Continuing education test

614 JOURNAL OF EMERGENCY NURSING 27:6 December 2001

C E T E S T

CE Earn 5.5 Contact Hours

by Reading the Journal and Taking

This Post Test

Continuous Arteriovenous Rewarming: Rapid Restoration ofNormothermia in the Emergency Department (pp 533-7)

1. Which of these EKG changes is most likely to develop ina patient who is hypothermic?

A. Right axis deviation

B. Left bundle branch block

C. Prolonged PR and QT intervals

D. Elevated ST segments and inverted T waves

2. A patient with a temperature of 33.2°C (91.8°F) who isbeing externally rewarmed without adequate corerewarming is at increased risk for the development of:

A. hypokalemia.

B. ventricular ectopy.

C. metabolic alkalosis.

D. third-degree heart block.

3. According to the manufacturer, to successfully rewarm apatient with use of continuous arteriovenous rewarming(CAVR), it is necessary for the patient to have a:

A. pH of 7.10.

B. heart rate of 60.

C. systolic blood pressure of 60 mm Hg.

D. core temperature of at least 32.5°C (90.5°F).

4. CAVR is contraindicated for use in a patient who has:

A. mitral stenosis.

B. hyperthyroidism.

C. occlusive arterial vascular disease.

D. chronic obstructive pulmonary disease.

TO RECEIVE CONTINUING EDUCATION (CE)CREDIT, FOLLOW THESE INSTRUCTIONS:

1. After reading the articles, darken the appropriate circles (num-bers 1-27) on the answer sheet on page 615 (or a photocopy).Each question has only 1 correct answer.

2. Review learning objectives on page 614 and complete the regis-tration information and program evaluation* on the answersheet.

3. Send the answer sheet with your registration fee to: ContinuingEducation Department, Lippincott Williams & Wilkins, 345Hudson St, 16th Fl, New York, NY 10014.

4. Your registration fee for this offering is $33.Within 6 weeks after Lippincott Williams & Wilkins receives

your answer sheet, you will be notified of your test results. A passingscore for this test is 20 correct answers (75%). If you pass, LippincottWilliams & Wilkins will send you a CE certificate indicating thenumber of contact hours you have earned. If you fail, LippincottWilliams & Wilkins gives you the option of taking the test again atno additional cost. All answer sheets for this test must be received byDecember 31, 2003.

This continuing nursing education (CNE) activity for 5.5 con-tact hours is provided by Lippincott Williams & Wilkins, which isaccredited as a provider of continuing education in nursing by theAmerican Nurses Credentialing Center’s Commission onAccreditation and by the American Association of Critical-CareNurses (AACN 9722, category O). This activity is also providerapproved by the California Board of Registered Nursing, ProviderNumber CEP11749, for 5.5 contact hours. Lippincott, Williams &Wilkins is also an approved provider of CNE in Alabama, Florida,and Iowa* and holds the following provider numbers:AL#ABNP0114, FL#FBN2454, and IA#75. All of its home studyactivities are classified for Texas nursing continuing educationrequirements as Type I.

GENERAL PURPOSE

The general purpose of this CE activity is to provide registeredprofessional nurses with an opportunity to enhance their knowledgeabout current issues affecting emergency nursing practice.

*In accordance with Iowa Board of Nursing administrative rules govern-ing grievances, a copy of your evaluation of this CE offering may be sub-mitted directly to the Iowa Board of Nursing.

T E S T Q U E S T I O N S

December 2001 27:6 JOURNAL OF EMERGENCY NURSING 615

CE TEST

5. CAVR can increase a patient’s core temperature by:

A. 10°C every 10 minutes.

B. 1°C every 10 minutes.

C. 1°C every hour.

D. 10°C every hour.

Knowledge Assessment and Preparation for the CertifiedEmergency Nurses Examination (pp 566-7)

6. A patient comes to the emergency department with anacute exacerbation of asthma. To help reverse bron-chospasm, you would initially expect to give which of thefollowing types of medications?

