Emergency Preparedness Response Course (EPRC) - Clinician 8 hr
The following equipment is used for collection and/or detection of biological agents, EXCEPT:
Surface Acoustic Wave (SAW) detectors
Experts anticipate that biological incidents are ________
most likely to occur, and will have the greatest impact on the greatest number of people
Which of the following is NOT a challenge in gaining access and acceptance?
similar cultural values
Which nerve agent is the most persistent, is very oily, and will stay active in an area for several days?
vx
One of the contributing factors to stress reactions is the physical factor. Which of the following is associated with this factor?
worries about others (correct)
This form of detection provides warning in sufficient time to implement protective and/or treatment measures before exposure to agent.
Detection to protect or treat
___ may be thought of as a form of identification.
Detection to protect or treat
What is the purpose of a secondary device?
Injure or kill first responders
Disaster victims presenting for medical care should be assessed for common short-term stress reactions which fall into all categories EXCEPT?
Intellectual
What type of CBRNE agent acts by inhibiting a crucial enzyme called acetylcholinesterase (AChE)?
Nerve
What is the most available explosive agent?
Nitroglycerin
Experts anticipate that a ________ incident is the least likely to occur but would have a great impact upon the environment and people.
Nuclear
In a stress management briefing, a clinician attendee says this is the first disaster to which she has been called. She states her biggest frustration is that no one has really defined her role. What category of stressor is this responder experiencing?
Occupational factors
The majority of the injuries to gas-containing organs is usually attributed to which of the following?
Primary blast effect
Treatment of patients suffering from pulmonary agent exposure should focus on?
Recognizing which compartment(s) are damaged and minimizing that damage.
Definitive diagnosis of Viral Hemorrhagic Fever rests on _______________.
Specific virologic diagnosis
You are certain that your patient, who is now convulsing from nerve agent exposure, has already received three MARK 1/ATNAA kits and their diazepam. What else should be done?
All of the Above
A metallic taste in the mouth, epigastric distress, and possible nausea and vomiting are ingestion symptoms for which chemical agent?
Cyanide
Which of these are fast-acting compounds that attack oxygen-dependent tissues known to be particularly sensitive tothese compounds?
Cyanide Compounds
What is the role of the liaison officer within the Hospital Incident Command System (HICS)?
Function as the incident contact person for representatives from other agencies
What technique may be used to test for T-2 Mycotoxins in environmental and clinical samples?
Gas Chromatography-Mass Spectrometry
Which post disaster phase is generally characterized by optimism due to an infusion of resources?
Honeymoon phase
Which post disaster phase is generally characterized by optimism due to an infusion of resources?
Honeymoon phase
Vesicant (blister) agents include all of the following, EXCEPT:
Sarin (GB)
What type of explosive is widely used by the military, and is one of the least sensitive explosives.
TNT
Which of the following decontamination method is NOT recommended for removing vesicants from casualties?
Wash patient with their clothing still on.
A secondary explosive device has been spotted. Which of the following options describes how to proceed?
Withdraw at least 50 yards from the scene and tell the Incident Commander (IC) immediately.
Experts anticipate that biological incidents are ________________.
the most likely to occur, and will have the greatest impact on the greatest number of people.
A patient presents to the emergency room all exhibiting the following symptoms: nausea, vomiting, problems with eye movement, dry mouth, sore throat, difficulty swallowing, no gag reflex, and extreme weakness. Patient is alert and oriented during the exam. What toxin do you suspect and how do you treat it?
Botulinum toxin, supportive care and antitoxin.
Which of these are fast-acting compounds that attack oxygen-dependent tissues known to be particularly sensitive to these compounds?
Cyanide Compounds
What type of laboratory test(s) would NOT be conducted if you suspect a patient has contracted plague?
Gas Chromatography-Mass Spectrometry
Wearing PPE can put the responder at considerable risk both physically and psychologically. Which of the following is NOT considered a risk factor?
Hyperactivity
Wearing PPE can put the responder at considerable risk both physically and psychologically. Which of the following is NOT considered a risk factor?
Hyperactivity
MOPP Level __ has flexibility built into the system to allow relief during hot weather.
IV
What Mission Oriented Protective Posture (MOPP) level provides the greatest level of protection?
IV
Disaster victims presenting for medical care should be assessed for common short-term stress reactions which fall into what categories EXCEPT?
