Med-Surg Ch 44: Care of Patients in Disasters or Bioterrorism Attack

Sucking chest wound, fully conscious A. Red tag: ermegent B. Yellow tag: urgent C. Green tag: nonurgent D. Black tag: terminal

Yellow tag: urgent

Toddler with partial-thickness burns on both legs A. Red tag: ermegent B. Yellow tag: urgent C. Green tag: nonurgent D. Black tag: terminal

Yellow tag: urgent

While admitting a young, previously healthy patient with a severe respiratory illness, you become suspicious of a bioterrorism event. Which question would you ask to confirm the suspicion? A. "Have you been washing your hands frequently?" B. "Has the illness progressed rapidly?" C. "Do you have a fever?" D. "Are you a local resident?"

"Has the illness progressed rapidly?" *Rapid progression of illness in a previously healthy young adult is suggestive of a bioterrorism event because it is not an expected pattern. (1, 3) These questions could be indirectly related to an event, but they are general questions that could be relevant to a large number of typical disease patterns. (4) Asking about recent travel or participation in a large local event would be better than asking the patient if they are a local resident.

Which statement by the nurse indicates that the goals of critical incident stress debriefing are being met? A. "I still have nightmares about the disaster, but I don't think about it during the day." B. "I am surviving, although I guess I am still drinking more than I should." C. "I went out with friends the other night and we talked about how we were all doing." D. "I am super-prepared now. I check the disaster equipment every day."

"I went out with friends the other night and we talked about how we were all doing."

The nursing staff is participating in a discussion about practical measures to prepare for a possible pandemic flu event. Which comment by a staff member indicates an understanding of what should be done? A. "The hospital needs to get more ventilators for the intensive care unit." B. "None of the nurses with children should have to come under those conditions." C. "We need to review respiratory isolation precautions and reinforce handwashing." D. "This is not a third-world country; we will be okay if we just use common sense."

"We need to review respiratory isolation precautions and reinforce handwashing."

You are participating in a disaster drill. A mock victim with a green tag asks, "What does this tag mean?" What is the best response? A. "You can go home because you no longer need health management." B. "You potentially pose a health hazard, so you must sit in the green area." C. "You will have to wait for care because your injuries are not life threatening." D. "You will be seen and treated immediately by a health care provider."

"You will have to wait for care because your injuries are not life threatening." *Green tags signify relatively minor injuries that can wait 4 to 6 hours for treatment. Examples include closed fractures and contusions. (1) Telling the patient to go home is not appropriate because the patient needs some medical attention. (2) Green-tagged patients may be contaminated or pose a health risk, but the green tag does not specifically signify contamination. (4) Red-tagged patients are seen immediately. Examples of their injuries include shock or airway problems (those with a high chance of survival if the problem is corrected).

You are teaching a group of people about water and food safety after a disaster. Which comments by the learners indicate successful teaching? (select all that apply) A. "Contaminated water should be boiled for at least 20 minutes." B. "Eight drops of bleach to a gallon of water will purify the water." C. "A full freezer will keep food safe for 48 hours." D. "Any food that has an unusual odor, color, or texture should be thrown away." E. "Tightly sealed containers of food are safe to use even if in contact with flood waters."

1. "Eight drops of bleach to a gallon of water will purify the water." 2. "A full freezer will keep food safe for 48 hours." 3. "Any food that has an unusual odor, color, or texture should be thrown away." *After a disaster, 8 drops of bleach per 1 gallon of water will purify the water. A full freezer will keep food safe for 48 hours. Any food that has an unusual odor, color, or texture should be thrown away. (1) Boiling water for 3 to 5 minutes is sufficient; additional time does not hurt, but fuel may be an issue, and prolonged boiling will cause evaporation if there is a water shortage. (5) Lids that screw on, snap on, or are crimped cannot be disinfected and should be discarded if they come in contact with flood water.