A. A mucolytic and an expectorant

B. A β2-agonist and an anticholinergic agent

C. A leukotriene inhibitor and a long-acting steroid

D. An α-adrenergic agonist and a mast cell stabilizer

7. Humidified oxygen with an FIO2 of 50% administered viaa t-piece aerosol nebulizer has been ordered for a patientwho has a tracheostomy. To correctly set up and adminis-ter the prescribed oxygen, it would be necessary for you to:

A. remove the water trap from the aerosol tubing.

B. set the flow meter at 14 L per minute.

C. adjust the FIO2 on the venturi mask at 50%.

D. place a non-rebreather mask on the patient.

8. Which of the following statements about a newborn’sApgar score is true?

A. The score is an average of the first and second assessments.

B. It is necessary to assess pulse and temperature to deter-mine the score.

C. The assessment is performed at 1 minute and 20 min-utes after birth.

D. Each area assessed has a maximum possible score of 2.

9. Epiglottitis is most common in pediatric patients who arebetween the ages of:

A. 6 and 12 months.

B. 12 and 18 months.

C. 2 and 5 years.

D. 7 and 10 years.

10. A patient who has diabetes mellitus type 2 comes to theemergency department with a blood glucose level of 800mg/dL. Which of the following actions should you per-form first?

A. Administer intravenous fluids

B. Give regular Humulin insulin

C. Assess the arterial blood gases

D. Check the urine for the presence of ketones

Is This a Drill? Improving Pediatric Emergency Preparednessin North Carolina’s Emergency Departments (pp 568-70)

11. In a study of North Carolina emergency departments, itwas determined that:

A. the majority of ED nurses report feeling confident with their ability to provide care to pediatric trauma patients.

B. only 10% of hospitals had all of the pediatric equip-ment recommended by a national EMSC consensus group.

C. during a mock pediatric trauma exercise, only 5% of the staff could properly use the required equipment.

D. only 20% of hospitals had provided the opportunity for staff to attend Pediatric Advanced Life Support (PALS) courses.

12. The Broselow-Luten resuscitation tape is used to:

A. teach staff PALS protocols.

B. determine a child’s neurologic status.

C. identify risk factors for pediatric trauma.

D. determine appropriate pediatric equipment sizes and dosages.

13. Which of the following strategies is not likely to increasean ED nurse’s ability to perform proficiently during pedi-atric resuscitation?

A. Using available resuscitation equipment every day

B. Conducting routine mock training exercises in the clinical setting

C. Incorporating the use of the Broselow-Luten tape into all pediatric patient contacts

D. Delegating the restocking of pediatric resuscitation equipment cart to unlicensed personnel


CE TEST

From the Feds: Research, Programs, and Products (pp 574-7)

14. Lyme disease is the least prevalent in which of these USregions?

A. Mid Atlantic

B. Northeastern

C. Southwestern

D. North central

15. Which of the following statements about the Lyme vac-cine is true?

A. It has proven to be 98% effective.

B. It should be given annually to high-risk persons.

C. It is recommended for persons between the ages of 15 and 70 years.

D. It should be given within 72 hours of the development of symptoms.

16. Which of the following is the second leading cause ofinjury-related deaths in the United States?

A. Falls

B. Sports-related injuries

C. Motor vehicle accidents

D. Firearm-related injuries

17. Which of the following statements about the emergencytreatment of nonfatal injuries in the United States is true?

A. About 96% of nonfatal injuries are violence related.

B. House fires are the leading cause of unintentional, nonfatal injuries.

C. One out of 20 US residents are treated for nonfatal injuries in the emergency department annually.

D. Fatal and nonfatal unintentional injury rates are high-est among persons aged 15 to 24 years.

Implementing a Critical Pathway for Oral Rehydration of Mildto Moderate Dehydration of Children (pp 597-601)

18. When evaluating a child who comes to the emergencydepartment with gastroenteritis and mild dehydration,initially you should plan to:

A. provide oral rehydration at 10 mL/kg/h.

B. administer intravenous therapy at 15 to 20 mg/kg/h.

C. give the child nothing by mouth until vomiting subsides.

D. instruct the parents to limit the child’s diet to bananas, rice, applesauce, and toast.

19. The recommended protocol for the treatment of moder-ate dehydration is:

A. administering 0.9% sodium chloride at 30 mL/h for 6 hours.

B. administering oral rehydration therapy at 15 to 20 mL/kg/h.

C. assessing the child’s ability to tolerate 25 mL of clear liquids over 1 hour.

D. giving oral rehydration therapy at 50 mL/h via a naso-gastric tube until the urine output is 30 mL/h.

Universal Screening and Mandatory Reporting: An Update onTwo Important Issues for Victims/Survivors of Intimate PartnerViolence (pp 602-6)

20. Up to what percentage of women who come to the emer-gency department screen positive for intimate partnerviolence?

A. 30%

B. 40%

C. 50%

D. 60%

21. Which of the following statements about the mandatoryreporting of victims of intimate partner violence is true?

A. About 92% of women surveyed prefer mandatory to voluntary reporting policies.

B. It is not known how this policy affects women’s imme-diate or long-term safety.

C. States that require mandatory reporting have had a 15% decline in reported intimate partner violence.

D. States that require mandatory reporting have deter-mined that this policy positively affects the abusers’ behavior.

Back to Basics: Monitoring Trauma Patients for HypothermiaInduced by Treatment in the Emergency Department (pp 607-8)

