Emergency Preparedness Response Course (EPRC) - Clinician Course (8 hrs)

What form of ionizing radiation can penetrate deeply into body tissue?

Photon

The majority of the injuries to gas-containing organs is usually attributed to which of the following?

Primary blast effect

Cyanide is historically found in the following EXCEPT:

Teflon (correct)

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

Experts anticipate that a ________ incident is the least likely to occur but would have a great impact upon the environment and people.

nuclear

Which of the bacterial diseases produces a non-specific illness that may produce a prolonged disability but is rarely fatal?

q fever

Which of the following is NOT a challenge in gaining access and acceptance?

similar cultural values

For which virus is the mosquito not known as a possible vector?

smallpox

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 (correct)

Wearing PPE can put the responder at considerable risk both physically and psychologically. Which of the following is NOT considered a risk factor?

hyperactivity

What Mission Oriented Protective Posture (MOPP) level provides the greatest level of protection?

level IV

Experts anticipate that biological incidents are ________________.

the most likely to occur, and will have the greatest impact on the greatest number of people. (correct)

Smallpox can spread from one person to another by the following routes:

All of the Above (correct)

The amount of radiation that an individual absorbs depends on ____?

All of the Above (correct)

Select the three components, in correct order of administration, utilized in the treatment for cyanide exposure.

Amyl nitrite, sodium nitrite, sodium thiosulfate

Advantages of adopting a comprehensive all-hazards approach includes the following EXCEPT:

Attention 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 (correct)

Which of the following cell types are most sensitive to radiation damage?

Cells that are actively dividing (correct)

Which of the following cell types are least sensitive to ionizing radiation damage?

Cells that divide slowly

Which of the following is considered a pulmonary (choking) agent?

Chlorine

Which of these are fast-acting compounds that attack oxygen-dependent tissues known to be particularly sensitive to these compounds?

Cyanide Compounds (correct)

You approach the scene of a terrorist incident that occurred 2 minutes prior in an enclosed room. It is reported that the smell of bitter almonds is in the air. The door is open; many victims are lying on the floor. What do you do first?

Don your mask before going into the room (correct)

How is the victim of a pulmonary agent exposure presenting with respiratory distress less than 4 hours after exposure classified?

EXPECTANT

What technique may be used to test for T-2 Mycotoxins in environmental and clinical samples?

Gas Chromatography-Mass Spectrometry

What type of laboratory test(s) would NOT be conducted if you suspect a patient has contracted plague?

Gas Chromatography-Mass Spectrometry (correct)

Used in life-threatening situations, the goal is to remove contaminant as quickly as possible.

Immediate decontamination (correct)

What command system is a widely used and accepted tool for command, control and coordination of a response to a disaster?

Incident Command System (correct)

Who is responsible for directing the command and control of all operations.

Incident Commander (correct)

An all-hazards approach affects preparedness by allowing communities to:

Increase the speed, effectiveness, and efficiency of incident management. (correct)

Pulmonary (choking) agents primarily enter the victim by what means?

Inhalation (correct)

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 (correct)

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 (correct)

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 (correct)

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 (correct)

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 (correct)

What CBRNE agent inhibits the enzyme AChE allowing ACh to accumulate affecting the way cells transmit signals to the body? [Remediation Accessed :N]

Nerve (correct)

________ damage brings death very quickly so that the consequences of exposure to other systems do not have time to express themselves.

Neurovascular

What is the most available explosive agent?

Nitroglycerin (correct)

Which phase of CBRN response synchronizes planning and execution efforts with the efforts of the supported civil authorities?

Phase III - Operate (correct)

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

A patient is exhibiting the following symptoms: fever, cough, dyspnea, prominent gastrointestinal symptoms, and absence of buboes. Which form of plague is responsible?

Pneumonic (correct)

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 (correct)

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

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 (correct)

Personal Protective Equipment (PPE) is generally divided into two categories. They are:

Respiratory Protection & Chemical Protective Garments (correct)

When conducting a medical assessment, what status is checked first?

Respiratory Status (correct)

What type of biological toxin is predominantly derived from the bean of the castor plant?

Ricin (correct)

Vesicant (blister) agents include all of the following, EXCEPT:

Sarin (GB) (correct)

__________ occurs outside of the incident area when people come in contact with a contaminated person or object.

Secondary Contamination (correct)

Penetrating trauma caused by shrapnel is usually attributed to which of the following?

Secondary blast effect (correct)

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 (correct)

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 (correct)

How do nerve agents produce effects in the body?

They inhibit the enzyme Acetylcholinesterase (AChE) allowing Acetylcholine (ACh) to accumulate

Which of the following bacterial diseases typically produce ulcers on the skin?

Tularemia (correct)

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. (correct)

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. (correct)

The primary toxicity of pulmonary agents is to the ________ and follows __________ of smoke, particles, vapors, or gases.

airways, inhalation (correct)

In industry, cyanide compounds are widely used during:

all of the above

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

Which of the following is NOT a physical requirement of those expected to wear PPE?

Ability to handle emergency conditions (correct)

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 excessive ACh?

Administer additional 2-PAM Cl (correct)

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. (correct)

What type of care is a stress management component that fosters a mourning process and helps treat psychological stress reactions?

Pastoral care (correct)

What bacterial infection requires confirmation through serological testing since it is difficult to culture the organism (causative agent)?

Q fever

Treatment of patients suffering from pulmonary agent exposure should focus on?

Recognizing which compartment(s) are damaged and minimizing that damage.

During which post disaster phase do survivors realize that they will need to solve their problems of rebuilding their homes, businesses, and lives and have gradually assumed the responsibility to do so?

Reconstruction/Recovery Phase

START stands for

Simple Triage and Rapid Treatment

Definitive diagnosis of Viral Hemorrhagic Fever rests on _______________.

Specific virologic diagnosis

What type of explosive is widely used by the military, and is one of the least sensitive explosives.

TNT

Which of the following is NOT relevant to a laboratory diagnosis of smallpox (variola)?

A positive Tzank smear (correct)

What blood test is available that will give an accurate estimate of radiation dose?

Lymphocytes count (correct)

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 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. (correct)

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 (correct)

Which of the following statements does NOT describe spores produced by Bacillus anthracis, causative agent of anthrax?

Sensitive to UV light. (correct)

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.

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. (correct)

Type of decontamination that is carried out by a unit to reduce contamination equal to natural background or to the lowest level possible.

Thorough (correct)

Which type of nerve agent is the MOST persistent?

VX (correct)

Secretary of Defense has the responsibility to provide defense support to civil authorities when the actions:

are legal (correct)

__________ occurs when people come in direct contact with a harmful agent at or near an incident.

contamination

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

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 (correct)

What form of ionizing radiation is the least penetrating?

alpha

What is the comprehensive preparedness required to manage the casualties resulting from the host of possible hazards?

All-hazard preparedness (correct)

A metallic taste in the mouth, epigastric distress, and possible nausea and vomiting are ingestion symptoms for which chemical agent?

Cyanide

Decontamination will be conducted in the __________ hazard zone.

warm

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 (correct)

The decontamination site should NOT be located:

Near waterways and drainage systems

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 (correct)

How is the victim of nerve agent exposure presenting with convulsions classified?

Smallpox, because the rash is centrifugal on the patient (correct)

One of the contributing factors to stress reactions is the physical factor. Which of the following is associated with this factor?

worries about others

Which post disaster phase is generally characterized by optimism due to an infusion of resources?

Honeymoon phase (correct)

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 (correct)