Which statement accurately describes how water can be rendered safe for drinking in the event of a disruption of service? (select all that apply) A. Allow water to sit for 24 h before using B. Boil water for 3 to 5 minutes C. Add 1 mL (16 drops) of household bleach to a gallon of water and let it stand for 30 minutes D. Drain water from hot water heaters E. Pour water through several layers of cotton towels

1. Boil water for 3 to 5 minutes 2. Add 1 mL (16 drops) of household bleach to a gallon of water and let it stand for 30 minutes 3. Drain water from hot water heaters *Water can be rendered safe for drinking by boiling, treating with hoursehold bleach, or removing from hot water heaters or commode tanks. Allowing water to sit for 24 h or pouring water through layers of cotton towels does not adequately render the water safe to drink

Which category A organisms may be released in a bioterrorism attack because of lethality? (select all that apply) A. Ebola B. Avian flu C. Botulism D. Smallpox E. Tularemia

1. Ebola 2. Botulism 3. Smallpox 4. Tularemia *Avian flu (bird flu) is not on the category A list

According to the CDC, which psychological stages do individuals go through after a major disaster? (Select all that apply.) A. Honeymoon stage B. Impact stage C. Acceptance stage D. Heroic stage E. Reconstruction stage F. Disillusionment stage

1. Honeymoon stage 2. Impact stage 3. Heroic stage 4. Reconstruction stage 5. Disillusionment stage *According to the CDC, psychological stages individuals go through after a major disaster include the impact stage, the heroic stage, the honeymoon stage, the disillusionment stage, and the reconstruction stage. The acceptance stage is most commonly associated with death and grieving stages.

The nurse is participating in an educational program concerning nuclea disasters. Which factor(s) determine a victim's level of exposure to radiation? (select all that apply) A. Age of victim B. Body surface area of the victim C. Length of exposure D. Distance of the victim from the nuclear source E. Shielding of the victim from the nuclear source

1. Length of exposure 2. Distance of the victim from the nuclear source 3. Shielding of the victim from the nuclear source *The amount of damage to each person depends on the type of radiatio, the dose received, the length of time of exposure, and the route of the exposure. Time, distance, and shielding are key to the quantity of radiation an individual will receive. The short the time of exposure, the farther away from the radiation source, and whether or not the person was shielded by materials that are impermeable to radiation are details pertinent to radiation risk

The nurse is preparing a list of items that are needed in a disaster kit. Which items should the nurse include? (select all that apply) A. A 12 day supply of bottled water B. Nonperishable food items C. Prescription medications D. Portable radio E. Bedding F. First aid kit

1. Nonperishable food items 2. Prescription medications 3. Portable radio 4. Bedding 5. First aid kit *Nonperishable food items, prescription medication, a portable radio, bedding, and a first aid kit are essential components of an adequate disaster kit. A water supply that will last 3 days is sufficient for a disaster kit

Essential elements in a disaster plan include provision of which components? (select all that apply) A. Shelter for victims B. Transportation C. Communication D. Welfare of victims E. Food

1. Shelter for victims 2. Transportation 3. Communication 4. Welfare of victims 5. Food *All options are essential elements in a disaster plan

Local civil defense courses on disaster preparedness explain the roles of which people/entities? (select all that apply) A. State government B. Federal government C. Law enforcement agencies D. Individual service agencies E. Nurse as a volunteer

1. State government 2. Federal government 3. Law enforcement agencies 4. Individual service agencies 5. Nurse as a volunteer *Civil defense courses should explain the role of all of these participants

In the event of a disaster requiring evacuation of homes, what items should be in a "go bag"? (select all that apply) A. All personal valuables B. Water and medications C. Flashlight and batteries D. Camp stove and eating utensils E. Clothing and important documents

1. Water and medications 2. Flashlight and batteries 3. Clothing and important documents *Water, medications, flashlights and batteries, clothing, and important documentation should all be included in a "go bag." (1) It is not practical to try to evacuate with all items considered personally valuable. (4) A camp stove would be a nice thing to have but is bulky and requires flammable fuel that may not be safe to carry.

The nurse is teaching disaster preparedness at a community center. The nurse knows that which water sources may be used in the event of the water supply being disrupted? (Select all that apply.) A. Water that has been distilled. B. Flood or storm water. C. Water that has been brought to a rolling boil for 3 to 5 minutes. D. Water that has had household bleach containing 5.25% sodium hypochlorite (16 drops of bleach/gallon of water and let stand for 30 minutes). E. Stored bottled water.

1. Water that has been distilled. 2. Water that has been brought to a rolling boil for 3 to 5 minutes. 3. Water that has had household bleach containing 5.25% sodium hypochlorite (16 drops of bleach/gallon of water and let stand for 30 minutes). 4. Stored bottled water. *A drinking water source that may be used safely in the event of the water supply being disrupted includes use of stored bottled water and the use of water that has been distilled. In addition, use of boiled water that has been brought to a rolling boil for 3 to 5 minutes and use of water that has had household bleach containing 5.25% sodium hypochlorite (16 drops of bleach/gallon of water and let stand for 30 minutes) is safe. Use of flood or storm water is not safe for drinking.

