Infection & Prevention- Bioterrorism/Emergency Preparedness
The nursing director of a long-term care facility is designated as the "incident commander" for the facility's emergency management plan. What is the priority action for the incident commander?
Activate the disaster management process according to the plan
To promote effective coping for survivors of a mass-casualty event, the nurse uses which principles while interacting with patients in crisis?
Actively listening to feelings and expression of experience Helping to problem-solve Conveying caring behaviors
The hospital in a small mountain town is updating its emergency management plan to incorporate the "all hazards approach" and to address all credible threats to the area. Which disaster events are likely priorities in this community's emergency management plan?
Avalanches "Active shooter" Car accidents Pandemic influenza
Which disaster situation is most likely to increase the complexity of managing the green-tagged patients who are more likely to self-transport from the scene of the incident to the health care facility?
Breach of containment at a nuclear plant
The nurse is assigned to assist the hospital incident commander during a disaster drill. Which responsibility is appropriate for the nurse in this capacity?
Call all nursing units to determine the number of patients who could potentially be discharged
The patient has been exposed to anthrax. What treatment will the nurse plan to administer?
Ciproflaxacin (Cipro) and doxycycline (Vibramycin)
A local news station calls the hospital seeking permission to verify the number of victims and details of a local disaster. What is the nurse's best response?
"Please hold and I will connect you to the community relations officer"
The patient tells the nurse that she is concerned about terrorist activity and questions if everyone should be immunized against smallpox. What is the best response by the nurse?
"The vaccine has side effects, which are serious and could kill many people" (An estimated 75,000 Americans could die if all Americans were vaccinated against smallpox)
At 3:00 am, the ED charge nurse of a large suburban hospital receives notification that a commercial plane has just crashed outside the city limits. What does the nurse do?
Collaborate with the medical command physician Initiate the staff telephone tree Collaborate with the triage officer Organize nursing and ancillary services
The nurse is teaching a class on anthrax to a group of emergency response workers. What is the best instruction to include?
Cutaneous anthrax is the most common form, but inhaled anthrax it the most lethal form
A nurse wants to become part of a Disaster Medical Assistance Team but is concerned about maintaining licensure in several different states. Which statement best addresses these concerns?
Deployed DMAT providers are federal employees, so their licenses are good in all 50 states
An ED charge nurse prepares to receive clients from a mass casualty within the community. What is the role of this nurse during the event?
Direct medical-surgical and critical nurses to assist with client currently in the ED while emergency staff prepare to receive the mass casualty victims
The nurse serves on a committee that is tasked with developing tools and aids that the medical command physician could use during a disaster event. What is an appropriate project for this purpose?
Make a current list, including contact information, of trauma and orthopedic surgeons
The nurse is making a personal emergency preparedness plan. What is the nurse sure to include in the plan?
Make a disaster supply kit with clothing and basic survival supplies
A hospital is participating in a bioterrorism drill. A client is admitted with inhalation anthrax. Under what type of precaution does the charge nurse admit the client?
Standard precautions (inhalation anthrax not spread person to person)
A multiple-car accident with mass casualties has occurred near an urban hospital. The hospital's emergency preparedness plan is activated. For what purposes is the post plan administrative review conducted?
To provide all employees the opportunity to express positive and negative comments
The nursing instructor is teaching student nurses about the use of viruses in a bioterrorism attack. The nurse determines that learning has occurred when the students make which statement?
"A bioterrorist attack with viruses is a real threat to Americans" (There are not effective therapies for treating patients infected by most types of viruses used in a bioterrorist attack)
The nurse is preparing an educational plan for parents about how to protect their children if a bioterrorist attack occurs. What is the best information to include?
"Follow the CDC and Prevention guidelines for immunizations"
A nurse working on a medical surgical unit is informed by the charge nurse that the emergency preparedness plan has been activated and a large number of injured patients are expected to arrive over the next few hours. Which question is the charge nurse most likely to ask?
"Potentially, could any of your patients be immediately discharged?"
Following a tornado disaster, a charge nurse is assigned to be the group co-leader of a critical incident stress debriefing session. During the session, a nurse says, "We weren't prepared for this! The administration at this hospital is a joke." What is the best response?
"Tell us about what you experienced while you were caring for victims."
A patient comes to the ED with an anxiety attack. He tells the nurse he heard that there was another anthrax attack in the capitol and is concerned about running out of medications. What is the best response by the nurse?
"The CDC maintains a large stockpile of medications for us in case that occurs"
A nurse working at a small rural hospital gets a frantic phone call about a rumor of a student attacking other students at a local high school. Which information is the most important to determine potential for a multi-casualty event versus a mass casualty event?
