Nclexpn Quiz: Emergency Response And Cpr Participation

What this quiz covers

This quiz focuses on Emergency Response And Cpr Participation, giving you a quick way to practice the rules, question types, and explanations that matter most for Nclexpn.

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

Question 1

1. Initiate CPR and send someone to activate the emergency response system and obtain the AED (correct answer)
2. Check the client's capillary blood glucose level and administer oral glucose
3. Place the client in recovery position and monitor for spontaneous breathing
4. Call the family to report the change in condition and request advance directive paperwork

Explanation: This question tests knowledge of emergency response and CPR participation in diabetic client arrest. The priority framework is the ABCs, initiating CPR for no pulse or breathing. Initiating CPR and activating response with AED is the highest priority despite diabetes history. Checking glucose (B) delays, recovery position (C) assumes breathing, and calling family (D) is non-urgent. The decision-making principle is treating as arrest unless proven otherwise. Etiology secondary to CPR. A transferable strategy is to start CPR in unresponsive pulseless clients regardless of comorbidities.

Question 2

1. Administer intramuscular epinephrine per emergency protocol and activate emergency response (correct answer)
2. Remove the latex gloves and observe the client for 30 minutes for symptom resolution
3. Obtain a peak flow reading and document the value before intervening
4. Call the provider to request an order for a corticosteroid

Explanation: This question tests knowledge of emergency response and CPR participation in latex anaphylaxis. The priority framework is immediate safety, treating with epinephrine. Administering IM epinephrine and activating response is the highest priority for airway and shock. Removing gloves (B) is insufficient, peak flow (C) delays, and requesting steroid (D) is slower. The decision-making principle is epinephrine for severe allergy symptoms. Stay with client. A transferable strategy is to avoid triggers but treat exposures aggressively with protocols.

Question 3

1. Stop the infusion and administer intramuscular epinephrine per emergency protocol while calling for help (correct answer)
2. Notify the provider and wait for an order for an antihistamine
3. Obtain a complete allergy history and document the reaction before intervening
4. Apply a warm blanket and elevate the legs, then reassess blood pressure in 15 minutes

Explanation: This question tests knowledge of emergency response and CPR participation in anaphylaxis during IV antibiotics. The priority framework is immediate safety, focusing on stopping the allergen and treating shock. Stopping the infusion and administering IM epinephrine per protocol while calling for help is the highest priority to reverse bronchospasm and hypotension. Notifying for antihistamine (B) delays, obtaining history (C) is post-stabilization, and applying blanket (D) ignores airway. The decision-making principle is recognizing anaphylaxis signs requiring epinephrine as first-line. Prompt action prevents progression to arrest. A transferable strategy is to always have epinephrine ready for suspected allergic reactions and activate help immediately.

Question 4

1. Perform abdominal thrusts until the obstruction is relieved or the client becomes unresponsive (correct answer)
2. Give the client water to help wash down the food bolus
3. Encourage the client to cough and obtain a full set of vital signs
4. Call the provider for an order for a chest x-ray and keep the client NPO

Explanation: This question tests knowledge of emergency response and CPR participation in choking with airway obstruction. The priority framework is immediate safety, using abdominal thrusts for conscious choking. Performing abdominal thrusts until relieved or unresponsive is the highest priority to dislodge the obstruction. Giving water (B) worsens obstruction, encouraging cough (C) is for mild cases, and calling for x-ray (D) delays. The decision-making principle is the universal choking sign indicating severe blockage needing thrusts. Continue until effective or CPR needed. A transferable strategy is to assess cough effectiveness before intervening in choking incidents.

Question 5

1. Start chest compressions at the recommended rate and depth while calling for help (correct answer)
2. Place the client in high Fowler position and encourage deep breathing
3. Obtain a full set of vital signs and notify the provider of the change in condition
4. Delegate a staff member to suction the airway and wait for the code team to arrive

Explanation: This question tests knowledge of emergency response and CPR participation for sudden unresponsiveness in a client with pneumonia. The priority framework is the ABCs, focusing on immediate circulation support when pulse is absent. Starting chest compressions at the recommended rate and depth while calling for help is the highest priority to maintain perfusion in cardiac arrest. Placing in high Fowler position (B) is inappropriate for arrest, obtaining vital signs (C) delays intervention, and delegating suctioning (D) assumes the code team without starting CPR. The decision-making principle is to initiate CPR immediately upon confirming no pulse and abnormal breathing. Agonal gasps indicate arrest, not effective respiration. A transferable strategy is to prioritize compressions over other actions in pulseless clients to buy time for advanced care.

