Exam 4 EAQs: Ch. 68 - Disaster Nursing

A group of people accidentally came in contact with anthrax while cleaning a storage space. What is important for nurses to ask such patients after anthrax exposure? Select all that apply. "Are you having abdominal pain?" "Are you allergic to any antibiotics?" "Do you have any shortness of breath?" "Was this the result of a terrorist attack?" "Have you received the anthrax vaccine?" "Have you flushed your skin to decontaminate?"

"Are you allergic to any antibiotics?" "Do you have any shortness of breath?" "Have you received the anthrax vaccine?" "Have you flushed your skin to decontaminate?" Anthrax vaccines are provided to high-risk individuals and the military. Antibiotics can be used in treatment, depending on the anthrax organism. Anthrax vaccines can help protect against cutaneous and inhaled anthrax, but safety monitoring, such as asking about shortness of breath, and treatments, such as flushing the skin, are recommended. It is not necessary for treatment for the nurse to ask how the anthrax exposure occurred. Anthrax may cause nausea, but it does not cause abdominal pains.

The nurse on duty receives a call requiring an emergency first responder team to deploy to the incident location. Which statement by the caller confirms an emergency situation in an extraordinary event? "I feel tremors and think it is an earthquake." "I have hurt my finger and there is blood everywhere." "I need to report a multivehicle crash on the highway." "I think my husband is having a stroke. Could you please send someone to my home?"

"I need to report a multivehicle crash on the highway." The term emergency is used to refer to an event that would require a rapid and skilled response and that can be managed within the community's existing resources. A multivehicle crash on a highway is an emergency situation that endangers the lives of the people involved. A large earthquake is a natural disaster and cannot be handled with the existing resources of a community. Communities such as the American Red Cross and Federal Emergency Management Agency may be called for support of casualties caused by a natural disaster. A finger injury can be treated with administration of first-aid at home. Stroke patients need to be rushed to the hospital for immediate attention, but stroke is not an extraordinary event.

During an educational program about emergency response provided to hospital staff nurses, which nursing statement indicates he or she requires further education? "Nurses are part of the community emergency response teams." "Community emergency response teams help with life-saving measures." "Community emergency response teams are taught to help themselves first." "Community emergency response teams immediately organize untrained volunteers."

"Nurses are part of the community emergency response teams." Nurses are not directly part of a community emergency response team (CERT), but they can offer help to the CERT as an untrained volunteer until professional help arrives. CERT members are taught to help themselves first, help with life-saving measures, and immediately organize untrained volunteers until professional help arrives.

Radiation exposure is expected after an explosion. What does the nurse say to the victims after they arrive at the hospital? Select all that apply. "Did you see the radiation dust?" "Radiation dust cannot be smelled." "I understand the radiation tasted like metal." "The radiation light may have hurt your eyes." "It is great you covered your nose and mouth." "You need a second shower upon arrival at the hospital."

"Radiation dust cannot be smelled." "It is great you covered your nose and mouth." "You need a second shower upon arrival at the hospital." Radiation cannot be seen, smelled, or tasted, and it should be limited by a cover over the nose and mouth. A second shower will be needed upon arrival. Radiation dust is not visible, radiation does not taste like metal, and radiation will not produce light.

A land slide occurs, injuring a group of people. Victims who are moaning and clearly in pain are still at the scene. How long will the rescue nurse assess each victim before placing the appropriate triage tag? 15 seconds 30 seconds One minute Five minutes

15 seconds The rescue worker should take 15 seconds to quickly make an assessment to determine the triage level. Thirty seconds, one minute, and five minutes are too long for triage purposes.

Power was disrupted in a long-term care facility for a prolonged period of time. The air temperature has been 95˚F (35˚C) for several hours. Transport has been arranged to a local emergency department. Which are priority patients for the nurse? Select all that apply. 70-year-old patient with uncontrolled atrial fibrillation 95-year-old patient who states a muscle cramp is not relieved 75-year-old patient with a heart rate of 99 beats/minute and complaints of nausea 85-year-old patient with mild confusion and blood pressure of 86/40 mmHg 68-year-old patient who is combative and whose skin is hot and dry 57-year-old patient on oxygen who complains of shortness of breath

70-year-old patient with uncontrolled atrial fibrillation 85-year-old patient with mild confusion and blood pressure of 86/40 mmHg 68-year-old patient who is combative and whose skin is hot and dry 57-year-old patient on oxygen who complains of shortness of breath The 85-year-old patient with mild confusion and a blood pressure of 86/40 mmHg is experiencing heat exhaustion and requires immediate attention. The patient who is combative with hot and dry skin is experiencing heat stroke and should be provided medical care immediately. The 57-year-old patient on oxygen who complains of shortness of breath and the 70-year-old patient with uncontrolled atrial fibrillation are experiencing heat exhaustion and need immediate attention. The 75-year-old patient with a heart rate of 99 beats/minute and complaints of nausea and the 95-year-old patient who states a muscle cramp is not relieved are suffering less dangerous effects of the heat and are therefore lower priority.