Intellectual
How does cyanide cause cell death in the body?
Interferes with anaerobic metabolism of the cell
A patient suffering blast effect presents with dyspnea, some hearing loss, and tinnitus following an explosion. Which of the following is NOT a likely diagnosis?
Intestinal rupture
An explosion victim was admitted to your facility approximately 4 hours ago with chest pain, normal oxygenation and radial pulse. His condition continues to worsen with symptoms that include labored, rapid breathing, low blood pressure, and semi-consciousness. What emergency treatment would be appropriate?
Intubate and provide assisted ventilation with Positive End Expiratory Pressure (PEEP). (correct)
What phase is characterized by improvement of symptoms but becomes shorter with increasing doses.
Latent
One of the five intervention principles in the management of the stress response is promoting the sense of safety. How can this be accomplished?
Leadership provide an accurate, organized voice to help circumvent threat
One of the five intervention principles in the management of the stress response is promoting the sense of safety. How can this be accomplished?
Leadership provides an accurate, organized voice to help circumvent the threat
________ damage brings death very quickly so that the consequences of exposure to other systems do not have time to express themselves.
Neurovascular
A male, non-smoking chemical worker is accidentally exposed to phosgene. The chest radiograph taken 2 hours post-exposure is normal. Should you discharge him?
No, because pulmonary edema normally takes longer to develop, he should be closely watched
What color triage tag would be used for a patient that requires immediate treatment?
Red
All of the following are procedures for activating the Hospital Incident Command System (HICS) EXCEPT:
Refer to your Job Action Sheet (JAS) for response duties
__________ occurs outside of the incident area when people come in contact with a contaminated person or object.
Secondary Contamination
Penetrating trauma caused by shrapnel is usually attributed to which of the following?
Secondary blast effect
Which of the following statements does NOT describe spores produced by Bacillus anthracis, causative agent of anthrax?
Sensitive to UV light.
For which virus is the mosquito not known as a possible vector?
Smallpox
Victims caught in a fire have inhaled toxic smoke from furnishings and plastics that have released cyanide in the burning process. What precaution/side effects should you be aware of when administering cyanide antidotes?
Sodium nitrite can increase methemoglobin levels, which will decrease blood oxygenation
What treatment should be given to a patient exposed to T-2 mycotoxins via ingestion?
Therapy for poison ingestion including the administration of super-activated charcoal.
Following a nuclear detonation, some of the casualties with survivable inju1ies are possibly contaminated with radiological material. Which of the below courses of action is most appropriate for the situation?
Treat all life-threatening injuries first
Secretary of Defense has the responsibility to provide defense support to civil authorities when the actions:
are legal
Which of the following is NOT relevant to a laboratory diagnosis of smallpox (variola)?
A positive Tzank smear
Which of the following is NOT a physical requirement of those expected to wear PPE?
Ability to handle emergency condition;
A patient who works at an insecticide manufacturing plant is admitted to the emergency room. He states he was splashed with a large quantity of liquid and is now exhibiting symptoms of vomiting, diarrhea, difficulty breathing, body twitching and is generally very weak. What is the preferred treatment to block the effects of accessive ACh?
Administer additional 2-PAM Cl (correct)
Which of the following is NOT critical in the treatment of a nerve agent casualty?
Administering pyridostigmine bromide (PB)
A bomb blast victim presents with nausea and abdominal pain. A Computed Tomography (CT) scan shows no hemorrhage. What treatment should be recommended?
Admit patient for observation for 12 to 24 hours in case a hematoma develops.
Smallpox can spread from one person to another by the following routes:
All of the Above
In industry, cyanide compounds are widely used during:
All of the Above Plastic production Gold and silver extraction Hide tanning
What is the value of ve1ification or confirmation of biological agents?
Determination of genetic differences in pathogens may allow determination of source laboratories
You are certain that your patient, who is now convulsing from nerve agent exposure, has already received three MARK 1/ATNAA kits and their diazepam. What else should be done?
All of the Above Provide ventilator assistance, oxygen, and IV fluids Administer more atropine to reduce secretions and relax the airway Give more diazepam to prevent seizures
The amount of radiation that an individual absorbs depends on ____?
All of the Above Time exposed to a radioactive source Distance a person is from a radioactive source Type and amount of shielding between a person and a radioactive source
What types of objects might a terrorist use to disguise a secondary explosive device?
