Deck 65: Disaster Nursing

Question 1

The nurse who is a member of a Disaster Medical Assistance Team (DMAT) has the remains of several victims of a disaster to be identified and collected. Which group should the nurse contact for this service?

A) Disaster Mortuary Operations Response Teams
B) Department of Health and Human Services employees
C) Centers for Disease Control employees
D) Office of Environmental Protection employees

Answer 1

Disaster Mortuary Operations Response Teams

Question 2

A patient tells the nurse that he thought that he would feel better because it has been a few days since his radiation exposure, but he still feels weak and tired. What is the nurse's best response to this patient?

A) "Increasing your activity will help with the feelings of fatigue."
B) "After your strength returns, you might have diarrhea."
C) "This means that your body is healing."
D) "The weak and tired feelings will continue for a while longer."

Answer 2

"The weak and tired feelings will continue for a while longer."

Question 3

A patient is brought into the emergency department after an acute exposure to radiation from the local atomic power plant. The patient has skin burns on the face, arms, and neck. The nurse implements which priority intervention?

A) Prepare to administer a blood transfusion.
B) Determine amount of radiologic exposure.
C) Begin antibiotic therapy.
D) Provide support for the onset of hypotension and diarrhea.

Answer 3

Determine amount of radiologic exposure.

Question 4

The nurse is admitting the fourth patient in 2 days who is experiencing malaise, high fever, and headache. All patients attended a local air show the previous weekend. Which nursing action is necessary?

A) Discuss the need to contact public health authorities regarding the similarity of the cases.
B) Plan to place the patients in the same room.
C) Ask the patients for permission to talk with family members regarding other symptoms.
D) Assess the patients for what foods they ate while at the air show.

Question 5

The nurse is assessing victims of a building collapse. Ambulances are nearby and there is a shelter set up with carts, chairs, tables, and refreshments for the victims. The nurse is most likely working within which decontamination zone?

A) Cold
B) Warm
C) Control
D) Hot

Question 6

A group of workers arrives at the hospital after being exposed to chemicals during an industrial accident. The nurse would prepare to supervise decontamination in which zone?

A) Warm
B) Red
C) Cold
D) Green

Question 7

The nurse is interested in learning how to become a disaster relief nurse. What should the nurse consider prior to joining the Disaster Medical Assistance Team (DMAT) program?

A) The nurse must be licensed to practice nursing in the state of the disaster.
B) The nurse must provide and pay for his or her own personal gear, including a sleeping bag.
C) The nurse must be willing to be a volunteer, as the positions are unpaid.
D) The nurse must be willing to pay for his or her own travel to the disaster region.

Question 8

A group of nurses are attending a meeting to discuss the outcomes and results of care provided to victims of a recent building collapse. The nurses are participating in which phase of the disaster planning process?

A) Mitigation
B) Recovery
C) Response
D) Preparedness

Question 9

Facilitators of a critical incident stress debriefing are instructing the nurses on ways to cope with the stress created by providing disaster care. The nurses are participating in which phase of the debriefing session?

A) Reaction
B) Reentry
C) Fact
D) Teaching

Question 10

After an anthrax exposure, the health care provider orders doxycycline 100 mg PO. The label on the bottle of doxycycline oral powder states to reconstitute with sterile water to prepare a concentration of
0.025 g/5 mL. The nurse should prepare to administer ______ mL to the patient.

Question 11

Law enforcement authorities have notified the emergency department that several people who have been exposed to nerve gas will be arriving. The nurse manager alerts the department nursing staff to expect patients with which assessment findings?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Muscle pain
B) Flaccid paralysis
C) Shortness of breath
D) Miosis
E) Rhinorrhea

Question 12

The hospital has activated its incident command system (HICS) and is currently triaging patients and determining the extent of injuries and casualties. The nurse would refer calls from the media to which person?

