Review Practice Exericise 1

Emergency Nursing Principles and Management > Adult Health

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Practice Exericise 1

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Total Questions : 5

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Question 1:

In a mass casualty incident (MCI), what are the primary goals of the triage process? Select all that apply

A. To identify all injuries for every patient. B. To provide definitive care to the most critically ill first. C. To allocate resources to do the greatest good for the greatest number of people. D. To prioritize patients based on the severity of their injuries and their likelihood of survival. E. To transport all patients to the nearest hospital immediately.

Answer and Explanation

Choice A:

To identify all injuries for every patient: Detailed assessment is not the goal during initial MCI triage; rapid categorization is key.

Choice B:

To provide definitive care to the most critically ill first: In an MCI, patients with minimal survival chances may be assigned lower priority to conserve resources for those who can benefit most.

Choice C:

In a mass casualty incident (MCI), the primary goals of triage are to allocate limited resources in a way that achieves the greatest good for the greatest number of people and to prioritize patients based on injury severity and likelihood of survival. Triage in an MCI is focused on rapid assessment to determine treatment priority rather than providing detailed diagnoses or definitive care at the scene.
Rationale for correct answers:

Choice D:

To prioritize patients based on the severity of their injuries and their likelihood of survival: Patients most likely to survive with timely intervention are prioritized for care and transport.Rationale for incorrect answers:

Choice E:

To transport all patients to the nearest hospital immediately: This can overwhelm facilities; transport is prioritized based on triage category and hospital capacity.

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Question 2:

A trauma patient arrives at the emergency department. After ensuring a patent airway with cervical spine stabilization, the next step in the primary survey is to assess the patient's:

A. Mental status and neurological function. B. Breathing and ventilation. C. Circulation, hemorrhage, and pulse. D. Full set of vital signs.

Answer and Explanation

Choice A:

Mental status and neurological function: This is evaluated later under "D" (Disability) in the primary survey.

Choice B:

Circulation, hemorrhage, and pulse: This comes after breathing assessment under "C" in the primary survey.

Choice C:

After ensuring a patent airway with cervical spine stabilization, the next step in the primary survey is to assess breathing and ventilation. This involves checking for adequate chest rise, respiratory rate, oxygen saturation, and the presence of any injuries that could impair ventilation, such as pneumothorax or flail chest. Immediate interventions may be required to restore adequate oxygenation.
Rationale for correct answer:

Choice D:

Full set of vital signs: Obtained after the primary survey is complete and life-threatening issues have been addressed.

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Question 3:

During a mass casualty incident, a triage nurse assesses a patient who is awake and able to walk. The patient has a laceration on their arm but no other apparent life-threatening injuries. According to the START triage system, what color tag should be assigned to this patient?

A. Red B. Yellow C. Green D. Black

Answer and Explanation

Choice A:

Red: Indicates immediate care is needed for life-threatening conditions that are potentially reversible with prompt intervention.

Choice B:

Yellow: Indicates delayed treatment for serious but not immediately life-threatening injuries; patients are stable for now but require hospital care.

Choice C:

In the START (Simple Triage and Rapid Treatment) triage system, a patient who is awake, able to walk, and has no life-threatening injuries is assigned a green tag, indicating the "minor" category. These patients can ambulate to a designated safe area and can wait for medical treatment until more urgent cases are addressed.
Rationale for correct answer:

Choice D:

Black: Indicates the patient is deceased or injuries are incompatible with survival.

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Question 4:

Select all the components that are typically included in a secondary survey of a trauma patient. Select all that apply

A. A focused assessment on the most obvious injury. B. A head-to-toe physical examination. C. A detailed patient history, including AMPLE. D. Insertion of a definitive airway, if needed. E. Diagnostic studies such as X-rays and CT scans.

Answer and Explanation

Choice A:

A focused assessment on the most obvious injury: This is more relevant to the primary survey when addressing immediate threats, not the full systematic secondary survey.

Choice B:

A detailed patient history, including AMPLE: Provides critical background for diagnosis, treatment, and surgical planning.

Choice C:

The secondary survey in trauma care is a comprehensive, head-to-toe assessment performed after life-threatening conditions have been identified and treated in the primary survey. It includes a full physical examination, obtaining a detailed patient history using the AMPLE mnemonic, and performing diagnostic studies such as X-rays, CT scans, and lab work to identify additional injuries.

Choice D:

Insertion of a definitive airway, if needed: This is part of the primary survey under "A" (Airway), not the secondary survey.

Choice E:

Diagnostic studies such as X-rays and CT scans: Help confirm suspected injuries and guide further interventions.Rationale for incorrect answers:

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Question 5:

What is the fundamental difference in the purpose between a primary survey and a secondary survey?

A. The primary survey is performed by paramedics, while the secondary survey is performed by physicians. B. The primary survey is a rapid assessment to identify and manage life-threatening conditions, while the secondary survey is a more thorough head-to-toe evaluation. C. The primary survey is only for conscious patients, whereas the secondary survey is for unconscious patients. D. The primary survey is completed in the field, and the secondary survey is completed at the hospital

Answer and Explanation

Choice A:

The primary survey is performed by paramedics, while the secondary survey is performed by physicians: Both can be performed by any trained healthcare provider; it is about purpose, not provider.

Choice B:

The primary survey is only for conscious patients, whereas the secondary survey is for unconscious patients: Both assessments apply to all patients, regardless of consciousness level.

Choice C:

The fundamental difference between the primary and secondary survey is that the primary survey is a rapid, systematic assessment aimed at identifying and managing life-threatening conditions immediately, while the secondary survey is a thorough, head-to-toe evaluation to detect all other injuries or issues once the patient is stabilized.
Rationale for correct answer:

Choice D:

The primary survey is completed in the field, and the secondary survey is completed at the hospital: Location does not define the surveys; they can occur in any setting where trauma care is provided.

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Practice Exericise 1

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