Everything Bioterr/Disaster

Which public health risk became a major focus for hospitals after the September 11, 2001 terrorist attacks? Anthrax exposure Multi-casualty incidents Mass casualty incidents (MCI) Weapons of mass destruction (WMD)

Weapons of mass destruction (WMD)

Which medication should be listed as the antidote to a nerve agent in the disaster plan for a terrorist attack? 1 Atropine ) 2 Dopamine ) 3 Epinephrine ) 4 Norepinephrine

1 Atropine )

Which signs/symptoms should the nurse assess in the client who has been exposed to the anthrax bacillus via the skin? 1. A scabby, clear fluid-filled vesicle. 2. Edema, pruritus, and a 2-mm ulcerated vesicle. 3. Irregular brownish-pink spots around the hairline. 4. Tiny purple spots flush with the surface of the skin.

2. Edema, pruritus, and a 2-mm ulcerated vesicle.

Which amount of time is appropriate for nurse to spend triaging each patient during a mass casualty incident? 1 Less than 10 seconds ) 2 Less than 15 seconds ) 3 Less than 30 seconds ) 4 Less than 60 seconds )

2. Less than 15 seconds

When conducting triage assessments using Simple Triage and Rapid Treatment (START), how long does the nurse assess a patient before moving to the next one? 15 seconds or less 30 seconds or less 45 seconds or less 60 seconds or less

60 seconds or less

Which cultural issues should the nurse consider when caring for clients during a bioterrorism attack? Select all that apply. 1. Language difficulties. 2. Religious practices. 3. Prayer times for the people. 4. Rituals for handling the dead. 5. Keeping the family in the designated area.

1-4 1. Language difficulties. 2. Religious practices. 3. Prayer times for the people. 4. Rituals for handling the dead.

Which are the most common types of injuries that should be identified along with treatment options in an organizational disaster plan for the use of explosive devices as agents of terrorism? Select all that apply. 1 Burn 2 Blast 3 Crush 4 Penetration 5 Psychological

2,3,4 2 Blast 3 Crush 4 Penetration

The triage nurse has placed a disaster tag on the client. Which action warrants immediate intervention by the nurse? 1. The nurse documents the tag number in the disaster log. 2. The unlicensed assistive personnel documents vital signs on the tag. 3. The health-care provider removes the tag to examine the limb. 4. The LPN securely attaches the tag to the client's foot.

3. The health-care provider removes the tag to examine the limb.

The nurse responds to a mass casualty event and implements Simple Triage and Rapid Treatment (START) to triage patients. Which patient does the nurse tag as green? The patient who remains apneic after airway repositioning. The patient who begins breathing after airway management is implemented. 3.The patient who is walking, has abrasions, and follows commands appropriately 4. The breathing patient with a capillary refill of 3 seconds who cannot follow simple direction.

3. The patient who is walking, has abrasions, and follows commands appropriately

A workplace violence prevention plan is often one component of a hospital disaster plan. Which unit assumes priority for implementation and evaluation of this component to the plan? 1 Medical unit 2 Surgical unit 3 Radiology department 4 Emergency department

4 Emergency department

Which events may require a hospital evacuation with no advanced warning? Select all that apply. A. Explosions B. Floods C. Building Fires D. Hurricanes E. Tornadoes

A,C, E A. Explosions C. Building Fires E. Tornadoes

What is the priority intervention when treating patients during a mass casualty event using Simple Triage and Rapid Treatment (START)? Assessing for a pulse Administering oxygen Preparing for endotracheal tube intubation Applying direct pressure to control bleeding

Applying direct pressure to control bleeding

The nurse works in an emergency department (ED) in a city that experiences an earthquake prepares to care for patients with which type of injury? Drowning Electrocution Crush injuries Carbon monoxide poisoning

Crush injuries

What is the priority in the preparedness of healthcare professionals in any type of disaster plan? Identification of hazards Cooperation with state authorities Collaboration with local authorities Implementation of federal mandates

Identification of hazards

During the implementation of a disaster plan, who is responsible for all aspects of the response? Planning chief Operations officer Logistics section chief Incident commander

Incident commander

The nurse administrator for a long-term care facility is implementing a disaster response plan for staff and residents. Which staff member statements indicate correct understanding of the plan? 1 "We have to implement annual drills." ) 2 "Nursing homes are not required to have a plan." ) 3 "Our facility is held to the same standards as hospital facilities." ) 4 "This is an important component to receive insurance payments for care." )

1 "We have to implement annual drills." )