Question 6

1. Call for emergency assistance and begin rescue breathing or bag-valve-mask ventilation with oxygen as available (correct answer)
2. Obtain a full set of vital signs and complete a neurologic assessment
3. Place the client in a supine position and wait for the provider to prescribe an antidote
4. Ask a staff member to search the client's belongings for medication bottles

Explanation: This question tests knowledge of emergency response and CPR participation in opioid overdose. The priority framework is the ABCs, supporting breathing in respiratory depression. Calling for assistance and beginning rescue breathing is the highest priority to correct hypoxia. Obtaining vitals (B) delays, waiting for antidote (C) risks arrest, and searching belongings (D) is unethical. The decision-making principle is providing ventilation if pulse present but breathing inadequate. Naloxone may follow but breathing first. A transferable strategy is to suspect overdose in pinpoint pupils and bradypnea, prioritizing airway support.

Question 7

1. Start CPR and direct someone to activate the code and bring the AED (correct answer)
2. Insert an oral airway and suction secretions before starting compressions
3. Obtain a 12-lead electrocardiogram and notify the provider of the rhythm
4. Check the client's temperature and apply warm blankets

Explanation: This question tests knowledge of emergency response and CPR participation in ED arrest. The priority framework is the ABCs, starting CPR promptly. Starting CPR and directing for code and AED is the highest priority after confirmation. Inserting airway (B) is advanced, obtaining ECG (C) delays, and checking temperature (D) is irrelevant. The decision-making principle is immediate compressions in no pulse. Team response follows. A transferable strategy is to reassess pulse quickly but act on absence in unresponsiveness.

Question 8

1. Ensure no one is touching the client while the AED analyzes and during any shock delivery (correct answer)
2. Continue compressions while the AED analyzes to avoid any pause in CPR
3. Remove the AED pads to quickly check for a pulse before analysis
4. Ask a nursing assistant to hold the client's shoulders steady during analysis

Explanation: This question tests knowledge of emergency response and CPR participation during AED analysis. The priority framework is safety during defibrillation to avoid harm. Ensuring no one touches the client during analysis and shock is the highest priority for effective AED use. Continuing compressions (B) interferes, removing pads (C) counterproductive, and holding shoulders (D) unsafe. The decision-making principle is clearing the area for analysis. Resume CPR post-shock. A transferable strategy is to verbalize 'clear' loudly before AED functions in all settings.

Question 9

1. Administer intramuscular epinephrine per protocol and maintain airway while calling for emergency assistance (correct answer)
2. Pause the medication and restart it slowly once the rash begins to fade
3. Obtain a detailed medication history and document the suspected allergy
4. Request an order for oral diphenhydramine and reassess in 30 minutes

Explanation: This question tests knowledge of emergency response and CPR participation in medication anaphylaxis. The priority framework is immediate safety, using epinephrine for symptoms. Administering IM epinephrine and maintaining airway is the highest priority while calling help. Pausing medication (B) insufficient, history (C) post-care, and requesting diphenhydramine (D) secondary. The decision-making principle is recognizing anaphylaxis needing urgent reversal. Monitor vitals. A transferable strategy is to observe closely during new medication administration for reactions.

Question 10

1. Administer two rescue breaths using a mouth-to-mask device.
2. Begin high-quality chest compressions at a rate of 100 to 120 per minute. (correct answer)
3. Place the client in a side-lying recovery position to maintain the airway.
4. Perform an abdominal thrust (Heimlich maneuver) to clear a potential obstruction.

Explanation: Current AHA BLS guidelines use the C-A-B sequence (Compressions, Airway, Breathing) for adults in cardiac arrest, reflecting research demonstrating that early, high-quality chest compressions are the most critical survival factor. When a client is pulseless and not breathing, the nurse must immediately begin chest compressions at a rate of 100 to 120 per minute with a depth of at least 2 inches, minimizing interruptions. Rescue breaths (A) come after compressions in the C-A-B sequence and should not delay compressions. The recovery position (C) is used for unconscious clients who are breathing and have a pulse — not for cardiac arrest. Abdominal thrusts (D) are for choking victims with airway obstruction, not cardiac arrest.

Question 11

1. Encourage the visitor to cough as forcefully as possible.
2. Perform a series of quick, upward abdominal thrusts. (correct answer)
3. Lay the visitor on the floor and begin chest compressions.
4. Deliver five firm back blows between the visitor's shoulder blades.

