Med-Surg 1: Ch.12 EAQ: Emergency and Disaster Preparedness and Response

After losing her home to a hurricane several years ago, the patient says, "I get very nervous during a thunderstorm and want to hide under the bed." Which response by the nurse would the most therapeutic?

"What do you do when you feel this way?"

Which action would the high school nurse take first after a random shooting at the high school?

Assess his or her own feelings

Which organization offers training in disaster management to all levels of health care professionals?

NDLSF

Which organization published the Life Safety Code?

National Fire Protection Association

A new nurse is learning about the nurse's role in a disaster as part of orientation. Which statement about the nurse's role in a mass casualty incident is accurate?

Nurses may have to assume roles in making decisions for the most appropriate treatment of casualties

Which team member of the ER plays a leadership role in emergency situations after usual business hours until hospital leadership personnel arrive?

Nursing supervisor

During a mass casualty, which injury receives care first?

Obstructed airway

The nurse, assisting a triage team at the site of a multiple motor vehicle crash, would assign which patient a green tag?

Older man with a cut on the forearm

The nurse is assessing multiple patients at a mass casualty scene. Which patient condition correctly corresponds to the appropriate colored tag? Patient A: Airway obstruction Patient B: Open fracture with distal pulse Patient C: Closed fracture and abrasions Patient D: Sprained knee

Patient D is given a green tag

The triage area of a hospital has received several patients brought in from the site of an air crash. Which patient would the nurse anticipate discharging to make a bed available for a crash victim?

Patient newly diagnosed with diabetes requiring insulin teaching

The ER charge nurse is making patient assignments and delegating care after a mass casualty event. Which patient would be delegated to an AP?

Patient who is unconscious with massive aortic bleeding from the chest

Which patient would the nurse refer to as the "walking wounded" when assisting the triage team at an earthquake site?

Patient with several bruises and a closed fracture of the elbow

The triage nurse is a member of the medical relief team who has been delegated to a hurricane-hit area. Which supplies would the nurse take along in the go bag?

Personal ID with emergency contacts in a waterproof bag

During a mass casualty incident, which task would the ER nurse delegate to the nurse from the CCU?

Resuscitate the patient if required

After successful treatment of patients involved in a mass casualty incident, the incident commander deactivates the emergency response plan. Which activity is most important for the ER charge nurse to initiate at this time?

Take inventory and restock the ER with supplies and equipment

A patient comes to the ER covered in coagulated blood and a white powder. The patient is hysterical and fears that is in anthrax. Which action would the nurse take first?

Take the patient to the decontamination room

Which organization stockpiles critical equipment and supplies in case they are needed for a pandemic influenza outbreak?

The U.S. government

Which channel would the nurse use if he or she has a suggestion for improving response in the next mass casualty event?

The administrative review

In a mass casualty event, which person has the role of facilitating patient movement through the system?

The hospital incident commander

The disaster management nurse is performing triage on victims of a mass casualty incident. Which nursing action reflects a good understanding of the triage system?

The nurse gives a red tag to a patient with airway obstruction

During disaster management, which explanation supports the idea that a patient with a black tag is the lowest priority?

The patient is not expected to survive

In the military form of triage, which explanation is accurate regarding why "expectant" patients are attended to after others receive care?

They are highly critical with little chance of survival

In the military form of the triage process, which action would be taken for patients with massive injuries?

They are triaged into the expectant category

Which concern is the priority when patients with green tags evacuate themselves and go to a hospital for treatment on their own?

They may unknowningly carry contaminants from the disaster site to the hospital

During a mass casualty, if the triage officer is incapacitated, who would be the best choice for replacement?

Triage nurse

After a bomb blast, injured patients were brought to the ER. Which health care team member will be responsible to assign order of priority to patients for providing care?

Triage officer

Which patient would the triage nurse identify as being in the "expectant" category at the site of an earthquake?

Unconscious man with agonal breathing

How do health care workers identify the people in leadership positions in the chaotic work environment of an emergency situation?

Using brightly colored vests with large lettering

The nurse assisting with triage in the field after a large airplane crash is assessing a victim who has an open tibial fracture and a large laceration to the head but who is otherwise stable. Which color tag would be assigned to this patient?

Yellow

Which tag will the triage nurse use for a patient who has open fracture with large wound after an earthquake?

Yellow

Which requirement would be expected of the staff members of an ER during a mass casualty situation? Select all that apply.