"What are the number and severity of the injuries?"
A nurse triages clients arriving at the hospital after a mass casualty. Which clients are correctly classified? A 35-year old female with sever chest pain: RED TAG A 42-year old male with full-thickness body burns: BLACK TAG A 55-year old female with a scalp lacerations: GREEN TAG A 60-year old male with and open fracture with distal pulses: YELLOW TAG An 88-year old male with SOB and chest bruises: RED TAG
A 35-year old female with sever chest pain: A 42-year old male with full-thickness body burns: A 55-year old female with a scalp lacerations: A 60-year old male with and open fracture with distal pulses: An 88-year old male with SOB and chest bruises:
Which event would be considered an internal disaster?
A fire in a long-term care facility
Which scenario is most likely to require activation of the emergency preparedness plan?
A multi-car accident occurs in front of a small rural hospital after midnight on Sunday
Using disaster triage principles, which patient has been correctly triaged and marked with the appropriate color tag?
An older man with shortness of breath and a hemothorax: RED TAG A toddler who has died of his injuries: Green tag—-BLACK TAG An older woman with a fractured ankle: Yellow tag—-GREEN TAG A teenager with profuse bleeding from a severe arm laceration—Black tag—YELLOW TAG ?
A nurse presenting information regarding anthrax should include which information?
Anthrax can spread easily There are there basic types of anthrax
An ED charge nurse notes an increase in sick calls and bickering among the staff after a week with multiple trauma incidents. Which action should the nurse take first?
Arrange for critical incident stress debriefing
The emergency department nurse is instructing a group of unlicensed personnel on ho two use PPE when caring for patients who may have been exposed to bioterrorism agents. One of the group is clowning around and making jokes. What should the nurse do first?
Ask him to demonstrate the use of PPE in the care of a patient with Ebola
The nurse is working in the ED where several local gang members are being treated for gunshot and knife wounds. The nurse hears gunshots in the waiting room, followed by screaming and cries for help. What does the nurse do first?
Assess the level of threat to self and others and call for help
Which nurse activity would best help the hospital to meet The Joint Commission's mandate for emergency preparedness?
Assist in planning drills that include patient simulations
A long-term care facility formed a committee to review the facility's emergency preparedness plan. Which element needs to be resolved in order to meet the guidelines of the Life Safety Code, which is published by the National Fire Protection Association?
Building has one main front door, and side doors are sealed shut
A hospital prepares to receive large numbers of casualties form a community disaster. Which clients should the nurse identify as appropriate for discharge or transfer to another facility?
Client who had open reduction and internal fixation of a femur fracture 3 days ago Client on the medical unit for wound care
To prevent the development of post-traumatic stress disorder (PTSD) in hospital staff, what action is likely to be taken by the facility?
Conducting critical incident stress debriefings
The nurse is assigned to assist the incident commander who is evaluating the feasibility of deactivating the emergency management plan. The commander directs the nurse to accomplish certain tasks. Which task is the priority?
Contact all hospital departments and determine if needs have been met
After a major city-wide environmental crisis, which type of intervention is most appropriate for hospital staff?
Critical incident stress debriefing
Following a bioterrorism attack, the nurse finds that the victims are suffering form small, black lesions on their forearms. The nurse collaborates with the physician to treat exposure to which agent?
Cutaneous anthrax
After a hospitals ED has efficiently triaged, treated, and transferred clients from a community disaster to appropriate units, the hospital incident command officer wants to stand down from the emergency plan. Which question should the nursing supervisor ask at this time?
Do all areas of the hospital have the supplies and personnel they need?
To protect hospital staff from experiencing PTSD, what are appropriate recommendations by the facility to its employees?
Drink plenty of water and eat healthy snacks
A community hospital is reviewing the activation and implementation of its emergency preparedness plan after a recent mass-casualty event. Which outcome statement reflects the goal of an administrative review?
Emergency preparedness plan was activated in a timely fashion, but telephone tree was outdated and did not include new employees
A gang-related incident has occurred involving major casualties from gunshot wounds to 11 victims. Which intervention would be included in the critical stress incident debriefing?
Encouraging unconditional acceptance of all thoughts and feelings
A patient comes to the ED worried that he has been exposed to an infectious bioterrorism agent that was sent to him through the mail. What is the priority actin for the ED nurse to take?
Escort the patient to a quarantined area
For which event would a large urban hospital's emergency management plan typically be activated?
