Emergency Response Plans Practice Test 8
Emergency Response Plans NCLEX Practice Test
Emergency Response Plans is a key topic within the NCLEX test plan, located under Safe and Effective Care Environment → Safety and Infection Control → Emergency Response Plans. This section prepares nurses for disaster roles, surge protocols, and emergency communication procedures. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 8th part of the Emergency Response Plans series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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In the Emergency Response Plans Study Cards section, shared by real NCLEX candidates, you’ll find concise summaries and high-yield insights related to the most tested concepts. It’s a perfect space to reinforce challenging topics and sharpen your recall through quick, focused repetitions. Short, powerful, and repeatable!
Emergency Response Plans Practice Test 8
A 2-year-old at an outpatient clinic stops breathing and does not have a pulse. CPR is initiated. When the automated external defibrillator (AED) arrives, the nurse notes that it has only adult AED pads. What is the appropriate action at this time?
- Continue CPR without using the automated external defibrillator (AED) until paramedics arrive
- Place one AED pad on the chest and the other on the back
- Place one AED pad on the upper right chest and the other on the lower left side
- Place one AED pad on the upper right chest and dispose of the other
Explanation: Answer reason: If pediatric pads are unavailable, adult pads may be used in small children as long as the pads do not touch each other, because contact can prevent effective shock delivery and risk skin burns. An anterior-posterior (chest/back) placement increases pad separation on a small chest and is recommended when standard anterolateral placement would cause overlap. Continuing CPR without using the AED delays definitive therapy, and discarding one pad makes defibrillation impossible.
The nurse is walking through a mall parking lot and witnesses the collapse of a child. The child is not breathing and has a pulse of 50/min. After the nurse calls emergency services and delivers rescue breaths for 2 minutes, the child is still not breathing and is now pale with a pulse of 49/min. What is the nurse's next action?
- Assess the child's airway
- Begin chest compressions
- Continue rescue breathing
- Perform abdominal thrusts
Explanation: Answer reason: After 2 minutes of effective ventilation, the child remains apneic and is now pale with a pulse of 49/min, indicating inadequate circulation despite oxygenation attempts. The appropriate next step is to start chest compressions while continuing ventilations (CPR). Continuing rescue breathing alone is no longer sufficient because the heart rate is below the CPR threshold with clinical signs of poor perfusion.
A client is having a seizure when the nurse enters the room. What should be the most appropriate action of the nurse?
- Note the first area that starts to seize.
- Take note of the time the seizure began and how long it lasted.
- Place pads on the side rails.
- Provide privacy to the client during the seizure.
Explanation: Answer reason: The immediate nursing priority during an active seizure is safety assessment and rapid identification of prolonged seizure activity that may require emergent treatment. Timing the onset and duration is essential to recognize status epilepticus risk and to guide medication decisions and provider notification. Protective measures like padding side rails are important but should ideally be in place beforehand and must not delay monitoring of duration and airway/safety. Documenting the seizure’s progression is useful, but duration is the most critical real-time datum for urgent clinical decisions.
A client admitted after using crack cocaine develops ventricular fibrillation. After determining unresponsiveness, which action should the nurse take next?
- Defibrillate at 200 J.
- Establish IV access.
- Place an oral airway and ventilate.
- Start cardiopulmonary resuscitation (CPR).
Explanation: Answer reason: Ventricular fibrillation is a pulseless, shockable cardiac arrest rhythm, and immediate high-quality chest compressions are the first action after confirming unresponsiveness to maintain coronary and cerebral perfusion. CPR is initiated while the defibrillator is being brought in/charged because any delay in compressions reduces the likelihood of successful defibrillation and ROSC. Defibrillation is the definitive therapy for VF, but it is performed as soon as the defibrillator is ready, not before starting compressions. Establishing IV access or placing an airway are secondary priorities and should not interrupt early compressions and rapid defibrillation in pulseless VF.
A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic and has no palpable pulses. What is the first action that the nurse should take?
- Perform synchronized cardioversion.
- Start cardiopulmonary resuscitation (CPR).
- Administer atropine per agency dysrhythmia protocol.
- Provide supplemental oxygen via non-rebreather mask.
Explanation: Answer reason: In an apneic, pulseless patient, the priority is immediate initiation of the cardiac arrest algorithm to restore circulation and oxygen delivery. A monitor rhythm that appears like sinus tachycardia can still represent pulseless electrical activity, which is treated with high-quality chest compressions and rapid activation of the resuscitation response. Synchronized cardioversion is reserved for unstable tachyarrhythmias with a pulse, not for pulseless arrest. Atropine is for symptomatic bradycardia, and applying a non-rebreather delays definitive life-saving circulation support when there is no pulse.
