Deck 11: Emergency Preparedness and Poisonings

Question 1

The client has been exposed to a nerve agent. For which symptoms will the nurse most likely assess?

A) Salivation and involuntary urination
B) Dilated pupils and increased heart rate
C) Pinpoint pupils and decreased blood pressure
D) Rapid Tachypnea and cold, clammy skin

Answer 1

Salivation and involuntary urination

Question 2

The client was exposed to cutaneous anthrax 2 weeks ago. What will the nurse see when assessing the client's skin?

A) Large pustules and later, reddish scabs
B) Small, fluid-filled vesicles, and later, small skin erosions
C) Ulcerated areas and later, keloids
D) Small skin lesions and later, black scabs

Answer 2

Small skin lesions and later, black scabs

Question 3

The client tells the nurse that she is concerned about terrorist activity and questions if everyone should be immunized against smallpox. What is the best response by the nurse?

A) "The vaccine has side effects, which are serious and could kill many people."
B) "I really do not think our country has enough vaccine to do this."
C) "Don't be so concerned; if an attack comes, we will immunize people then."
D) "The vaccine has some serious side effects, but this is probably a good idea."

Answer 3

"The vaccine has side effects, which are serious and could kill many people."

Question 4

The nurse works for the Centers for Disease Control and Prevention (CDC). In planning for a bioterrorist attack, what will the best plan of the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Learn the signs and symptoms of chemical and biological agents.
B) Obtain a listing of health and law enforcement contacts.
C) Assist in the stockpiling of medications.
D) Obtain current knowledge of emergency management.
E) Assist in triage at local hospitals.

Question 5

A small nuclear weapon has been detonated in a nearby city. Which immediate symptoms of radiation sickness will the nurse assess in clients who have been exposed?

A) Dilated pupils and aggression
B) Nausea, vomiting, and diarrhea
C) Weight loss and fatigue
D) Anorexia and fatigue

Question 6

A nurse who is presenting community education states, "Drugs are among our most powerful weapons for emergency preparedness." What additional statements, made by the nurse, would support this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Drugs help us treat the diseases that could be caused by bioterrorism."
B) "We can use drugs to neutralize our enemies."
C) "If we control the manufacture and distribution of drugs, we will control global politics."
D) "Without drugs, we might be quickly overwhelmed by a bioterrorist attack."
E) "Drugs can be used in chemical or nuclear attacks."

Question 7

The client comes to the emergency department with an anxiety attack. He or she tells the nurse he heard that there was another anthrax attack in the capitol, and is concerned about running out of medications. What is the best response by the nurse?

A) "You don't need to worry about another attack at all; I think our government can take care of us."
B) "Your health is in danger due to the anxiety; we really need to focus on reducing your anxiety now."
C) "The Centers for Disease Control and Prevention (CDC) maintains a large stockpile of medications for us in case that occurs."
D) "I'm sure the Centers for Disease Control and Prevention (CDC) has contingency plans in the event of an anthrax attack."

Question 8

A student nurse asks a nurse what items are found within the Strategic National Stockpile (SNS). What is the nurse's best response?

A) Two-way radios
B) Prepared meals
C) Drinking water
D) Antibiotics

Question 9

The nurse is preparing an educational plan for parents about how to protect their children if a bioterrorist attack occurs. What is the best information to include?

A) "Don't worry, the Centers for Disease Control and Prevention (CDC) has everything under control."
B) "Plan to call the Centers for Disease Control and Prevention (CDC) if an attack occurs."
C) "Follow the Centers for Disease Control and Prevention (CDC) guidelines for immunizations."
D) "Realistically, there is nothing that can be done."

Question 10

The nurse is teaching a class on anthrax to a group of emergency response workers. The nurse plans to include which of the following?

A) Anthrax is a deadly bacterium; the most common and deadly form is gastrointestinal anthrax.
B) Cutaneous anthrax is the most common form, but inhaled anthrax is the most lethal form.
C) Anthrax most commonly affects wild rodents such as mice, rats, squirrels, and chipmunks.
D) Cutaneous anthrax is serious because it quickly spreads by person-to-person contact.

Question 11

The nurse conducts a seminar in a local community center on how citizens can be affected by radiation from a nuclear attack. The nurse determines that the education is effective when the clients make which statement?

A) "I can protect myself from cancers by taking potassium iodide (KI)."
B) "I need to stay inside my house for at least 2 days after the attack to be safe."
C) "I need to take at least four showers every day or I will develop skin ulcers."
D) "I am at risk to develop leukemia as a result of radiation exposure."

Question 12

Following a bioterrorism attack, the nurse finds that the victims are suffering from small, black lesions on their forearms. The nurse collaborates with the healthcare provider to treat exposure to which agent?

A) Cutaneous anthrax
B) Phosgene gas
C) Gastrointestinal anthrax
D) Hydrogen cyanide

Question 13

The nurse administers potassium iodide (KI) tablets to a client who has been exposed to radiation from a nuclear weapon. What is the rationale for administering potassium iodide (KI) to this client?

A) Prevent thyroid cancer
B) Prevent brain cancer
C) Prevent liver cancer
D) Prevent renal cancer

Question 14

A client is admitted to the emergency department with suspected exposure to anthrax. The nurse anticipates the healthcare provider will prescribe which medication?

