irritant with the concomitant vomiting to remove the
swallowed poison will further cause irritation and damage to the mucosal lining of the digestive tract. Vomiting
is only indicated when non-corrosive poison is swallowed.
5. Answer: B Rationale: Sudden death of a family member creates a state of shock on the family. They go into a
stage of denial and anger in their grieving. Assisting them with information they need to know, answering their
questions and listening to them will provide the needed support for them to move on and be of support to one
another.
6. Answer: C Rationale: Perform 5 abdominal thrusts. At this age, the most effective way to clear the airway of
food is to perform abdominal thrusts.
7. Answer: D Rationale: Ensure an intake of at least 3000 ml of fluid per day. Gouty arthritis is a metabolic disease
marked by urate deposits that cause painful arthritic joints. The patient should be urged to increase his fluid intake
to prevent the development of urinary uric acid stones.
8. Answer: A Rationale: The Heimlich maneuver is used to assist a person choking on a foreign object. The
pressure from the thrusts lifts the diaphragm, forces air out of the lungs and creates an artificial cough that expels
the aspirated material.
9. Answer: C Rationale: The exact and safe location to do cardiac compression is the lower half of the sternum.
Doing it at the lower third of the sternum may cause gastric compression which can lead to a possible aspiration.
10. Answer: B Rationale: Sudden death of a family member creates a state of shock on the family. They go into
a stage of denial and anger in their grieving. Assisting them with information they need to know, answering their
questions and listening to them will provide the needed support for them to move on and be of support to one
another.