Explanation: The visitor is displaying the universal sign of choking — both hands at the throat — combined with inability to breathe or speak and cyanosis, confirming a severe foreign body airway obstruction (FBAO) in a conscious adult. Per AHA BLS guidelines, which NCLEX-PN follows, the recommended intervention for a conscious adult with severe FBAO is to perform abdominal thrusts (Heimlich maneuver) repeatedly until the object is expelled or the person loses consciousness. Note that the American Red Cross recommends a '5-and-5' approach alternating five back blows with five abdominal thrusts; however, NCLEX follows AHA guidelines. Encouraging coughing (A) is appropriate for a mild obstruction where the person can still forcefully cough — this visitor cannot. Chest compressions (C) are used only after the person loses consciousness and becomes pulseless.

Question 12

1. Perform a primary assessment and assign triage tags to all victims.
2. Provide immediate care for minor injuries to keep the area clear. (correct answer)
3. Administer complex emergency medications to critically injured victims.
4. Decide which victims should be transported to the hospital first.

Explanation: The LPN/VN functions within the limits of their educational preparation and scope of practice, including during disaster responses. In a mass casualty triage setting, primary triage decisions — assigning triage tags, determining priority categories, and making transport decisions — are typically performed by registered nurses or advanced providers who have the scope of practice for independent complex assessment. The LPN/VN's most appropriate role is to provide direct care for clients who have already been triaged, including treating minor injuries, providing supportive care, and assisting more advanced providers. Administering complex emergency medications (C) and making transport priority decisions (D) also exceed LPN/VN independent scope during disaster operations.

Question 13

1. Administer a prescribed 15-gram dose of a rapid-acting carbohydrate. (correct answer)
2. Give the client an intramuscular injection of glucagon immediately.
3. Notify the primary health care provider and wait for new orders.
4. Provide the client with a high-protein snack, such as a piece of cheese.

Explanation: This client has severe hypoglycemia (blood glucose 42 mg/dL, well below the normal range of 70 to 100 mg/dL) and is still conscious and able to swallow. The standard treatment is the 15-15 rule: administer 15 grams of a rapid-acting carbohydrate (glucose tablets, 4 oz juice, or glucose gel), then recheck blood glucose in 15 minutes. This is the fastest intervention to safely raise blood sugar in a conscious client. Glucagon by IM injection (B) is appropriate only when the client is unconscious or unable to swallow safely — it is not the first-line treatment for a conscious, swallowing client. Notifying the PHCP and waiting (C) delays emergency treatment of a potentially life-threatening hypoglycemic episode. Protein (D) raises blood glucose very slowly through gluconeogenesis and is not appropriate for acute hypoglycemia treatment.

Question 14

1. The client is slumped over in the bedside chair.
2. The skin is cool to the touch and appears mottled.
3. The absence of a palpable carotid pulse and breathing. (correct answer)
4. The client is 65 years old and had cardiac surgery.

Explanation: The simultaneous absence of a palpable carotid pulse and spontaneous breathing are the definitive clinical findings that confirm cardiac arrest and require immediate resuscitative intervention. These two findings together indicate that the heart has stopped circulating blood and the client is not oxygenating — the classic definition of cardiac arrest. Slumped posture (A) can have many causes including sleep or syncope and is not definitive on its own. Cool and mottled skin (B) indicates poor peripheral perfusion and is a supporting finding consistent with arrest, but it is not as immediately diagnostic as the absence of pulse and breathing. Age and surgical history (D) are predisposing risk factors, not current assessment findings.

Question 15

1. Impaired airway clearance related to post-operative sedation.
2. Anxiety related to the sudden onset of an emergency.
3. Risk for injury related to falling from the bedside chair.
4. Decreased cardiac output related to electrical or mechanical failure. (correct answer)

Explanation: Decreased cardiac output related to electrical or mechanical cardiac failure is the priority hypothesis because it encompasses the most immediate and completely life-threatening consequence of the presentation: the heart has stopped circulating blood, depriving the brain, heart, and all organs of oxygen. Every nursing action flows from this hypothesis — activating the emergency system and beginning CPR are both direct responses to it. Impaired airway clearance (A) is a secondary concern that becomes addressable once circulation is restored or as part of the CPR sequence. Risk for injury from falling (C) is a past event (the client is already in a chair) and is entirely secondary to the cardiac arrest. Anxiety (B) is not a clinically applicable hypothesis for an unresponsive, pulseless client.