A school bus crash leaves many children injured. Which children will be given a yellow tag? Select all that apply. A child with a broken leg A child with minor scrapes A child in respiratory distress A child with a bruised and swollen arm A child complaining of abdominal pains A child who is drowsy and has a head wound

A child with a broken leg A child with a bruised and swollen arm The children with urgent non-life-threatening injuries are given yellow tags; these include the child with a broken leg and the child with a bruised and swollen arm. The children in respiratory distress, with abdominal pains, and with a head wound and drowsiness need red tags and should be transported to the hospital first. The child with minor scrape will be given a green tag, indicating minor injuries, and will be transported last.

A storm causes flooding in the two lower levels of a hospital. The hospital must evacuate. Which patient is given immediate transfer to another full-service hospital? A hospice patient who is cold and mottled A dialysis patient with a potassium level of 6.0 A postoperative patient two days following surgery An asthma patient recovering from an exasperation

A dialysis patient with a potassium level of 6.0 The dialysis patient with a potassium level of 6.0 should be given immediate transfer for a full-service hospital to receive dialysis on arrival. The asthma patient is recovering and may be released home. The hospice patient is provided comfort and does not need immediate treatment, so this patient does not need to be immediately transferred. The postoperative patient may be discharged home after two days if he or she is tolerating oral fluids.

After identifying the need for a critical incident stress management session after a serious accident involving many local residents, what resource does the nurse manager provide? A chaplain to discuss end-of-life care A group discussion to allow staff to verbalize feelings and emotions A day off for staff to visit the employee assistance program (EAP) provider An online educational program on disasters in the emergency department (ED)

A group discussion to allow staff to verbalize feelings and emotions A critical incident stress management session is recommended after a stressful critical incident. This session involves a group discussion to allow staff to verbalize feelings and emotions. A chaplain can come as part of the discussion on providing end-of-life care to help the staff resolve their feelings and emotions, but this is not the focus of this particular session. An online educational program on disasters in the ED is recommended for new staff orientation and for ongoing staff competency but not for a critical debriefing. If after all other resources have been provided a nurse is still having emotional distress about the incident, he or she should be allowed time off to visit the EAP provider.

The nurse is triaging a group of patients after a natural disaster. For which patients can the nurse delegate care to an unlicensed assistance personnel (UAP) who has floated from the medical unit? Select all that apply. A patient needing a tetanus vaccine A patient complaining of abdominal pain A patient on a ventilator who needs to be turned A family member wanting an update on a parent A patient who needs to be transported to radiology A patient with a fracture of the leg who has to go to the bathroom

A patient on a ventilator who needs to be turned A patient who needs to be transported to radiology A patient with a fracture of the leg who has to go to the bathroom The UAP can assist the patient with a fractured leg with a bedpan or urinal, help turn a patient on a ventilator, and transport a patient to radiology. The UAP is not licensed to help a patient with pain, update family on a patient's condition, or administer a tetanus vaccine.

Many people lost power for a long period during a snow storm, and a large group of people developed frostbite while trying to walk to a shelter. Which patient requires the nurse's priority attention? A child with a red face who is crying in pain A patient with edema and blisters on the left leg A patient who is insensitive to touch on a mottled leg A patient whose arm is pale yellow with frozen-feeling skin

A patient who is insensitive to touch on a mottled leg The leg that is mottled and insensitive to touch has deep frostbite. If circulation is not restored, the patient may lose the leg, so this patient requires the nurse's immediate attention. The child with a red face should be treated for pain next. The patient with pale yellow skin that feels frozen has superficial frostbite and should be treated next. The patient with edema and blisters has likely had the injury for 24 hours or more and should be treated as soon as the others have been treated.

A group of patients have suffered injuries following a building collapse. Which patient with an open wound requires a tetanus vaccine? A patient who received a tetanus vaccine two months ago in the wellness clinic A patient who received a tetanus vaccine seven years ago and has already received two vaccines A patient who received a tetanus vaccine four years ago and has already received four vaccines A patient who received a tetanus vaccine two years ago and has already received three vaccines

A patient who received a tetanus vaccine seven years ago and has already received two vaccines The patient should receive a tetanus vaccine if one was not received in the past five years and fewer than three have ever been received. The patient who received a vaccine seven years ago and has received two meets these criteria. The patients who received vaccine two years, four years, and two months ago do not meet these criteria.

An explosion at a large industrial plant has left many injured. Which victim should receive a black tag? A patient with chest pains after a crushing injury A patient with a gaping head wound and no pulse A patient with a bleeding leg after a stabbing injury A patient with a blood pressure of 60/30 mmHg and a heart rate of 40 beats/minute

A patient with a gaping head wound and no pulse The patient with a gaping head wound and no pulse is dead and should receive a black tag. The patient having chest pains after a crushing injury, the patient with a bleeding leg after a stabbing injury, and the patient with blood pressure of 60/60 mmHg and a heart rate of 40 beats/minute should receive red tags, as all of these conditions are life-threatening.

