420 Final Practice Questions

You are a nurse who is called to the scene of a disaster. Specify the order that you would triage the following victims at the disaster site? 1) A 60-year-old man with a broken wrist and a history of heart disease. 2) A 30-year-old woman with "road burn" lacerations on her forearms and thighs. 3) A 12-year-old boy with third-degree burn marks over 40% of his body.

3, 1, then 2

Which disasters would the nurse categorize as natural events? Select all that apply. A. Blizzards B. Droughts C. Wildfires D. Nuclear explosion E. Industrial accidents

A. Blizzards B. Droughts C. Wildfires Natural disasters include weather-related events that inflict significant damage to life and property, exceeding the resource capabilities of local communities. Blizzards, droughts, and wildfires are a few examples of natural disasters. Man-made occurrences are related to identifiable human actions and also include technological events such as nuclear explosions and major industrial accidents.

disaster

a hazard that overwhelms a community's ability to cope, and may cause harm to people

triage

coding to determine order of patients

code red

immediate treatment needed

emergency management

management of emergencies using the disaster management process

preparedness

measures taken to prevent future threat of disaster

code green

minimal care required

code black

no priority, life will not be saved

preparedness

preparing to respond or recover

response

preparing to respond or recover

Nurses responding to the needs of populations and communities affected by environmental disasters and/or emergencies require understand of which of the following: A. the immediate health effects related to the event B. The potential for short-term health effects resulting from the event C. advocating for foreign policies D. the community agencies designated to respond to the event

Answer: A. the immediate health effects related to the event

After a mass casualty incident related to an accidental fire in a residential area, the medical care team is assessing clients who were affected by this disaster. The nurse notices that many of the clients are incoherent and have panic attacks and exaggerated startle responses. What condition are the clients experiencing? A. Ineffective coping B. Post-trauma syndrome C. Compromised resilience D. Disturbed personal identity

B. Post-trauma syndrome Incoherence, panic attacks, and exaggerated startle responses are symptoms of post-trauma syndrome. Ineffective coping and compromised resilience is characterized by an inability to meet basic needs, inadequate problem solving, inability to attend to information, and isolation. Disturbed personal identity is manifested as self-hatred, feelings of being ineffectual, and perceived lack of control.

What is the most important milestone achieved in global health over the last 50 years?

Decrease in the under 5 mortality rate to 65 per 1000 children

In which World Bank region would you expect females to be the least healthy compared to males? a. europe and central asia b. south asia c.south and central america d. east asia and pacific

Answer: b South Asia

What is the purpose of an administrative review debriefing session after a disaster? A. Change responsibility roles B. Prevent the development of burnout C. Analyze the amount of resources used D. Determine what went right and what went wrong

D. Determine what went right and what went wrong The goal of the administrative review debriefing is to discern what went right and what went wrong during activation and implementation of the emergency preparedness plan. This debriefing is not used to change responsibility roles. Preventing the development of burnout is the goal of critical incident stress debriefing (CISD). Analyzing resource use would occur after the disaster plan is discontinued.

What is the most important factor in the spread of TB from lower-income countries to higher-income countries?

Immigration

TRUE OR FALSE The most important factor in the spread of TB from lower-income countries to higher-income countries is immigration.

TRUE

TRUE OR FALSE. Nearly 10% of the total burden of disease in low- and middle-income countries is due to poor water, sanitation, and hygiene, urban air pollution, and indoor air pollution. Select one: True False

TRUE

TRUE OR FALSE: Evaluation needs to be completed during drills and actual disasters?

TRUE

A nurse notes that a client is refusing a vital life-saving surgery due to financial constraints. The client's insurance has lapsed and the healthcare facility's policies do not allow surgeries to be performed free of cost. What should the nurse do first to deal with the situation? 1 Identify all possible courses of action to help the client. 2 Verbalize the problem by writing a simple, clear statement. 3 Negotiate a plan with other members of the healthcare team. 4 Collect information relevant to the issue from multiple sources.

4 Collect information relevant to the issue from multiple sources. The nurse identifies the situation to be an ethical dilemma. When resolving the ethical dilemma, the nurse should first gather all relevant information related to the situation from multiple sources, such as the client, family, the institution, etc. The nurse may identify all possible courses of action after gathering information, clarifying values, and verbalizing the problem at hand. It is essential to verbalize the problem by agreeing to a simple, clear statement. This helps the team of healthcare workers to conduct a discussion. However, this step is performed after gathering relevant information and performing value clarification. Negotiation of a plan is possible only after identifying all possible courses of action. This step is not performed first by the nurse.

Young pregnant female. Voices shortness of breath. RR 38, shallow, strained. Skin pale, cool and dry, capillary refill > 2 seconds. Conscious, alert, but very agitated. Responds to questions but demonstrates lack of understanding. A. Black B. Green C. Red D. White E. Yellow

Answer: C. RED

Two key tools of the crisis/disaster worker are A. talking and responding B. taking information and relaying it C. active listening and problem solving D. triaging and directing victims

Answer: C. active listening and problem solving

All of the following statements about the World Health Organization (WHO) are true, EXCEPT: A. WHO is primarily a technical agency involved in advocacy, and generating and sharing knowledge. B. WHO leads the development of international agreements and conventions. C. WHO is a major financing agency for global health projects. D. WHO is governed through the annual World Health Assembly.

C. WHO is a major financing agency for global health projects.

People who flee or are forced to migrate during a disaster and leave their homes but stay in the country in which they were living are called: A. Internally displaced persons B. Externally displaced persons C. Refugees D. Immigrants

D. Internally displaced persons

The geographic location of a community makes it vulnerable to storms. The community health nurse teaches the community about safety measures to be taken during a storm. Which phase of disaster management is this action? A. Recovery B. Response C. Mitigation D. Preparedness

D. Preparedness Preparedness is the phase in which a plan is designed before the disaster event to best structure the response. Teaching safety measures to the people of a locality is the preparedness phase. The recovery phase involves stabilizing the community after a disaster event. Response is the implementation of the disaster plan. Mitigation is a phase of disaster management in which attempts are made to limit the disaster's impact.

