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Q1A 47-year-old female presents today with a history of arthritis. She reports that she fell on, landing on her right knee about 2 weeks ago. She reports using ice and acetaminophen for pain. However, the knee has increased in size; it's hot to touch; has mild patellar erythema; and is difficult to move due to pain. She denies any fever or chills.<br/><br/>Which of the following does the patient exhibit?
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✓ Correct answer: 【2】Septic Arthritis
The patient is exhibiting signs of septic joint. Most symptoms occur suddenly. However, there are exceptions. The invasion of the joint space now has bacteria and blood.<br/><br/>When caring for these patients make sure to obtain a CBC and monitor for acute signs of infection and septicemia. Treatment includes drainage of the infected synovial fluid, application of antibiotic ointment, then cover, and antibiotic therapy.
Q2There are four stages of pressure ulcers. An elderly women presents with blisters on bilateral heels.<br/><br/>What stage are her ulcers?
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✓ Correct answer: 【3】II
Stage II ulcers is when there is skin over a wound, specifically blisters and the blisters may be broken or unbroken. Stage I is when the surface of the skin is erythematic and does not blanch. Stage III involves an ulcer that extends through all layers of skin, and has a higher rate of infection. Stage IV ulcers extend through all skin layers and involve muscle, even tendons and bone. These patients may require surgical intervention for debridement to promote healing of the wound.
Q3Lidocaine with Epinephrine is contraindicated for lacerations of:
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✓ Correct answer: 【3】All of the above
Epinephrine is contraindicated for suturing fingers, toes, penis, nose, and ears. Epinephrine is a vasoconstrictor and can compromise circulation to the healthy tissues.
Q4The 6 P's of neurovascular assessment include all of the following except:
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✓ Correct answer: 【3】Pathologic
Pathologic is not one of the 6 P's: Pain, pallor, polar, pulselessness, paresthesia, paresis/paralysis.
Q5There are three types of heat related injuries.<br/><br/>Which of the following describes heat stroke?
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✓ Correct answer: 【1】Rapid elevation in temperature which leads to failure of the body's cooling mechanisms.
Heat stroke is when the temperature goes above 105.8°F which can causes failure in the body's normal cooling mechanism. Patient can develop irreversible brain damage, heart failure and coagulopathies. Choice "a" is Heat Cramps and choice "C" is heat exhaustion.
Q6Health care workers in the ED should be immunized with all of the following vaccines EXCEPT:
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✓ Correct answer: 【2】Hepatitis C
A current vaccine against Hepatitis C does not exist. Hepatitis A, hepatitis B, and influenza are recommended vaccines for all healthcare workers.
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