community 17
As part of secondary prevention, the community health nurse engages in crisis intervention to achieve which of the following? A) Reestablish equilibrium to the lives of those involved B) Prevent the crisis altogether C) Involve as many people as possible in the resolution D) Triage clients during the recovery phase of the crisis
A Feedback: The stated goal of crisis intervention is to reestablish equilibrium. Prevention is the best approach, but some crises, such as natural disasters, cannot be prevented. They can, however, be prepared for to decrease the negative effects of the crisis as much as possible. It is important to have an adequate number of people needed to come to resolution. However, too many people involved in resolution may cause additional confusion, chaos, and unnecessary delays. Triage decisions need to be made during the response phase of the disaster or crisis and not deferred until the recovery phase. Triage is an ongoing process throughout the response phase.
A community health nurse is part of a disaster response team that is first to respond to an earthquake. The team evaluates the level of destruction and devastation, identifying this as which of the following? A) Intensity B) Scope C) Casualty D) Range of effect
A Feedback: The intensity of a disaster is the level of destruction and devastation it causes. The scope of a disaster is the range of its effect, either geographically or in terms of the number of victims. Casualty refers to the human being(s) injured or killed by or as a direct result of an accident.
Which of the following are necessary components of a nurse's personal preparedness? Select all that apply. A) Workplace and community disaster plans have been reviewed by the nurse. B) An individual disaster plan for the nurse's own family has been developed. C) The nurse participated in disaster drills at the workplace and had a family disaster drill to practice what actions to take in the event of a disaster. D) It is not necessary for the nurse to bring copies of their nursing license and driver's license. E) In the case of an actual disaster, the nurse will be able to use equipment made available to them.
A, B, C Feedback: To be personally prepared, a nurse should have read and understood workplace and community disaster plans, should have developed a disaster plan for his or her own family, and should have participated in disaster drills. Nurses preparing to work in disaster areas should bring copies of their nursing license and driver's license and bring basic equipment.
Which of the following would be most appropriate for community health nurses to encourage when helping communities cope with the anxiety associated with terrorism? A) Maintaining high levels of alertness and fear B) Spending time with children and young people C) Spending more time indoors D) Keeping a fear journal
B Feedback: Most young people carry a charge of positive energy that is infectious. Maintaining high levels of alertness and fear are not healthy. Instead individuals should be a little afraid because a certain level of fear is healthy if the person learns to use it as positive energy. Spending more time outdoors is helpful remedy. Individuals should keep a courage journal; fear immobilizes and courage takes action.
When providing secondary prevention activities for individuals experiencing psychological consequences of a disaster, which of the following would the nurse do as a generic approach? A) Providing situational support for stress relief B) Conveying warmth and concern for the client C) Teaching about expected emotional reactions D) Reunifying family members who were separated
C Feedback: The generic approach is designed to reach high-risk individuals and large groups who have experienced the same disaster, teaching them about the expected emotional reactions to the type of disaster they have experienced and promoting adaptive responses. Environmental manipulation results in the change of a person's physical or interpersonal situation, providing situational support to relieve stress. An example of environmental manipulation is when a community health nurse coordinates the reunification of family members separated by the disaster. General support is defined as the caring, warmth, and concern the community health nurse conveys to the client as she or he delivers services.
Which of the following statements about disaster planning is most accurate? A) Disaster planning is essential for a community, business, or hospital. B) A disaster plan must be lengthy and detailed. C) A disaster plan should be created by the person responsible for the emergency management of the community. D) It is assumed that all professionals have addressed their personal preparation.
A Feedback: Disaster planning is essential for a community, business, or hospital. A disaster plan need not be lengthy. A disaster plan should be created by all involved, including community leaders, health and safety professionals, and lay people. All nurses should address their own personal preparedness to respond in a disaster, but this may not be assumed.
A community health nurse is assisting the local community in preparing a disaster plan. Which of the following would the nurse expect to be addressed? Select all that apply. A) Chain of command B) Routes for transportation C) Triage D) Basic equipment E) Copies of licenses
A, B, C Feedback: A disaster plan should address the chain of command, routes and modes of transportation, and triage methods. Basic equipment and licenses are items that a nurse should bring along when preparing to work in a disaster area.
A community health nurse is engaged in primary prevention activities related to disasters. Which of the following would be examples of appropriate activities? Select all that apply. A) Providing anticipatory guidance B) Practicing an escape plan C) Providing emergency assistance D) Planning disaster drills E) Providing immediate response F) Reducing the degree of disability
A, B, D Feedback: Anticipatory guidance, practicing escape plans, and planning disaster drills all constitute primary prevention activities. Providing emergency assistance and immediate response reflect secondary prevention activities. Reducing the degree of disability or damage resulting from the disaster reflects tertiary level prevention activities.