TRUE OR FALSE: Moral distress can be managed and prevented

TRUE

response

actions taken immediately following a disaster

recovery

restoring, rebuilding, reshaping

code yellow

urgent, not immediate treatment required

Which health care provider would besthelp a homeless client receive needed medication for a communicable disease? 1 Navigator 2 Case manager 3 Primary nurse 4 Unlicensed assistive personnel

Answer: 1 Navigator The navigator role was conceived to reduce barriers to care for vulnerable clients who may cope with delays in access, diagnosis, treatment, and/or fragmented and uncoordinated care. A homeless person would be appropriately cared for by a navigator. The case manager, primary nurse, or unlicensed assistive personnel (UAP) would not be appropriate to aid the homeless client receive medication for a communicable disease.

Which of the following do mental health professionals need to be aware of? 1. Their own emotional reactions to the disaster and the impact it would have on their work. 2. Realization that they too have access to support and counseling. 3. Diagnosis of what the victim is experiencing. 4. Personal impression of the victim. 5. Personal impact they can have on other health care workers

Answer: all of the above

What is the most important milestone achieved in global health over the last 50 years? Select one: a.Decrease in the communicable disease rate b.Decrease in the obesity rate c.Decrease in the under-5 mortality rate d.Decrease in non-communicable disease rate

Answer: c.Decrease in the under-5 mortality rate

Clients with which tag are referred to as "walking wounded" clients while managing a disaster? A. Red B. Black C. Green D. Yellow

C. Green Clients who sustained minor injuries during a disaster and can evacuate themselves are referred to as walking wounded clients and they are green-tagged. Red tags are given to clients who have immediate threats to the life and should be treated immediately. Black tags are given the clients who are not expected to live or are dead. Yellow tags are given to clients who sustained major injuries and need treatment within 30 minutes to 2 hours.

TRUE OR FALSE: A rapid ongoing needs assessment is important since the lack of information regarding the scope of the disaster and it's initial effects can cause a mismatched resources supply and increased morbidity

TRUE

TRUE or FALSE. In today's tightly connected world, a disease can be transported from any remote village to any major city on all continents in as little as 36 hours. Select one: True False

TRUE

What is the nurse's role in the ethics of disaster? A. put disaster plans in place B. review disaster history and how disasters have affected community health care delivery C. care that maximizes the benefits to the greatest number D. identify and educate vulnerable populations about disaster/help make disaster plan E. Mobilization of first responders during a disaster

Answer: C. care that maximizes the benefits to the greatest number

Which client should be treated first, according to the disaster triage tagging system? A. Client with red tag B. Client with black tag C. Client with green tag D. Client with yellow tag

A. Client with red tag The red tag is applied to clients who require immediate treatment according to the disaster triage tag system, so client A requires immediate treatment. A black tag is applied to clients who are dead or expected to die and are not prioritized for immediate critical care. The green tags are applied to clients who can ambulate on their own, and there is no need of attending these clients first. The yellow tag is applied to clients who can wait a short duration for treatment and who can be treated after treating clients with red tags.

Which of the following statements about health equity is correct? A. Health equity is a multidimensional concept, that includes issues of fairness within and across countries B. Health equity involves equal distribution of health resources across countries C. Health equity ensures all countries have equal access to vaccines for vaccine-preventable diseases. D. None of these statements are correct.

A. Health equity is a multidimensional concept, that includes issues of fairness within and across countries

Elderly female complaining of severe leg pain and dizziness. Alert and orientated. RR 24. Pulse strong and mildly rapid at 120. Left leg has obvious deformity, and large, open wound with bone visible. Small amount of bleeding. A. Black B. Green C. Red D. White E. Yellow

Answer: E. Yellow

Which of the following are considered core values of global health? SELECT ALL THAT APPLY Select one or more: a.Research b.Human Rights c.Justice d.Diplomacy e.Health equity

Answer: b.Human Rights c.Justice e.Health equity

What is likely to be the least related to the social determinants of health? a. dowry death b. female infanticide c. breast cancer d. sexual abuse

Answer: C breast cancer

Which color tag is used for a client who is expected to die after a disaster with mass casualties? A. Red tag B. Black tag C. Green tag D. Yellow tag

B. Black tag The disaster triage tag system categorizes triage priority by color. The clients who are expected to die after a disaster are marked with a black tag. The clients who have an immediate threat to life and need emergency treatment are marked with a red tag. The clients who have minor injuries that do not require immediate treatment are marked with a green tag. The clients who have major injuries and require treatment are marked with a yellow tag.

What is the purpose of critical incident stress debriefing (CISD) after a disaster? A. Evaluate the outcomes of the care provided B. Prevent post-traumatic stress disorder (PTSD) C. Ensure all documentation has been completed D. Determine if role assignments need to be adjusted

B. Prevent post-traumatic stress disorder (PTSD) Critical incident stress debriefing (CISD) addresses pre-crisis through post-crisis interventions. After working through the turmoil and the emotional impact of the incident as well as the aftermath, the staff may find it difficult to "get back to normal." Without intervention during and after the emergency, they may develop post-traumatic stress disorder (PTSD). CISD is not conducted to evaluate outcomes of care, ensure documentation is completed, or analyze role performance during the disaster.

A nurse is responding to the needs of victims at a collapsed building. What principle guides the nurse's priorities during this disaster? A. To save the most lives, hemorrhage necessitates immediate care. B. Those requiring minimal care are treated first so they can help others. C. Because the care is most complex, victims with head injuries are treated first. D. Children receive the highest priority because they have the greatest life expectancy.

B. Those requiring minimal care are treated first so they can help others. The goal in a disaster, when need exceeds resources, is to benefit the largest number of people; helping those who need less care first benefits the largest number because they become available to help others. Hemorrhage necessitating immediate care, victims with head injuries, and children are not priorities in a disaster.

Which clients belong to class I according to the disaster triage tag system? A. Clients who can wait a short time for treatment B. Clients who are dead or expected to die C. Clients who need emergency treatment D. Clients who have no urgent need for treatment

C. Clients who need emergency treatment Emergent clients are identified with red tags and belong to class I according to the disaster triage tag system. Clients who can wait a short time for treatment are identified by yellow tags and belong to class II according to the disaster triage tag system. Clients who are expected to die or are dead are given a black tag and belong to class IV in the disaster triage tag system. Clients who have no urgency for treatment are issued green tags and belong to class III.