In the event of a mass casualty, prioritized medical care is provided based on the triage of victims using colored tags. Which patient receives immediate intervention? A patient with a red tag A patient with a blue tag A patient with a green tag A patient with a yellow tag

A patient with a red tag When a mass casualty incident occurs, the victims are triaged according to color-coded tags. These colored tags are used to designate both the seriousness of the injury and the likelihood of a patient's survival. Red indicates a life-threatening injury, such as shock that requires immediate intervention. Blue indicates those who are expected to die due to a massive head trauma. Green is for minor injuries like sprains, and yellow is for urgent, but not life-threatening injuries like open fractures. In general, two-thirds of patients are tagged green or yellow, and the remaining are tagged red, blue, or black.

A storm arrives quickly at an outdoor concert location. The stage collapses, injuring many people and killing several. Which patients are given priority transfer to the hospital and will arrive first? Select all that apply. A patient with an amputated leg A patient who does not have a pulse A patient with an injured broken arm A patient who is crying and vomiting blood A patient with chest pain and shortness of breath A patient who is non-responsive and has a blunt chest wound

A patient with an amputated leg A patient who is crying and vomiting blood A patient with chest pain and shortness of breath The patients who will arrive first to the hospital are the patients with problems related to airway, breathing, and circulation (ABC). These include the patient who is crying and vomiting blood, the patient with chest pains and shortness of breath, and the patient with an amputated leg. The patient with a broken arm has a non-life-threatening injury. The unresponsive patient and the patient without a pulse are dead.

A recent flood disaster has left the local emergency department staff angry and frustrated. Which conditions may prevent the staff from coping well? Select all that apply. A staff member recently died from cancer. Many of the staff have supportive families. There was also a tornado disaster last year. Close friends of the staff died during the disaster. The group discussed their feelings and emotions. The staff received the victims with the worst conditions.

A staff member recently died from cancer. There was also a tornado disaster last year. Close friends of the staff died during the disaster. The staff received the victims with the worst conditions. Multiple disasters have a cumulative effect on the psychologic stress of the emergency team. Receiving the worst victims and a recent staff member death add to posttraumatic psychologic stress. Friends of the staff dying during the disaster will add to the psychologic stress. All of these factors can prevent staff members from coping well. Supportive families and discussion of feelings and emotions can help with emotional recovery and coping.

The patient has been part of a community emergency response team (CERT) for a tropical storm where it has been 100 oF (37.7 oC) or more for the last two weeks. With assessment, the nurse finds hypotension, body temperature of 104 oF (40 oC), dry and ashen skin, and neurologic symptoms. What treatments should the National Disaster Medical System (NDMS) nurse anticipate? Select all that apply. Administer 100% O 2 Immerse in an ice bath Administer cool intravenous (IV) fluids Cover the patient to prevent chilling Administer acetaminophen (Tylenol)

Administer 100% O 2 Administer cool intravenous (IV) fluids The patient is experiencing heatstroke. Treatment focuses first on stabilizing the patient's airway, breathing, and circulation (ABCs) and rapidly reducing the core temperature. Administration of 100% O 2 compensates for the patient's hypermetabolic state. Cooling the body with IV fluids is effective. Immersion in an ice bath will cause shivers that increase core temperature, so a cool water bath should be used for conductive cooling. Removing the clothing, covering the patient with wet sheets, and placing the patient in front of a fan will cause evaporative cooling. Excessive covers will not be used. Acetaminophen will not be effective because the increase in temperature is not related to infection.

A flu outbreak in a small town has infected 50 people, with many requiring medical attention. The local emergency department is overwhelmed. Which organization is best able to help? American Red Cross Local police department Hazardous materials team Centers for Disease Control and Prevention (CDC)

American Red Cross The Red Cross can help manage patients who do not need the most immediate medical attention so that trained medical personnel can care for those that do. The police department can help with crowd control situations. The hazardous materials team is not called in for flu epidemics. The CDC may be called in to identify the source of the outbreak, but its role is to contain the outbreak, not provide care.

The nurse is triaging in a mass casualty incident. Which patient would likely be designated "red" during triage at the site of this occurrence? An individual who is distraught at the violence of the incident. An individual who has experienced an open arm fracture from falling debris. An individual who is not expected to survive a crushing head and neck wound. An individual whose femoral artery has been severed and is bleeding profusely.

An individual whose femoral artery has been severed and is bleeding profusely. Red indicates a life-threatening injury requiring immediate intervention, such as severe bleeding. Emotional trauma would not warrant a "red" designation, whereas a fracture would likely be deemed "yellow," urgent, but not life-threatening. Those not expected to survive are categorized "blue."

Following a terrorist attack, the people injured in the bomb blast have inhaled anthrax-causing biologic agents. Which treatment strategy would provide effective management of the condition? Antidote Antitoxin Antibiotics Vaccination

Antibiotics Biologic agents are bacteria or viruses used in terrorism. Antibiotics are used in the effective treatment of anthrax, especially when the organisms are not resistant. Nerve agent poisoning is treated with antidotes such as atropine and pralidoxime chloride. Antitoxin is helpful in treating botulism.