During a power failure, at what temperature should perishable food be maintained to precent a possibility of food poisoning? A. 40F B. 45F C. 50F D. 55F

40F *To prevent spoilage, perishable foods should be kept at 40F

A freezer full of food at the time of the powewr failure will keep food to eat for what period of time? A. 8 h B. 12 h C. 24 h D. 48 h

48 h *Food frozen in a full freezer will keep the food safe for 48 h. A partially filled freezer will keep food safe for 24 h

The nurse is caring for multiple victims who are rapidly arriving from a nearby disaster site. Which communication strategy is the nurse most likely to use? A. Active listening B. Short directive statements C. Therapeutic touch D. Silence and reflection

Active listening

When can patients with plague who have been treated with appropriate antibiotics be released from respiratory droplet precautions? A. After resolution of all symptoms B. After three sputum samples are negative for blood C. After all lesions are dried D. After the patient receives 48 h of antibiotic treatment

After the patient receives 48 h of antibiotic treatment *The patient with plague can be released from respiratory precautions 48 h after initiation of antibiotic therapy

Which behavior by a nurse indicates that there is a need for additional counseling beyond the counseling offered through a critical incident stress debriefing? A. Talks openly about the incident but is not ruminating B. Avoids coworkers and friends for a prolonged period C. Takes extra vacation time away from the city D. Attempts to resume a health lifestyle but is not sleeping well

Avoids coworkers and friends for a prolonged period *Avoiding friends, family, and routine relationships is a sign that the nurse is not coping well in the post-trauma period, particularly if the behavior is prolonged. (1, 3) Openly talking without ruminating and taking vacation time are both good coping strategies. (4) Not sleeping well is another cause for concern, but the attempt to reestablish routines is a healthy sign; this person would probably benefit from counseling if normal sleep does not resume.

The nurse is teaching community members about precautions related to a pandemic occurrence. Which information is most helpful for the nurse to include in the teaching plan? A. Be sure to cover your mouth when coughing B. Be prepared to stay at home for at least 2 weeks C. Dispose of tissues after using them D. Avoid shaking hands

Be prepared to stay at home for at least 2 weeks *The nurse should be sure to include information that differentiates pandemic flu occurrences from normal respiratory illness. The priority education about pandemic flu involves teaching people to be prepared to stay at home for at least 2 weeks. While covering the mouth when coughing or sneezing, tissue disposal, and avoiding handshakes are important, all of these considerations are precautions for prevention of any respiratory illness

Crushed chest, paraplegia A. Red tag: ermegent B. Yellow tag: urgent C. Green tag: nonurgent D. Black tag: terminal

Black tag: terminal

A nurse is caring for a patient with acute radiation sickness syndrome. The patient states she did not receive a very high dose of radiation. What subsyndrome may be seen depending on the dose of radiation she received? A. Bone-marrow syndrome B. Gastrointestinal (GI) lining syndrome C. Cardiovascular system syndrome D. Central nervous system (CNS) syndrome

Bone-marrow syndrome *Exposure to high doses of radiation rays that penetrate the body even for a few minutes may result in acute radiation sickness syndrome. Bone-marrow tissue is affected first; then with increased dosage, the GI lining is affected. The person who receives a high enough dose of radiation to cause cardiovascular/central nervous system syndrome will experience effects on the bone-marrow and GI system as well.

During a tornado warning with sirens, the nursing staff are caring for 36 patients on the second floor medical-surgical unit. How should the staff protect the patients? A. Move all patients to the evacuation center across the street B. Bring all patients into the hall and close doors and windows C. Seal all patients in their bathrooms and cover windows with bed mattresses D. Evacuate patients to the basement via the elevators

Bring all patients into the hall and close doors and windows *Movement to the hall is the safest and fastest and does not expose the patients to being out of doors, in elevators, or near exterior windows

The patient is admitted for a diagnosis of anthrax. What is the health care provider most likely to order to treat this patient? A. IV fluids and oxygen therapy B. Ciproflaxacin (Cipro) C. Gentamicin (Garamycin) D. Antitoxin type A or B

Ciproflaxacin (Cipro)

A visitor in the hospital lobby threatens bystanders and brandishes a firearm. Which action is the nurse's priority? A. Evacuate the area. B. Activate the fire alarm. C. Notify the nursing supervisor. D. Try to take down the perpetrator.