Which action, if performed by the nurse, is inappropriate while caring for different clients after a disaster? A. Teaching and supervising volunteers B. Providing on-site first aid and emergency care C. Evacuating injured and uninjured people from a danger area D. Teaching clients about procedures that are needed for safety

C. Evacuating injured and uninjured people from a danger area Following a disaster, the evacuating the injured and uninjured people from the danger area and placing them in a safer place is done by firefighters and other disaster-trained emergency personnel. The nurse should not perform this action because they are not provided with specific rescue training. The nurse should teach and supervise volunteers to effectively perform during disasters. The nurse should provide on-site first aid treatment to the clients. The nurse should also perform the emergency care at the disaster site. Teaching the client about safety measures at home is appropriate.

What would the registered nurse describe as the role of the American Red Cross in emergency nursing after a community disaster? A. To manage mass fatalities B. To establish fully functional field surgical facilities C. To set up shelters for clients who have lost their homes D. To deal with emotions of healthcare providers after a disturbing event

C. To set up shelters for clients who have lost their homes American Red Cross is activated by state and federal government authorities for mass casualty situations or disasters. American Red Cross sets up shelter for clients who lost their homes in the disaster or are relocated from their homes. Disaster Mortuary Operational Response Teams (DMORTs) are a healthcare service that helps to manage mass facilities. International Medical Surgical Response Teams (IMSuRTs) are healthcare services that establish fully functional field surgical facilities in a disaster. Critical Incident Stress Debriefing (CISD) teams are called to deal with emotions of healthcare providers after a disturbing event.

A nurse who is a member of a disaster medical assistance team (DMAT) has been asked to travel to a community that recently experienced devastating tornadoes. What should the nurse communicate to the nurse manager about the work schedule before leaving on this trip? A. Will return to work the next day B. Will return to work in one week C. Will not be able to work for 2 weeks D. Will need to be off work for 72 hours

C. Will not be able to work for 2 weeks Disaster medical assistance team (DMAT) personnel are deployed for a period of 2 weeks. The nurse will need to communicate his/her unavailability for work for the next 2 weeks. The nurse will not return to work the next day, in one week, or in 72 hours.

The registered nurse raises a concern about preparedness after the community healthcare provider explains the disaster plan schedule. Which statement made by the provider is the registered nurse concerned about? A. "We found a few issues when the plan was implemented in a drill session." B. "We should have more resources to mitigate the impact of disaster on the community." C. "We have to focus on elaborating the plan for stabilizing the community after the disaster." D. "We should improvise the plan structure for handling the risks associated with the disaster."

D. "We should improvise the plan structure for handling the risks associated with the disaster." The registered nurse is concerned that improvising the plan indicates an issue with preparedness. Drills are utilized as part of training for the response phase in order to identify aspects of the plan that may need improvement. Mitigation is the phase of the disaster management continuum that includes attempts to limit the disaster's impact on the human and community function. Stabilization following a disaster would indicate the recovery phase of the disaster management continuum.

Which nursing behavior helps establish rapport with survivors of a disaster? A. Evaluating B. Assessment C. Collaboration D. Active listening

D. Active listening Rapport can be established through active listening. Evaluating and assessment are steps in the nursing process and are not helpful to establish rapport. Collaboration is a behavior best used when working with others during the active stages of a disaster.

The nurse is caring for the survivors of a disaster. Which tag would be assigned to a client who has an open fracture with a distal pulse? A. Red B. Black C. Green D. Yellow

D. Yellow A yellow tag is assigned to clients with open fractures that require treatment within 30 minutes to 2 hours. A red tag is assigned to clients with life-threatening conditions such as severe hemorrhage or airway obstruction that require immediate treatment. A black tag is assigned to clients who are dead or expected to die. A green tag is assigned to clients with minor injuries.

Interventions focused on which of the social determinants of health would have the largest global impact? Select one: a.Education b.Social context c.Economic stability d.Built environment e.Access to healthcare

Answer: a.Education

Nine-year old boy sitting. Very pale, shaking, and crying. No obvious injuries. Alert and oriented, and follows commands. A. Black B. Green C. Red D. White E. Yellow

Answer: Green

You find a Middle-aged female. Unconscious. Red blistered burns on arms, chest, and face, with singed hair on face and head, burnt flesh smell. Shallow, irregular respirations at 4-5/min. Under the triage system above, this patient would be classified as: A. Black B. Green C. Red D. White E. Yellow

Answer: A. Black

What are the characteristics of equitable care? Select all that apply. 1 It strives to serve underserved people. 2 It does not vary in quality among groups. 3 It promotes delivery of care in a timely manner. 4 It is responsive to individual client preferences. 5 It is delivered in a system that allows for exemptions.

Answer: 1 It strives to serve underserved people. 2 It does not vary in quality among groups. 5 It is delivered in a system that allows for exemptions.

30-year old female. Walking through area, mumbling. Some scratches and abrasions. No breathing difficulties. Oriented to name, and address, however, speech is bizarre. When asked she states she is worried that her life is in danger and that someone is trying to kill her. She describes having a psychiatric history. A. Black B. Green C. Red D. White E. Yellow

Answer: B. Green

What is moral distress? A. process through which a person develops and maintains moral integrity B. knowing the right thing to do, but organizational constraints make it difficult to pursue the right actions C. being unsure as to which moral principles to apply. D. doing the right thing E. doing no harm

Answer: B. knowing the right thing to do, but organizational constraints make it difficult to pursue the right actions

As a community nurse, you are assigned to the disaster management team. In relation to environmental disasters, what would be your role? A. advocating for federal funds B. becoming educated regarding hazards in the community c. creating an environment that promotes health outside of the community D. showing little interest in conducting research on the health effects of toxic environmental agents