A community health nurse is working with a community that is involved with improving community and individual reaction and responses, so that the effects of a disaster are minimized. This community is in which phase of disaster management? A) Prevention B) Preparedness C) Response D) Recovery
B Feedback: Disaster preparedness involves improving community and individual reaction and responses so that the effects of a disaster are minimized. During the prevention phase, no disaster is expected or anticipated. The task during this phase is to identify community risk factors and to develop and implement programs to prevent disasters from occurring. The response phase begins immediately after the onset of the disastrous event. During the recovery phase, the community takes actions to repair, rebuild, or relocate damaged homes and businesses and restore health and economic vitality to the community.
After teaching a group of students about agents associated with chemical warfare, the instructor determines that additional teaching is needed when the students identify which as an example? A) Explosives B) Nerve agents C) Anthrax D) Jet fuel
C Feedback: Anthrax is considered a bioweapon. Explosives, nerve agents, and jet fuel are considered agents of chemical warfare.
A community health nurse is working with people who experienced a tornado and have been forced to leave their homes to escape the effects of a disaster. The nurse would identify these people as which of the following? A) Indirect victims B) Refugees C) Displaced persons D) Casualties
C Feedback: Displaced persons are those who have been forced to leave their homes to escape the effects of a disaster. Indirect victims are the relatives and friends of direct victims. Refugees are direct victims who are forced to leave their homeland, usually due to war, religious persecution, or political turmoil. A casualty is a human being who is injured or killed by or as a direct result of an accident.
A community health nurse is preparing a presentation for a community group about possible agents of terrorism. Which of the following would the nurse include as an example of a bioweapon? Select all that apply. A) Mustard gas B) Sarin C) VX gas D) Nerve agents E) Bombs
A, B, C Feedback: Bioweapons include mustard gas, sarin, VX gas, and anthrax. Nerve agents and bombs are examples of chemical warfare agents.
After teaching a class about the factors that contribute to disasters, the instructor determines that the teaching was successful when the students identify which of the following as the agent? A) Population's age B) Radiation C) Level of preparedness D) Flood-prone location
B Feedback: The agent is the natural or technologic element that causes the disaster. For example, the high winds of a hurricane and the lava of an erupting volcano are agents, as are radiation, industrial chemicals, biologic agents, and bombs. The population's age is an example of host factor. The level of preparedness and flood-prone location are examples of environmental factors.
Which of the following examples of disasters are natural disasters? Select all that apply. A) The Earthquake and tsunami in Japan in 2011 B) The 2008 shootings at Virginia Tech C) The terrorist attacks on the United States on September 11, 2001 D) Wildfires that affected California in October 2007 E) The oil spill in the gulf coast in 2010 that threatened hundreds of species of wildlife
A, D Feedback: Examples of natural disasters include the earthquake and tsunami in Japan in 2011 and wildfires that affected California in October 2007. The following disasters are man-made: the 2008 shootings at Virginia Tech; the terrorist attacks on the United States on September 11, 2001; and the oil spill in the gulf coast in 2010 that threatened hundreds of species of wildlife.
Which time after the disaster would be the ideal time for this to occur? A) Within 18 hours B) 1 to 3 days C) 4 to 6 days D) 7 to 10 days
B Feedback: The ideal time for CISD is between 24 and 72 hours after the disaster event.
When would the nurse expect the response phase of a disaster to occur? A) When no disaster is expected or anticipated B) Immediately after the onset of the disastrous event C) Long-term phase occurring after the disastrous event D) Prior to the disastrous event
B Feedback: The response phase of disaster occurs immediately after the onset of the disastrous event. During the prevention phase no disaster is expected or anticipated. Long-term phase occurring after the disastrous event is the recovery phase. Prior to the disastrous event is the preparedness phase.
A community health nurse responding to a disaster is involved with caring for the bodies of the casualties who have died. Which of the following would be an appropriate method for documentation? A) Making a note on the triage tag B) Using a toe tag for identification C) Placing the name on a casualty list D) Recording the name on the victim's body
B Feedback: Toe tags make documentation visible and accessible and are the most appropriate means for documentation. Making a note on the triage tag, placing the name on a casualty list and recording the name on the victim's body are inappropriate.