22. When admitting a patient to the trauma room, it isimportant to:

A. cover the patient with warm, moist towels.

B. make sure the room is heated to at least 80°F.

C. warm intravenous fluids to 110°F prior to administration.

D. measure the patient’s core temperature every 15 minutes.

December 2001 27:6 JOURNAL OF EMERGENCY NURSING 617

CE TEST

23. An early sign of mild hypothermia is:

A. tachycardia.

B. respiratory alkalosis.

C. a widened pulse pressure.

D. a decreased bleeding time.

A 52-year-old Man with a Cough and a Sore Throat (pp 609-10)

24. Which of the following findings is typically observed ina patient with active pulmonary tuberculosis?

A. A hematocrit level of 17%

B. A white blood cell count of 25,000 mm3

C. A chest radiograph that reveals multiple diffuse nodules

D. A chest radiograph that reveals an enlarged left ventricle

25. Which of the following findings should cause you to sus-pect that a patient has a compromised immune system?

A. A well-circumscribed ulcer on the tongue and lip

B. A small, heavily pigmented, round lesion on the back of the hand

C. A cheesy, white coating on the posterior tongue and buccal membranes

D. Elevated, sharply circumscribed, silvery white scales on the elbows and knees

26. Which of the following is not a classic symptom associ-ated with tuberculosis?

A. Cough

B. Ascites

C. Anorexia

D. Hemoptysis

27. In the United States, tuberculosis has an increased preva-lence in which of the following states?

A. California, Illinois, Texas, New York, and Florida

B. Ohio, New Jersey, Missouri, Rhode Island, and Louisiana

C. Alaska, Washington, Oregon, Nevada, and Massachusetts

D. Connecticut, Minnesota, Georgia, Maine, and New Hampshire

LEARNING OBJECTIVES

After reading the designated articles and completing thetest, you will be able to:1. explain the use of continuous arteriovenous resuscitation for

the restoration of normothermia.

2. review questions in preparation for the Certified EmergencyNurse (CEN) examination.

3. describe strategies designed to help improve pediatric emer-gency preparedness for ED staff.

4. discuss the most recent research, programs and products fromFederal Agencies.

5. discuss the effectiveness of implementing a critical pathway fororal rehydration for the treatment of patients who have mild tomoderate dehydration.

6. explain research studying the mandatory policy preferences ofvictims/survivors of intimate partner violence.

7. describe the appropriate monitoring of trauma patients forhypothermia induced by treatment received in the emergencydepartment.

8. list symptoms associated with active pulmonary tuberculosis inan immunocompromised patient.


CE TEST

CE ENROLLMENT FORM

December 2001 issue—Journal of Emergency Nursing

Expiration date: December 31, 2003CEN-RO Category: ClinicalCE credit: 5.5 contact hoursFee: $33 (payable by US check or money order)

To receive continuing education credit for this issue, simply do thefollowing:1. Read the articles.2. Take the test and record your answers on the form below. (You

may send photocopies of the answer form.)3. Mail the completed answer form and enrollment coupon, with

check or money order for $33 per test. Payment must be included.Please do not send cash.

The deadline for submitting your enrollment/answer form isDecember 31, 2003.

Program evaluation:Please rate this CE material by darkening the appropriate circlesbelow:

1. Did this CE activity’s learning objectives relate to its general purpose?O Yes O No

2. Was the Journal home study format an effective way to present thematerial?O Yes O No

3. Was the content current to nursing practice?O Yes O No

4. How long did it take you to complete each CE activity? Hours _________

5. Suggestions for future topics

Please print clearly

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Address

City State Zip

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Position/Title RN LPN Other

Clinical specialty—where you work most often

Instructions: Darken only one circle for your answer to each question.

1.O a 2.O a 3.O a 4.O a 5. O a 6.O a 7.O aO b O b O b O b O b O b O b

O c O c O c O c O c O c O c

O d O d O d O d O d O d O d

8. O a 9. O a 10.O a 11.O a 12. O a 13.O a 14.O aO b O b O b O b O b O b O b



15. O a 16.O a 17.O a 18.O a 19.O a 20.O a 21.O aO b O b O b O b O b O b O b








O d O d O d O d O d O c O c

36. O a 37.O a 38.O aO b O b O bO c O c O c

O d O d O d

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Continuing education test