Answer: B. becoming educated regarding hazards in the community

In a world where resources are limited, what intervention would be the most valuable in reducing mortality globally? Select one: a.Childhood vaccinations b.Cardiovascular risk assessments c.Nutrition aid to developing countries d.Anti-malarial medication distribution

Answer: a.Childhood vaccinations

The nurse wishes to join the medical relief team made up of civilian medical, paraprofessional, and support personnel that is deployed to a disaster area with enough medical equipment and supplies to sustain operations for 72 hours. Which organization is this team a part of? A. Disaster Medical Assistance Team (DMAT) B. Hospital Incident Command System (HICS) C. National Disaster Life Support Foundation, Inc. D. Federal Emergency Management Agency (FEMA)

A. Disaster Medical Assistance Team (DMAT) A Disaster Medical Assistance Team (DMAT) is a medical relief team made up of civilian medical, paraprofessional, and support personnel that is deployed to a disaster area with enough medical equipment and supplies to sustain operations for 72 hours. DMATs are part of the National Disaster Medical System (NDMS) in the United States. The HICS is the facility-level organizational model for disaster management; it is a part of the National Incident Management System implemented by the Department of Homeland Security and Federal Emergency Management Agency (FEMA). The National Disaster Life Support Foundation, Inc. offers Core, Basic, and Advanced Disaster Life Support training courses on disaster response and management. FEMA provides numerous online resources, including CERT training so that people are better prepared for disasters and are able to respond more self-sufficiently

What is the priority in preparing health care professionals for any type of disaster? A. Identification of hazards B. Cooperation with state authorities C. Collaboration with local authorities D. Implementation of federal mandates

A. Identification of hazards Identification of hazards is the priority in the preparedness of health care professionals in any type of disaster plan. While cooperation with state authorities, collaboration with local authorities, and implementation of federal mandates also play a role in being prepared for a disease, these are not the priority because it is essential to identify the specific hazard in order to implement the most appropriate portion of the disaster plan.

When a disaster occurs, the nurse may have to first treat mass hysteria that is indicated by what response? A. Panic B. Coma C. Euphoria D. Depression

A. Panic People in a panic may initiate a group panic reaction even in those who appear to be in control. Comatose individuals will not cause panic in others. Euphoric individuals will not adversely affect others. Depressed people will be quiet and not affect others.

Which tag is suitable for a client with high priority during a disaster with mass casualties? A. Red B. Black C. Green D. Yellow

A. Red The red tag is assigned to a client who requires immediate emergent treatment since he or she has a life-threatening condition. A green tag is assigned to a client who does not require immediate treatment. A black tag is assigned to a client who is about to die. The yellow tag is assigned to a client with major injuries that requires immediate treatment.

Which tag color according to the disaster triage tag system is assigned to a client who has an immediate threat to life? A. Red tag B. Black tag C. Green tag D. Yellow tag

A. Red tag According to the disaster triage tag system, a red colored tag is used for a client who has an immediate threat to life. A black colored tag is used for a client who is expected to die or is dead. Green colored tags are used for a client who has minor injuries. A yellow colored tag is used for a client who has major injuries and is requiring immediate treatment.

Which is essential for ensuring disaster readiness in a community? A. Trauma system B. State government C. Federal government D. Emergency response system

A. Trauma system A well-functioning trauma system is essential to general public health and safety. It provides the structure necessary for disaster readiness and community emergency preparedness. Although most states now have at least some basic elements of a trauma system in place, significant gaps still exist in many regions. The federal government may provide oversight for disaster readiness; however, it does provide the fundamental structure. The emergency response system is one aspect of disaster readiness; however, it does not provide the structure.

The nurse is trained to work as a member of a disaster preparedness team. Which activities should the nurse be prepared to perform if a disaster were to occur? Select all that apply. A. Triage B. Palliative care C. Home visits to newborns D. Decontamination procedures E. Evaluation of the disaster plan

A. Triage D. Decontamination procedures E. Evaluation of the disaster plan If a disaster were to occur, the nurse may be required to work with hospitals and community disaster preparedness groups. The nurse must be prepared to triage mass casualties. The nurse may also be involved in decontamination procedures in case of a biological attack. The nurse must evaluate the strengths and weaknesses of the disaster management plan. The nurse provides palliative care to clients whose health status does not improve. This is not an aspect of working on a disaster preparedness team. The nurse provides community-based care by visiting the homes of newborns especially those of high-risk mothers.

The terrorist attack event on the World Trade Center on September 11, 2001, resulted in mass casualties that led to changes in hospital and community disaster planning efforts. What would the nurse say was the impact of this technological external disaster on the emergency medical services (EMS) for improving the safety of the public? Select all that apply. 1 Providing routine training to facility staff about hazardous materials 2 Upgrading decontamination facilities and equipment to protect staff 3 Making structural changes that would offer protection from utility failures 4 Preparedness of healthcare facilities for pandemic infections, including influenza 5 Developing approaches for preparedness to nuclear, biologic, chemical (NBC) threats

Answer 1 Providing routine training to facility staff about hazardous materials 2 Upgrading decontamination facilities and equipment to protect staff 5 Developing approaches for preparedness to nuclear, biologic, chemical (NBC) threats The technological external disaster event of September 11, 2001 and the resulting focus on terror threats had a great impact on the disaster planning efforts for improving the safety of the public. Emergency medical services (EMS) agencies and hospitals improved safety by providing routine training to staff about hazardous materials handling. Upgrades were made to decontamination facilities and equipment to protect staff. Approaches were designed to make the staff prepared for nuclear, biologic, and chemical (NBC) threats. Preparedness of healthcare facilities for pandemic infections resulted more from natural external disasters, such as Hurricane Katrina. Unfortunately, there still have not been sufficient structural changes that would offer protection from utility failures.

What are the effects of moral distress? SATA A. increased patient care B. difficulty concentrating C. higher self-esteem D. increased irritability E. decreased job satisfaction F. burnout syndrome

Answer: B. difficulty concentrating D. increased irritability E. decreased job satisfaction F. burnout syndrome

The nurse is contributing to a disaster plan for a possible terrorist attack. Which biologic agents should be included in the plan? Select all that apply. 1 Rubella 2 Anthrax 3 Measles 4 Botulism 5 Tularemia 6 Smallpox

Answer: 2 Anthrax 4 Botulism 6 Smallpox Biologic agents most commonly used in terrorist attacks include anthrax, smallpox, botulism, plague, tularemia, and hemorrhagic fever. Measles and rubella are not biologic agents commonly used in terrorist attacks; therefore these would not be included in a disaster plan for terrorist attacks.

