Deck 75: Emergency Preparedness: Bioterrorism and Management of Poisoning

Question 1

A group of concerned people ask the community nurse speaking at a local town hall meeting if there is a vaccine for anthrax and,if so,if they should get it.The nurse's best response would be:

A)"Yes,the vaccine is available,but it is limited to select groups,such as the military."
B)"No vaccine has been developed to prevent anthrax."
C)"Yes,the vaccine is available,and you should ask your primary health care provider for it."
D)"Yes,the vaccine is available,but it has not been approved by the Food and Drug Administration."

Answer 1

"Yes,the vaccine is available,but it is limited to select groups,such as the military."

Question 2

The nurse needs to find out what antibiotics are being stored by the Strategic National Stockpile (SNS).What agency will the nurse contact for this information?

A)Centers for Disease Control and Prevention
B)Department of Defense
C)Department of Homeland Security
D)Joint Commission of Accreditation of Healthcare Organizations

Answer 2

Centers for Disease Control and Prevention

Question 3

Clients arrive in the emergency department complaining of difficulty breathing and eye tearing after a bomb explosion in a nearby store.The priority intervention of the health care team initially should be to:

A)notify local law enforcement.
B)flush the skin and eyes with water.
C)complete a history and physical.
D)identify the offending agent.

Answer 3

flush the skin and eyes with water.

Question 4

A client was exposed to cyanogen chloride.What will the nurse do to help this client?

A)Remove contaminated clothing.
B)Apply sodium bicarbonate to skin lesions.
C)Administer antibiotics intravenously.
D)Initiate emetic measures.

Question 5

Which agent would the nurse administer to prevent the absorption of a poison that the client ingested?

A)Syrup of ipecac
B)Sodium bicarbonate
C)Charcoal
D)Furosemide (Lasix)

Question 6

The nurse is reviewing the components of the Strategic National Stockpile (SNS),which include: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)intravenous administration equipment.
B)antibiotics.
C)life-support medications.
D)chemical antidotes.
E)hospital beds.

Question 7

The nurse is helping stock Push Packages.The purpose of these packages is to:

A)transport appropriate personnel to disaster sites.
B)maintain supplies available for emergencies within 12 hours.
C)manage incoming equipment when a disaster occurs.
D)provide information booklets to communities experiencing a disaster.

Question 8

A client is diagnosed with acute poisoning of acetylsalicylic acid (aspirin).The nurse knows that ion trapping will be the therapy of choice for this medication and prepares to:

A)Insert a nasogastric tube for lavage.
B)Provide supportive therapy.
C)Hang a bag of 100 mL normal saline solution with 100 units regular insulin adjusted to the client's rising blood glucose levels.
D)Administer sodium bicarbonate and furosemide (Lasix)intravenously.

Question 9

Which medication will the nurse prepare to administer as the primary antibiotic of choice for the treatment of anthrax?

A)Erythromycin
B)Ciprofloxacin
C)Ampicillin
D)Vancomycin

Question 10

The nurse contacts the pharmacy to have the antidote for nerve agent poisoning available when victims of a mass casualty event arrive in the emergency department.The agent that the nurse is requesting is:

A)methylprednisolone.
B)acetylcysteine.
C)protamine sulfate.
D)atropine sulfate.

Question 11

At a local health fair,the community nurse is educating the public on poison-control strategies.Which strategy should the nurse emphasize as the most important to follow?

A)Keeping the Poison Control Hotline number handy
B)Preventing potential household poisoning
C)Identifying household poisons
D)Maintaining a stockpile of selected antidotes

Question 12

A client is found at home unconscious with an empty bottle of diltiazem (Cardizem)near the couch.The emergency response team prepares to administer which antidote?

A)Naloxone
B)Pyridoxine
C)Calcium
D)Atropine

Question 13

The nurse is reviewing a list from the Centers for Disease Control and Prevention that identifies bioterrorism agents that can easily be spread by person-to-person contact.What agents would be on this list?