→ The staff members should be flexible → The staff members should be creative → The staff members should know whom to call during an emergency

Which rationale is accurate as to why automated tracking system using infrared and radiofrequency technologies are available in some ER? Select all that apply.

→ To track the patient's triage priority upon arrival → To show the overall census and acuity of patients → To track contacts between patients and caregivers

For which role would the DMAT be responsible when deployed to a disaster area? Select all that apply.

→ Triage to evacuation → Provide primary health care → Provide staff to assist health care facilities

Which factor adversely affects the resource capabilities of the health care system during the outbreak of a pandemic? Select all that apply.

→ Worker illness and absenteeism → Self-imposed quarantine by health care workers → Increase in the number of people seeking medical care

In case of a fire within the hospital, arrange the actions of the nurse in the sequence in which they would be performed.

→ Shift patients and staff from the area of immediate danger of fire or smoke → Discontinue O2 for all patients and provide manual respiratory support while moving them → Direct ambulatory patients to assist wheelchair patients to a safe location → Have the staff members move bedridden patients on blankets or stretchers away from the fire area → Close doors and windows and contain the fire with an ABC fire extinguisher

Which assessment finding suggests that a patient is suffering from PTSD? Select all that apply.

→ The patient is easily startled → The patient relieves the disaster through flashbacks → The patient has been unable to sleep for more than 2 weeks

During a mass casualty, which information would the nurse use on the identification band of a patient brought to the triage area of the hospital?

Disaster number

The nurse is exhausted after caring for victims of a massive highway accident. Which actions may be required to prevent PTSD?

Drink plenty of water and eat healthy snacks

Which point would the nurse teach the community about human waste management if toilets do not flush?

Emphasize the importance of using a hand sanitizer

The triage nurse informs the incident commander that all patients in the triage area have been cared for, and some have left the hospital for their homes. Which point would the incident commander consider before deactivating the emergency response plan?

Ensure staff and supply availability to meet ongoing needs

Which role of the IMSURTs is accurate?

Establish fully functional field surgical facilities

Which action would a nurse take if designated as the triage officer in the hospital?

Evaluates each patient to determine priorities for treatment

A nurse is performing a mental health assessment for survivors of a terrorist attack. Which finding in the group indicates the risk for PTSD?

Experiencing flashbacks

Which manifestation is associated with PTSD?

Feeling numb 2 weeks or more after a disaster

Which color tag would the nurse apply to nonurgent patients during a mass casualty event?

Green tag

Which acronym represents the facility-level organizational model for disaster management?

HICS

How does a hospital in the U.S. test its disaster preparedness according to mandates set by TJC in 2020?

It involves community-wide resources in at least 2 drills per year

Which rationale for using a military form of triage in a disaster situation is accurate?

It is based on doing the greatest good for the greatest number of people

Which statement is true of the FEMA?

It provides several online resources, such as Community Emergency Response Team training

A school bus overturns in a small, rural community that is served by a critical access hospital and one volunteer fire department. How would this incident be categorized?

May be a mass casualty

Which health care personnel within the institution's emergency response plan decides the number, acuity, and resource needs of patients in a mass casualty event or disaster?

Medical command physician

Which person is responsible for determining the number of staff needed to care for the anticipated victims of a mass casualty situation?

Medical command physician

Which role is the nurse's responsibility when responding to health care facility fires? Select all that apply.

→ Move bedridden patients from fire area by stretcher → Use an ABC extinguisher if possible after everyone is out of danger → Remove any patient or staff from immediate danger of the fire or smoke

For which role is the nurse who works in the ER responsible when internal and external emergency response plans are being developed? Select all that apply.

→ Participate in disaster drills → Develop communication methods → Consider alternative treatment areas

Which patient does the ER nurse prepare to discharge to free up beds for disaster victims? Select all that apply.

→ Patient with no critical change in condition for the past 3 days → Patient who is to be shifted to a rehabilitation or long-term care facility → Patient being discharged soon to be cared for at home by the family

Which vital action would a health care system take after deactivating an emergency response plan? Select all that apply.

→ Provide the staff with adequate rest periods → Wash, pack, and resterilize instrument trays → Reorder critical supplies that have been depleted

For which duty is the triage nurse responsible during a mass casualty event? Select all that apply.

→ Quickly assessing each patient → Determining the highest-priority patients

How would the staff members from the ER prioritize their actions when called to the scene of a serious disaster? Place your answers in the correct order.

→ Remove people from the danger area → Triage victims → Provide on-site first aid and emergency care → Teach and supervise volunteers

The nurse is working with a group of patients regarding the potential for PTSD after an emergency event in the community. Which statement made by a patient indicates a need for further instruction?