Within thirty seconds after birth, an unresponsive and limp newborn is placed on the warmer in the "sniffing" position. The nurse clears the airway, dries, and stimulates the newborn. At 1 minute of life, the newborn has shallow, gasping respirations with a heart rate of 62/min. What action should the nurse take?
- Administer epinephrine
- Begin positive pressure ventilation
- Continue stimulating the newborn
- Start chest compressions
Explanation: Answer reason: A heart rate <100/min with gasping or apnea after initial steps requires immediate positive-pressure ventilation to establish effective oxygenation and improve heart rate. Chest compressions are reserved for persistent heart rate <60/min after at least 30 seconds of effective ventilation, so starting compressions now is premature. Epinephrine is indicated only if the heart rate remains <60/min despite effective ventilation and compressions.
A patient presents with signs of anaphylaxis after a bee sting. Which medication should the nurse administer first?
- Antihistamine.
- Epinephrine.
- Corticosteroid.
- Bronchodilator.
Explanation: Answer reason: Anaphylaxis is a life-threatening airway and circulatory emergency requiring immediate reversal of bronchospasm, mucosal edema, and vasodilation. This drug rapidly provides alpha-1 vasoconstriction to raise blood pressure and reduce airway swelling and beta-2 bronchodilation to improve ventilation. Antihistamines and corticosteroids are adjuncts with slower onset and do not promptly correct shock or airway compromise. Bronchodilators can help wheezing but do not treat the underlying vasodilation and edema driving anaphylactic collapse.
A 21-year-old woman in active labor is admitted to the labor suite. An hour later, the membranes rupture spontaneously. The nurse observes a glistening white cord protruding from the vagina. Which of the following actions should the nurse take FIRST?
- Return to the nurses’ station and place an emergency call to the physician.
- Administer oxygen by mask at 10–12 L/min and assess the mother’s vital signs.
- Place a clean towel over the cord and wet it with sterile normal saline.
- Apply manual pressure to the presenting part and have the mother assume a knee-chest position.
Explanation: Answer reason: Umbilical cord prolapse is an obstetric emergency because cord compression rapidly compromises fetal oxygenation. The immediate priority is to relieve pressure off the cord by elevating the presenting part and using a gravity-assisted position (knee-chest) to reduce compression while preparing for urgent delivery. Calling the provider and administering oxygen are important but do not address the immediate cause of fetal hypoxia if the cord remains compressed. Covering the cord with moist sterile gauze helps prevent vasospasm and drying, but it is secondary to immediately relieving compression.
While helping a patient with a chest tube reposition in the bed, the chest tube becomes dislodged. What is your immediate nursing intervention?
- Stay with the patient and monitor their vital signs while another nurse notifies the physician.
- Place a sterile dressing over the site and tape it on three sides and notify the physician.
- Attempt to re-insert the tube.
- Keep the site open to air and notify the physician.
Explanation: Answer reason: A dislodged chest tube creates an open pneumothorax risk, so the priority is to prevent additional air entry into the pleural space while allowing air to escape. A sterile occlusive dressing taped on three sides functions as a flutter valve to minimize inspiratory air ingress and reduce progression to tension physiology. Reinsertion is outside nursing scope and can cause tissue injury and contamination. Simply monitoring or leaving the site open fails to address the immediate life-threatening air leak.
The nurse in the newborn nursery receives a telephone call to prepare for the admission of a neonate born at 43 weeks’ gestation with Apgar scores of 1 and 4. When planning for the admission of this infant which is the nurse’s highest priority?
- Turning on the apnea and cardiorespiratory monitor
- Connecting the resuscitation bag to the oxygen outlet
- Setting up the intravenous line with 5% dextrose in water
- Setting the radiant warmer control temperature at 36.5°C (97.6°F)
Explanation: Answer reason: Preparing functional positive-pressure ventilation equipment is the most time-critical intervention because ventilation is the primary corrective step in neonatal resuscitation and rapidly improves heart rate. Monitoring and warming are important supportive measures, but they do not correct apnea or poor ventilation. Starting an IV with D5W is not the first priority in initial stabilization and may delay life-saving ventilation readiness.
You are working in the emergency department and find out that a tornado has hit the local area. Numerous casualties are being sent to the emergency department. What action should you take at this time?
- Prepare the triage room.
- Obtain additional supplies.
- Activate the agency disaster plan.
- Call in additional staff.
Explanation: Answer reason: Mass-casualty incidents require a coordinated, predefined command structure to rapidly allocate resources, establish triage flow, and maintain safety. Initiating the facility’s disaster plan triggers the incident command system, clarifies roles, opens surge capacity processes, and mobilizes communications and supply chains in the correct sequence. Actions like preparing triage space, getting supplies, or calling staff are important but should be done under the standardized protocol to prevent duplication, missed steps, and unsafe improvisation. The disaster plan also ensures documentation, security, and patient tracking processes are implemented early when volume will quickly overwhelm normal operations.
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