- Email: [email protected]
CLINICAL TEST QUESTIONS
CE TESTS
11. Which of these medications should you anticipate administering to a patient with AWS who is experiencing moderate symptoms? A. midazolam (Versed) B. naloxone (Narcan) C. oxazepam (Serax) D. propofol (Diprivan)
6. When caring for a patient with cyanide toxicity, which drug would you expect to administer initially? A. Vitamin K B. 3% sodium nitrate C. Activated charcoal D. 1% methylene blue
7. What is the half-life of acetonitrile? A. 4 –8 hours B. 16 –20 hours
CLINICAL TEST QUESTIONS
A 52-year-old Acyanotic Man With Severe Hypoxia and Profound Metabolic Acidosis Following an Industry Chemical Exposure (pp 113-6)
C. 32 – 36 hours D. 44 –48 hours Intranasal Drug Delivery: An Alternative to Intravenous Administration in Selected Emergency Cases (pp 141-7)
1. Cyanide commonly is found in: A. insulation and lawn fertilizer. B. banana peels and apple seeds. C. aerosol hair spray and fingernail polish. D. cigarette smoke and cosmetic nail glue remover.
2. Which of these medications, if administered over a long period, may result in cyanide toxicity? A. Amyl nitrite
8. Which of these statements about nasal transmucosal medication delivery is accurate? A. This delivery method requires sterile technique using a
nasogastric tube. B. This delivery method allows rapid drug absorption into the cerebral spinal fluid. C. The absorption rate of this delivery method is the same
as that of oral medications.
B. Sodium thiosulfate
D. A disadvantage of this delivery method is that it is
C. Acetylsalicylic acid
reported as uncomfortable by patients. 9. When administering medication via the intranasal route it is important to:
D. Sodium nitroprusside
3. You would expect the arterial blood gas results of a patient with cyanide toxicity to reflect: A. metabolic acidosis. B. metabolic alkalosis. C. respiratory acidosis. D. respiratory alkalosis.
4. Which of the following odors may be detected in a patient with cyanide toxicity? A. Fruity B. Metallic C. Bitter almond D. Coffee ground
5. You should suspect cyanide toxicity in a patient who has: A. bradycardia and hypertension. B. acyanosis and severe hypoxia.
A. use the lowest concentration of the mediation that
is available. B. limit the amount that is instilled into each nostril to
2 mL. C. deliver one half of the prescribed dose into each nostril. D. don a surgical mask and sterile gloves.
10. When using the Venturi Atomizer it is important to know that: A. this is the least expensive intranasal medication delivery method. B. it is necessary to re-sterilize this device prior to reuse. C. there is limited medication wasting when using this
device. D. this is the only device that is capable of delivering a
measured dose.
C. nystagmus and an absent red reflex. D. abdominal pain and projectile vomiting.
April 2004 30:2
JOURNAL OF EMERGENCY NURSING
195
CE TESTS
Controlling Bleeding in the Field: Hemostatic Powders and Dressing Debut in the Prehospital Setting (pp 160-1)
11. TraumaDEX is applied by: A. placing this 4-inch square bandage directly over the surface of a wound. B. spraying this liquid form of fibrinogen and thrombin
directly into a wound. C. surgically inserting this natural polymer into a wound after it has been debrided. D. sprinkling the material directly on the wound surface
after existing clots have been removed. 12. From what material is the product Quick Clot made? A. Marine micro-algae B. Proteins derived from human blood
15. Which of these medications work by increasing tissue sensitivity to insulin? A. Acarbose (Precose) and miglitol (Glyset) B. Nateglinide (Starlix) and repaglinide (Prandin) C. Rosiglitazone (Avandia) and pioglitazone (Actos) D. Chlorpropamide (Diabinese) and tolazamide (Tolinase)
16. Which 2 of these antidiabetic agents have the same mechanism of action? A. Sulfonylureas and biguanides B. Meglitinides and sulfonylureas C. Thiazolidinediones and meglitinides D. Thiazolidinediones and a-glucosidase inhibitors
17. a-glucosidase inhibitors control postprandial glucose levels by inhibiting a-glucosidase enzymes in the:
C. A refined volcanic mineral called zeolite
A. duodenum.
D. A natural polymer found in shrimp shells
B. small intestine.
13. When caring for a patient who has had the product Crosseal applied to a wound, it is important to recognize that: A. careful observation for signs and symptoms of an
allergic reaction is necessary if the patient has an allergy to shellfish. B. the product does not require contact with the blood of the patient’s wound in order to become activated. C. the patient is at risk for disease transmission since the
product is made from proteins derived from human blood. D. the product should be separated from the clotted surface of the wound 10 to 90 minutes after its application. Managing Pediatric Ingestions of the New Antidiabetic Agents (pp 183-4)
C. pancreatic beta cells. D. islets of Langerhans.
18. What is the most common adverse reaction associated with the use of a-glucosidase inhibitors? A. Xerostomia B. Paresthesia C. Gastrointestinal upset D. Rebound hypoglycemia A 27-year-old Man With Ringing in his Right Ear and Decreased Hearing: Five-level Acuity Scale Discrimination of Pain (pp 191-2)
19. When using the 3-level acuity scale, a patient who is assigned to triage level II should be seen: A. immediately. B. within 15 minutes.