All of the above Knapsack, backpack, or parcel Trash can or dumpster Automobile or truck
What is the comprehensive preparedness required to manage the casualties resulting from the host of possible hazards?
All-hazard preparedness
What form of ionizing radiation is the least penetrating?
Alpha
what type of ionizing radiation is the least penetrating?
Alpha
Select the three components, in correct order of administration, utilized in the treatment for cyanide exposure.
Amyl nitrite, sodium nitrite, sodium thiosulfate
Secretary of Defense has the responsibility to provide defense support to civil authorities when the actions:
Are legal
Advantages of adopting a comprehensive all-hazards approach includes the following EXCPECT:
Attent10n is directed towards a single hazard
Radiation burns, which cause delayed, irreversible changes of the skin, can be caused by high doses of what form of ionizing radiation?
Beta
Radiodermatitis, which causes delayed, in-eversible changes of the skin, can be caused by high doses of what form of ionizing radiation?
Beta
A patient was admitted to the hospital suffering from the following symptoms for the past week: fever, chills and weakness, very swollen tender lymph nodes of bubo, and skin ulcerations. He states the ulcerations are exactly where very small insects bit him. Which type of plague is responsible for the patient's symptoms?
Bubonic
A patient was admitted to the hospital suffering from the following symptoms for the past week: fever, chills and weakness, very swollen tender lymph nodes of bubo, and skin ulcerations. He states the ulcerations are exactly where very small insects bit him. Which type of plague is responsible for the patient's symptoms?
Bubonic
What type of explosive is widely used by the military, and is one of the least sensitive explosives.
C-4
Which of the following cell types are most sensitive to radiation damage?
Cells that are actively dividing
Which of the following cell types are least sensitive to ionizing radiation damage?
Cells that divide slowly (correct)
Attendants at the hockey game are complaining of a strange smell and headaches. Some have begun to vomit. Only those in the arena seem to be affected. Which CBRNE agent would most likely produce this outcome?
Chemical
What type of decontamination neutralizes the contaminant?
Chemical decontamination
Which of the following is considered a pulmonary (choking) agent?
Chlorine
__________ occurs when people come in direct contact with a harmful agent at or near an incident.
Contamination
Which of the following CBRNE Consequence Task Pillars coordinates activities that include exercise; warning and reporting; and command and control.
Coordinate operations
A metallic taste in the mouth, epigastric distress, and possible nausea and vomiting are ingestion symptoms for which chemical agent?
Cyanide
Wearing PPE can put the responder at considerable risk both physically and psychologically. Which of the following is NOT considered a risk factor?
Hyperactivity
How is the victim of a pulmonary agent exposure presenting with respiratory distress less than 4 hours after exposure classified?
Expectant
How is the victim of a pulmonary agent exposure presenting with respiratory distress less than 4 hours after exposure classified?
Expectant
Burned skin, shrapnel wounds, blunt trauma injuries, and ruptured organs may be symptoms of what type of CBRNE exposure?
Explosives
What directive establishes a single comprehensive national incident management system that allows all levels of government to work efficiently and effectively together?
Homeland Security Presidential Directive-5
How is the victim of a vesicant agent presenting with pulmonary distress more than 4 hours after exposure classified?
Immediate
How is the victim of nerve agent exposure presenting with convulsions classified?
Immediate
Used in life-threatening situations, the goal is to remove contaminant as quickly as possible.
Immediate decontamination
When should the self-protection measures of time, distance, and shielding be implemented?
Immediately upon arrival at the incident scene
What command system is a widely used and accepted tool for command, control and coordination of a response to a disaster?
Incident Command System
What command system is a widely used and accepted tool for command, control, and coordination of a response to a disaster?
Incident Command System
Who is responsible for directing the command and control of all operations.
Incident Commander
An all-hazards approach affects preparedness by allowing communities to:
Increase the speed, effectiveness, and efficiency of incident management.
Pulmonary (choking) agents primarily enter the victim by what means?
Inhalation
A patient was admitted to the hospital suffering from the following symptoms for the last 5 days: fever, malaise, fatigue, and nonproductive cough. Chest x-rays reveal a widened mediastinum and the patient's white blood cell count is elevated. Which type of anthrax is responsible for the patient's symptoms?
