Question 1

A community disaster has occurred and the hospital's emergency department (ED)has efficiently triaged,treated,and transferred most clients to appropriate units.The hospital incident command officer wants to "stand down" from the emergency plan.Which question by the nursing supervisor is most beneficial at this time?

Accepted Answer

Before "standing down," the incident command officer ensures that the needs of the other hospital departments have been taken care of because they may still be stressed and may need continued support to keep functioning.Many more "walking wounded" victims may present to the ED; that number may not be predictable.Giving staff the chance to eat and rest is important,but all areas of the facility need that too.Although agreement among incident officers is important,it is not the priority concern before standing down.

Question 2

The triage nurse is assessing a client who has been brought to the emergency department (ED)by emergency medical services (EMS)following a mass casualty incident.Which assessment questions are used to determine the appropriate triage category for the client?

Accepted Answer

The triage nurse should assess for possible spinal cord injury,shortness of breath,abdominal or back pain,and disorientation when the client is brought to the ED.Determining allergies,although important,does not assist in categorizing clients,nor does inquiring about the client's family.

Question 3

A client has been treated in the emergency department after a tornado and is awaiting discharge instructions.This client is close to losing control,although other family members are attempting to calm him down.Which response by the nurse is most helpful?

Accepted Answer

Offering people choices often is a good way to get them to focus on something other than their distress.Calling security and telling the person to leave might escalate the situation,although if all other methods fail,the safety of staff,clients,and other visitors takes priority.Asking the family to help move the client puts him in a difficult position and may end up causing them injury.

Question 4

A family in the emergency department is overwhelmed at the loss of several family members due to a shooting incident in the community.Which intervention by the nurse is most beneficial?

Accepted Answer

Offering choices when appropriate and when possible gives some personal control back to individuals.The family may or may not want the assistance of religious personnel; the nurse should assess for this before calling anyone.Visiting procedures should take into account the needs of the family.The family may appreciate privacy,but this is not as helpful as allowing choices when the family is able to make them.

Question 5

The nurse working with survivors of a disaster wants to assess them for post-traumatic stress disorder.For which clients does the nurse perform further assessment before administering the Impact of Event Scale-Revised?

Accepted Answer

The Impact of Event Scale-Revised tool should not be used with people who have short-term memory loss,so the nurse should assess the older adult survivor and the client with the brain injury for this problem before administering the tool.The other clients do not have medical issues that would preclude use of this tool.

Question 6

A hospital has "stood down" from a mass casualty disaster.The staff have rested and eaten.Which action by the nursing supervisor takes priority?

Accepted Answer

Inventorying and stocking the ED are high-priority actions because the usual flow of emergency clients may not be lessened in the wake of a disaster.Supplies may be low or exhausted,and it would be vital to resupply the area.Rounding on inpatient units,determining the staff who can be relieved,and planning a debriefing are certainly important items,but they do not take priority over getting the ED ready for more clients.

Question 7

Emergency medical services (EMS)brings a large number of clients to the emergency department following a mass casualty incident.The nurse identifies clients with which injuries with yellow tags?

Accepted Answer

Clients with burns,spine injuries,eye injuries,and stable abdominal injuries should be treated within 30 minutes to 2 hours,and therefore should be identified with yellow tags.The client with the open fracture and the client with the head injury would be classified as urgent with red tags.

Question 8

A hospital is receiving large numbers of casualties from a disaster.Which clients does the supervisor identify as appropriate for discharge or transfer to another facility?

Accepted Answer

The client with the femur fracture could be transferred to a rehabilitation facility and the RN could provide care and teaching to her father.The newly admitted client with pneumonia would not be a good choice because culture results are not yet available and antibiotics have not been administered long enough.Also,the infant has not been in the hospital long enough for cultures to return for a definitive diagnosis.The client in the medical decision unit should be identified for dismissal if diagnostic testing reveals a noncardiac source of chest pain.

Question 9

A wing of a hospital is on fire.Which actions by the nurse promote safe evacuation of clients?

Accepted Answer

Ambulatory clients can evacuate themselves with direction or could be used to help push wheelchair-bound clients.Clients on ventilators need to be removed from the ventilator and "bagged" until evacuated,then they can be put back on the ventilator if one is available.Bedridden clients should be moved in their beds or on stretchers,or carried if needed.Any client who can breathe without oxygen should have it removed for the evacuation because oxygen is an accelerant.

Question 10

An emergency department (ED)supervisor has noted an increase in sick calls and bickering among the ED staff after a week with multiple trauma incidents.What action by the supervisor is most helpful?

Accepted Answer

The staff may be suffering from critical incident stress and needs to have a debriefing by the critical incident stress management team to prevent the consequences of long-term,unabated stress.The other interventions may be helpful as well but are not as important as a debriefing.

Question 11

A large number of victims arrive at the emergency department after a bus is hit by a train.Which interventions are performed immediately for red-tagged victims?

Accepted Answer

Priority interventions are those that must be performed to save the client's life,including intubation,IV fluid replacement for shock,and pacemaker placement.Splinting a fracture and removing glass from a client's arm can wait until after life-threatening injuries are cared for.Postmortem care would wait until after all clients have been cared for.

Quiz 12: Concepts of Emergency and Disaster Preparedness

The triage nurse is assessing a client who has been brought to the emergency department (ED) by emergency medical services (EMS) following a mass casualty incident.Which assessment questions are used to determine the appropriate triage category for the client?