A patient is brought to the emergency department with a core body temperature of 41°C, hot, dry skin, and altered mental status. The nurse recognizes these as signs of heat stroke. What is the priority nursing intervention?
[a] Administering an antipyretic like paracetamol.
[b] Starting an IV infusion of a vasopressor.
[c] Initiating rapid cooling measures, such as applying ice packs to the axillae and groin.
[d] Obtaining a detailed medical history from the family.
A farmer is admitted after being bitten by a snake on the leg. Which first aid action, if performed by a bystander, is considered incorrect and potentially harmful?
[a] Keeping the victim calm and still.
[b] Immobilizing the affected limb with a splint.
[c] Applying a tourniquet and making an incision over the bite mark.
[d] Removing tight clothing and jewelry from the affected limb.
A child is rescued from a swimming pool and is unresponsive and not breathing. After ensuring the scene is safe, what is the rescuer's first priority action?
[a] Performing abdominal thrusts to remove water from the lungs.
[b] Immediately starting chest compressions.
[c] Opening the airway and providing two rescue breaths.
[d] Applying a warming blanket to treat hypothermia.
A victim is found hanging and is cut down by emergency responders. What is the most critical initial assessment and management priority for the nurse?
[a] Assessing for ligature marks around the neck.
[b] Covering the patient with a warm blanket.
[c] Securing the airway while maintaining cervical spine immobilization.
[d] Establishing two large-bore IV lines.
Which clinical finding is the key differentiator between heat stroke and the less severe condition of heat exhaustion?
[a] Tachycardia.
[b] Profuse sweating.
[c] Thirst and weakness.
[d] Central nervous system dysfunction (e.g., confusion, seizure).
A patient bitten by a krait (a neurotoxic snake) begins to show signs of ptosis (drooping eyelids) and difficulty speaking. The nurse should be most prepared for which imminent complication?
[a] Severe localized swelling.
[b] Spontaneous bleeding.
[c] Acute respiratory failure.
[d] Renal failure.
A drowning victim has been successfully resuscitated at the scene and is now awake and breathing spontaneously. Why is it essential for this patient to be transported to the hospital for observation?
[a] To receive prophylactic antibiotics for water-borne infections.
[b] To check for hypothermia, which is the main risk.
[c] To monitor for delayed pulmonary edema or ARDS (secondary drowning).
[d] To provide psychological counseling for the traumatic event.
Why are antipyretic medications like paracetamol generally ineffective and contraindicated in the management of heat stroke?
[a] They can cause a rapid drop in blood pressure.
[b] The elevated temperature is due to environmental exposure, not a change in the hypothalamic set point.
[c] They increase the risk of seizures in these patients.
[d] They interfere with the effectiveness of cooling measures.
Before administering Anti-Snake Venom (ASV), what is a crucial nursing action to perform?
[a] Administering a dose of tetanus toxoid.
[b] Ensuring the patient has a full stomach.
[c] Assessing for a history of allergies and preparing for a potential anaphylactic reaction.
[d] Applying a warm compress to the bite site.
A victim of a near-drowning in cold water is brought to the ED with a core temperature of 33°C. Which method represents active internal rewarming?
[a] Removing wet clothes and covering with warm blankets.
[b] Placing the patient under a Bair Hugger (forced-air warming blanket).
[c] Administering warmed, humidified oxygen and warmed IV fluids.
[d] Immersing the patient in a warm water bath.
A patient is admitted after a near-hanging attempt. Besides airway and C-spine injuries, the nurse should assess for signs of increased intracranial pressure (ICP) such as:
[a] Hypotension and tachycardia.
[b] Pinpoint pupils and rapid respirations.
[c] Decreased level of consciousness and pupillary changes.
[d] Facial flushing and diaphoresis.
A patient with a Russell's viper bite (a hemotoxic snake) has a positive 20-minute whole blood clotting test (20WBCT). What does this result indicate?
[a] The patient has a neurotoxic envenomation.
[b] The patient's blood is clotting normally.
[c] The patient does not require anti-snake venom.
[d] The patient has a coagulopathy and the blood is not clotting.
The primary pathophysiological problem in a drowning victim that leads to cardiac arrest is:
[a] Hypothermia.
[b] Hypoxia.
[c] Electrolyte imbalance.
[d] Hemodilution.
An elderly patient collapses while gardening on a hot day. They are conscious, sweating profusely, and complain of nausea and dizziness. Their core temperature is 38.5°C. These are classic signs of:
[a] Heat exhaustion.
[b] Heat stroke.
[c] Heat cramps.
[d] Sunburn.
A patient who survived a near-hanging may have petechial hemorrhages on the face and conjunctiva. This finding is due to:
[a] A direct injury from the ligature.
[b] An allergic reaction.
[c] A clotting disorder.
[d] Acute venous congestion from compression of the jugular veins.
Which patient population is at the highest risk for developing heat stroke?
[a] Teenagers who play video games indoors.
[b] Office workers in air-conditioned buildings.
[c] The elderly and very young children.
[d] Adults who swim regularly.
The most important first aid measure for a snake bite is to:
[a] Capture the snake for identification.
[b] Apply ice to the wound.
[c] Reassure the victim and transport them to a medical facility immediately.
[d] Administer an oral analgesic for pain.
The management of a drowning victim in the hospital primarily focuses on correcting hypoxia and preventing which major pulmonary complication?
[a] Pneumonia.
[b] Pneumothorax.
[c] Acute Respiratory Distress Syndrome (ARDS).
[d] Bronchitis.
A conscious patient with heat exhaustion should be managed initially by:
[a] Giving salt tablets and encouraging strenuous exercise.
[b] Immersing them in an ice bath.
[c] Moving them to a cool place and providing oral fluids like water or sports drinks.
[d] Starting an IV infusion of 5% dextrose.
In the "Big Four" common venomous snakes of India, which two are primarily neurotoxic?
[a] Russell's Viper and Saw-scaled Viper.
[b] Saw-scaled Viper and Common Krait.
[c] Common Cobra and Common Krait.
[d] Common Cobra and Russell's Viper.
A patient is admitted after a near-drowning event. The nurse's priority respiratory assessment should include monitoring for:
[a] A decreased respiratory rate.
[b] A loud, barking cough.
[c] The presence of a barrel chest.
[d] Adventitious breath sounds like crackles and wheezing.
A patient is being treated for heat stroke. A potential complication is rhabdomyolysis. The nurse should monitor for this by checking which laboratory value?
[a] Serum sodium.
[b] White blood cell count.
[c] Creatine Kinase (CK) and urine for myoglobin.
[d] Liver function tests.
What is a common finding in a patient with a hemotoxic/vasculotoxic snake bite (e.g., from a viper)?
[a] Fixed, dilated pupils.
[b] Muscle paralysis.
[c] Severe localized pain, swelling, and bleeding from gums.
[d] A lack of any local signs at the bite site.
The initial management of a drowning victim is the same regardless of whether the drowning occurred in salt water or fresh water because the primary problem is:
[a] Different types of electrolyte shifts.
[b] The risk of infection.
[c] The degree of hypothermia.
[d] A lack of oxygen to the brain and vital organs.
Following a near-hanging, even if the patient is conscious with no apparent neck injury, a cervical spine X-ray is mandatory because:
[a] It is a hospital policy for all trauma patients.
[b] It can reveal the cause of death in fatal cases.
[c] The patient may have memory loss and cannot report pain.
[d] A "hangman's fracture" (C2 fracture) or other cervical injury can be present without obvious signs.
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