Inhalational
A patient suffering blast effect presents with dyspnea, some hearing loss, and tinnitus following an explosion. Which of the following is NOT a likely diagnosis?
Intestinal rupture
An explosion victim was admitted to your facility approximately 4 hours ago with chest pain, nonnal oxygenation and radial pulse. His condition continues to worsen with symptoms that include labored, rapid breathing, low blood pressure, and semi-consciousness. What emergency treatment would be appropriate?
Intubate and sedate
What level of civilian chemical equipment would healthcare providers don when providing initial medical treatment after an incident but not involved with decontamination?
Level C
An explosion casualty suffering from crush injuries of the lower extremities has been admitted to your hospital with severe hyperkalemia. What emergency treatment is NOT recommended?
Limit fluids.
What blood test is available that will give an accurate estimate of radiation dose?
Lymphocytes count
All-hazards are often categorized as:
Man-made: technological
How is the victim of vesicant (blister agent) exposure with skin burn over less than 5 percent of Body Surface Area (BSA) and minor eye irritation classified?
Minimal
A group of people is presenting with a delayed onset of blisters and a dry productive cough that later turns productive. What is the likely culprit?
Mustard
The decontamination site should NOT be located:
Near waterways and drainage systems
What CBRNE agent inhibits the enzyme AChE allowing Ach to accumulate affecting the way cells transmit signals to the body?
Nerve agents
What type of care is a stress management component that fosters a mourning process and helps treat psychological stress reactions?
Pastoral care
Which phase of CBRN response focuses on the prioritization of forces to deploy for mission task?
Phase II - Response
Which phase of CBRN response synchronizes planning and execution efforts with the efforts of the supported civil authorities?
Phase III - Operate
A patient is suffering from painful, highly corrosive bums similar to acid, and wheals have begun to appear on the skin. Which vesicant (blister agent) is suspected?
Phosgene oxime
A patient is suffering from painful, highly corrosive burns similar to acid, and wheals have begun to appear on the skin. Which vesicant (blister agent) is suspected?
Phosgene oxime
What form of ionizing radiation can penetrate deeply into body tissue?
Photon
A patient is exhibiting the following symptoms: fever, cough, dyspnea, prominent gastrointestinal symptoms, and absence of buboes. Which form of plague is responsible?
Pneumonic
Which of the following bacterial agents is contagious person to person?
Pneumonic plague
Which of the following bacterial diseases is contagious person to person?
Pneumonic plague
Your unit has responded within minutes to a suspected CBRNE incident. Select the important steps that you should take.
Practice protective measures of time, distance, and shielding
What directive establishes policies to strengthen the preparedness of the US to prevent and respond to threatened or actual domestic terrorist attack, major disasters and other emergencies by requiring a national domestic all-hazards preparedness goal?
Presidential Policy Directive-8
The maj01ity of injuries to gas-containing organs are usually attributed to which of the following?
Primary blast effect
A nerve gas attack has occurred in one of the city's underground subway stations. This is the second attack this month. After arriving on the scene, a veteran responder, considered a "tough guy" by his team, freezes up and is unable to continue. After talking to him, you determine he responded to the previous attack. What personal situation stressor is this veteran exhibiting?
Prior disaster experience
What is the correct order for the phases of Acute Radiation Syndrome (ARS)?
Prodromal, latent, and manifest
The Disaster Mental Health Response Team can be called upon to assist victims and disaster responders. ·which of the following is NOT a service that they may provide:
Provide professional psychological treatment
The Disaster Mental Health Response Team can be called upon to assist victims and disaster responders. Which of the following is NOT a service that they may provide:
Provide professional psychological treatment
An all-hazards approach affects preparedness by allowing communities to:What bacterial infection requires confirmation through serological testing since it is difficult to culture the organism (causative agent)?
Q Fever
What bacterial infection requires confirmation through serological testing, because it is difficult to culture the organism (causative agent)?
Q Fever
Which of the bacterial diseases produces a non-specific illness that may produce a prolonged disability but is rarely fatal?
Q Fever
Personal Protective Equipment (PPE) is generally divided into two categories. They are:
Respiratory Protection & Chemical Protective Garments
When conducting a medical assessment, what status is checked first?