"I will avoid talking about this event with others who also experienced it."

Accredited health care institutions are required to take an "all hazards approach" to disaster planning. Which disaster drill is an example of this approach?

A hospital in North Carolina plans a response to a hurricane

Which patient would be identified as emergent when triaged at the scene of a bomb blast?

A patient with an airway obstruction

Which member may be designated as the team leader of a crisis support team during a mass casualty incident?

A person who has a background in a mental health or behavioral health field

Which information is used on identification tags to identify a patient brought in from a disaster site?

Digital photo

Which statement regarding disaster triage categories is accurate?

Class I patients are given red tags

Which class of patients can wait a short time for care according to the triage method during a mass casualty incident?

Class II

During a natural disaster event, which member of the team will coordinate patients moving into a lunge to free bed space?

Hospital incident commander

Which health care personnel can assume overall leadership for implementing the emergency plan during a disaster?

Hospital incident commander

Which team member is responsible for "standing down" or deactivating the emergency response plan?

Hospital incident commander

Which essential item is added to a go bag?

Portable water

After a mass casualty event, the hospital administration seeks help from the crisis support team to provide sessions for small groups of staff. How will this debriefing provide psychosocial assistance to hospital workers?

Promotes effective coping strategies

Which responsibility would the general nurse be assigned to assist the ER nurse during a disaster?

Provide care for stable patients in the ER

The presence of a large number of media personnel is interfering with care to the victims of a mass casualty event. Whose responsibility is it to actively resolve this issue?

Public information officer

Which color tags would the nurse use for patients who need priority emergency treatment during a disaster?

Red tag

Which intervention would the nurse provide for a patient who is the sole survivor of a family in a hurricane and had a high score on the Impact of Event scale-Revised (IES-R)?

Refer the patient to a clinical psychologist

Which statement made by a new nurse indicates the need for further teaching after learning about the basic supplies required for personal preparedness? Select all that apply.

→ "I should keep matchboxes in paper bags." → "I should have food items that are ready to cook."

For which duty would the chief in a HICS be responsible during a disaster? Select all that apply.

→ Control finances → Manage logistics → Delegate duties to unit leaders

During a mass casualty event, which strategy would staff members utilize to prevent PTSD? Select all that apply.

→ Drink plenty of water → Take breaks when needed → Encourage and support co-workers

Which item would be included in a go bag for each member of a family in the event of a community evacuation? Select all that apply.

→ Emergency blanket, sleeping bag, and pillow → Personal ID with emergency contact and phone number → First aid kits with OTC and prescription medicines

Which services would a MRC team contribute to the health care for the people in an area affected by a tornado? Select all that apply.

→ Establish first aid stations or special-needs shelters → Help staff community centers that face shortage of personnel → Set up an ACC to alleviate hospital overcrowding

Which example is a type of internal disaster that a health care facility would prepare for by doing practice drills? Select all that apply.

→ Fire → Violence → Loss of critical utilities

Which action by the nurse helps people in crisis after a mass casualty event? Select all that apply.

→ Having an honest interaction → Conveying a sense of security → Offering simple, concrete explanations

Which statement describes an internal disaster? Select all that apply.

→ It creates the need to evacuate the health care facility → It endangers the safety of patients and staff in a health care facility → It requires activation of the facility's emergency management plan

Which statement is accurate regarding the HICS? Select all that apply.

→ It is a part of the NIMS → It is the facility-level organizational model for disaster management → It establishes an EOC or command center

Which duty is the chief responsible for under the HICS model for disaster planning? Select all that apply.

→ Logistics → Finance → Planning

Which action would the nurse take when evacuating patients during a fire in the health care facility? Select all that apply.

→ Maintain respiratory status manually for patients on life support → Seek assistance from ambulatory patients to move patients in wheelchairs → Discontinue the O2 supply for all patients who can breathe without it → Have staff members use blankets to move bedridden patients to safer areas

For which duty is the hospital incident commander responsible during a mass casualty incident? Select all that apply.

→ Making the decision to move patients due to be discharged to the lunge area → Directing teams to convert the PT area into a minor treatment area → Expanding hospital capacity, recruiting volunteers, and arranging medical supplies

The nurse is called from the hospital to assist the EMT in a disaster response. The nurse classifies some victims into the black-tagged category based on which assessment finding? Select all that apply.

→ Massive head trauma → Full-thickness body burns → High cervical spinal cord injury