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

Answer: 1 Atropine Atropine should be listed as the antidote for nerve agent poisoning in the disaster plan for a terrorist attack. Nerve gases cause the client's system to be flooded with acetylcholine, which results in an overstimulation of the nerve cell. Atropine works by blocking the acetylcholine receptors. Therefore the receptors will not pick up the acetylcholine. Dopamine, epinephrine, and norepinephrine are not medications used to treat nerve agent poisoning.

A financially struggling, large family is instructed by the home health nurse about ways to increase the dietary intake of calcium. Which suggestion should the nurse make? 1 Collards or kale in one meal a day 2 Fruit-flavored yogurt every other day 3 Bread made with cornmeal each morning 4 Eight ounces (240 mL) of milk with every meal

Answer: 1 Collards or kale in one meal a day Leafy green vegetables are an excellent source of calcium, are inexpensive, and can be home-grown; collards and kale are high in calcium. Yogurt does contain calcium, but it is costly for a large, financially struggling family. Cornbread and other bread products provide limited sources of calcium unless specifically enriched, making them more expensive. Although milk contains calcium, serving milk at every meal exceeds the recommended amount of milk for adults and is costly.

A nurse determines that a client who, although ambivalent, is considering an abortion because of financial difficulties is in crisis. How should the nurse intervene to alleviate the crisis? 1 Helping the client express her feelings 2 Identifying how family members interact 3 Suggesting that the client seek spiritual counseling 4 Involving the father in the decision-making process

Answer: 1 Helping the client express her feelings The ability to express one's feelings is often a first step in the recognition and resolution of a crisis. Identifying how family members interact is not a priority need; it may come later in the nurse-client relationship. First, the client must explore her own feelings; it is she who should decide whether she wants to seek spiritual counseling or whether the father should be involved in the decision-making process.

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 antibio

Answer: 1. covering the nose Radiologic dispersal devices (RDDs), also known as "dirty bombs," consist of a mix of explosives and radioactive material (e.g., pellets).The priority nursing action to protect against the radioactive dust and smoke that can cause illness from an RDD is covering the nose and the mouth to decrease the risk for inhalation. Protecting the eyes is the priority if present during the explosion, but not necessarily when exposed to the subsequent dust and smoke. Decontaminating the skin is important but not the priority. Administering prophylactic antibiotics will not be effective to prevent illness related to an RDD.

Which would the nurse consider to be an example of a potential internal disaster? 1 Hospital fire 2 Fertilizer plant explosion 3 Nuclear reactor explosion 4 Terrorist device explosion

Answer: 1. hospital fire An internal disaster is any kind of event inside a healthcare facility or campus that could endanger the safety of clients or healthcare staff. A fire in a hospital is an example of an internal disaster that can cause harm to the clients and the staff. A fertilizer plant explosion is an external disaster. A nuclear reactor explosion may cause radiation exposure to the external environment. Terrorism with explosive devices is an external disaster.

The mother of a large family asks the home health nurse for inexpensive sources of B vitamins. Which suggestion should the nurse make? 1 "Eat more red meat." 2 "Bake with whole wheat flour." 3 "Include more eggs in the diet." 4 "Sprinkle organic wheat germ on casseroles."

Answer: 2 "Bake with whole wheat flour." Whole grains are the least expensive source of B vitamins. Red meat is a source of B vitamins, but it is expensive. Eggs contain B vitamins, but they are expensive. Organic wheat germ is a source of B vitamins, but it is expensive.

A nurse understands that the effects of different variables on client's health beliefs and practices can help healthcare providers to plan and deliver individualized care. Which statement made by the client is a socioeconomic influence on the client's health beliefs? 1 "I am a vegetarian; I cannot eat meat because it is against my tradition." 2 "I cannot afford expensive medications because I have to take care of my family." 3 "My family members always pray before a meal because it is important to thank God." 4 "I believe that giving vaccinations to infants is sinful."

Answer: 2 "I cannot afford expensive medications because I have to take care of my family." When a client states that he or she cannot afford expensive medications because he/she has to take care of a big family, this statement is an example of a socioeconomic influence on health beliefs. When a client says that he or she is a vegetarian and cannot eat meat because of this tradition, this statement is an example of the influence of cultural background on health beliefs. When a client says that his or her family members always pray before a meal, this statement is an example of the influence of family practices. When a client says that he or she believes that infant vaccinations are sinful, this statement is an example of spiritual factors influencing health beliefs and practices.

Which statement accurately describes a health care policy as it relates to health care economics? 1 It relates to maintaining standards of health care and achieving outcomes related to the goals of health care. 2 It provides overarching goals and helps in setting priorities and values for the distribution of health resources. 3 It governs the insurance industry and plays a very important role in the application of health care funding and reform. 4 It involves the collaboration of health care workers and other resources required to perform all required client care activities.

Answer: 2 It provides overarching goals and helps in setting priorities and values for the distribution of health resources. A health care policy provides overarching goals and helps in setting priorities and values for the distribution of health resources. Health care quality relates to issues surrounding standards of care and health care outcomes. Health care coordination involves the collaboration between health care professionals and other resources, which are required to deliver client care. Health care law is a governing factor in health care economics and plays a vital role in the application of health care funding and reform.

A home health nurse is caring for school-aged children in a family that is economically deprived. Which characteristic is most common to those living in poverty? 1 Open expression of anger 2 Long-term feeling of powerlessness 3 Willingness to postpone gratification 4 Compliance with health recommendations

Answer: 2 Long-term feeling of powerlessness People living in poverty feel powerless because they do not have the buying power or social status to effect change. Their anger is covert and not direct; in addition, the anger rarely resolves their situation, resulting in feelings of powerlessness and hopelessness. Economically deprived people are less likely to postpone gratification because they focus on the present, not the future. Health recommendations may be misunderstood, confusing, or perceived as of little value and are frequently ignored.