14. Which of these statements about the biguanide class of antidiabetic agents is accurate? A. The actions of this class of drugs result in decreased
hepatic glucose production. B. Phenformin is currently being prescribed to adolescents
who have type 2 diabetes mellitus. C. The ingestion of medications from this drug class has
resulted in the documented deaths of 50 pediatric patients since 1998. D. This entire class of antidiabetic agents was taken off the
C. within 20 minutes to 2 hours. D. within 2 to 4 hours. 20. Using the Candadian Triage and Acuity Scale (CTAS), a patient who reports acute but severe pain should be triaged as: A. level I. B. level II. C. level III. D. level IV.
market in 2002 due to fatalities from severe hepatotoxicity.
196
JOURNAL OF EMERGENCY NURSING
30:2 April 2004
CE TESTS
PROFESSIONAL/ADMINISTRATIVE TEST QUESTIONS
Avoid Verbal Orders (pp 157-9)
1. According to The Joint Commission for the Accreditation of Healthcare Organizations (JCAHO), organizations need to: A. eliminate the use of verbal orders in the acute care setting. B. limit the use of verbal orders to those that are face-to-
face. C. require the person receiving a verbal order to obtain a
written order within 2 hours. D. require the person receiving a verbal order or test result
to verify or ‘‘read back’’ the entire order or test result. 2. Which of the following is a recommended strategy for preventing errors associated with verbal order communication in the emergency department? A. Have clerical staff co-sign the transcription of the verbal order. B. Utilize preprinted order protocols or fax transmission. C. Require designated staff members to give and receive
verbal orders. D. Limit acceptance of verbal orders to medications such
as thrombolytics. 3. Which of these statements, made by a prescriber, is an example of an appropriate verbal order? A. ‘‘Administer one ampule of Atropine via ET tube stat.’’ B. ‘‘Administer 50 milligrams of Lopressor P.O. T.I.D.’’ C. ‘‘Give Digoxin, d-i-g-o-x-i-n, zero point two-five mi-
lligrams intravenously now.’’
5. Which intravenous solution is recommended for an infant with a serious burn injury prior to transport to the burn center? A. Lactated Ringers (LR) B. Normal saline (0.9% NaCl) C. Dextrose 5% in water (D5W) D. Dextrose 5% in lactated Ringers (D5LR)
6. When a patient with severe burns is being prepared for transfer to a burn center, it is essential for you to: A. give the patient a bath and observe the wounds. B. apply dry sterile dressings to the patient’s burns. C. apply antibacterial ointment to the patient’s burns. D. attempt to cool the patient’s core temperature to 97.0jF.
7. To correctly use a bag-valve-mask it is helpful to: A. use the ‘‘E-C clamp’’ technique. B. avoid ripping the storage bag from the bottom. C. place your fingers on the fleshy portion of the patient’s
neck. D. squeeze the bag for one full second after the patient’s chest begins to rise. 8. When caring for a patient who presents to the emergency department in an agitated, anxious state, it is important to: A. avoid making eye contact with the patient. B. ask the patient what has worked in the past. C. limit conversation to ‘‘yes’’ or ‘‘no’’ questions. D. remind the patient that feelings of dying are not real. Care Plans for Patients With Frequent ED visits for Such Chief Complaints as Back Pain, Migraine and Abdominal Pain (pp 150-3)
D. ‘‘Give Cerebyx 15 milligrams per kilogram over 50
minutes intravenously immediately.’’ Clinical Nurses Forum (pp 154-6)
4. Which intravenous solution is recommended for an adult patient with a serious burn injury prior to transport to the burn center? A. Lactated Ringers (LR) B. Normal saline (0.9% NaCl) C. Dextrose 5% in water (D5W) D. Dextrose 5% in lactated Ringers (D5LR)
9. A conclusion by the authors is that their program can decrease: A. the number of drug seeking patients in the emergency department. B. the ED length of stay by 1 hour for patients with pain. C. the length of hospital stay for patients who are admitted
from the emergency department. D. the cost per visit for patients who present to the
emergency department with reports of pain. 10. The leading cause of pain for patients in the program was: A. cancer. B. back pain. C. abdominal pain. D. migraine headache.