A community health nurse suspects that a client who was a victim of a disaster 3 months ago is experiencing post-traumatic stress disorder. Which of the following would the nurse expect to find? Select all that apply. A) Diminished startle response B) Hypervigilance C) Feelings of detachment D) Flashbacks E) Full range of affect
B, C, D Feedback: Signs and symptoms of post-traumatic stress disorder include increased startle response, hypervigilance, feelings of detachment, flashbacks, and restricted affect.
The nurse is using the epidemiological triad to explain the factors contributing the disaster. Which one of the following statements about the environment factors that contribute to disasters is most accurate? A) The environment is the natural or technologic element that causes the disaster. B) The environment is the human being who experiences the disaster. C) Factors that could potentially contribute to or mitigate a disaster are environmental. D) Examples of environmental factors that cause a disaster are high winds of a hurricane and the lava of an erupting volcano.
C Feedback: Factors that could potentially contribute to or mitigate a disaster are environmental. The agent factor is the natural or technologic element that causes the disaster, for example the high winds of a hurricane and the lava of an erupting volcano. The host is the human being who experiences the disaster.
A community health nurse is working with a community that is involved with identifying risk factors for program development in case of a disaster. This community is in which phase of disaster management? A) Prevention B) Preparedness C) Response D) Recovery
A Feedback: During the prevention phase, no disaster is expected or anticipated. The task during this phase is to identify community risk factors and to develop and implement programs to prevent disasters from occurring. Disaster preparedness involves improving community and individual reaction and responses so that the effects of a disaster are minimized. The response phase begins immediately after the onset of the disastrous event. During the recovery phase, the community takes actions to repair, rebuild, or relocate damaged homes and businesses and restore health and economic vitality to the community.
When performing triage during a disaster, which color would indicate that the victim is in urgent need of care? A) Red B) Yellow C) Green D) Black
A Feedback: During triage, red indicates that the victim has injuries or medical problems that will likely lead to death if no treated immediately. Yellow indicates that the person has injuries that require medical attention but time to treatment is not yet critical. Green indicates that the victim has minor injuries or are presenting with minimal signs of illness. Black indicates that the victim is dead or has suffered mortal wounds.
A community health nurse is responding to a disaster. Which of the following would most likely be the least appropriate area for the nurse to be located? A) The disaster site B) Triage C) Victim treatment area D) Local hospitals
A Feedback: Usually, the immediate disaster site is not the best place for the disaster nurse, who can be far more effective in triage and treatment of victims. One of the lessons of the World Trade Center bombing was that the greatest need for medical professionals was at the local hospitals, not at the disaster site.
A community health nurse working as a part of a disaster response team is told that the disaster is classified as a multiple-casualty incident. The nurse would interpret this to mean which of the following? A) There is more than 1 but less than 10 casualties. B) The number of casualties is between 2 and 100. C) Casualties number over 100. D) There are too many casualties to count.
B Feedback: If casualties number more than two people but fewer than 100, the disaster is characterized as a multiple-casualty incident. A mass-casualty incident involves100 or more casualties.
When describing primary prevention activities that would occur in the preparedness phase of a terrorist attack involving biologic weapons like smallpox or anthrax to a local community group, which of the following would the nurse include? A) Investigating outbreaks to determine source B) Administering vaccines C) Screening suspected cases D) Treating persons who have been infected
B Feedback: Primary prevention activities that would occur in the preparedness phase of a terrorist attack involving biologic weapons like smallpox or anthrax would include administering vaccines. Investigating outbreaks to determine the source, screening suspected cases, and treating persons who have been infected would be secondary prevention activities.
Which of the following federal agencies would a community health nurse expect to be contacted to assist with a disaster in the United States? A) American Red Cross B) Federal Emergency Management Agency (FEMA) C) WHO's Emergency Relief Operations D) Pan American Health Organization
B Feedback: The Federal Emergency Management Agency (FEMA) is the federal agency responsible for assessing and responding to disaster events in the United States. The American Red Cross is authorized to provide disaster assistance free of charge across the country through its more than 1 million volunteers. It is not supported by the federal government. The World Health Organization's Emergency Relief Operations provide disaster assistance internationally, and the Pan American Health Organization works to coordinate relief efforts in Latin America and the Caribbean.
A group of ten people from the commune in the hills come into town dressed in robes and have their faces covered. They have weapons hidden in their clothing and begin entering the three banks in town to rob them. These actions can be classified as which of the following? A) Natural disaster B) Terrorism C) Casualty D) Adventitious crisis
B Feedback: The actions resemble terrorism, the unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population or any segment thereof in furtherance of political or social objectives. The actions are not a natural disaster. Casualty refers to the person who is injured or killed by or as a direct result of an accident. An adventitious crisis is an event that is out of the ordinary in magnitude and personal experience.