A nurse is explaining about healthcare plans to a patient. Which healthcare plan finances a large portion of care for low-income children, their parents, pregnant women, and disabled very poor adults? 1Medicare 2 Medicaid 3 Long-term care (LTC) insurance 4 Private insurance

Answer: 2 Medicaid Medicaid finances a large portion of care for low-income children, their parents, pregnant women, and disabled very poor adults. Medicare covers services of nurse practitioners. LTC insurance is very expensive and is used for coverage of LTC services. Private insurance is typically expensive and clients have to meet deductibles before insurance pays.

A 70-year-old client needs to undergo heart surgery but cannot afford it. The client seeks the assistance of a nurse. Which is the preferred program that the nurse may suggest? 1 Medicaid 2 Medicare 3 Managed care organization 4 Preferred care organization

Answer: 2 Medicare The nurse should discuss the Medicare program to this client. This health insurance program is designed for clients 65 years of age and older. There are four parts of Medicare; part A takes care of the medical, surgical, and psychiatric costs. Medicaid is a state-operated program that provides long-term care to low-income families and disabled older clients. The nurse may suggest this program in case of disabilities, but Medicare is the preferred choice. Managed care organizations (MCO) provide comprehensive preventive and treatment services to a specific group of voluntarily enrolled people. Preferred care organizations (PCO) narrow down the list of hospitals, physicians, and healthcare providers preferred by the member. PCO and MCO members need to pay from his or her own pocket in order to afford these facilities.

Which group benefits from Medicare? 1 Self-insured employers 2 People who are 65 years or older 3 Members of low-income families 4 Children who are not poor enough for Medicaid

Answer: 2 People who are 65 years or older Medicare is a health insurance program for people 65 years or older. The payment for the plan is deducted from monthly individual social security checks. A Preferred Provider Organization (PPO) plan is a contractual agreement between a set of providers and self-insured employers. It offers comprehensive health services at a discount to companies under contract. The Medicaid plan is a federally funded, state-run program that provides health insurance for low-income families. It finances a large portion of care for poor children, their parents, pregnant women, and disabled very poor adults. The State Children's Health Insurance Programs (SCHIP) is a federally funded, state-run program for children who are not poor enough for Medicaid.

While caring for clients with injuries after a terrorist attack, the nurse observed ear bleeding, conjuctival hemorrhage, and severe lacerations in a client and provided mechanical ventilation. Which tag would be appropriate for this client according to the disaster triage tag system? 1 Red tag 2 Black tag 3 Green tag 4 Yellow tag

Answer: 2. black tag Clients with ear bleeding, conjuctival hemorrhage, and severe lacerations who require mechanical ventilation are not expected to live. Therefore, they are given a black tag. A red tag is issued to a client who needs immediate treatment. Green tags are appropriate for clients with minor injuries. Yellow tags are appropriate for clients with major injuries who can wait a short time for care. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

Which organization assists in establishing policies related to Medicare and Medicaid payment for meaningful use of EHRs? 1 National Institute of Health (NIH) 2 American Medical Informatics Association (AMIA) 3 Center for Medicare and Medicaid Services (CMS) 4 Health Information Management Systems Society (HIMSS)

Answer: 3 Center for Medicare and Medicaid Services (CMS) CMS rules specify how health care facilities and providers make meaningful use of the EHRs and technologies to receive payment from Medicare and Medicaid. The National Institutes of Health uses translational bioinformatics for medical research. The American Medical Informatics Association and the Health Informatics Management Systems Society have been involved in identifying nursing informatics competencies.

A nurse identifies that an older adult has not achieved the desired outcome from a prescribed proprietary medication. When assessing the situation, the client shares that the medication is too expensive and that the prescription was never filled. What is an appropriate nursing response? 1 Ask the pharmacist to provide a generic form of the medication. 2 Encourage the client to acquire the medication over the Internet. 3 Inform the healthcare provider of the inability to afford the medication. 4 Suggest that the client purchase medical insurance that covers prescription medications.

Answer: 3 Inform the healthcare provider of the inability to afford the medication. The healthcare provider needs to be aware of the reason for the client's lack of response to the medication so that an alternate treatment plan or financial assistance can be arranged. A healthcare provider may prefer the proprietary form of the medication. To ask the pharmacist to provide a generic form of the medication is unsafe. To recommend that the client obtain a generic form of the medication is not within the legal role of the nurse, unless the healthcare provider documents that this is acceptable. Medications purchased over the Internet may be illegally imported, counterfeit, expired, or contaminated and therefore should be avoided. Although some prescription insurance plans may help to reduce the cost of some medications, the client may not be able to afford the insurance.

What does the basic principle of advocacy provide to the nurse according to the American Nurses Association (ANA) code of ethics? 1 The basic principle of advocacy helps the nurse remain competent in nursing practice. 2 The basic principle of advocacy helps the nurse provide care on the basis of the client's specific needs. 3 The basic principle of advocacy helps the nurse make a unique contribution to the understanding of the client's point of view. 4 The basic principle of advocacy helps the nurse ensure that professional actions can be explained to clients and the employer.

Answer: 3 The basic principle of advocacy helps the nurse make a unique contribution to the understanding of the client's point of view. The nurse advocates for the health, safety, and rights of clients along with their right to privacy. This helps the nurse to make a unique contribution to understanding the client's point of view. The basic principle of responsibility ensures that the nurse is responsible for his or her own actions and the actions of people to who tasks are delegated. In addition, this principle helps the nurse to remain competent in his or her practice. The nurse ensures that care is provided to clients only on the basis of their need. Accountability refers to ensuring that professional actions can be explained to the clients and the employer.

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

Answer: 3. Antibiotics Anthrax is treated effectively with antibiotics if sufficient supplies are available and the organisms are not resistant. Antivirals would not be effective against anthrax, and there is no established treatment for most viruses that cause hemorrhagic fever. Botulism is treated with antitoxin, though several vaccines are being studied. Smallpox can be prevented or the incidence reduced by vaccination, even when first given after exposure.