April 2004 30:2
JOURNAL OF EMERGENCY NURSING
197
11. Which of these medications should you anticipate administering to a patient with AWS who is experiencing moderate symptoms? A. midazolam (Versed) B. naloxone (Narcan) C. oxazepam (Serax) D. propofol (Diprivan)
6. When caring for a patient with cyanide toxicity, which drug would you expect to administer initially? A. Vitamin K B. 3% sodium nitrate C. Activated charcoal D. 1% methylene blue
7. What is the half-life of acetonitrile? A. 4 –8 hours B. 16 –20 hours
CLINICAL TEST QUESTIONS
A 52-year-old Acyanotic Man With Severe Hypoxia and Profound Metabolic Acidosis Following an Industry Chemical Exposure (pp 113-6)
C. 32 – 36 hours D. 44 –48 hours Intranasal Drug Delivery: An Alternative to Intravenous Administration in Selected Emergency Cases (pp 141-7)
1. Cyanide commonly is found in: A. insulation and lawn fertilizer. B. banana peels and apple seeds. C. aerosol hair spray and fingernail polish. D. cigarette smoke and cosmetic nail glue remover.
2. Which of these medications, if administered over a long period, may result in cyanide toxicity? A. Amyl nitrite
8. Which of these statements about nasal transmucosal medication delivery is accurate? A. This delivery method requires sterile technique using a
nasogastric tube. B. This delivery method allows rapid drug absorption into the cerebral spinal fluid. C. The absorption rate of this delivery method is the same
as that of oral medications.
B. Sodium thiosulfate
D. A disadvantage of this delivery method is that it is
C. Acetylsalicylic acid
reported as uncomfortable by patients. 9. When administering medication via the intranasal route it is important to:
D. Sodium nitroprusside
3. You would expect the arterial blood gas results of a patient with cyanide toxicity to reflect: A. metabolic acidosis. B. metabolic alkalosis. C. respiratory acidosis. D. respiratory alkalosis.
4. Which of the following odors may be detected in a patient with cyanide toxicity? A. Fruity B. Metallic C. Bitter almond D. Coffee ground
5. You should suspect cyanide toxicity in a patient who has: A. bradycardia and hypertension. B. acyanosis and severe hypoxia.
A. use the lowest concentration of the mediation that
is available. B. limit the amount that is instilled into each nostril to
2 mL. C. deliver one half of the prescribed dose into each nostril. D. don a surgical mask and sterile gloves.
10. When using the Venturi Atomizer it is important to know that: A. this is the least expensive intranasal medication delivery method. B. it is necessary to re-sterilize this device prior to reuse. C. there is limited medication wasting when using this
device. D. this is the only device that is capable of delivering a
measured dose.
C. nystagmus and an absent red reflex. D. abdominal pain and projectile vomiting.
April 2004 30:2
JOURNAL OF EMERGENCY NURSING
195
CE TESTS
Controlling Bleeding in the Field: Hemostatic Powders and Dressing Debut in the Prehospital Setting (pp 160-1)
11. TraumaDEX is applied by: A. placing this 4-inch square bandage directly over the surface of a wound. B. spraying this liquid form of fibrinogen and thrombin
directly into a wound. C. surgically inserting this natural polymer into a wound after it has been debrided. D. sprinkling the material directly on the wound surface
after existing clots have been removed. 12. From what material is the product Quick Clot made? A. Marine micro-algae B. Proteins derived from human blood
15. Which of these medications work by increasing tissue sensitivity to insulin? A. Acarbose (Precose) and miglitol (Glyset) B. Nateglinide (Starlix) and repaglinide (Prandin) C. Rosiglitazone (Avandia) and pioglitazone (Actos) D. Chlorpropamide (Diabinese) and tolazamide (Tolinase)
16. Which 2 of these antidiabetic agents have the same mechanism of action? A. Sulfonylureas and biguanides B. Meglitinides and sulfonylureas C. Thiazolidinediones and meglitinides D. Thiazolidinediones and a-glucosidase inhibitors
17. a-glucosidase inhibitors control postprandial glucose levels by inhibiting a-glucosidase enzymes in the:
C. A refined volcanic mineral called zeolite
A. duodenum.
D. A natural polymer found in shrimp shells
B. small intestine.
13. When caring for a patient who has had the product Crosseal applied to a wound, it is important to recognize that: A. careful observation for signs and symptoms of an
allergic reaction is necessary if the patient has an allergy to shellfish. B. the product does not require contact with the blood of the patient’s wound in order to become activated. C. the patient is at risk for disease transmission since the
product is made from proteins derived from human blood. D. the product should be separated from the clotted surface of the wound 10 to 90 minutes after its application. Managing Pediatric Ingestions of the New Antidiabetic Agents (pp 183-4)
C. pancreatic beta cells. D. islets of Langerhans.
18. What is the most common adverse reaction associated with the use of a-glucosidase inhibitors? A. Xerostomia B. Paresthesia C. Gastrointestinal upset D. Rebound hypoglycemia A 27-year-old Man With Ringing in his Right Ear and Decreased Hearing: Five-level Acuity Scale Discrimination of Pain (pp 191-2)
19. When using the 3-level acuity scale, a patient who is assigned to triage level II should be seen: A. immediately. B. within 15 minutes.