Evacuate the area. *If a firearm is seen, health care workers should evacuate if possible, hide in a location, not visible to the shooter, lock the doors, and silence pagers and cell phones. A call to 911 should be made when it is safe to do so. As a last resort and if life is in imminent danger, incapacitating or acting with physical aggression and throwing items at the shooter may be attempted. Activating the fire alarm to alert people of about a potentially violent situation is not an appropriate use of the fire alarm system. The nursing supervisor can be notified after the incident is over.

A smallpox outbreak has occurred, and victims are reporting to the hospital for treatment, which includes the smallpox vaccine. The nurse knows patients with what symptoms will be admitted? A. Eczema, edema, and headache B. Double vision, droopy eyelids, and difficulty swallowing C. Fever, headache, and myalgia D. Fatigue, dizziness, and muscle aches

Fever, headache, and myalgia *Patients with smallpox will have high fever, headaches, myalgia, backache, malaise, vomiting, and delirium. They will develop a rash that contains firm, deep-seated vesicles or pustules all in the same stage of development on any one area of the body. Eczema, edema, and headache are not signs of smallpox. Fatigue, dizziness, and muscle aches are signs of a hemorrhagic fever. Double vision, droopy eyelids, and difficulty swallowing are signs of botulism.

After a truck crashes into the dayroom of a long-term care facility, many of the residents are injured, and noninjured residents are stunned and frightened. What action should the nurse take? A. Firmly instruct two CNAs to start wheeling residents to the dining room in their wheelchairs B. Begin wheeling residents bacl to their rooms herself C. Shout for everyone to hurry to the dining room D. Begin treating the injured in the center of the dayroom

Firmly instruct two CNAs to start wheeling residents to the dining room in their wheelchairs *The nurse should recognize that everyone is in the impact stage. In the impact stage, firm direction is needed to get people to a central place for safety and information. The nurse should not try to single-handedly correct the situation, shout and increase confustion, or treate patients in the middle of the chaotic environment

During a flood, the public water supply has been contaminated. Which action is most important for the nurse to take? A. Designate which commodes can be used for body waste B. Gather a large pot, household bleach, and other supplies C. Run cold water in sinks to have reservoirs of water D. Reserve existing water for handwashing only

Gather a large pot, household bleach, and other supplies *The nurse will need to purify water and should gather supplies that are necessary to do so. Using any of the water for wast disposal is inappropriate. using cold water pulls from the contaminated water supply. Contaminated water should not be used to wash hands, prepare food, make ice, or prepare baby formula

A nurse is attempting to restore order to a group of people trapped in a building by rising flood waters. Which action is best for the nurse to take? A. Give each person a specific duty B. Allow people to direct themselves to helpful tasks C. Make a list of essential jobs and ask for volunteers D. Compile all food in a central location and direct people to form a line to take what they need

Give each person a specific duty *During the impact stage, firm direction is needed, and executing essential helpful jobs will help restore order. Asking for volunteers when there is a loss of order and control would be counterproductive and would lack the direction needed by those affected. Food will need to be rationed in the event there is no rescue for an extended period of time. The rationing should be performed with direction and should not allow the people to take whatever they wish

There are multiple victims during a disaster. The majority of these victims will be triaged and identified with which color of tag? A. Red tag B. Black tag C. Yellow tag D. Green tag

Green tag

Closed fracture of arm, head laceration A. Red tag: ermegent B. Yellow tag: urgent C. Green tag: nonurgent D. Black tag: terminal

Green tag: nonurgent

Woman in labor, pains 10 minutes apart A. Red tag: ermegent B. Yellow tag: urgent C. Green tag: nonurgent D. Black tag: terminal

Green tag: nonurgent

The nurse is assisting in a temporary housing shelter that has been created for displaced victims of a hurricane. What is the priority diagnosis for this group? A. Potential for grief related to loss of property, friends, family, etc. B. Limited coping ability related to sudden catastrophic event C. High potential for infection related to crowding, poor hygienic conditions D. Fatigue related to unfamiliar surroundings and stress