Respiratory Status
Over 20 people who worked together developed cough, excess fluid in their lungs, and difficulty breathing. Chest x-rays show bilateral infiltrates with bronchial aspirates rich in protein. Several died. What was the likely agent?
Ricin
What type of biological toxin is predominantly derived from the bean of the castor plant?
Ricin
__________ occurs outside of the incident area when people come in contact with a contaminated person or object.
Secondary contamination
START stands for ____ ?
Simple Triage and Rapid Treatment
For which vims is the mosquito not known as a possible vector?
Smallpox
Patient presents with 5-day-old blisters/rash mostly on the arm, face, and hands. No scabs are present. Patient reports fever started several days before blisters appeared. Based on the information would you suspect chickenpox or smallpox?
Smallpox, because the rash is centrifugal on the patient
Victims caught in a fire have inhaled toxic smoke from furnishings and plastics that have released cyanide in the burning process. What precaution/side effects should you be aware of when administering cyanide antidotes?
Sodium nitrite can increase methemoglobin levels, which will decrease blood oxygenation
Definitive diagnosis of Viral Hemorrhagic Fever rests on -------
Specific virologic diagnosis
Processed foods and temperature-abused foods are most commonly associated with ____ poisoning.
Staphylococcal Enterotoxin B (SEB)
Your patient is recovering from injuries sustained in a terrorist incident and is exhibiting stress symptoms. Which of the following is a common behavior reaction associated with severe short-term stress reactions?
Substance abuse
Which of the following statements does NOT describe Brucellosis?
The brucellae are highly infectious via the aerosol route and brucellosis is associated with a high mortality rate.
ICS has been used to manage incidents such as fires, earthquakes, hurricanes, and acts of terrorism. Which of the following situations represents another viable application for the use of ICS?
The planning and operation of the Central City annual Labor Day celebration, including a parade and fair.
How do nerve agents produce effects in the body?
They inhibit the enzyme Acetylcholinesterase (AChE) allowing Acetylcholine (ACh) to accumulate
Type of decontamination that is carried out by a unit to reduce contamination equal to natural background or to the lowest level possible.
Thorough
Following a nuclear detonation, some of the casualties with survivable injuries are possibly contaminated with radiological material. Which of the below courses of action is most appropriate for the situation?
Treat all life-threatening injuries first.
An avid outdoorsman who was hunting rabbits about a week ago presents with the following symptoms: fever, headache, sore throat, diarrhea, conjunctivitis, and inflammation of lymph nodes. What is responsible for the patient's symptoms?
Tularemia
Which of the following bacterial diseases typically produce ulcers on the skin?
Tularemia
A group of victims has been admitted to your triage unit. All victims have recently been in an area where canisters exploded spraying them with an amber colored liquid that smells like flowers and burns intensely. You suspect Lewisite. Which of the following is not a consideration during treatment of the victims?
Unroofing of blisters.
When washing with water, what procedures should be used when decontaminating a patient that has been exposed to a CBRNE agent?
Use high-flow, low-pressure water for 2-3 min. Gently scrub with soap and water using a soft b1istle brush.
Which nerve agent is the most persistent, is very oily, and will stay active in an area for several days?
VX
What types of CBRNE agents are man-made and act rapidly, burn and blister skin, mucous membranes, airways and gastrointestinal systems?
Vesicants
A patient presents to the hospital. He has been feeling ill since his return from safari in Africa a few days ago. He exhibits symptoms of fever, mild hypotension, flushing, conjunctival injection, and now a bad rash has appeared that is bleeding in spots. What type of viral infection do you suspect?
Viral Hemorrhagic Fever
A patient presents to the hospital. He has been feeling ill since his return from safari in Africa a few days ago. He exhibits symptoms of fever, mild hypotension, flushing, conjunctival injection, and now a bad rash has appeared that is bleeding in spots. What type of viral infection do you suspect?
Viral Hemorrhagic Fever
Decontamination will be conducted in the __________ hazard zone.
Warm
Which of the following decontamination method is NOT recommended for removing vesicants from casualties?
Wash patient with their clothing still on
The primary toxicity of pulmonary agents is to the ________ and follows __________ of smoke, particles, vapors, or gases.
airways, inhalation
Patients with concurrent surgical injuries and radiation exposure should either be operated on expeditiously or _____________________________.
delayed until past the time of bone marrow suppression and delayed wound healing