A nurse on the emergency medical team is required to triage victims at the site of an accident. How should the nurse tag a patient with a feeble pulse and severe head injury? Black Blue Green Yellow

Blue The nurse should tag the patient blue to indicate that the patient is expected to die. Green indicates that the patient has a minor injury such as a sprain. Yellow indicates urgent, non-life-threatening injuries such as open fractures. Red indicates life-threatening injuries requiring immediate intervention, and a black tag is used to identify the dead.

A patient has his or her eyes closed at the scene of a disaster. What method will the nurse use first to assess level of consciousness? Touch the patient Talk with the family Call the patient by name Yell loudly at the patient

Call the patient by name The appropriate first method to assess level of consciousness in a patient with his or her eyes closed is to call the patient by name. If the patient does not respond, one should repeat the patient's name. If the patient still does not respond, one may touch the patient to get his or her attention. Talking with the patient's family will not assist in determining the patient's level of consciousness. Yelling is not appropriate at any time.

A mail room worker was exposed to anthrax (Bacillus anthracis). The patient is not sure if any of the anthrax was inhaled or if it got on the skin because the patient dropped the envelope upon seeing the powder. What treatment(s) should the nurse anticipate? Induce vomiting and administer antitoxin Patient isolation to prevent spread of virus Immediate vaccinia immune globulin (VIG) Ciprofloxacin to prevent systemic manifestations

Ciprofloxacin to prevent systemic manifestations To treat someone exposed to anthrax, antibiotics are effective to prevent systemic manifestations if treatment is begun early. Ciprofloxacin is the treatment of choice. Botulism is treated by inducing vomiting and administering antitoxin. A patient with hemorrhagic fever will be isolated to prevent the spread of the virus. VIG is used for smallpox.

A patient suffered cardiac arrest while manually shoveling snow after a blizzard. The patient's temperature is 96.8˚F (36˚C) on arrival to the emergency department. Which methods are used to provide therapeutic hypothermia? Select all that apply. Warming blanket Cold saline infusions Stocking hat on head Ice placed under arms Cooled ventilator circuit Socks applied bilaterally

Cold saline infusions Cooled ventilator circuit A cooled ventilator circuit and cold saline infusions are used to provide therapeutic hypothermia for a patient after return of spontaneous circulation after cardiac arrest. A cooling blanket (as opposed to a warming blanket) or internal cooling catheter device can be used to provide continuous consistent hypothermia. Socks applied bilaterally will not contribute to therapeutic hypothermia. With use of ice, it is difficult to maintain a consistent temperature so this is not an appropriate intervention. Transcutaneous devices provide a cooling pad for the head to help with management of the temperature; a stocking hat would not assist in providing hypothermia.

A patient in the emergency department has been fully assessed using the primary survey. What is the nurse's next step in emergency management at this time? Complete a secondary survey. Provide medications as prescribed. Allow the family to visit at the bedside. Place the head of the bed at 30 degrees.

Complete a secondary survey. After the primary survey has been completed, the appropriate next step is to conduct a secondary survey. The nurse should elevate the head of the bed only if it is warranted by the patient's condition, and allowing the family to visit at the bedside occurs during the primary survey. The nurse will provide medications as prescribed after the primary and secondary surveys have been completed.

After assessing and treating a patient affected by a chemical spill, while completing documentation, what is the nurse's priority action? Continue to monitor the patient for changes. Ask another nurse to relieve him or her for a break. Clean up the area, and prepare for another patient. Ask the patient if he or she would like to watch television.

Continue to monitor the patient for changes. Because the patient remains in his or her care, it is important that the nurse continue to monitor the patient for any changes or adverse effects of therapy. It is not appropriate to take a break unless absolutely necessary. Cleaning the area should not be done at the expense of monitoring the patient. Offering television to the patient is not a priority.

A large group of people were involved in a tractor trailer accident. Gasoline was spilled, and several people experienced skin contact with the substance. What is the recommended solution to rinse most toxins from the skin? Sterile water Soap and water Half-strength peroxide Copious amounts of water

Copious amounts of water Rinsing the skin with copious amounts of water will remove most toxins. Peroxide is not recommended for rinsing toxins. Soap and water is recommended after the water rinse. Sterile water is not required.

A terrorist's dirty bomb scattered radioactive material in the city. What initial measure does the nurse take to limit radioactive contamination? Assess vital signs. Administer antibiotics. Attend to the blast injuries. Cover patients' noses and mouths.

Cover patients' noses and mouths. In a "dirty bomb" blast, radioactive material is scattered into the surrounding environment, resulting in radioactive contamination. The radioactive dust and smoke can spread and cause illness if inhaled. Hence the nurse should initiate measures like covering patient's noses and mouths to limit contamination. Victims who have sustained blast injuries can be treated, but this does not limit radioactive contamination. The nurse assesses vital signs in emergency care during a primary survey when patients are presented in triage. Administration of antibiotics is relevant when patients are suffering from a disease that can be effectively treated with medicines, not to prevent radioactive contamination.