High potential for infection related to crowding, poor hygienic conditions

The nurse explains difference between and emergency situation and a disaster to high school class. Which statement is true? A. An emergency consists of fewer than 50 people who require emergent treatment B. In an emergency situation, the local emergency rooms can meet the need C. An emergency situation lacks the need for a prearranged management plan D. In an emergency situation, the community population is not affected by the event

In an emergency situation, the local emergency rooms can meet the need *An emergency situation, such as a plane crash at a local airport, can be handled by community emergency departments. Each community has in place an emergency plan as to dispersal of people needing to be treated, law enforcement participation, and transportation. Communities are always affected when a large-scale emergency situation occurs

A large number of patients are arriving at the hospital from the scene of a chemical disaster. What is the priority action? A. Take vital signs to determine which patients are in distress B. Call poison control for assistance in determining antidotes C. Decontaminate all patients outside the hospital by showering D. Instruct all caregivers to don personal protective equipment

Instruct all caregivers to don personal protective equipment *In a chemical emergency, caregivers should don personal protective equipment prior to assisting patients. Patients are likely to be physically and emotionally in need of attention; however, health care personnel must be protected in order to serve the greater numbers that may follow. (1, 2, 3) The other options are correct but should be accomplished after protecting personnel.

Bacillus anthracis, the causative agent of anthrax, is a potentially threatening biologic weapon for which reason? A. It has no known treatment or cure. B. It is highly contagious. C. It is airborne. D. It has no vaccine.

It is airborne. *Dispersal would be highly effective if the bacteria were released into the environment. Anthrax is not contagious. The bacillus must be inhaled as it is being dispersed; it is not infectious. Anthrax can be treated and cured with ciprofloxacin, doxycycline, or penicillin. There is a vaccine for anthrax; it is available in limited supply. Current recommendations are that it be administered only to individuals known to have been exposed to the anthrax bacillus.

The nurse is assigned to assist the health care provider with "reverse" triage during a disaster event. What information is most relevant to this process? A. Identifying the patient's blood type and history of transfusions B. Knowing the pattern of pain and vital signs over the past few days C. Reviewing the past and present medication history D. Evaluating the patient's emotional response to the disaster event

Knowing the pattern of pain and vital signs over the past few days

After a terrorist attact with smallpox virus, the nurse assesses a newly admitted patient with large vesicles. The nurse understands that which assessment finding differentiates smallpox vesicles from chickenpox vesicles? A. Lesions on the face B. Lesions on mucous membranes C. Lesions on the soles of the feet D. Lesion in the axilla

Lesions on the soles of the feet *The lesions of smallpox can be found on the palms of the hands and soles of the feet. The lesions of chickenpox do not appear there

What is a simple way to purify water when the supply has been disrupted? A. Rolling boil for 3-5 minutes B. Adding 16 teaspoons of household liquid bleach C. Water that drips from a source into a clean cup D. Low-boil the water for 20 minutes

Low-boil the water for 20 minutes

Which task related to disaster management would be appropriate to assign to a nursing assistant? A. Assisting victims to shower after exposure to toxin B. Debriefing others during a critical incident C. Triaging incoming green-tag victims D. Moving black-tagged victims to designated areas

Moving black-tagged victims to designated areas

A patient is admitted with radiation sickness. What would the nurse expect to find documented in the patient's chart? A. Cardiac arrhythmias and low blood pressure B. Nausea, vomiting, diarrhea, and hair loss C. Lethargy, constipation, and blurred vision D. Renal failure and electrolyte imbalances

Nausea, vomiting, diarrhea, and hair loss

Based on a patient's answers to interview questions, the nurse suspects that the patient may have been exposed to a possible Category A infectious agent. What should the nurse do first? A. Notify the supervisor about the possibility of contagion B. Don an N-95 or P-100 respirator mask C. Have the patient and family perform hand hygiene D. Isolate the patient in a negative-pressure room

Notify the supervisor about the possibility of contagion

When the nurse is assigned to decontaminate patients exposed to chlorine, which primary decontamination material is used in the first step of the process? A. Hydrogen peroxide B. Bleach C. Plain water D. Soap and water

Plain water *The primary decontamination material is plain water. Exposed skin and hair should be flushed with plain water for 2 to 3 minutes; then washed twice with soap and water. Bleach and hydrogen peroxide are not the primary decontamination materials.

