After a crush injury, muscle pain, weakness and a markedly elevated creatine kinase level point to rhabdomyolysis, the breakdown of skeletal muscle.
Missing Word
rhabdomyolysis
Rhabdomyolysis is the breakdown of skeletal muscle, often after sustained pressure or crushing. Creatine kinase leaks from damaged muscle cells, so a very high level is its hallmark, and the released contents can injure the kidneys.
Category: Trauma Care
Question 2
Potassium released from crushed muscle can cause hyperkalemia, so a patient with a crush injury is placed on a cardiac monitor to watch for dysrhythmias.
Missing Word
hyperkalemia
Hyperkalemia is an abnormally high blood potassium level. Damaged muscle cells spill their potassium into the blood, and the excess can disturb the heart's electrical activity, so continuous cardiac monitoring is essential.
Category: Trauma Care
Question 3
Calcium can be drawn into damaged muscle after a crush injury, leaving the patient with hypocalcemia and at risk for tingling, muscle spasms and dysrhythmias.
Missing Word
hypocalcemia
Hypocalcemia is a low blood calcium level. After a crush injury, calcium shifts into injured muscle tissue, and the low serum level raises neuromuscular excitability and can affect heart rhythm.
Category: Trauma Care
Question 4
Because swelling after a crush injury can compress both the blood vessels and the nerves of the limb, the nurse performs frequent neurovascular checks below the injury, comparing pulses, capillary refill, movement and sensation.
Missing Word
neurovascular
Neurovascular checks compare circulation, movement and sensation below an injury. Rising pressure in a crushed limb can squeeze vessels and nerves, so weaker pulses, slower capillary refill, new numbness or pain on moving the fingers or toes is reported to the provider at once because it can signal compartment syndrome.
Category: Trauma Care
Question 5
In carbon monoxide poisoning, the gas binds hemoglobin to form carboxyhemoglobin, which a standard pulse oximeter cannot tell apart from oxygenated hemoglobin, so the reading can look normal.
Missing Word
carboxyhemoglobin
Carboxyhemoglobin is hemoglobin bound to carbon monoxide, which cannot carry oxygen. A standard pulse oximeter reads it as if it were oxygenated, so a normal reading does not rule out dangerous hypoxia in this poisoning.
Category: Poisoning Care
Question 6
When a drug or toxin drives body temperature up by producing excess heat rather than by resetting the brain's thermostat, the condition is called hyperthermia, and external cooling such as a cooling blanket is used.
Missing Word
hyperthermia
Hyperthermia is an elevated body temperature caused by heat production or heat gain that outpaces heat loss, without a change in the brain's set point. Because the set point is unchanged, external cooling is the key measure.
Category: Poisoning Care
Question 7
After the whole body has been inspected during the exposure step, the nurse covers the patient with warm blankets to prevent hypothermia, an abnormally low core body temperature.
Missing Word
hypothermia
Hypothermia is an abnormally low core body temperature. Removing clothing for a full inspection exposes the patient to heat loss, so the nurse restores coverage and warms the patient once the inspection is done.
Category: Triage and Primary Survey
Question 8
In an unresponsive patient, relaxed muscles can let the tongue fall back against the throat and block air flow, a problem the head-tilt, chin-lift maneuver relieves.
Missing Word
tongue
The tongue is the most common cause of a blocked upper airway in a person with a decreased level of consciousness. Tilting the head and lifting the chin pulls it forward and opens the passage.
Category: Triage and Primary Survey
Question 9
In a patient in a mental health crisis, the neurological check includes orientation and whether both pupils are equal and constrict briskly to light.
Missing Word
pupils
Pupil size and reaction to light are a quick screen for a physical cause of a behavior change, such as a head injury, a stroke or a drug effect. Unequal or sluggish pupils point toward a medical emergency, which is treated before the psychiatric assessment continues.
Category: Safety and Behavioral Emergencies
Question 10
A nurse with specialized training in caring for people harmed by violence and in collecting and preserving evidence for legal cases is called a forensic nurse.
Missing Word
forensic
Forensic nurses care for patients affected by violence or abuse, collect and preserve evidence, maintain the chain of custody and may testify in court. The role requires education beyond basic nursing licensure.
Category: Abuse and Forensic Care
Question 11
When a caregiver fails to provide a dependent person with food, shelter, clothing or medical care, rather than committing a harmful act, the maltreatment is called neglect.
Missing Word
neglect
Neglect is the failure to meet a dependent person's basic needs. Signs in a child or older adult include poor hygiene, malnutrition, worn clothing and missed medical care, and nurses report suspected neglect just as they report abuse.
Category: Abuse and Forensic Care
Question 12
When collecting evidence after an assault, the nurse puts on fresh gloves before handling each new specimen so material from one item cannot transfer to another.
Missing Word
gloves
Changing gloves between specimens prevents cross-contamination, which could make evidence unreliable. Each item is also packaged and labeled separately.
Category: Abuse and Forensic Care
Question 13
Acute psychosis, a loss of contact with reality with fixed false beliefs or hearing voices while alertness and attention stay intact, is one of the psychiatric emergencies seen in the emergency department.
Missing Word
psychosis
Psychosis is a loss of contact with reality marked by delusions or hallucinations. Unlike delirium, it does not cloud alertness and attention, though a medical cause is still ruled out before it is treated as a psychiatric problem.
Category: Safety and Behavioral Emergencies
Question 14
When an unresponsive patient arrives with no known history, the nurse checks a fingerstick glucose during the disability step, because hypoglycemia is a common and quickly reversible cause.
Missing Word
hypoglycemia
Low blood glucose starves the brain and can cause confusion, seizures or coma that look like a stroke, an overdose or a head injury. A bedside check takes moments, and treatment can restore consciousness quickly, so it is never skipped in a patient with a decreased level of consciousness.
Category: Triage and Primary Survey
Question 15
During moderate alcohol withdrawal, a patient who sees insects crawling on a blank wall is having a hallucination, a perception of something that is not there.
Missing Word
hallucination
A hallucination is a sensory perception with no real stimulus. Hallucinations and seizures mark moderate alcohol withdrawal, and they appear along with high fever, rapid heart rate and hypertension in delirium tremens.
Category: Safety and Behavioral Emergencies