Which trained team or team member may a nurse voluntarily assist at a disaster site for up to two weeks? Nursing supervisor Hazardous material team Emergency department doctor Disaster medical assistance team (DMAT)

Disaster medical assistance team (DMAT) A DMAT is deployed to a disaster site to care for victims for up to two weeks. The emergency department doctor and the nursing supervisor are not on the site of a disaster unless they are acting in a different capacity. A hazardous materials team is deployed to contain hazardous material related to a disaster and will work with the DMAT, but the nurse will not assist this team.

In the triage area, a patient complains of pain in the right foot. The nurse assesses an injury sustained during a natural disaster. What should the nurse do while the patient waits for a full assessment? Elevate the right leg and place ice on the injury. Tell the patient the doctor has been busy all day. Give the patient a popsicle in the flavor of choice. Have the family take the patient to the waiting room.

Elevate the right leg and place ice on the injury. Pain management strategies should start with nonpharmacologic methods such as splinting, elevation, ice, and distraction. Pain relief measures should be instituted before the patient and family are moved to the waiting room. The patient should not consume anything until the doctor has evaluated the patient. It is not appropriate to tell the patient the doctor has been busy all day, as this may cause more distress for the patient and does not address the patient's problems.

Which event is defined as requiring a rapid and skilled medical response that existing resources can manage easily? Emergency First responder Hazardous conditions Mass casualty incident

Emergency An emergency is defined as an event that requires a rapid and skilled medical response that existing resources can manage easily. A mass casualty incident is an event that overwhelms community resources. A hazardous condition is variable; it may be handled well by local resources, but it can also take complex materials and special staff to manage. A first responder is a person who arrives first to a scene to care for victims until medical professionals arrive.

A patient has an injury due to an explosive device. Which is an example of an explosive device? A knife Fireworks Falling debris Toxic chemical

Fireworks Fireworks are explosive and can cause injury. Falling debris, a knife, and toxic chemicals on their own are not explosive.

A terrorist attack involving a nuclear bomb occurred in a nearby city, and the closest hospital is expected to receive a large volume of victims. The hospital has activated its emergency response plan and patients are beginning to arrive. To utilize resources effectively and efficiently, there are colored tags available for triaging patients in order to determine the seriousness of injury and the likelihood of survival. A nurse is triaging a patient who is able to walk, has no obvious deformities, is in no distress, and is complaining of wrist pain. What tag should the nurse give this patient? Red tag Blue tag Black tag Green tag

Green tag Triaging for a mass casualty incident (MCI), such as a nuclear bombing, requires the use of colored tags to determine the seriousness of the injury and likelihood of survival. The nurse should apply a green tag, because it is used for minor injuries. Red tags designate life-threatening injuries that need immediate intervention. Blue tags designate those who are expected to die. Black tags are for those victims who are dead.

A patient has suffered a severe blow to the head during a tornado. Which observation during the nursing assessment places this patient at the greatest risk and must therefore be addressed first? Vomiting blood Deep facial lacerations Hematoma to the left neck Complaints of a headache

Hematoma to the left neck A hematoma to the left neck means the patient's airway is at risk for collapse due to compression; this is the greatest risk for this patient. Vomiting blood and deep facial lacerations may cause a circulatory problem if the bleeding is excessive, but this is a secondary concern to airway obstruction. Complaints of a headache are secondary to the ABCs: airway, breathing, and circulation.

A mass casualty incident (MCI) overwhelms a community's ability to respond with existing resources, and it requires assistance from resources outside of the affected community. Which are examples of MCIs that would require outside resources? Select all that apply. Hurricane Terrorist attack with anthrax Terrorist attack with phosgene gas Multi-vehicle crash with five vehicles Multiple gunshot victims of gang violence

Hurricane Terrorist attack with anthrax Terrorist attack with phosgene gas An MCI is a man-made or natural event or disaster that overwhelms a community's ability to respond with existing resources. A hurricane is an MCI. Anthrax is a man-made biologic agent most commonly associated with terrorist attacks and is considered an MCI. A terrorist attack involving phosgene gas, which is a man-made chemical gas, is considered an MCI. A multi-vehicle crash is considered an emergency that a community's existing resources can manage; therefore, it is not an MCI. Similarly, a community's hospitals will likely be able to handle treating multiple gunshot victims.

A nurse is eating out with a friend and witnesses several people injured in a building fire at the restaurant. Considering the Good Samaritan Law, which statement concerning this situation is correct? As a healthcare provider, the nurse must provide care at the scene. The nurse must report to the assigned first aid station before providing assistance. The nurse should care for the older aging patients after caring for women and children. If the nurse does try to assist, he or she must not leave until trained responders arrive.

If the nurse does try to assist, he or she must not leave until trained responders arrive. When a nurse becomes involved in any way at the scene of a disaster, he or she is obligated to stay until trained responders arrive at the scene. As an off-shift healthcare provider, the nurse is not obligated to provide care at a scene under the Good Samaritan Law. It is considered gross negligence to treat victims based on age, sex, or disability. The nurse must report to an assigned first aid station when volunteering with a disaster team, but this is not part of the Good Samaritan Law.