Which would the registered nurse say is the priority action of first responders after a community disaster? 1 Providing on-site first aid 2 Providing emergency care 3 Removing the victims from danger 4 Categorizing victims using triage system

Answer: 3. removing the victims from danger First-responders in a disaster include other disaster-trained emergency personnel who had specific search and rescue training. The priority action of first responders is to remove injured and uninjured victims. The nursing staff provides on-site first aid and emergency care. After removing victims from danger, the healthcare personnel categorize victims using the triage system.

The nurse is teaching safe transportation techniques to new parents who have a low economic background. Which advice given by the nurse is appropriate? 1 "You should borrow or buy a second-hand car seat." 2 "You should place padding in the car seat behind the baby." 3 "You should buy an infant-only model and an infant-toddler convertible car seat." 4 "You should place the baby's car seat in the rear-facing position in the backseat."

Answer: 4 "You should place the baby's car seat in the rear-facing position in the backseat." The nurse instructs the parents to place the baby's car seat in the rear-facing position in the backseat, because it prevents injury to the infant from the air bag in case of a crash. It is dangerous to borrow or buy second-hand car seats. Placing padding behind the baby will create slack in the harness, which may result in the baby being ejected from the seat in the event of a crash. Therefore it is not a safe intervention. The parents of the baby are from a low economic background. Therefore convertible-type car seats are preferable. Though convertible-type seats cost more initially, they work out to be less expensive than buying both an infant-only model and an infant-toddler convertible model.

What does a public health nurse expect to encounter when working with families raised in a culture of poverty? 1 Willingness to delay gratification 2 Optimism about improving their lifestyle 3 Shame because of their inadequacy as parents 4 Powerlessness relative to changing their situation

Answer: 4 Powerlessness relative to changing their situation Powerlessness is a characteristic feeling among people in the culture of poverty, which tends to erode their hope for change. People in the culture of poverty usually require immediate gratification because they do not have enough faith in the future to delay gratification. Pessimism, not optimism, about changing a lifestyle is more common in these families. There is not sufficient evidence to indicate that poor people feel shame for their situation or that they are inadequate parents.

A community healthcare nurse is conducting a survey about homeless children in the community. Which finding helps the nurse distinguish absolute homelessness from relative homelessness? 1 The children are under-immunized and at a risk for childhood illnesses. 2 The children are more likely to drop out of school and become unemployable. 3 The children have access to healthcare only through the emergency department. 4 The children do not have a physical shelter and may sleep outdoors or in vehicles.

Answer: 4 The children do not have a physical shelter and may sleep outdoors or in vehicles. Public health organizations use the term absolute homelessness to describe people who have no physical shelter. These children sleep outdoors, in vehicles, abandoned buildings, or other places not intended for human habitation. Relative homelessness describes those who have a physical shelter but one that does not meet the standards of health and safety. Children from both sections of the community tend to be under-immunized and are at risk for childhood illnesses. Both types of homeless children are unable to meet residency requirements for public schools and are more likely to drop out of school and be rendered unemployable. A lack of finances leads both types of homeless children to seek healthcare only in emergency conditions.

An older adult is hospitalized for weight loss and dehydration because of nutritional deficits. What should the nurse consider when planning care for this client? 1 Financial resources usually are unrelated to nutritional status. 2 An older adult's daily fluid intake must be markedly increased. 3 The client's diet should be high in carbohydrates and low in proteins. 4 The nutritional needs of an older adult are basically unchanged except for a decreased need for calories.

Answer: 4 The nutritional needs of an older adult are basically unchanged except for a decreased need for calories. A well-balanced diet with fewer calories because of decreased metabolism is suggested for older adults. Limited financial resources are one cause of malnutrition in the older adult. Fluid needs do not increase. An older client who becomes dehydrated probably is not maintaining a minimum fluid intake. High carbohydrates will provide excessive calories, which may result in obesity. Balance should be maintained among the food groups according to dietary guidelines advocated by the United States Department of Agriculture and the United States Department of Health and Human Services (Canada: Canada's Food Guide, Health Canada); protein is needed for tissue replacement.

After a terrorist attack, the nurse notes that all victims at the disaster site have breath with almond odor. What agent does the nurse assume was used in the attack? A Cyanide B Sarin gas C Phosgene D Mustard gas

Answer: A Cyanide Cyanide poisoning can give the breath an almond odor. Almond odor breath is not associated with sarin gas or phosgene; these agents cause paralysis of respiratory muscles and respiratory depression, respectively. Likewise, mustard gas does not give an almond odor to the breath; it results in skin blisters and burns.

The registered nurse is teaching a student nurse about handling mass casualty disaster situations in the field. Which statements made by the student nurse shows the need for further teaching? Select all that apply. A. "I will work with a goal of doing the greatest good for the greatest number of people." B. "I will try to provide maximum care and save the clients tagged expectant or critically ill." C. "I will provide green-tagged clients the least priority of care compared to other categories." D. "I will manage the walking wounded clients with fractures and abrasions in a delayed fashion." E. "I will categorize clients according to the disaster triage tag system based on the severity of injuries."

B. "I will try to provide maximum care and save the clients tagged expectant or critically ill." C. "I will provide green-tagged clients the least priority of care compared to other categories." The least priority while providing care should be given to critically ill clients who are black-tagged or triaged as expectant. The triage system is implemented with the desired outcome of doing the greatest good for the greatest number of people. The walking wounded or green-tagged clients do not have immediate life threatening injuries. Most mass casualty response systems use a disaster triage tag system that categorizes triage priority by color and number based on the severity of injuries.