Explosion at a chemical factory
A committee is reviewing the hospital's emergency management plan. In the event of a large-scale multi-casualty event, which group is likely to require the largest amount of physical space to accommodate the number of victims?
Green-tagged patients
A hospital prepares for a mass casualty event. Which functions are correctly paired with the personnel role?
Hospital incident commander: assumes overall leadership for implementing the emergency plan Triage officer: rapidly evaluates each client to determine priorities for treatment
A nurse cares for clients during a community-wide disaster drill. Once of the clients asks, "Why are the individuals with black tags not receiving any care?" How should the nurse respond?
In a disaster, extensive resources are not used for one person at the expense of many others
A nurse is field-triaging client after an industrial accident. Which client condition should the nurse triage with a red tag?
Multiple fractured ribs and SOB NOT: dislocated right hip and an open fracture of the right lower leg; large contusion to the forehead and a bloody nose; closed fracture of the right clavicle and arm numbness
The hospital staff is participating in a disaster drill, and the nurse is assigned to organize personnel who are called in from home. Which task would be appropriate to delegate to unlicensed assistive personnel who usually work in the labor and delivery area?
Obtain vital signs of the "yellow tag" patients
Emergency medical services (EMS) brings a large number of clients to the ED following a mass casualty incident. The nurse identifies the clients with which injuries with yellow tags?
Partial thickness burns covering both legs Neck injury and numbness of both legs Small pieces of shrapnel embedded in both eyes Bruising and pain in the right lower abdomen (Clients with burns, spine injuries, eye injuries, and stable abdominal injuries should be treated within 30 minutes to 2 hours, therefore yellow tags. R RED TAGS: Open fractures of both legs with absent pedal pulses Head injury and difficult to arouse
Which priority intervention would be more likely to occur during an internal disaster compared to an external disaster?
Patients and staff would be evacuated
The triage method for multi-casualty or mass response utilizes what sorting methods?
Patients are labeled by number Patients are ranked using colored labels
The emergency management plan is activated because a major earthquake has caused many serious and minor injuries. Which nurse reassignment is most likely to meet the needs of the patients while best utilizing available personnel?
Performance improvement nurse is reassigned to care for "green tag" patients
The hospital committee is reviewing the emergency management plan of their small community hospital in a suburban area of a large city. What is a priority to include in this hospital's emergency management plan?
Plan for transporting patients to other hospitals
Which action meets The Joint Commission's 2015 mandate for the hospital's emergency preparedness plan?
Plan is tested twice a year using simulated patients to assess collaboration and command
A nurse based in Iowa is a volunteer member of the Medical Reserve Corps and has been called to serve in Ohio, where he does not hold an active nursing license. What should the nurse do?
Prepare for deployment because he will be considered a federal employee with valid licensure
A family in the ED is overwhelmed at the loss of several family members due to a shooting incident in the community. Which intervention should the nurse complete first?
Provide a calm location for the family to cope and discuss needs
A hospital responds to a local mass casualty event. Which action should the nurse take to prevent staff PTSD during a mass casualty event?
Provide water and healthy snacks for energy throughout the event
The nurse is using the Impact of Event Scale-Revised (IES-R) to assess a CNA who was working in a long-term care facility that was devastated by a fire. The IES-R score is high on all sub scales. What should the nurse do?
Refer the CNA to a psychiatrist or clinical psychologist for additional evaluation
The patient has been exposed to a nerve agent. For which symptoms will the nurse likely assess?
Salivation, involuntary urination, and convulsions
The patient has been exposed to cutaneous anthrax 2 weeks ago. What will the nurse see when assessing the patient's skin?
Small skin lesions, and later black scabs
A nurse wants to become involved in community disaster preparedness and is interested in helping set up and staff aid stations or community acute care centers in the event of a disaster. Which organization is the best fit for the nurse's interests?
The Medical Reserve Corps
A city committee reviews possible scenarios related to a disaster event. Which is an example of the "greatest good for the greatest number of people"?
Thirty people with possible exposure to a bioterrorism agent are quarantined, including five children who are asymptomatic
The hospital administration arranges for critical incident stress debriefing for the staff after a mass casualty incident. Which statements by the debriefing team leader is most appropriate for this situation?
You are free to express your feelings; whatever is said here stays here
A client who is hospitalized with burns after losing the family home in a fire becomes angry and screams at a nurse when dinner is served late. How should the nurse respond?
You seem upset. I have time to talk if you would like
A nurse is caring for a client whose wife died in a recent mass casualty accident. The client says, I can't believe that my wife is gone and I am left to raise my children all by myself. How should the nurse respond?
You sound anxious about being a single parent