The nurse is working to prepare a disaster team. What is the function of a community emergency response team (CERT)? The team members participate in community disaster drills. The team members are first responders providing first aid on the scene. It is a team of community volunteers trained to provide help first on the scene. It is an extension of the emergency department intended to provide medical care on site.

It is a team of community volunteers trained to provide help first on the scene. A CERT is a team of community volunteers trained to provide help first on the scene of a disaster. CERT volunteers may provide basic first aid but are not prepared to provide medical care. CERT team members are an extension of first responders to assist until professional services have arrived. While team members may participate in community disaster drills, this is considered part of their preparation, not their function.

Chemical agents were used to cause harm to a group of patients. What parts of the body are most affected by chemical agents? Lungs and skin Adrenal glands Heart and lungs Bladder and rectum

Lungs and skin Chemical agents used in terrorism affect lungs by inhalation and the skin by contact. The heart, adrenal glands, bladder, and rectum are not as commonly directly affected by contact or inhalation of chemical agents.

While examining the chest of a patient after a motor vehicle accident, which finding during the assessment will prompt the nurse to take immediate action? A bruise on the right chest Lacerations along the arms and legs Muffled and low-pitched heart sounds Complaints of pain when the chest is touched

Muffled and low-pitched heart sounds Muffled heart tones may indicate trauma to the heart, and the patient should be immediately evaluated for a blunt chest injury, which represents the most immediate threat to the patient's life. A bruise is blood already coagulated; this may not cause further problems with circulation, but it should be observed closely. Lacerations on the limbs are dangerous if they are hemorrhaging, but this is secondary to heart trauma. Complaints of topical pain are secondary to the potential of a chest trauma.

Which chemical causes a patient to experience eye irritation and skin burns? Sarin Phosgene Mustard gas Pralidoxime chloride

Mustard gas Mustard gas is a toxic substance that causes eye irritation and skin burns. Sarin is a highly toxic gas that causes immediate death of an individual. Phosgene is a colorless gas that causes severe respiratory distress, pulmonary edema, and death. Pralidoxime chloride is an antidote that helps to antagonize the effects of sarin.

The east coast of the United States is experiencing a hurricane, and the emergency departments in the area are informed that they will be receiving hundreds of patients in the next hour. What organizations will health care organizations contact in order to obtain more resources to manage the mass casualty incident (MCI)? Select all that apply. The Joint Commission National Disaster Medical System (NDMS) Federal Emergency Materials Agency (FEMA) National Incident Management System (NIMS) The local community emergency response team (CERT)

National Disaster Medical System (NDMS) National Incident Management System (NIMS) The local community emergency response team (CERT) NDMS is a part of the U.S. Department of Health and Human Services, Office of Preparedness Response, which sends disaster medical assistance teams (DMATs) to disaster sites with supplies and equipment to provide medical care for 72 hours. NIMS is responsible for coordinating federal, state, and local government efforts to respond to and manage domestic MCIs. The local CERT is an extension of the first responder services. The Federal Emergency Materials Agency is not associated with disaster preparedness. The Federal Emergency Management Agency is the organization that provides resources to communities experiencing an MCI. The Joint Commission is not involved in providing emergency resources.

Decontamination is required after disasters involving toxins. Which personal protective equipment is required to prevent a nurse's secondary exposure to a toxin? Face mask Head cover Lead apron Nonsterile gloves

Nonsterile gloves Nonsterile gloves are required to prevent secondary exposure during decontamination after a disaster involving toxins. Head covers are not required. Lead aprons are used to prevent exposure to radiation. Respirators, not face masks, are required for exposure to inhaled toxins.

A disaster medical assistance team (DMAT) has been activated to the site of a flood. Which members are included in the DMAT? Select all that apply. Nurses Doctors Security Logistics Communications team members Community emergency response team (CERT) members

Nurses Doctors Security Logistics Communications team members DMAT members consist of nurses, doctors, communications, security, and logistics. CERT members help at the scene until the DMAT arrives.

The nurse is completing the secondary survey on a patient who survived a tornado. Which does the nurse include in the secondary assessment? Select all that apply. Palpating the spine for deformities and pain Performing a rectal exam to check for internal bleeding Inspecting the genitalia for bleeding and obvious injuries Inspecting the back for ecchymosis, abrasions, and wounds Checking for circulation, pain, and numbness of any areas that have swelling Ordering a computed tomography (CT) scan to confirm an intraabdominal hemorrhage

Palpating the spine for deformities and pain Inspecting the genitalia for bleeding and obvious injuries Inspecting the back for ecchymosis, abrasions, and wounds Checking for circulation, pain, and numbness of any areas that have swelling The secondary survey includes inspecting the back for ecchymosis, abrasions, and wounds; palpating the spine for deformities and pain; checking for circulation, pain, and numbness of any areas that have swelling; and inspecting the genitalia for bleeding and obvious injuries. The doctor, not the nurse, performs a rectal exam to check for internal bleeding and orders a CT scan if he or she suspects an intraabdominal hemorrhage.

