BCEN CEN Practice Test

The correct answer is to initiate chest compressions. In a submersion injury, the primary concern is hypoxia. The 2020 American Heart Association guidelines emphasize starting with chest compressions in cardiac arrest situations, even in drowning victims. This approach ensures immediate blood flow to vital organs, particularly the brain. While rescue breaths are important in drowning cases, chest compressions take precedence to quickly restore circulation. Warming the patient is important but secondary to initiating CPR. Attempting to remove water from the lungs through abdominal thrusts (Heimlich maneuver) is no longer recommended as it delays CPR and may increase the risk of aspiration.

Preterm labor is defined as labor that begins before the completion of 37 weeks of pregnancy. It is critical for healthcare providers to correctly identify and manage preterm labor to prevent complications. The other options describe labor at different gestational ages or a condition related to the postpartum period, which do not align with the core characteristics of preterm labor.

The perception of a sudden increase in floaters or spots and the appearance of a shadow or curtain descending over the field of vision are hallmark symptoms of retinal detachment. This condition involves the separation of the retina from its underlying supportive tissue, which disrupts its function and can lead to vision loss. The other options, while potentially indicative of other eye issues, are not primarily associated with retinal detachment.

High altitude can lead to noncardiac pulmonary edema, known as High Altitude Pulmonary Edema (HAPE). The primary treatment for HAPE is descent to a lower altitude and supplemental oxygen. A beta-agonist bronchodilator is a treatment for conditions such as asthma or COPD, but it is not the primary intervention for HAPE.

The correct answer is to respect the patient's wishes and explore alternative treatments. This aligns with the ethical principle of patient autonomy, which is a fundamental aspect of healthcare ethics. Even when a treatment is medically necessary, competent adult patients have the right to refuse treatment based on their personal beliefs. The nurse's role is to ensure the patient is fully informed about the consequences of their decision and to explore alternative treatments that may be acceptable to the patient. While involving the ethics committee is a good step, it is not the immediate best action. Attempting to convince the patient against their beliefs or proceeding with the transfusion without consent would be unethical and potentially illegal. Documenting the patient's refusal is important but is not the primary action in this situation.

Cooling the burn with lukewarm water is the recommended initial management technique for thermal burns. This method helps reduce the temperature of the burn site, alleviate pain, and limit the depth of the burn injury. Using ice can cause vasoconstriction and potentially further damage the tissue, which is not recommended. While an antibiotic cream could be useful later, it should not be the first method of wound management. Removing adhered clothing involves risk of further skin damage and should only be done under specific conditions where clothing is not fused with the skin.

This statement is correct because providing interpretive services is a matter of adhering to patients' rights and ensuring effective communication. Hospitals must comply with federal regulations, including Title VI of the Civil Rights Act of 1964, which prohibits discrimination based on national origin, which includes language. Not having appropriate language access services could lead to misunderstandings, misdiagnosis, and inappropriate treatment. Interpretive services must be offered to eliminate language barriers for the delivery of appropriate and effective care.

While antibiotic ointment may be used to prevent infection in the case of corneal abrasions, the use of an occlusive eye patch is no longer universally recommended for all types of corneal abrasions. Current treatment approaches consider factors such as the size and location of the abrasion, patient comfort, and the risk of infection. Most uncomplicated corneal abrasions heal within 24 to 48 hours with proper care, which may include pain management and monitoring for signs of infection rather than the use of an occlusive eye patch.

Lower left quadrant abdominal pain is a typical symptom of diverticulitis, reflecting the common location of the inflamed diverticula in the sigmoid colon. In contrast, symptoms like severe right lower quadrant pain or generalized abdominal swelling are more indicative of conditions such as appendicitis or ascites respectively.

This statement is incorrect. Patients with a spontaneous abortion, also known as miscarriage, typically present with bleeding, cramping, and an open cervical os. An open cervical os allows the passage of products of conception, which is characteristic of a miscarriage that has already occurred or is in progress. Conversely, a threatened abortion may present with vaginal bleeding, but the cervical os remains closed, and the pregnancy may continue without incident.

Beta-agonists, such as albuterol, are the primary treatment for acute asthma exacerbations. They work by relaxing bronchial smooth muscles and opening the airways, making them an appropriate first-line intervention when delivered via nebulizer or inhaler to provide rapid relief from respiratory distress.

The correct response is True. In acute pericarditis, electrocardiogram (EKG) findings commonly include diffuse ST-segment elevations and PR-segment depressions across multiple leads, which are hallmark signs helping in the diagnosis. These changes reflect the inflammation of the pericardium. It is critical for emergency nurses to recognize these EKG patterns for appropriate diagnosis and timely intervention.

Obstetric trauma specifically refers to injuries that occur to the maternal structures as a direct result of childbirth. This involves trauma during the labor and delivery process, including vaginal tears or lacerations, uterine rupture, and pelvic fractures. Understanding these specific injuries helps in appropriate treatment and management to prevent further complications. The incorrect options, while also concerning conditions related to pregnancy, do not specifically categorize under the injuries caused by the childbirth process itself.

The most appropriate next step in managing this patient's condition is an immediate surgical consultation for fasciotomy. This patient is showing signs of acute compartment syndrome, which is characterized by increased pressure within a muscle compartment that can impair circulation and cause muscle and nerve damage. Immediate intervention is critical to release the pressure and prevent permanent damage. Measuring compartment pressures might support the diagnosis but does not address the urgency of surgical intervention. Administering additional analgesia might help in managing pain but does not treat the underlying compartment syndrome. Reassessment in several hours could lead to worsening of the condition and is inappropriate given the current signs and symptoms.

The correct answer is anaphylaxis. This patient's presentation is consistent with distributive shock, characterized by vasodilation and increased vascular permeability. The warm, flushed skin is a key indicator of vasodilation. While septic shock can present similarly, the rapid onset and combination of hypotension with elevated liver enzymes and thrombocytopenia are more indicative of anaphylaxis, particularly if there's a history of allergen exposure.

Neurogenic shock typically presents with bradycardia due to loss of sympathetic tone, not tachycardia. Cardiogenic shock usually presents with cool, clammy skin due to poor perfusion, unlike the warm skin in this case. Hypovolemic shock from internal bleeding might cause elevated liver enzymes if there's hepatic congestion, but wouldn't typically cause thrombocytopenia this quickly.

It's important to note that shock states can have overlapping features, and a thorough history and physical examination are crucial for accurate diagnosis. In this case, the combination of distributive shock features with specific lab abnormalities points most strongly to anaphylaxis.