•What current global health causes of Death rank #1 and #2 as of 2019? SELECT ALL THAT APPLY A. Maternal Death B. Cardiovascular Disease C. Pneumonia D. Infectious Diseases

B. Cardiovascular Disease D. Infectious Disease

Which medical relief team would the nurse explain provides relief services ranging from primary healthcare and triage to evacuation and staffing to assist healthcare facilities in a massive disaster? A. Medical Reserve Corps (MRC) B. Disaster Medical Assistance Team (DMAT) C. Hospital Incident Command System (HICS) D. International Medical Surgical Response Teams (IMSuRTs)

B. Disaster Medical Assistance Team (DMAT) The DMAT is a team of civilian, medical, and paraprofessionals who are deployed to a disaster area. They provide relief services ranging from primary healthcare and triage to evacuation and staffing to assist healthcare facilities in a massive disaster. The MRC is a group of volunteer medical and public healthcare professionals. The MRC helps healthcare settings that face personnel shortages in a mass casualty event. The HICS is a facility-level organizational model to homogenize disaster operations. The IMSuRTs provide fully functional field surgical facilities in a mass casualty event whenever needed.

The registered nurse is appointed as a triage officer of the disaster management team. What would be the responsibility of the nurse as a triage officer? A. To decide the resources needed for the clients B. To determine the priority of treatment for clients C. To act as leader in implementing the emergency plan D. To serve as a liaison between the hospital and the media

B. To determine the priority of treatment for clients The role of the triage officer in disaster management is to evaluate each client and to determine the priority of treatment based on the severity of the client's condition. Deciding the resource needs of clients is the responsibility of the medical command physician. The role of the hospital incident commander is to act as a leader in overall implementation of the emergency plan. Serving as a liaison between the healthcare facility and the media is the responsibility of public information officer.

Several nurses from Pennsylvania who are members of a disaster medical assistance team (DMAT) are being sent to South Carolina to provide healthcare to hurricane victims. What action is required prior to these nurses providing care? A. Applying for licensure in South Carolina B. Showing Pennsylvania state nursing license C. None since the nurses are acting as federal employees D. Calling the National Council for the State Boards of Nursing and request licensure

C. None since the nurses are acting as federal employees Because licensed healthcare providers such as nurses act as federal employees when they are deployed, their professional licenses are recognized and valid in all states. There is no need for the nurses to apply for licensure in South Carolina, show Pennsylvania license, or call the National Council for the State Board of Nursing to request licensure.

Which psychosocial nursing actions are appropriate when providing client care after a community disaster? Select all that apply. A. Performing triage of injuries B. Administering first aid to wounds C. Offering choices whenever possible D. Establishing rapport through active listening E. Requesting assistance from crisis counselors

C. Offering choices whenever possible D. Establishing rapport through active listening E. Requesting assistance from crisis counselors Psychosocial nursing actions appropriate when providing care after a community disaster include offering choices whenever possible, establishing rapport through active listening, and requesting assistance from crisis counselors. Performing triage of injuries and administering first aid to wounds are not psychosocial nursing actions.

For which type of injury would the nurse classify a client with a black tag during a disaster situation? A. Young adult with closed fractures of the right leg B. Young adult with bruises and superficial lacerations C. Older adult with massive head trauma and multiple open fractures D. Middle-aged adult with third-degree burns over 20 percent of his body

C. Older adult with massive head trauma and multiple open fractures An older adult with massive head trauma and open fractures is categorized with a black tag. A young adult with closed fractures of the right leg is assigned a yellow tag. A young adult with bruises and superficial lacerations is classified with a green tag. A middle-aged adult with third-degree burns over 20 percent of his body would receive a red tag.

The nurse is helping a triage officer evaluate the victims of a large scale disaster. Which client does the nurse anticipate will be given a black tag? A. A client with a contusion B. A client with airway obstruction C. A client with open fractures and a distal pulse D. A client with extensive full-thickness body burns

D. A client with extensive full-thickness body burns A black-tagged client in a mass casualty triage situation is a critically ill client who is expected and allowed to die or is not treated until others have received care. This is done so that limited resources can be dedicated to saving the most lives, and not expended to save one life at the possible expense of many others. The client with extensive full-thickness body burns falls in this category. A client with a contusion would be green-tagged because a contusion is a minor injury that can be managed in a delayed fashion. A client with airway obstruction would be red-tagged. This client has an immediate threat to life and requires immediate attention. A client with open fractures with a distal pulse would be yellow-tagged. This is major injury that requires treatment within 30 minutes to two hours.

Which organization provides the Community Emergency Response Team (CERT) training so that people are better prepared for disasters? A. National Disaster Medical System (NDMS) B. Hospital Incident Command System (HICS) C. National Disaster Life Support Foundation, Inc. D. Federal Emergency Management Agency (FEMA)

D. Federal Emergency Management Agency (FEMA) FEMA provides numerous online resources, including CERT training so that people are better prepared for disasters and are able to respond more self-sufficiently to incidents and hazard situations in their own communities. The NDMS provides various types of relief services ranging from primary healthcare and triage to evacuation and staffing to assist healthcare facilities that have become overwhelmed with casualties. The HICS is the facility-level organizational model for disaster management; it is a part of the National Incident Management System implemented by the Department of Homeland Security and FEMA. The National Disaster Life Support Foundation, Inc. offers Core, Basic, and Advanced Disaster Life Support training courses on disaster response and management.

Which statement by the registered nurse is true regarding the mitigation phase of disaster management? A. It is a phase of identifying the potential risks due to the disaster. B. It is a process of assisting clients to regain a normal level of functioning. C. It is a process of combating a disaster event and providing assistance to victims. D. It is a process of minimizing of the disaster's influence on human health and community.

D. It is a process of minimizing of the disaster's influence on human health and community. The process of minimizing the disaster's influence on human health and community is the mitigation phase. Identifying potential risks due to the disaster is the preparedness phase of disaster management. The process of assisting clients to regain a normal level of functioning is the response phase. The process of combating a disaster event and providing assistance to victims is the recovery phase.

Several emergency preparedness agencies are developing emergency response plans in case of an earthquake alert. In which phase of the disaster management continuum would the nurse state this activity is included? A. Response B. Recovery C. Mitigation D. Preparedness

D. Preparedness The first phase of the disaster management continuum is preparedness. This is a protective plan designed before the event to structure the response, assess the risk, and evaluate the response. The response phase of the disaster continuum includes the actual implementation of the disaster plan. The recovery phase is related to actions focusing on stabilization of the community and returning it to the previous state. The mitigation phase includes attempts to limit a disaster's impact on human health and community function.