Which type of event can often be handled by an individual hospital disaster plan without collaboration with other systems? 1 A motor vehicle accident involving five cars ) 2 A tornado destroying 50 homes and businesses ) 3 An act of terrorism injuring and kills hundreds of people ) 4 A hurricane causing flooding, displacing thousands of p

1 A motor vehicle accident involving five cars )

Which is the priority nursing action to include in a disaster plan for the radioactive dust and smoke that can cause illness from a radiologic dispersal device (RDD)? 1 Covering the nose ) 2 Protecting the eyes ) 3 Decontaminating the skin ) 4 Administering prophylactic antibiotics

1 Covering the nose )

A green-tagged patient arrives at the emergency department after a mass casualty incident (MCI) involving radiation. Which is the priority nursing action for this patient? 1 Implementing decontamination measures ) 2 Performing a head-to-toe physical examination ) 3 Placing a special bracelet with a disaster number ) 4 Taking a digital photo and placing it on the medical reco

1 Implementing decontamination measures )

Which nursing actions during a mass casualty incident should be included in the triage portion of an organizational disaster plan? Select all that apply. 1 Treatment ) 2 Stabilization ) 3 Evaluation of interventions ) 4 Formulation of nursing diagnosis ) 5 Decontamination for suspected contamination )

1, 2, 5

Which nursing actions are necessary when initiating care for patients who have been injured in a natural disaster? Select all that apply. 1 Taking risks ) 2 Using principles ) 3 Stepping into the unknown ) 4 Showing a commanding presence ) 5 Formulating individualized plans of care

1-4

The nurse manager is reviewing the hospital disaster plan with other members of the committee. Which is the minimum number of disaster drills the committee must plan and implement each year? 1. Two 2. Three 3. Four 4. Five

1. Two

The nurse is contributing to a disaster plan for a possible terrorist attack. Which biological agents should be included in the plan? Select all that apply. 1 Rubella ) 2 Anthrax ) 3 Measles ) 4 Botulism ) 5 Tularemia )

2,4,5 2 Anthrax ) 4 Botulism ) 5 Tularemia )

The nurse in the emergency department has admitted five (5) clients in the last two (2) hours with complaints of fever and gastrointestinal distress. Which question is most appropriate for the nurse to ask each client to determine if there is a bioterrorism threat? 1. "Do you work or live near any large power lines?" 2. "Where were you immediately before you got sick?" 3. "Can you write down everything you ate today?" 4. "What other health problems do you have?"

2. "Where were you immediately before you got sick?"

Which emergency medical system (EMS) first responders can perform triage during mass casualty incidents? 1 Unlicensed assistive personnel ) 2 Nurses appointed to a field team ) 3 A physician who survives the incident ) 4 Community response team members )

2. Nurses appointed to a field team

A chemical exposure has just occurred at an airport. An off-duty nurse, knowledgeable about biochemical agents, is giving directions to the travelers. Which direction should the nurse provide to the travelers? 1. Hold their breath as much as possible. 2. Stand up to avoid heavy exposure. 3. Lie down to stay under the exposure. 4. Attempt to breathe through their clothing.

2. Stand up to avoid heavy exposure.

The triage nurse is working in the emergency department. Which client should be assessed first? 1. The 10-year-old child whose dad thinks the child's leg is broken. 2. The 45-year-old male who is diaphoretic and clutching his chest. 3. The 58-year-old female complaining of a headache and seeing spots. 4. The 25-year-old male who cut his hand with a hunting knife.

2. The 45-year-old male who is diaphoretic and clutching his chest.

The nurse is teaching a class on biological warfare. Which information should the nurse include in the presentation? 1. Contaminated water is the only source of transmission of biological agents. 2. Vaccines are available and being prepared to counteract biological agents. 3. Biological weapons are less of a threat than chemical agents. 4. Biological weapons are easily obtained and result in significant mortality.

4. Biological weapons are easily obtained and result in significant mortality.

The off-duty nurse hears on the television of a bioterrorism act in the community. Which action should the nurse take first? 1. Immediately report to the hospital emergency room. 2. Call the American Red Cross to find out where to go. 3. Pack a bag and prepare to stay at the hospital. 4. Follow the nurse's hospital policy for responding

4. Follow the nurse's hospital policy for responding

According to the North Atlantic Treaty Organization (NATO) triage system, which situation is considered a level red (Priority 1)? 1. Injuries are extensive and chances of survival are unlikely. 2. Injuries are minor and treatment can be delayed hours to days. 3. Injuries are significant but can wait hours without threat to life or limb. 4. Injuries are life threatening but survivable with minimal interventions.

4. Injuries are life threatening but survivable with minimal interventions.

A nurse is helping to triage a group of clients at a mass casualty incident who were involved in an explosion at a local factory. Which of the following clients should the nurse tag to be the priority for care?