A)Plague
B)Botulism
C)Hemorrhagic fever
D)Anthrax

Question 14

Which of the five general principles for treating acute poisoning would the nurse use to treat a client who was exposed to an external chemical agent? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Topical decontamination
B)Increase in the rate of excretion
C)Prevention of absorption
D)Neutralization
E)Antidotes and symptomatic therapy

Question 15

A client who experienced whole-body radiation exposure 6 hours ago is brought to the emergency department with radiation sickness.On assessment,the nurse would expect the client to report:

A)bleeding from the gums and nose.
B)bruises on skin not covered by clothing.
C)nausea and vomiting.
D)hair loss.

Question 16

The difference between the standard emergency triage practice and the current emergency triage of mass casualties is that:

A)current emergencies triage women and children first.
B)standard triage treats those with least serious injuries first.
C)previous emergencies never involved the triage of mass casualties or victims of infectious agents.
D)emergency triage focuses on the clients with the best chance to live.

Question 17

The danger from radiation exposure arises primarily from: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)the amount of exposure.
B)the long-lasting effects.
C)the amount of cellular death.
D)the distance from the initial incident.
E)the amount of potassium iodine ingested after exposure.

Question 18

Which health problem is a direct effect of exposure to ionizing radiation?

A)Type 2 diabetes
B)Leukemia
C)Hypertension
D)Gout

Question 19

The nurse instructs a group of adults with young families that the five general principles for the treatment of acute poisoning are:

A)modification of lifestyle,health teaching,antidote therapy,symptomatic therapy,absorbent administration,and dialysis.
B)antidote therapy,decontamination,neutralization,prevention of absorption,and increase in the rate of excretion.
C)identification of poison,symptomatic therapy,neutralization,dialysis,and absorbent administration.
D)identification of poison,modification of lifestyle,health teaching,decontamination,and increase in the rate of excretion.

Question 20

A client was exposed to iodine-131. Which medication would the nurse administer to counteract the effects of this exposure?

A)Anti-iodine vaccine intramuscularly
B)Potassium iodide orally
C)Penicillin intravenously
D)Antiviral nasal spray

Question 21

A client was exposed to radiation from a nuclear reactor explosion a month ago.What care will the nurse most likely provide to the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Appetite stimulant as prescribed
B)Uninterrupted rest periods
C)Infection control precautions
D)Antiemetic as prescribed
E)Antidiarrheal as prescribed

Question 22

A client is brought to the emergency department after being exposed to nitrogen mustard.Which symptom(s)is the nurse likely to assess? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Conjunctivitis
B)Skin blisters
C)Nasal irritation
D)Vomiting
E)Excessive salivation

Question 23

A client is suspected of exposure to Clostridium botulinum because of respiratory distress experienced after eating food from a street vendor during a carnival.What care should the nurse provide for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Prepare for endotracheal intubation.
B)Administer the trivalent botulinum antitoxin.
C)Administer the pentavalent toxoid vaccine.
D)Administer penicillin.
E)Administer ciprofloxacin and doxycycline.

Question 24

A client has taken 24 acetaminophen (Tylenol)tablets at once in a suicide attempt.Which medication would most likely be administered to reverse the effects of Tylenol?

A)Acetylcysteine (Mucomyst)
B)Flumazenil (Romazicon)
C)Atropine (Protopam)
D)Naloxone (Narcan)

Question 25

A client with spinal stenosis was found unconscious by family members.The client's opioid pain medication and tricyclic antidepressant medication containers were empty.What will the nurse prepare to administer to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Naloxone (Narcan)
B)Sodium bicarbonate
C)Pyridoxine (vitamin B₆)
D)Syrup of ipecac
E)Activated charcoal

Question 26

Which interventions might the nurse include when planning care to enhance the removal of poison from a client who has overdosed on drugs? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Administering activated charcoal
B)Monitoring urine output
C)Preparing the client for dialysis
D)Inserting a nasogastric tube
E)Preparing corticosteroids for administration

Question 27

A group of students arrive at the emergency department with complaints of burning eyes,coughing,and skin burning with blisters.The nurse reviews these symptoms and suspects the students could have been exposed to: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)a vesicant.
B)an acid.
C)tear gas.
D)nerve gas.
E)incapacitating agent.

