A nurse working on a medical-surgical unit is notified about a mass casualty event that recently took place in the community. Which of the following assignments should the nurse anticipate?

Provide informational updates to members of the media.

Determine the acuity and number of casualties arriving at the facility.

Assist in discharging stable clients to home.

Delegate tasks to emergency health care specialists

Answer and Explanation

The Correct Answer is B

Determine the acuity and number of casualties arriving at the facility

During a mass casualty event, the nurse working on a medical-surgical unit can anticipate being assigned the task of determining the acuity and number of casualties arriving at the healthcare facility. This involves assessing the severity of injuries and prioritizing care based on the level of urgency. The nurse will be responsible for triaging and assigning appropriate resources to each patient based on their condition.

Provide informational updates to members of the media. In (option A) is incorrect. While communication and coordination with the media may be necessary during a mass casualty event, this is typically handled by designated spokespersons or hospital administration. Nurses are primarily focused on providing direct patient care and managing the influx of patients.

Assist in discharging stable clients to home in (option C) is incorrect. During a mass casualty event, the focus is on providing care to the injured and managing the influx of casualties. Discharging stable clients to home would not be a priority task during such an event.

Delegate tasks to emergency healthcare specialists in (option D) is incorrect. Nurses may collaborate with emergency healthcare specialists during a mass casualty event, but they usually take on leadership roles in coordinating and providing direct care. Nurses are responsible for assigning tasks and coordinating the efforts of the healthcare team, including specialists, to ensure effective care delivery.

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Correct Answer is D

Explanation

Hyperkalemia refers to an elevated level of potassium in the blood. It can have various manifestations, and one of the critical effects of hyperkalemia is its impact on cardiac function. High levels of potassium can disrupt the normal electrical conduction in the heart, leading to arrhythmias or irregular heart rate. These arrhythmias can range from mild palpitations to more severe and life-threatening conditions like ventricular fibrillation.

Dry mucous membranes are more commonly associated with dehydration or reduced fluid intake. Hyperkalemia does not directly cause dry mucous membranes.

Trousseau's sign is a clinical manifestation of hypocalcemia, not hyperkalemia. It is characterized by carpal spasms induced by inflating a blood pressure cuff above the client's systolic blood pressure for a few minutes.

Hyperactive reflexes are commonly seen in conditions such as hyperthyroidism or certain neurologic disorders. They are not directly related to hyperkalemia.

A. Release the client's restraints every 4 hr. B. Check the client's status every hour. C. Document the client's behavior leading to the initiation of the restraints. D. Obtain written consent from the client for the placement of the restraints.

Correct Answer is C

Explanation

Document the client's behavior leading to the initiation of the restraints: Accurate and comprehensive documentation is essential in the client's medical record. This includes documenting the client's behavior or actions that necessitated the use of restraints. It is important to document the reason, duration, and type of restraint used.

Release the client's restraints every 2 hours or as per institutional policy: It is important to periodically release the restraints to assess the client's circulation, skin integrity, and overall well-being. Restraints should never be kept on continuously without intermittent release.

Check the client's status every 15 minutes: The nurse should closely monitor the client's vital signs, level of comfort, and any signs of distress or complications. Frequent assessment ensures early identification and intervention if any issues arise.

Obtain informed consent: While obtaining consent is necessary for many procedures or treatments, including the use of restraints, it is not applicable in situations where there is an imminent risk of harm to the client or others. The use of restraints in mental health units is based on legal and ethical guidelines, prioritizing the client's safety and the safety of others.

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A nurse working on a medical-surgical unit is notified about a mass casualty event that recently took place in the community. Which of the following assignments should the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is in renal failure. The nurse should identify which of the following findings is a manifestation of hyperkalemia.

Correct Answer is D

Explanation

A nurse on a mental health unit is caring for a client who is in restraints. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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