A client who has a piece of wood punctured into the chest wall and has an audible hissing sound coming from the wound site

A number of nurses are floated to the ED to care for clients affected by an earthquake. Which appropriate float nurse assignments will the ED charge nurse make? (Select all that apply.) a. GI laboratory nurse assigned to clients undergoing sedation b. Orthopedic nurse assigned to accompany clients to radiology c. Nursing administrator assigned to monitor loved ones in the waiting room d. Community health nurse assigned to care for clients with fractures e. Medical surgical nurse assigned to healthcare worker who is feeling overwhelmed

A, C a. GI laboratory nurse assigned to clients undergoing sedation c. Nursing administrator assigned to monitor loved ones in the waiting room

Which organization in the United States mandates ongoing disaster preparedness for hospitals? 1 The Joint Commission (TJC) ) 2 The local government ) 3 The state government ) 4 The Occupational Safety and Health Administration (OSHA)

1 The Joint Commission (TJC) )

The nurse is teaching a class on bioterrorism. Which statement is the scientific rationale for designating a specific area for decontamination? 1. Showers and privacy can be provided to the client in this area. 2. This area isolates the clients who have been exposed to the agent. 3. It provides a centralized area for stocking the needed supplies. 4. It prevents secondary contamination to the health-care providers.

4. It prevents secondary contamination to the health-care providers.

The experienced nurse is teaching a new nurse about hospital emergency plans and personal emergency preparedness. Which specific arrangements should the experienced nurse discuss? (Select all that apply.) a. Assembly of a "go bag" b. Plans for child and/or elder care c. Neighbor who is willing to care for dog d. Who will be called when the plan is activated e. How long an emergency is expected to last f. Where a nurse is expected to report if the emergency plan is activated g. Names, addresses, and telephone numbers to be used if a crisis occurs

The whole alphabet except E

What is the highest level of personal protective equipment (PPE) for respiratory protection? Level A Level B Level C Level D

Level A

What is the most common example of an advanced warning event that might require a hospital evacuation? Bomb threat Earthquake Hurricane Tornado

Hurricane

A nurse is reviewing treatment protocols for clients exposed to bioterrrorism agents. For which of the following agents should the nurse plan to administer a vaccine?

smallpox

The ED nurse is working triage. Which client should be triaged first? 1. A client who has multiple injuries from a motor-vehicle accident. 2. A client complaining of epigastric pain and nausea after eating. 3. An elderly client who fell and fractured the left femoral neck. 4. The client suffering from a migraine headache and nausea.

1. A client who has multiple injuries from a motor-vehicle accident.

The health-care facility has been notified an alleged inhalation anthrax exposure has occurred at the local post office. Which category of personal protective equipment (PPE) should the response team wear? 1. Level A. 2. Level B. 3. Level C. 4. Level D.

1. Level A.

The nurse is conducting triage under mass casualty conditions. Which tag should the nurse use for a patient who is experiencing hypovolemic shock due to a penetrating wound? 1 Red 2 Black 3 Green 4 Yellow

1. Red

The client has expired secondary to smallpox. Which information about funeral arrangements is most important for the nurse to provide to the client's family? 1. The client should be cremated. 2. Suggest an open casket funeral. 3. Bury the client within 24 hours. 4. Notify the public health department.

1. The client should be cremated.

The nurse is conducting triage under mass casualty conditions and assigns which tag to the patient who is experiencing hypovolemic shock as a result of a penetrating wound? 1. Red 2. Black 3. Green 4. Yellow

1. red

Which are the most common types of injuries that should be identified along with treatment options in an organizational disaster plan for the use of explosive devices as agents of terrorism? Select all that apply. 1 Burn 2 Blast 3 Crush 4 Penetration 5 Psychological

2, 3, 4 2 Blast 3 Crush 4 Penetration

The nurse in a disaster is triaging the following clients. Which client should be triaged as an Expectant Category, Priority 4, and color black? 1. The client with a sucking chest wound who is alert. 2. The client with a head injury who is unresponsive. 3. The client with an abdominal wound and stable vital signs. 4. The client with a sprained ankle which may be fractured.