Which measurement best detects the daily amount of radiation to which a health worker is exposed? A. Radiation urinalysis B. Radiation badges C. Radiation spectrometer D. Radiation sputum analysis

Radiation badges *Radiation detection badges are worn under protective clothing and are analyzed for the amount of radiation absorbed

Compound fracture of both femurs, concussion A. Red tag: ermegent B. Yellow tag: urgent C. Green tag: nonurgent D. Black tag: terminal

Red tag: emergent

Amputated arm, conscious, but in shock A. Red tag: ermegent B. Yellow tag: urgent C. Green tag: nonurgent D. Black tag: terminal

Red tag: ermegent

The news reports that a train derailment 5 miles from a clinic spilled a large amount of liquid chlorine that has been vaporized by the atmosphere. Which finding indicates that the chlorine gas is an imminent threat to the clinic? A. Sighting of a low-lying green cloud. B. Smelling "almonds" or "burning feathers" C. Onset of sudden nausea in multiple patients D. Onset of skin blisters in multiple patients

Sighting of a low-lying green cloud. *Chlorine gas can be seen as a low-lying green cloud. The smell of almonds is associated with cyanide. Nausea is a non-specific finding. Skin blistering is a result of contact with liquid chlorine

A patient is tentatively diagnosed with chickenpox. During a skin assessment, what are you likely to find that confirms the diagnosis? A. Skin lesions are firm B. Skin lesions are found on palms and soles C. Skin lesions occur in various stages D. Skin lesions with other signs and symptoms

Skin lesions occur in various stages *Skin lesions in various stages are characteristic of chickenpox. (1, 2, 4) The symptoms provided in the other options are more associated with smallpox.

The patient has been diagnosed with the pneumonic plague. The nurse knows which isolation precautions are most appropriate? A. Strict isolation precautions with Standard Precautions B. Contact precautions C. Droplet precautions D. Standard Precautions plus droplet precautions

Standard Precautions plus droplet precautions *Precautions include Standard Precautions plus droplet precautions (eye protection and surgical mask) for 48 to 72 h after antibiotic administration has begun. Isolation and contact precautions are not necessary.

At a disaster scene, you notice that a person who has respiratory distress and severe total body burns has been triaged with a black tag. What should you do? A. Immediately obtain a portable oxygen tank and apply an oxygen mask B. Seek out emergency services personnel to transport the patient to the hospital C. Try and locate family members so that they can be present when the person dies D. Stay with the person for as long as possible to give support and comfort

Stay with the person for as long as possible to give support and comfort *Being present with the patient in the final moments is the only thing you can do; however, you are considered a resource, so you cannot linger to give comfort and support if dying is prolonged. (1, 2) No treatment is allocated for patients with black tags because the resources must be used to help those with a better likelihood of surviving. (3) Taking time to seek out the family is not a good use of your time. Family members also may be injured, and it will be excessively time-consuming to help them understand why the black tag means no treatment.

In a terrorist attack, introduction of the plague would most likely occur as an aerosolized weapon. The nurse understands that this organism is very vulnerable to exposure to which element? A. Temperature of 40F B. Sunlight C. Stong chlorine solution D. Nitrogen gas

Sunlight *Plague organisms can be destroyed by exposure to sunlight

Which patient needs to be put into isolation immediately? A. Diagnosed case of botulism poisoning B. Probable case of inhalation anthrax C. Known exposure to a high dose of radiation rays D. Suspected smallpox but probable chickenpox

Suspected smallpox but probable chickenpox *Isolate cases of smallpox or chickenpox; smallpox, although exceptionally rare these days, is highly contagious. (1, 2, 3) The other patients do not need immediate isolation; however, the patient who received a high dose of radiation will eventually need protective isolation.

The nurse is advising a community group about what to do in the event of a natural disaster such as an earthquake, tornado, or flood. What is appropriate information and advice? A. Evacuate the area and leave immediately B. Take refuse in the basement during a tornado warning C. During an earthquake, drop to the floor and crawl to an exit D. For flood warnings, push towels into the cracks under the doors

Take refuse in the basement during a tornado warning

Which agency requires preparedness plans for accredited hospitals? A. American Red Cross (ARC) B. The Joint Commission (TJC) C. Federal Emergency Management Agency (FEMA) D. Office of Civil Defense (OCD)

