Triage And Initial Patient Management Competency 2014

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PASSING IS 80%


Questions and Answers
  • 1. 
    Pain management protocol during invasive procedures may include all of the following EXCEPT:
    • A. 

      2% Lidocaine jelly topically prior to insertion of urethral catheter

    • B. 

      Lidocaine and Priolocaine cream 2.5%/2.5% topically to anticipated IV site. Cover with transparent dressing for at least 30 minutes.

    • C. 

      Lidocaine Solution 2% 4 ml via nebulization prior to insertion of nasogastric tube

    • D. 

      Lidocaine 1% intradermally prior to IV insertion

    • E. 

      Pain Ease spray for 4-10 seconds from a distance of 3-7 inches for vascular access

  • 2. 
    True or false? A patient with a Finger Stick Blood Sugar (FSBG) of 68 mg/dl should be treated regardless whether the patient is symptomatic or not. The FSBG must be rechecked in 15 minutes and treatment repeated until FSBG >70 mg/dl. 
    • A. 

      True

    • B. 

      False

  • 3. 
    All of the following interventions maybe initiated by the nurse to manage sepsis in adults 18 years of age and above EXCEPT:
    • A. 

      Blood culture x2

    • B. 

      CBC and CMP

    • C. 

      Lactic Acid

    • D. 

      Normal Saline 2 L bolus

  • 4. 
    All of the following interventions maybe initiated by the nurse to manage pain and nausea  EXCEPT:
    • A. 

      Acetaminophen 15 mg/kg to a max of 1000 mg po x 1 for mild pain in adult patients

    • B. 

      Morphine Sulfate 0.15 mg/kg IM or IV x1 dose for moderate pain (4-7 on 10 point scale) and severe pain (8-10 on 10 point scale) in adults

    • C. 

      Morphine Sulfate 0.1 mg/kg IM or IV x1 dose for moderate and severe pain in pediatric patients

    • D. 

      Zofran ODT 8 mg SL x 1 dose or Zofran 4 mg IV x 1 dose for nausea control in adult patients

    • E. 

      Zofran ODT 4 mg SL x 1 dose for peds 6 months to 3 years of age

  • 5. 
    The family of a 74-year-old male called 911 when he developed severe mid-abdominal pain and shoulder pain. “My husband is not a complainer,” reports his wife. “The only medication he takes is for high blood pressure.” On arrival in the ED, patient’s HR is 140, RR 28, SpO2 94%, BP 72/56.
    • A. 

      ESI 1

    • B. 

      ESI 2

    • C. 

      ESI 3

    • D. 

      ESI 4

    • E. 

      ESI 5

  • 6. 
    An 88-year-old female is brought to the ED by EMS. This morning she had an episode of slurred speech and weakness of her left arm that lasted about 45 minutes. She has a history of HTN and a previous stroke. She is alert and oriented with slightly slurred speech. VS: T-97.7, HR 92, BP 163/93, RR 28, SpO2 98% RA.
    • A. 

      ESI 1

    • B. 

      ESI 2

    • C. 

      ESI 3

    • D. 

      ESI 4

    • E. 

      ESI 5

  • 7. 
     A 72-year-old female with obvious chronic obstructive pulmonary disease (COPD) and increased work of breathing is wheeled into triage. Between breaths she tells you that she “is having a hard time breathing and has had a fever since yesterday.” The SpO2 monitor is alarming and displaying a saturation of 82 percent. The patient appears in severe distress.
    • A. 

      ESI 1

    • B. 

      ESI 2

    • C. 

      ESI 3

    • D. 

      ESI 4

    • E. 

      ESI 5

  • 8. 
    1.      A 40-year-old male presents to triage with vague, midsternal chest discomfort, occurring intermittently for one month. This morning, he reports a similar episode, which has now resolved. Currently complains of mild nausea, but feels good otherwise. Medical history: smoker. He is alert, with skin warm and dry, does not appear to be in any distress.
    • A. 

      ESI 1

    • B. 

      ESI 2

    • C. 

      ESI 3

    • D. 

      ESI 4

    • E. 

      ESI 5

  • 9. 
    A 63-year-old male is brought in from the local nursing home because of altered LOC. His blood pressure is 82/60 and Temp is 101.8. The patient was being treated with oral antibiotic for aspiration pneumonia at the nursing home.  He is more unresponsive than usual and his HR 128.
    • A. 

      ESI 1

    • B. 

      ESI 2

    • C. 

      ESI 3

    • D. 

      ESI 4

    • E. 

      ESI 5

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