The nursing emergency disaster team is planning an event to help the staff prepare for potential disasters. What is the best way to prepare staff? Provide a mass casualty community drill. Show a video of a disaster relief group working. Have a police officer talk with the staff about disasters. Ask the staff to write a scenario to turn in to the manager.

Provide a mass casualty community drill. A mass casualty community drill is an interactive way to prepare staff and the community for a disaster. The police officer may have some knowledge to share, but a talk is not interactive and is therefore a less effective method of preparation. Likewise, showing a video is passive learning and is not interactive. Having staff members write scenarios does not prepare them to deal with those potential scenarios.

A nurse is conducting an assessment of a patient in the emergency room after a violent attack. The patient is unwilling to share what happened. What can the nurse do to help the patient be more comfortable talking about the event? Provide a private space for the patient. Keep the door of the patient's room open. Have the patient's family come into the room. Turn on bright lights to help the patient see better.

Provide a private space for the patient. The nurse can help the patient be more comfortable talking about a violent event by providing a private space. The patient may not want to talk about it in front of his or her family. The door to the patient's room should be closed for privacy. The lights should be dim to help the patient relax.

A patient injured in a radioactive explosion requires immediate medical attention. What are the appropriate measures that should be taken in this scenario? Assess vital signs. Administer antibiotics. Attend to the blast injuries. Provide for decontamination.

Provide for decontamination. An immediate intervention requires initiation of decontamination procedures because the radioactive material on the patient's clothes and body can spread and cause illness if inhaled. The nurse assesses vital signs in emergency care during primary survey when patients are presented in triage. Administration of antibiotics is relevant when the patient is suffering from a disease that can be effectively treated with these medicines. The victims who have sustained blast injuries can be treated subsequently.

The nurse recalls that phosgene gas causes a patient to develop what condition? Skin burns Pulmonary edema Middle ear disorder Acute radiation syndrome

Pulmonary edema Phosgene gas causes pulmonary edema and impairs pulmonary functioning, resulting in death. Mustard gas causes skin burns. Explosives such as TNT and dynamite may cause middle ear disorders. If a patient is exposed to ionizing radiation, then it results in acute radiation syndrome.

A trauma patient has arrived in the emergency department after a tornado. Which actions can the nurse delegate to the unlicensed assistance personnel (UAP)? Select all that apply. Assess for a flail chest and respiratory effort. Remove the patient's clothes and valuables. Show the patient's family to the trauma room. Monitor skin color, temperature, and moisture. Gather equipment for rapid-sequence intubation. Transport packed red blood cells to the emergency department.

Remove the patient's clothes and valuables. Show the patient's family to the trauma room. Gather equipment for rapid-sequence intubation. Transport packed red blood cells to the emergency department. The nurse can delegate the removal of clothes and valuables, transportation of packed red blood cells to the emergency department, gathering of equipment for rapid-sequence intubation, and showing the family to the trauma room to the UAP. The nurse must complete the assessments and monitor the patient for changes; these are out of the scope of the UAP.

An emergency response program is being developed at a local hospital. Which educational programs are best for preparing staff for mass casualty incidents? Select all that apply. Staff in-services Reading articles Table top exercises Slide presentations Computer simulations Hospital disaster drills

Table top exercises Computer simulations Hospital disaster drills The best programs to provide education about emergency response programs are interactive and include computer simulations, hospital disaster drills, and tabletop exercises. Reading articles, slide presentations, and in-services are not as interactive and do not help the staff learn to collaborate and coordinate during mass casualty responses.

A nurse is interested in getting involved with helping after natural disasters. Guided by the Federal Emergency Management Agency (FEMA), what action will the nurse first take? Take an online training course offered by FEMA. Travel to the scene of a disaster, and provide care. Prepare to provide care by purchasing a first aid kit. Get training from the National Incident Management System (NIMS).

Take an online training course offered by FEMA. All emergency response service participants interested in helping after disasters are required to take training, such as an online course offered by FEMA. Only if the nurse is already on the scene at the time a disaster occurs should he or she provide emergency assistance until trained personnel arrive to the scene. The nurse should not travel to the scene if not previously trained in disaster recovery. NIMS trains facilities like hospitals and emergency response services rather than individuals. A first aid kit is useful to have prepared in case of a disaster to use if the nurse is present at the scene and at the time of an event, but this does not have to be purchased prior to training.

A nurse is directed to travel with a patient during transport to another hospital. About which condition does the nurse immediately call the doctor during the transport? The patient has 200 mL of fresh blood from the chest tube. The patient's blood pressure is 130/70 mmHg on a dopamine drip. The patient's urine output in the Foley catheter is blood-tinged. The patient's GLASCO score is 10, and the patient is hard to arouse on a versed drip.

