What should the emergency department nurse identify as a PRIMARY survey clinical priorities for the treatment of a client with a gunshot wound? Select all that apply.

Obtaining medical history.

Hypothermia prevention

Hemorrhage control.

Airway maintenance.

Ventilation assistance.

Answer and Explanation

Correct Answer : C,D,E

Rationale:

A. While obtaining a medical history is important, it is not part of the primary survey. In a life-threatening trauma situation, history is secondary to immediate life-saving interventions. History is collected after the patient is stabilized (secondary survey).

B. Preventing hypothermia is part of trauma care and important, but it is considered a secondary or adjunct intervention after immediate threats to life are addressed. It is not a primary survey priority.

C. Controlling bleeding is a primary survey priority. Severe hemorrhage can rapidly lead to hypovolemic shock and death, so it must be addressed immediately using direct pressure, tourniquets, or other interventions.

D. Airway is the first priority in the primary survey (A in ABCs: Airway, Breathing, Circulation). Ensuring the airway is patent prevents hypoxia and is essential for survival in trauma patients.

E. After ensuring the airway is open, the next priority is breathing (B in ABCs). Assessing and supporting ventilation ensures adequate oxygenation and carbon dioxide elimination. This may involve supplemental oxygen, bag-mask ventilation, or intubation if necessary.

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Correct Answer is C

Explanation

Rationale:

A. Social workers are trained to provide emotional support, help the family navigate practical matters after a death, and connect them with grief resources. This is a supportive and professional intervention.

B. Support groups can provide comfort, normalize the grieving process, and allow the mother to share experiences with others who have faced similar losses. This is a non-invasive and helpful intervention.

C. Recommending antidepressants immediately is inappropriate because normal grief is not a psychiatric disorder and does not automatically require pharmacologic treatment. Prescribing or suggesting medication without a thorough assessment by a qualified provider can be harmful and may pathologize a natural grieving process.

D. Spiritual support can provide comfort, guidance, and coping strategies in accordance with the mother’s beliefs. It is an acceptable and culturally sensitive intervention.

A. serum hepatitis antibodies B. complete blood count with platelets C. serum ammonia levels D. coagulation studies E. serum albumin

Correct Answer is ["B","D"]

Explanation

Rationale:

A. While hepatitis can cause liver injury, antibodies do not provide information about current clotting ability or bleeding risk. They indicate past exposure or immunity, not active coagulopathy.

B. Platelets are critical for primary hemostasis, and clients with liver cirrhosis often develop thrombocytopenia due to splenic sequestration or decreased production of thrombopoietin. Low platelet counts increase the risk of bruising and bleeding, which correlates with the observed ecchymoses.

C. Elevated ammonia is associated with hepatic encephalopathy, not directly with bleeding or bruising. Monitoring ammonia is important for neurological status but not for coagulation.

D. Liver cirrhosis impairs the synthesis of clotting factors, leading to prolonged PT, INR, and aPTT. Ecchymosis may indicate coagulopathy, so monitoring coagulation studies helps assess the severity of the bleeding risk.

E. Albumin reflects synthetic liver function and nutritional status, but low albumin itself does not directly cause bruising. While hypoalbuminemia may indicate advanced liver disease, it does not provide immediate information about bleeding risk.

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What should the emergency department nurse identify as a PRIMARY survey clinical priorities for the treatment of a client with a gunshot wound? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client dies in the emergency department. The client's mother states that she is overwhelmed and doesn't know how to proceed since she has never had a death in the family before. Which action should the nurse avoid?

Correct Answer is C

Explanation

The nurse notes new areas of ecchymosis on the arms and legs of a client with liver cirrhosis. Which laboratory test results should the nurse monitor because of this finding? Select all that apply.

Correct Answer is ["B","D"]

Explanation

A nurse assesses a client admitted to the emergency department with acute pancreatitis. Which treatment should the nurse prioritize?

A client has been admitted with acute liver failure. Which assessment findings are most important concerning?

A client is diagnosed with acute pancreatitis. Which laboratory results would the nurse anticipate to be elevated due to OBSTRUCTION in this condition? Select all that apply.

The nurse initiates a vasopressin drip for the client with gastrointestinal bleeding. What should the nurse consider the priority assessment?

A student nurse is completing an internship in the emergency department. The student asks the preceptor. "How is emergency department nursing different from other areas of nursing practice? How should the experienced emergency department nurse respond? Select all that apply.

The client with esophageal varices was admitted with hypovolemic shock secondary to upper gastrointestinal bleed. Which intervention is not appropriate for this client?

A client with acute pancreatitis presents with a board-like abdomen, guarding and absent bowel sounds. What should the nurse be most concerned about?

The nurse provides discharge teaching to the client diagnosed with acute pancreatitis. Which instruction is most important for the nurse to give the client?