A) The safety and security officer
B) The liaison officer
C) The public information officer
D) The incident commander

Question 13

During a natural disaster, the Strategic National Stockpile was deployed and supplies were used to treat patients. Now that the initial medical and nursing response is over, who is responsible for retrieving the remnants of the 12-hour push packs?

A) The Technical Advisory Response Unit
B) The vendors who supply the materials in the packs
C) Centers for Disease Control personnel
D) The nurses who provided emergency care to the victims

Question 14

The emergency department has been notified of a possible Category A biologic exposure in a rural community. When preparing staff for these patients, the nurse manager explains care for victims of which agents?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Botulism
B) Anthrax
C) Plague
D) Tularemia
E) Salmonella

Question 15

The nurse is planning to attend a program to learn how to respond to mass casualty incidents. The nurse anticipates this program will address which core competencies of emergency and disaster preparedness for nurses?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Creative problem-solving skills
B) Adherence to standard protocols and policies
C) Emergency communication skills
D) Understanding of personal limitations
E) Identification of emergency situations

Question 16

A patient is brought into the emergency department after being exposed to over 1,000 rads of radiation. Which intervention will take priority in the care of this patient?

A) Administer sedatives and analgesics.
B) Provide antibiotic therapy.
C) Prepare intravenous fluids and order a bland diet.
D) Provide antiemetics.

Question 17

The hospital incident command system (HICS) has been activated following a multivehicle accident. Nurses are moving ambulatory patients to one section of the emergency department. These patients will be assigned which START triage category?

A) Yellow
B) Green
C) Black
D) Red

Question 18

Because of high demand during a disaster, the pharmacy has run out of normal saline intravenous solutions and the blood bank is down to 10 units of type O+ blood. The directors of these services would contact which section of the hospital incident command system (HICS) to obtain these supplies?

A) Finance
B) Logistics
C) Planning
D) Operations

Question 19

A patient has been prescribed 400 mg ciprofloxacin IV for anthrax prophylaxis. The pharmacy has sent a 1 gram vial of ciprofloxacin to the nursing unit to be diluted with 10 mL of sodium chloride. The nurse should administer ____ mL.

Question 20

A mass casualty accident has occurred. The first patient the nurse receives has a color code of red. What is the nurse's disposition of this patient?

A) Send the patient home.
B) Plan to evaluate this patient in the next 30 minutes to 1 hour.
C) Intervene immediately in this patient's care.
D) Allow the patient to die.

Question 21

A nurse is contributing to the disaster plan for a newly established health care clinic in a rural area. Which scenarios would the nurse include in planning for human-generated disasters?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) A motor vehicle crash with numerous victims
B) Widespread destruction and injury from a large tornado
C) Release of dangerous chemicals from an industrial accident
D) Terrorist attack on a dam resulting in widespread flooding
E) Influenza epidemic

Question 22

The nurse is using the Simple Triage and Rapid Treatment (START) system to triage patients brought to the hospital after a tornado. Which triage designation has the nurse correctly assigned?

A) Red tag for a 67-year-old male complaining of chest pain; heart rate 120 beats/min, blood pressure 100/68 mmHg, respiratory rate 20 breaths/min
B) Red tag for a 27-year-old woman presenting with a respiratory rate of 36 breaths/min and capillary refill of 4 seconds
C) Yellow tag for a 58-year-old woman able to walk on her own and saying over and over, "I don't know what happened"
D) Red tag for a 30-year-old male with multiple chest trauma; respiratory effort minimal after airway is opened; carotid pulse faint

Question 23

The emergency department nurse manager is working with the physical plant manager to identify decontamination zones as part of the hospital's emergency preparedness plan. Which concepts should be considered in this planning?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) More than one decontamination area should be chosen.
B) The area should be large enough to accommodate three different zones for decontamination.
C) The site and zones should be painted on the hospital parking lot for easy identification at the time of need.
D) The red zone area should be large enough to accommodate triage activities.
E) There should be a method to limit entry to the cold zone.

