BCEN Course Questions

What are the correct steps ED nurses should take to manage an amputated finger to ensure optimal patient outcomes?

Remove debris, wrap in saline-soaked gauze, place in sealed plastic bag, place sealed bag in second bag of ice water

An adult patient is wearing a soft splint and bandages on their left leg after an injury in a motor vehicle accident. The patient complains of increased pain that is lower than the injury site, numbness & tingling in the leg, and poor mobility when trying to move it. The nurse should take which action FIRST?

Assess for pedal pulses

An adult patient presents to the emergency department after feeling a sudden, sharp pain and hearing a “pop” in their lower leg while playing basketball. They are unable to bear weight on the affected leg. The posterior lower leg is swollen and bruised, and the Thompson Test is negative for plantar flexion. What is the MOST likely diagnosis?

Achilles tendon rupture

A patient arrives with an obvious lower-leg deformity after a farm injury. There is a wound over the distal tibia with visible contamination and active oozing. Distal pulses are present, capillary refill is brisk, and the patient reports severe pain. Which of the following actions should the nurse anticipate FIRST?

Cover the wound with a moist sterile dressing; splint the extremity; initiate IV antibiotics as ordered

A construction worker was using a nail gun and accidentally shot himself in the foot. The nail is deeply embedded in the tissue. Which of the following is the PRIORITY?

Applying direct pressure to control bleeding and immobilizing the foot

A patient who had a knee replacement 6 months ago reports to the ED with redness, swelling, and warmth around the knee. What action should the nurse take FIRST?

Contact the surgery team

An adult patient presents to the ED with a casted arm due to a recent compound fracture. The patient is complaining of increased pain in the arm, fever, and chills. Redness is noted where the cast begins on the elbow. What is the INITIAL intervention for this patient?

Obtain blood cultures

A patient is admitted to the ED following a traumatic incident that resulted in a complete amputation of the arm below the elbow. Which intervention should the ED nurse prioritize to manage the patient’s condition?

Apply a tourniquet proximal to the amputation site

A patient presents to the ED with sharp, localized chest pain that worsens with deep breathing and movement. She describes pain as constant and says that it is exacerbated by physical activity and palpation of the area. The patient denies any recent trauma or known underlying medical conditions. The nurse should suspect which condition?

Costochondritis

An adult patient arrives in the emergency department following a high-impact motor vehicle collision. The patient’s right lower extremity is fixed in an adducted, internally rotated position and the knee and foot are rotated inward. Pulses are diminished in the affected limb, and the patient reports severe pain. What is the nurse’s HIGHEST priority?

Promptly assess and monitor neurovascular status of the affected limb.

A patient is transferred from a rural hospital directly to the ED 36 hours after a motor vehicle collision with a known mid-shaft femur fracture stabilized in a traction splint. Vital signs are

BP 124/78 mmHg

HR 118 beats/min

RR 30 breaths/min

SpO2 89% (room air)

Temp (oral) 100.8 F (38.2 C)

The patient is restless and confused and has a faint red-brown rash across the upper chest. What nursing action is the HIGHEST priority?

Administer high flow oxygen and consider the need for endotracheal intubation

A patient presents to the ED with a partial avulsion of the left index finger with exposed bone and soft tissue following a machinery accident. Active bleeding and wound contamination are noted at the injury site. What is the PRIORITY in the immediate management of this injury?

Apply direct pressure to control bleeding

A patient presents to the ED with a small puncture wound on the palm sustained while using a grease gun at work. The patient reports minimal pain and mild swelling. The ED nurse understands the MOST concerning finding is:

The mechanism of injury

A patient is being discharged from the ED after receiving Ethilon sutures for a forehead laceration. The nurse known the patient has understood their discharge care when they verbalize:

I need to have these sutures removed in 3-5 days

A patient with a broken humerus is being admitted to the ED after a witnessed fall. The patient has been placed in a cast and is waiting to see the surgical team. Radiographs were taken, and the patient is suspected of having compartment syndrome. Which of the following is the PRIORITY?

Perform a neuromuscular assessment

A patient presents to the ED with a fever, general malaise, and new-onset confusion. Upon physical assessment, the ED nurse notices that the patient has a stage 3 pressure ulcer on their sacrum that is inflamed with purulent drainage. Which of the following orders should the ED nurse complete FIRST?

Wound culture

Which of the following patient statements indicates an understanding of their care plan following an injection injury?

“You will not attempt to remove the fluid from my hand.”

A patient arrives at the ED after falling in their bathroom. Upon assessment, the right leg is noted to be shorter than the left, and the knee and foot are rotated externally. Based on the assessment, the nurse suspects:

Anterior hip dislocation

A patient was recently diagnosed with osteomyelitis after a compound fracture and is being sent home from the ED following a wound check. The patient is being discharged with antibiotics, wound care supplies, and pain medications. Which of the following is most important to include in patient discharge instructions?

Signs of worsening infection

A patient who experienced frontal lobe damage after a mild traumatic brain injury presents to the ED. The nurse anticipates the patient will demonstrate difficulty with

Self-control and problem-solving

A patient presents to the ED following a motor vehicle collision. Which of the following vital signs is most concerning for increased ICP?

BP: 158/55 mmHg

Which of the following are responsible for sending messages to the body via the spinal cord

Midbrain, pons, and medulla oblongata

A patient with an acute ischemic stroke on CT scan with symptoms that began 45 minutes ago is about to receive tPA. What is this medication’s mechanism of action?

TPA adheres to a fibrin clot. It activates plasminogen, which turns into plasmin. Plasmin degrades the fibrin coating on the clot, thus dissolving it

The nurse is assessing a patient with suspected meningitis. Which assessment finding is consistent with a meningitis diagnosis?

Inability to extend the knee when the hip is flexed

A patient is being held in the ED awaiting an inpatient room assignment. During the handoff report, the ED nurse is told that the patient has Guillain-Barré syndrome. The ED nurse understands that this is an autoimmune disorder that affects

The myelin sheath of the peripheral nervous system

A patient presents to the ED reporting gradual onset of blurred vision and muscle weakness that improves after a period of rest. What neurological condition should the ED nurse suspect?

Myasthenia gravis

The nurse is caring for a patient who reports a severe temporal headache that began in the evening with recurrent nasal congestion. What interventions should the nurse anticipate for this patient?

Antimigraine medication

A 9-year-old patient is brought to the emergency department by her family and is observed to have uncontrolled seizure activity that began 7 minutes before arrival. The child has a history of seizures and is allergic to lorazepam (Ativan). To most effectively terminate the seizure activity, the ED nurse should prepare to administer which medication?

Midazolam (Versed)

An 18-month-old male was brought to the ED after the mother noticed him fall unconscious with a rigid contraction of his muscles followed by repetitive arm jerking that lasted about 3 minutes. He has a fever of 103F (39.4C). What type of seizure does the nurse suspect?

Generalized tonic-clonic

Which of the following nursing interventions is required when maintaining an external ventricular drain (EVD)?

Zero the transducer at the level of the patient’s tragus

A patient brought to the ED at 1:00 am reporting acute-onset difficulty speaking that began 45 minutes prior to arrival. The ED nurse observes a unilateral facial droop. Which imaging method will be used FIRST?

Head CT scan without contrast

The nurse is providing patient education to a patient who presented to the ED with a TIA. What statement from the patient indicates that the teaching was effective?

“My risk for a stroke is higher within the next few months.”