2. The client with a head injury who is unresponsive.

Which treatment for anthrax should be included in the biological agent portion of a disaster plan for terrorist attacks? 1 Antivirals ) 2 Antitoxins ) 3 Antibiotics ) 4 Vaccinations

3 Antibiotics )

A nurse manager is a member of the emergency response planning team for a hospital located in the Rocky Mountains. Which type of natural disaster will the nurse manager recommend be included in their hospital disaster plan? 1 Tornado ) 2 Hurricane ) 3 Avalanche ) 4 Earthquake

3 Avalanche )

The nurse is teaching a class on bioterrorism and is discussing personal protective equipment (PPE). Which statement is the most important fact for the nurse to share with the participants? 1. Health-care facilities should keep masks at entry doors. 2. The respondent should be trained in the proper use of PPE. 3. No single combination of PPE protects against all hazards. 4. The EPA has divided PPE into four levels of protection.

3. No single combination of PPE protects against all hazards.

The triage nurse in a large trauma center has been notified of an explosion in a major chemical manufacturing plant. Which action should the nurse implement first when the clients arrive at the emergency department? 1. Triage the clients and send them to the appropriate areas. 2. Thoroughly wash the clients with soap and water and then rinse. 3. Remove the clients' clothing and have them shower. 4. Assume the clients have been decontaminated at the plant.

3. Remove the clients' clothing and have them shower.

A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the following clients should the nurse plant to care for first?

A client experiencing a tension pneumothorax

A nurse is the triage officer in the emergency department when four clients arrive following a factory explosion. Which of the following clients should the nurse care for first?

An unconscious adult client who has a sucking chest wound, respiration of 38/min, and capillary refill of < 2 seconds

A nurse is preparing a response protocol for botulism as bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply)

Botulism can produce paralysis within 12 hours to 72 hours following exposure Vomiting and diarrhea are expected findings following exposure

The nurse is helping devise a training plan to familiarize healthcare providers with emergency response procedures. Which training measure is most effective to adequately prepare the trainees? Drills Tabletop exercises Access to the policy Computer simulations

Drills

In a disaster, which hospital department is responsible for the secondary triage of patients? Medical unit Operating suite Radiology department Emergency department

Emergency department

Which patient injury would receive a black tag by the triage nurse during a mass casualty incident? Concussion Ankle sprain Open femur fracture Full-thickness body burns

Full-thickness burns

Which organization requires hospitals to have disaster and evacuation plans in the event of an emergency? American Hospital Association (AHA) Hospital Regulatory Agency Homeland Security Federal Emergency Management Agency (FEMA)

Hospital Regulatory Agency

The nurse understands that which is an example of an internal threat that could lead to a "shelter in place" (SIP) order? Infrastructure damage from an earthquake Civil unrest Chemical release Terrorist threat

Infrastructure damage from an earthquake

A nurse working in an emergency department is caring for a client who has been exposed to sarin gas following a bioterrorism attack. Which of the following actions should the nurse plan to take first?

Initiate seizure precaution

The nurse dons which level of personal protective equipment (PPE) when assigned to care for a patient when the type of airborne exposure is unknown? Level A Level B Level C Level D

Level A

The nurse dons which level of personal protective equipment (PPE) when assigned to care for a patient requiring the highest level of respiratory protection but less skin protection? Level A Level B Level C Level D

Level B

The nurse dons which level of personal protective equipment (PPE) when assigned to care for a patient when the type of airborne exposure is known? Level A Level B Level C Level D

Level C

The nurse dons which level of personal protective equipment (PPE) when needing only protection from nontoxic (nuisance) contamination? Level A Level B Level C Level D

Level D

What is the goal of triage? Maximize number of survivors Provide lifesaving measures Determine level of care needed Prioritize care needs of all victims

Maximize number of survivors

Based upon Simple Triage and Rapid Treatment (START), the nurse tags the patient with which injury as yellow during the triage process? Ankle sprain Hypovolemic shock Open femur fracture Massive head trauma

Open femur fracture

During the implementation of a disaster plan that involves exposure to toxic substances, who is responsible for decontamination? Safety/security officer Operations chief Logistics section chief Incident commander

Operations chief

A nurse is providing staff education about smallpox as a bioterrorism threat. Which of the following statements indicates an understanding of this agent?

Smallpox is transmitted person to person Naturally occurring smallpox has been eradicated from the world Smallpox is often confused with varicella

A nurse assisting with field triage following a motor-vehicle crash involving a bus with multiple victims. The nurse assesses a child who has an open fracture of the femur. Which of the following actions should the nurse take?

place a yellow tag on the child

After a mass casualty event, the nurse is triaging clients in the field. Which client is correctly classified? a. 38-year-old with an open femur fracture: Black tag b. 42-year-old with multiple abrasions and contusions: Yellow tag c. 54-year-old with third-degree burns over 90% of the body: Green tag d. 61-year-old who is having difficulty breathing and wheezing: Red tag

d. 61-year-old who is having difficulty breathing and wheezing: Red tag