MOCIII E4: ER Nursing / Study Guide Questions
with Definitive Solutions.
RN-FNEs - Answer: ✩ Forensic nurse examiners (RN-FNEs)
- SANE (Sexual assault nurse examiner). Must be a board certified RN.
- SAFE (Sexual assault forensic examiner). Could be nurse, physician, PA, or NP.
→ Do not tamper with the evidence. If you're not trained and touch them, you may jeopardize their case.Psych crisis nurse team role - Answer: They are called into to de-escalate situations. If that doesn't work, pt may be put into psych safe room. Rooms are usually bare & w/ a locked door.Paper scrubs for safety + regular psych safety precautions.
Staff Safety - Answer: ✩ Locked unit
✩ Security presence ✩ Panic button (notifies police & puts the unit into lock down) ✩ Metal detectors
✩ PPE
Geriatrics - Answer: ✩ >65 account for 16%+ of ED visits
✩ High-risk patients due to comorbidities, blood-thinners common, polypharmacy, poor historian ✩ Advanced directives (DNR, DNI, full code, what extent of care do they want provided in the case of loss of sound mind?). Absence may cause ethical issues when family is forced to decide. 1 / 3
An 88-year-old man is admitted to the ED from home with weakness and acute confusion. What is the nurse's priority for his care to maintain patient safety?
- Assess his mental status every 30 minutes
- Ensure that siderails are raised on his stretcher
- Check his bowel sounds for intestinal obstruction
- Teach him to move slowly when walking - Answer: Correct: b. Ensure that siderails are raised
- → Mental status would be assessed more frequently than Q30M.
- → We're keeping them safe first.
- → Somebody who is weak & confused is not going to be receptive to teaching.
on his stretcher.
Triage - Answer: ✩ Sorting/classifying patients based on acuity (most sick, most acute. Acute > chronic).✩ Takes much experience & knowledge to pick up on subtle signs. Rapid assessment for quickest intervention.
Triage categories - Answer: ✩ Emergent
- Immediate threat to life or limb (ex. active hemorrhage, major trauma, high spinal cord injury,
- Time is tissue. Seen immediately.
- Requires quick treatment but immediate threat to life does not exist at the moment. Can wait
- Can wait several hours, maybe even days, for care without significant risk (Could've gone to
drug overdose/ respiratory distress, DKA/HHS, SI)
✩ Urgent
usually about 1 hour (ex. stable asthma attack, GI issues, renal colic, gyne issues like cyst, open fractures) ✩ Nonurgent
the doctor's office/urgent care. Ex. sprains, strains, common cold, refills) 2 / 3
Emergency Severity Index (ESI) - Answer: Alternative triage method
✩ 5 groups, levels 1-5. Level 1 is the most severe, life-threatening situation.✩ Resource based model. ex. 5 → minimal resources, like an exam.
Trauma centers - Answer: ✩ Level 1
The most well-equipped level for a center. Large teaching hospitals serving dense populations, high resources and varied provider team. Will treat to the highest severity & diversity.ex. ULH ✩ Level 2 Community hospitals providing care for a large majority of injured patients, with limitations on highest severity or specialties.ex. Jewish ✩ Level 3 Smaller, rural hospitals focusing on stabilization and patient transfer if necessary. Basic care.ex. Baptist ✩ Level 4 Rural/remote settings offering ACLS & transfer after stabilization."Band-aid stations" Mechanism of injury (MOI) - Answer: ✩ Manner in which traumatic event occurred
- Blunt trauma (→ fractures, internal bleeding).
- Blast effect
- Acceleration-deceleration (coup countrecoup, falling from height. Shearing, tearing. Working
- Penetrating trauma (do not touch/pull out. Imaging before surgical removal)
- / 3
up XR → CT→ MRI)