Crisis Management

The nurse is receiving bedside report on a patient experiencing tremors in his hands, profuse diaphoresis, and agitation during attempts to interview or exam him. Which information does the nurse make a priority to collect?

A patient seeing her primary care physician responds “no” to the domestic violence screening question, “Do you feel safe in your home?” Which action does the nurse take next?

Which is the best response by the nurse interviewing a patient who has just stated she feels unsafe in her own home?

Following a major natural disaster, the charge nurse receives instruction from superiors to pair patients as roommates to increase the number of available rooms. The first patient to be paired is a 42-year-old patient with cellulitis who has a 103°C fever and tachycardia. The charge nurse places her in a room with which patient?

Which patient in the emergency department (ED) must be treated first?

The nurse is a first responder after a gas explosion at an apartment complex. Which patient does the nurse mark to be treated first?

The nurse is assisting the provider in performing triage of 30 patients after a mass casualty incident. The nurse observes the resident changing the triage tag for the unresponsive patient with an open skull fracture who is not breathing spontaneously from black to red and calls the EMT over to transport the patient to the hospital. Which response by the nurse is most appropriate?

The nurse is first on the scene following a multivehicle accident. After activating emergency services and verifying the safety of the scene, the nurse begins the triage process. The first patient is unconscious and not breathing. Which action does the nurse take first?

A fire breaks out on multiple floors of the hospital and the charge nurse has been instructed to evacuate the patients. In which order are the patients evacuated?

The adult child of the patient with dementia who is the patient’s in-home caregiver reports the patient exhibits increased confusion and agitation after 1600 each day. Which statement by the nurse will be most helpful to the caregiver?

The nurse is planning care for the elderly patient with dementia who experiences increased agitation and confusion during the evening hours. Which interventions does the nurse include to decrease evening agitation and confusion? Select all that apply.

The 60-year-old patient who was recently laid off from his factory job of 38 years presents to the emergency department complaining of severe superficial pain over the flank. Which assessment will be most important for diagnosis?

The 21-year-old patient with a body mass index of 10.1 undergoes placement of a peripherally inserted central catheter (PICC) at 1000 and total parenteral nutrition (TPN) is initiated at 1200. At 1600, 160 mL have infused and the patient is noted to be breathing shallowly, there is blood oozing from the PICC insertion site, and the patient is exhibiting confusion. Which action does the nurse perform first? 

The 22-month-old child is brought to the emergency department with large, blistered burns to both buttocks by his mother’s boyfriend. The mother’s boyfriend states the child has been in his care while the mother is away on a business trip. He reports the child accidentally fell into the bath during the preparation before the water had had a chance to cool. The child’s second-degree wounds are dressed after intravenous morphine is administered. The nurse works with the healthcare team to perform which intervention? 

The 24-year-old male patient presents to the clinic to request a consultation for rhinoplasty. He reports his unsightly nose ruined his most recent relationship because his girlfriend would not stop staring at it; he has missed work due to embarrassment and has started to use makeup to make it look smaller. Upon assessment, the nose appears normal and proportional to his face. Which course of action is the most appropriate?  

The 22-year-old patient presented 6 weeks ago to the clinic to request a consultation for rhinoplasty. He reports his unsightly nose ruined his most recent relationship because his girlfriend would not stop staring at it; he has missed work due to embarrassment and has started to use makeup to make it look smaller. Upon assessment, the nose appears normal and proportional to his face. Psychoeducation was started and the patient has been compliant. However, he reports minimal improvement in his perception. The nurse advocates for which treatment next?  

The 28-year-old patient checks himself into a center for detoxification from opiates, which he has used daily for 3 years. The patient begins to experience pain, diarrhea, salivation, and diaphoresis and is started on buprenorphine. Worsening pain throughout the body and uncontrollable diarrhea prompts stepwise increase of buprenorphine dose to the maximum dose without relief of withdrawal symptoms. The nurse contacts the provider to request an order for which medication?  

The 25-year-old patient is brought by her mother to the emergency department due to being unable to move the eyes or look down other than bending over. Her medical history is notable for schizophrenia and non-compliance with medication. A week ago, she was hospitalized and decided to pursue injectable haloperidol as a treatment option with which she could be more compliant. This morning, she was upset to find she could not move her eyes. The nurse prepares which therapy?