Question 24

The nurse manager is planning critical incident defusing for staff who provided care for patients injured in a house fire. What should be included in this planning?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Plan for each session to last 2 to 3 hours.
B) Gather groups of no more than 6 to 8 staff members.
C) Develop groups according to shift worked.
D) Emphasize strict confidentiality within the group.
E) Record level of participation in the groups.

Question 25

The nurse manager is determining whether a recent situation involving the injury and death of multiple patients in a gun battle should be classified as a critical incident. Which components of a critical incident should the nurse consider?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Have any of the staff involved asked for critical incident interventions?
B) Was the incident abnormal in this environment?
C) Have any of the staff involved behaved abnormally since the incident?
D) Did the incident disrupt the emotional culture of the ED?
E) Has there been evidence of inability to cope with severely injured patients since the incident?

Question 26

A hospital has been notified that a tornado injured numerous people in a neighboring town and the hospital may receive some victims. How should the hospital administration respond?

A) Immediately implement the hospital's incident command system.
B) Wait until the first victims arrive to implement the hospital incident command system.
C) Implement the positions and functions most likely to be required by the situation and reassess once patients arrive.
D) Notify the emergency department that a drill is possible.

Question 27

The nurse is working with a committee to revise the hospital's disaster preparedness plan. Which information will the basic plan include?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) A map of the area served by the hospital
B) The number and location of nursing homes in the area
C) The number of private homes in the immediate area of the hospital
D) The presence of an industrial area south of the hospital
E) The geographical area generally served by the hospital

Question 28

The emergency department (ED) is overwhelmed with victims of a disaster who are arriving in private vehicles. Many are seriously injured. What action should be taken by the nurse manager?

A) Notify law enforcement to divert traffic away from the hospital.
B) Provide quick instruction to housekeeping staff on safe ways to help patients out of the cars.
C) Contact the incident commander and ask that first responders be sent to the hospital.
D) Tell nurses that they should focus solely on those patients who can get into the hospital with no staff assistance.

Question 29

The nurse facilitators of a critical incident stress debriefing (CISD) have asked for time and funds for a short social time with refreshments at the end of the final day of the session. Which rationale would the facilitator provide as the primary reason for this request?

A) It would mark closure for the emotions generated during the session.
B) It would provide time for the facilitators to summarize the work of the group.
C) This time would allow participants to ask questions of the facilitators privately.
D) Food is a cultural expression of caring.

Question 30

The nurse manager is working on a committee to revise a hospital's emergency preparedness plan. What is the first step of this work?

A) Conduct a hazard risk analysis.
B) Write a basic plan that can be expanded as time permits.
C) Describe functional annexes.
D) Develop hazard-specific annexes.

Question 31

Which information would the nurse expect to be part of an effective initial disaster preparedness plan for a major metropolitan hospital?

A) Expect early notification of the numbers, types, and severities of casualties that can be expected.
B) The most seriously wounded victims can be expected to arrive first.
C) The initial response will be conducted by in-house staff.
D) Triage and decontamination will be conducted in the field before transport.

Question 32

The nurse manager has determined that critical incident stress debriefing (CISD) is necessary for staff members who provided care after a multivehicle accident that resulted in serious injury to 10 children and 8 adults. The manager should ensure that this session starts within ______ hours of the incident.

Question 33

The nurse has been assigned to monitor staff wearing personal protective equipment (PPE) during a disaster. The nurse would monitor for which types of distress?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Hypothermia
B) Dehydration
C) Inability to communicate
D) Claustrophobia
E) Vision limitation

Question 34

The nurse decides to respond to a disaster in another city. When arriving at the scene, what should the nurse do first?

A) Begin treating triaged patients.
B) Survey the scene for personal safety.
C) Locate the check-in station.
D) Begin triaging patients.

Question 35

A smallpox outbreak has been identified, and supplies have been requested from vendor-managed inventory. The nurse manager receiving these supplies would anticipate providing which material from the hospital's internal inventory?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Examination gloves
B) Diluent for the vaccine
C) Transfer needles
D) Sharps containers
E) Adhesive bandages