Question 16

1. Continue compressions until the AED is fully charged.
2. Turn on the AED and follow the voice prompts for pad placement. (correct answer)
3. Stop CPR and wait for the primary health care provider to arrive.
4. Use a towel to dry the client's chest if it is wet before applying pads.

Explanation: When an AED arrives, it should be powered on and its voice prompts followed immediately. The AED guides the entire sequence: it directs pad placement, instructs the rescuer when to pause compressions for rhythm analysis, advises whether a shock is indicated, and provides timing cues. The AED is designed to be operated by following its audio and visual instructions step by step. Choice A is partially correct — minimizing interruptions to compressions is important — but the AED's prompts will direct when to stop and resume; the nurse does not need to guess the timing. Choice D (drying the chest) is clinically correct practice for effective pad adhesion and is part of the pad placement process the AED will guide — it is not a separate step to perform before turning the device on. Stopping CPR to wait for the PHCP (C) is dangerous and unnecessary.

Question 17

1. The time the Code Blue was activated and the time the first shock was delivered. (correct answer)
2. The names of every staff member who witnessed the client collapse.
3. A detailed description of the client's breakfast intake earlier that morning.
4. The nurse's personal feelings about participating in a life-threatening situation.

Explanation: Accurate post-emergency documentation of a cardiac arrest must include: the time the event was identified, the time the code was activated, all interventions performed (CPR, defibrillation, medications), the times each intervention was initiated, and the client's response at each step. This information is essential for legal accountability, quality review, medical decision-making in the ICU, and potential resuscitation outcome analysis. The names of all witnesses (B) is not a standard documentation requirement — the names of the code team members who actively participated and provided interventions are recorded, but 'all witnesses' is not required. Breakfast intake (C) and personal feelings (D) are not relevant clinical documentation elements for a cardiac arrest event.

Question 18

1. Give five back blows followed by five chest thrusts. (correct answer)
2. Perform five quick abdominal thrusts (Heimlich maneuver).
3. Reach into the infant's mouth and perform a blind finger sweep.
4. Hold the infant by the feet and shake them to dislodge the toy.

Explanation: For a conscious infant under 1 year of age with severe FBAO, the correct sequence is five back blows followed by five chest thrusts, repeated until the object is expelled or the infant loses consciousness. Abdominal thrusts (A) are explicitly contraindicated in infants because the abdomen is poorly protected and abdominal thrusts risk lacerating the liver, spleen, or other organs. Chest thrusts (part of Choice A) are used instead. A blind finger sweep (C) is contraindicated at any age — reaching blindly into the airway risks pushing the object deeper. The infant should be supported in a face-down position for back blows and then turned face-up for chest thrusts; holding by the feet and shaking (D) is not a recognized technique and could cause injury.

Question 19

1. Notify the local news station that the hospital has lost power.
2. Manually check the vital signs of all clients who were on monitors. (correct answer)
3. Move all stable clients into the hallway to wait for the power to return.
4. Ask the family members to stay in the rooms and help with monitoring.

Explanation: When electronic monitoring fails due to a power outage, the nurse's immediate priority is to perform manual vital sign assessments on all clients who were being electronically monitored. Electronic monitors serve as continuous safety surveillance — when they fail, the nurse must re-establish that surveillance using manual techniques (blood pressure cuff, pulse palpation, direct respiratory observation) until power is restored or battery backup activates. Critically ill or unstable clients require the most immediate assessment. Contacting the news media (A) is not a nursing responsibility and diverts attention from client care. Moving clients to the hallway (C) is not indicated for a power outage and disrupts care unnecessarily. Delegating monitoring to family members (D) asks untrained individuals to perform clinical assessments that require professional nursing judgment.

Question 20

1. Oral (PO).
2. Subcutaneous (SubQ).
3. Intramuscular (IM) or Intravenous (IV). (correct answer)
4. Topical (Transdermal).

Explanation: In anaphylactic shock, speed of medication delivery is critical. Intramuscular injection into the anterolateral thigh is the standard first-line route for epinephrine administration in anaphylaxis — it provides rapid absorption directly into muscle tissue with a rich blood supply, producing peak plasma levels within 8 minutes. IV administration is used when the client is already in profound shock with vascular collapse or when IM access is not possible; it provides the fastest delivery but carries higher risk of cardiac side effects and requires careful dosing. Oral epinephrine (A) undergoes extensive first-pass metabolism and is not effective for emergency use. Subcutaneous injection (B) has slower and less predictable absorption than IM, particularly during anaphylaxis when peripheral vasoconstriction limits subcutaneous blood flow. Transdermal (D) is far too slow for any emergency.