Question 28

A client is brought to the emergency department with acute poisoning from an unknown powdered agent on the skin.Which of the general principles of treating poisonings does the nurse follow first?

A)Topical decontamination
B)Prevention of absorption
C)Neutralization
D)Increase in rate of excretion

Question 29

The nurse is attending a course to prepare for mass casualty incidents (MCIs).What technical skills will the nurse have to demonstrate to be a member of the response team? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Safe administration of medications
B)Safe administration of immunizations
C)Knowledge of nursing interventions for adverse medication events
D)Ability to insert a nasogastric tube
E)Ability to insert an intravenous infusion catheter

Question 30

A 3-year-old child ingested approximately 20 tablets of iron that were prescribed to the child's mother.The medication that the nurse will prepare to reverse iron is:

A)fomepizole (Antizol).
B)pyridoxine (vitamin B6).
C)deferoxamine (Desferal).
D)sodium bicarbonate.

Question 31

A client is prescribed dimercaprol as treatment for acute poisoning.The nurse understands that this medication is used as an antidote for which agents? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Arsenic
B)Gold
C)Mercury
D)Lead
E)Nickel

Question 32

A client is believed to have been exposed to the variola virus while working in a laboratory.What should the nurse assess before administering the vaccination to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)White blood cell count
B)HIV status
C)History of eczema
D)Allergy to antibiotics
E)Blood pressure and heart rate

Question 33

The nurse is facilitating a program on poison control and tells the group that if a known poison has been ingested,the first measure that must be taken is:

A)contacting the American Association of Poison Control Centers for the proper immediate treatment.
B)having the person drink large amounts of water to flush the poison through the gastrointestinal system.
C)notifying the local health agency and the Centers for Disease Control and Prevention after the person has stabilized.
D)administering syrup of ipecac within 30 minutes.

Question 34

The nurse is teaching a group of community members about common potentially toxic substances.Which vitamin or mineral supplement would be addressed in this instruction?

A)Iron
B)Vitamin C
C)Zinc
D)Salt

Question 35

After an explosion at a nearby restaurant,several individuals require treatment at the hospital.The clients arrive at the emergency department with complaints of visual disturbances,burning of the eyes and skin,and loss of hearing.The nurses prioritize care based on the nursing diagnosis of:

A)Knowledge,Deficient related to exposure to unknown material.
B)Communication: Verbal,Impaired related to lack of knowledge about the incident.
C)Poisoning,Risk for related to exposure to potential toxic substance.
D)Coping,Ineffective related to the unexpected incident.

Question 36

A client recovering from plutonium poisoning from a nuclear reactor explosion is receiving edetate calcium disodium (Calcium EDTA).What will the nurse do to support this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Administer intravenous fluids as prescribed prior to medication administration.
B)Apply chest leads for continuous cardiac rhythm monitoring.
C)Assess blood pressure frequently.
D)Stop the infusion if the client becomes febrile.
E)Notify the health care provider if the client develops a headache or nasal congestion.

Question 37

A cruise ship off the coast of Maryland has capsized,and the nurse is triaging victims who were submerged in cold water.Which supplies from the Push Packages would be of most use when caring for these victims? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Antibiotics
B)Life support medications
C)Intravenous administration equipment
D)Airway maintenance supplies
E)Activated charcoal

Question 38

A client is being treated for acute ethanol overdose.What interventions will the nurse perform when caring for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Ensure placement of an intravenous access device.
B)Ensure that dextrose 5% and water is available for infusion.
C)Notify the health care provider with serum electrolyte levels.
D)Monitor urine output.
E)Administer chelating medication as prescribed.

Question 39

The nurse is contacting the Centers for Disease Control and Prevention for supplies to be sent from the Strategic National Stockpile (SNS)to the site of a massive train derailment and chemical spill.What will the SNS provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Push Packages
B)Vendor-managed inventory packages
C)Whole blood and blood components
D)Hospital beds and surgical tables
E)Computer equipment and prepackaged meals