The patient has 200 mL of fresh blood from the chest tube. The patient is at risk for hemorrhage when there is 200 mL of fresh blood in the chest tube, and the nurse should immediately notify the sending doctor. A GLASCO score of 10 and difficulty to arouse may be expected on a versed drip. The blood pressure may be lowered by titrating the dopamine drip to a lesser dose; the nurse can do this without calling the physician. The Foley catheter may have caused some trauma resulting in blood-tinged urine; however, it is not critical to inform the doctor of this during the transport.

A group of people have suffered hypothermia after an ice storm on a highway. Which patient is exhibiting moderate hypothermia? The patient who is shivering and confused The patient who is acting irrationally and has slight heart rate changes The patient whose reflexes are absent and whose pupils are fixed and dilated The patient whose heart rate is 50 beats/minute and whose blood pressure is hard to obtain

The patient whose heart rate is 50 beats/minute and whose blood pressure is hard to obtain The patient with a heart rate of 50 beats/minute and whose blood pressure is difficult to obtain is exhibiting moderate hypothermia. The patient who is shivering and confused is exhibiting mild hypothermia. The patient with absent reflexes and pupils that are fixed and dilated is suffering from severe hypothermia. The patient who is acting irrationally and has slight heart rate changes has mild hypothermia.

An earthquake has left many injured. The nurse has just completed the primary and secondary survey for a male victim. Which conditions prompt the nurse to refrain from placing an indwelling catheter? Select all that apply. The penis head is bloody. The patient has a pelvic fracture. A hematoma is present on the scrotum. There is bruising around the perianal area. The bladder is tender and full on palpation. The patient is incontinent with blood-tinged urine.

The penis head is bloody. A hematoma is present on the scrotum. There is bruising around the perianal area. The nurse should refrain from inserting an indwelling catheter when the penis head is bloody, a hematoma is present around the scrotum, and there is bruising around the perianal area since this can cause further trauma. An indwelling catheter is safe to insert when the bladder is tender and full on palpation, the patient is incontinent with blood-tinged urine, and the patient has a pelvic fracture.

A patient has arrived in the emergency department after surviving a hurricane. The primary survey focuses on which priority assessment of this patient? Difficulty breathing Tracheal deviation Severe abdominal pain Hemorrhage to the lower left leg

Tracheal deviation The primary survey focuses on airway, breathing, and circulation (ABCs), then disability and exposure. Tracheal deviation involves the airway and is the priority assessment in the primary survey since this poses the most immediate threat to the patient's life. Difficulty breathing is the second priority and may be due to tracheal deviation. Hemorrhage to the lower left leg is the third priority. Severe abdominal pain is assessed after the ABCs.

The local hospital has accepted several patients who arrived on their own shortly after a local natural disaster. After such an event, what is the total estimated number of victims to expect to arrive on their own? 30% of the people injured in the disaster 50% of the people injured in the disaster Twice the number who arrived the first day Twice the number who arrived the first hour

Twice the number who arrived the first hour One can estimate the total number of victims who will arrive on their own by doubling the number of people who arrived on their own in the first hour. Twice the amount who arrived the first day will yield too many, and 30% and 50% of the people injured will not be possible to calculate since the amount of injuries is likely unknown that early after the incident.

A bomb explosion is most appropriately categorized as which type of disaster? Natural Violence Accident Poisoning

Violence Violence is defined as the acting out of fear and/or anger to cause harm to someone or something; a bombing is an example of this. Natural disasters and weather may harm people through extremes of wind, temperature, or water. Accidents may involve equipment or trauma to the body, but they are not intentional as in the case of a bomb. While a bomb may emit poisonous substances, it can also be harmful only via explosion.

After a land slide leaves many injured, what is the role of the off-shift nurse employed in a hospital? Wait for a call from the unit of work. Immediately call the unit to offer to work. Go immediately to the location of the land slide. Go immediately to his or her place of employment.

Wait for a call from the unit of work. Immediately after a disaster, a hospital puts its emergency response plan in motion. This involves the hospital command center initiating their staff to respond by calling all staff using a phone tree. Keeping the phone lines open is recommended so the nurse can receive the call from the unit of employment, so the nurse should not call the unit. It is not recommended that the nurse go to the site or place of employment until directed by the emergency response team. The nurse should not go to the site of the disaster because he or she will likely be needed at the hospital.

After a bomb has exploded in a public place, the nurse assesses a patient who has an open fracture to the left leg, a blood pressure of 160/90 mmHg, heart rate of 90 beats/minute, and respiratory rate of 24 breaths/minute. The patient is also anxious and crying in pain. Which color tag should the patient receive? Red Blue Green Yellow

Yellow This patient has urgent but non-life-threatening injuries and should receive a yellow tag. Green tags are for minor injuries. Red tags are for life-threatening injuries. Blue tags are for patients expected to die.

The nurse responds to a mass casualty incident (MCI). The nurse finds a patient whose condition is not life threatening but who has multiple traumas. What colored tag does the nurse use for the patient? Red Blue Green Yellow

Yellow Yellow colored tags are used for patients who need urgent medical attention but whose condition is not life threatening. Red tags are used to indicate life-threatening conditions that need immediate intervention. Blue tags are used for patients who are expected to die. Green tags are used for patients with minor injuries.