The Joint Commission (TJC) *TJC requires that all accredited facilities have a written emergency preparedness plan with designated roles and responsibilities. The ARC is a voluntary organization that traditionally provides the basic essentials of shelter, food, and first aid during a natural disaster. FEMA is an organization under the federal government. It is activated by the Department of Homeland Security. It acts when states require assistance in times of disaster. The Office of Civil Defense (OCD) is no longer in existence. It was a federal agency that acted in cases of large-scale disasters. It was replace by FEMA

In a terrorist attack, which period of time poses the greates chance for inhalation of aerosilized anthrax? A. The day of the attack B. The day after the attack C. 2 days after the attack D. 1 week after the attack

The day after the attack *Anthrax is an aerosolized form is most potent 1 day after the explosion. After that time, the organism dies very quickly and anthrax is not communicable from person to person

The nurse participating in a disaster drill knows to triage which patients with a yellow tag? A. The patient with an open femur fracture B. The patient with a large abrasion to the torso C. The patient with an uncontrolled arterial bleed D. The patient with Cheyne-Stokes breathing

The patient with an open femur fracture *Yellow tags are applied to patients with major injuries, open fractures, and large wounds. Red tags are applied to patients with injuries that are an immediate threat to life such as airway compromise or hemorrhagic shock. The patient with an uncontrolled arterial bleed would fit in this category. The patient with a large abrasion to the torso would receive a white tag. These patients have minor injuries such as abrasions and bruises. Patients who are dead or imminently dying are given black tags. The patient with Cheyne-Stokes breathing is imminently dying.

Why is a chelating agent administed after a person has been exposed to particulate radioactive material? A. To bind with radioactive material and allow it to be excreted B. To reduce radioactivity to nonharmful levels C. To form a protective coat in the gastrointestinal system D. To dissolve particulate material

To bind with radioactive material and allow it to be excreted *Chelating agents bind with radioactive material, allowing it to be excreted without absorption

What is the purpose of debriefing after caring for victims of a disaster? A. To analyze the effectiveness of the disaster plan B. To assess the efficiency of the response C. To modify the disaster plan D. To help allay posttraumatic stress disorders

To help allay posttraumatic stress disorders *The debriefins is for the purpose of allowing the health professionals to ventilate about their experiences in an effort to allay long-term psychological problems

How many times per year should accredited health care facilities test their emergency plans? A. Once B. Twice C. Three times D. Four times

Twice *Distaster drills should be conducted at least two times per year

A patient comes to the emergency department after exposure to a toxic chemical spill. Which action indicates that the nurse accurately understands proper management of this patient? A. disinfecting contact lenses before reinserting them B. Irrigating the patient's eyes for 5 to 7 minutes with water C. Using tongs to handle removed clothing D. Placing the clothing in a metal receptacle for disposal

Using tongs to handle removed clothing *Clothing and contact lenses are considered contaminated and should be removed and discarded. The nurse should use tongs to prevent touching the clothing directly. Contact lenses should be discarded, eyes should be irrigated for 10 to 15 minutes, ad clothing should be placed in a plastic bag for disposal

If terrorists were to use category B agents that produce low death rates and moderate illness, by which route would the organisms likely be delivered? A. Vaporization B. Water sources C. Explosion D. Person-to-person contact

Water sources *Category B agents are delivered via a water source. Category A agents may be transmitted without detection and can be easily spread from person to person. Category C agents are agents that have not yet been weaponized

If a disaster occurs, one example of how the disaster will affect the infrastructure of a city is by the effect it will have on which component? A. Houses and land B. First responders C. People who live there D. Water supply

Water supply *The infrastructure of a city includes transportation, electrical equipment, communications, fuel supplies, and water. Water could be affected by disruption of service, inadequate supply to fight a fire, and increased public health risk if the supply is not pure. People, including first responders, and housing are not part of the infrastructure.

A patient is being treated for radiation exposure. A chelating agent functions to reduce radiation damage by A. binding the radioactive material B. blocking specific isotopes C. mobilizing radioactive material D. reducing concentration of radioactive material

blocking specific isotopes

Victims who may have residual particulate after radiation or chemical exposure should be decontaminated. Victims should be instructed to A. remove and burn clothing B. wear protective gear and double gloves C. scrub skin with water and soap and rinse well D. brush off and vacuum residual particulates

scrub skin with water and soap and rinse well

The nurse is assigned to assist in triage. The purpose and goal of triage is to A. sort patients by priority of need for treatment B. ensure that all patients receive treatment C. ensure that medical equipment is available D. identify the need for supplies and support

sort patients by priority of need for treatment