14. Which of these statements about the biguanide class of antidiabetic agents is accurate? A. The actions of this class of drugs result in decreased
hepatic glucose production. B. Phenformin is currently being prescribed to adolescents
who have type 2 diabetes mellitus. C. The ingestion of medications from this drug class has
resulted in the documented deaths of 50 pediatric patients since 1998. D. This entire class of antidiabetic agents was taken off the
C. within 20 minutes to 2 hours. D. within 2 to 4 hours. 20. Using the Candadian Triage and Acuity Scale (CTAS), a patient who reports acute but severe pain should be triaged as: A. level I. B. level II. C. level III. D. level IV.
market in 2002 due to fatalities from severe hepatotoxicity.
196
JOURNAL OF EMERGENCY NURSING
30:2 April 2004
CE TESTS
PROFESSIONAL/ADMINISTRATIVE TEST QUESTIONS
Avoid Verbal Orders (pp 157-9)
1. According to The Joint Commission for the Accreditation of Healthcare Organizations (JCAHO), organizations need to: A. eliminate the use of verbal orders in the acute care setting. B. limit the use of verbal orders to those that are face-to-
face. C. require the person receiving a verbal order to obtain a
written order within 2 hours. D. require the person receiving a verbal order or test result
to verify or ‘‘read back’’ the entire order or test result. 2. Which of the following is a recommended strategy for preventing errors associated with verbal order communication in the emergency department? A. Have clerical staff co-sign the transcription of the verbal order. B. Utilize preprinted order protocols or fax transmission. C. Require designated staff members to give and receive
verbal orders. D. Limit acceptance of verbal orders to medications such
as thrombolytics. 3. Which of these statements, made by a prescriber, is an example of an appropriate verbal order? A. ‘‘Administer one ampule of Atropine via ET tube stat.’’ B. ‘‘Administer 50 milligrams of Lopressor P.O. T.I.D.’’ C. ‘‘Give Digoxin, d-i-g-o-x-i-n, zero point two-five mi-
lligrams intravenously now.’’
5. Which intravenous solution is recommended for an infant with a serious burn injury prior to transport to the burn center? A. Lactated Ringers (LR) B. Normal saline (0.9% NaCl) C. Dextrose 5% in water (D5W) D. Dextrose 5% in lactated Ringers (D5LR)
6. When a patient with severe burns is being prepared for transfer to a burn center, it is essential for you to: A. give the patient a bath and observe the wounds. B. apply dry sterile dressings to the patient’s burns. C. apply antibacterial ointment to the patient’s burns. D. attempt to cool the patient’s core temperature to 97.0jF.
7. To correctly use a bag-valve-mask it is helpful to: A. use the ‘‘E-C clamp’’ technique. B. avoid ripping the storage bag from the bottom. C. place your fingers on the fleshy portion of the patient’s
neck. D. squeeze the bag for one full second after the patient’s chest begins to rise. 8. When caring for a patient who presents to the emergency department in an agitated, anxious state, it is important to: A. avoid making eye contact with the patient. B. ask the patient what has worked in the past. C. limit conversation to ‘‘yes’’ or ‘‘no’’ questions. D. remind the patient that feelings of dying are not real. Care Plans for Patients With Frequent ED visits for Such Chief Complaints as Back Pain, Migraine and Abdominal Pain (pp 150-3)
D. ‘‘Give Cerebyx 15 milligrams per kilogram over 50
minutes intravenously immediately.’’ Clinical Nurses Forum (pp 154-6)
4. Which intravenous solution is recommended for an adult patient with a serious burn injury prior to transport to the burn center? A. Lactated Ringers (LR) B. Normal saline (0.9% NaCl) C. Dextrose 5% in water (D5W) D. Dextrose 5% in lactated Ringers (D5LR)
9. A conclusion by the authors is that their program can decrease: A. the number of drug seeking patients in the emergency department. B. the ED length of stay by 1 hour for patients with pain. C. the length of hospital stay for patients who are admitted
from the emergency department. D. the cost per visit for patients who present to the
emergency department with reports of pain. 10. The leading cause of pain for patients in the program was: A. cancer. B. back pain. C. abdominal pain. D. migraine headache.
April 2004 30:2
JOURNAL OF EMERGENCY NURSING
197