A) Anthrax vaccination
B) Atropine
C) Ciprofloxacin
D) Antiviral agents

Question 15

A nurse is planning a presentation regarding anthrax. What should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Anthrax can spread easily.
B) There are three basic types of anthrax.
C) Anthrax is killed by heat.
D) The main area affected by inhalation anthrax is the lung periphery.
E) Anthrax causes the release of multiple toxins, each affecting a different part of the body.

Question 16

A nurse is caring for a client who has been exposed to a nerve agent. Which antidote will the nurse plan to administer?

A) Apomorphine
B) Atropine
C) Acetate of ammonia
D) Hydroxyzine (Vistaril)

Question 17

The nurse is teaching the importance of drugs for emergency preparedness to local firemen. The nurse determines that learning has occurred when the firemen make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "The vendor-managed inventory (VMI) package can reach any community within 24 to 36 hours."
B) "Our local hospital is supposed to be stockpiling antibiotics."
C) "The push package can reach any community within 12 hours of an attack."
D) "The Strategic National Stockpile is located at the Centers for Disease Control and Prevention (CDC) in Atlanta."
E) "Our country's drug stockpile is managed by the Centers for Disease Control and Prevention (CDC)."

Question 18

The nursing instructor is teaching student nurses about the use of viruses in a bioterrorism attack. The nurse determines that learning has occurred when the students make which statement?

A) "The Centers for Disease Control and Prevention (CDC) has a plan to vaccinate Americans against most viruses."
B) "Actually, a bigger concern is a nuclear weapon exploding in a city."
C) "Most Americans have already been vaccinated against the lethal viruses."
D) "A bioterrorist attack with viruses is a real threat to Americans."

Question 19

The client has been exposed to anthrax. The nurse anticipates administering which of the following drugs?

A) Penicillin (Bicillin LA) and vancomycin (Vancocin).
B) Tetracycline (Sumycin) and erythromycin (Erythrocin).
C) Ampicillin (Principen) and cefepime (Maxipime).
D) Ciprofloxacin (Cipro) and doxycycline (Vibramycin).

Question 20

A nurse is planning a discussion of emergency preparedness with newly hired nurses. Which events would this nurse use as historical examples of terrorism? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The death of a client in a Texas hospital was confirmed to be due to the Ebola virus.
B) Many people died as a result of sarin gas exposure in a Tokyo subway.
C) Twenty-two confirmed or suspected cases of anthrax infection occurred as a result of the bacillus being sent through U.S. mail.
D) There is typically a marked increase in overdoses during winter holidays.
E) More people are contracting H1N1 avian influenza.

Question 21

A nurse is admitting a client to the emergency department who has overdosed on a benzodiazepine. The nurse should anticipate the healthcare provider will prescribe which of the following drugs?

A) Acetylcysteine
B) Digibind
C) Romazicon
D) Acetaminophen

Question 22

A nurse working in the emergency department is told that the smallpox virus was aerosolized at a parade attended by thousands of people. The nurse explains to the student nurse that the vaccine for this virus provides a high level of protection if given within ________ days of exposure.

Question 23

A nurse is teaching a student nurse about common treatments for victims of bioterrorism. The nurse tells the student that atropine would be most useful for a victim of bioterrorism exposed to which of the following?

A) Ionizing radiation
B) Nerve gas
C) Bacterial agents
D) Viral agents

Question 24

A student nurse asks a nurse what is included in the Strategic National Stockpile (SNS). The nurse explains that the SNS includes which of the following supplies? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply

A) Intravenous administration equipment
B) Antibiotics
C) Life-support medications
D) Chemical antidotes
E) Hospital beds

Question 25

A client has been admitted to the emergency department for treatment of poison ingestion. Gastric lavage and placement of activated charcoal has been prescribed. The nurse would withhold this treatment and collaborate with the prescriber if which instances occur? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The client vomits.
B) The client becomes unconscious.
C) The client discloses that lithium was the drug taken.
D) Paramedics report that it has been 2 hours since the drug was taken.
E) The client begins to pass copious amounts of watery diarrhea.

Question 26

A nurse is caring for a client that was exposed to radiation. The client asks the nurse what factors increase the amount of radiation that a person is exposed to. What should the nurse include in responding to the client's question? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The amount of exposure
B) The long-lasting effects
C) The amount of cellular death
D) The gender of the client exposed
E) The amount of naloxone (Narcan) ingested after exposure

Question 27

A client who has traveled to an area where Ebola is present is hospitalized with fever and malaise. The nurse anticipates this client will be considered potentially infectious for the length of the ________ day incubation period.

Question 28

A nurse is caring for a client following a bioterrorism attack. The client has experienced initial nausea and vomiting followed by weight loss and eventual thyroid cancer. What was the most likely causative agent?

A) Chemical agent
B) Viral agent
C) Bacterial agent
D) Ionizing radiation

Question 29

A client was exposed to ionizing radiation. The nurse plans to administer which of the following medications?

A) Potassium-iodine tablets
B) Calcium tablets
C) Antibiotics
D) Salt tablets

Question 30

A nurse is caring for a client admitted to the emergency department following a drug overdose. The nurse anticipates which of the following prescriptions to enhance removal of the poison from the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Administering activated charcoal
B) Changing the pH of urine
C) Preparing the client for enemas
D) Inserting a nasogastric tube
E) Preparing corticosteroids for administration