Deck 7: Nursing Care of Patients Experiencing Disasters

Question 1

A small commuter plane lost an engine and crashed into a shopping mall. The estimated number of injured people from this accident is 500. The nurse realizes this incident would be considered which of the following?

A)mass casualty incident
B)multiple casualty incident
C)man-made accidental disaster
D)intentional man-made disaster

Answer 1

mass casualty incident

Question 2

The nurse is admitting the second patient in two days who is experiencing malaise, high fever, and headache. Both patients were in attendance at a local air show the previous weekend. Which of the following should the nurse do?

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 the family members regarding other symptoms.
D)Assess the patients for what foods they ate while in attendance at the air show.

Answer 2

Discuss the need to contact public health authorities regarding the similarity of the cases.

Question 3

The nurse is caring for patients when a dirty bomb detonates at a nearby shopping mall. Which types of injuries should the nurse expect to see in the victims?

A)radiation sickness
B)fractured limbs and spinal injury
C)thermal burns
D)overexertion and exhaustion

Answer 3

radiation sickness

Question 4

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 of the following decontamination zones?

A)cold
B)warm
C)control
D)hot

Question 5

The nurse is arriving to a site of a bombed building. When preparing to triage victims, in which zone would decontamination occur?

A)warm
B)hot
C)cold
D)green

Question 6

The nurse is caring for a patient who has sustained injuries from an earthquake. The patient would be considered as being a victim of which of the following?

A)natural disaster
B)man-made disaster
C)emergency
D)multiple-casualty incident

Question 7

An emergency department nurse is working when two school buses carrying 75 children each collide en route to an out-of-state field trip. The emergency department nurse knows that reverse triage will need to be instituted. Which principles come under reverse triage? Select all that apply.

A)When there is a mass casualty event with greater than 100 victims, reverse triage may be instituted.
B)Reverse triage works on the principle of the greatest good for the greatest number.
C)A very basic reverse triage system is to categorize or label victims needing the most support and emergency care as red, so they can be treated first.
D)Victims most likely to survive are color-coded black, and are treated first.
E)Reverse triage works on the principle of the greatest good for the most critically ill.

Question 8

Several victims of a suspected biologic attack are brought into the emergency department. Which type of personal protective equipment should these victims wear?

A)mask
B)gown
C)gloves
D)goggles

Question 9

Several victims of a multi-vehicle accident are ambulatory. The emergency personnel determine that their injuries are minor and arrange for transportation for them to return home. The purpose for the emergency personnel to triage these victims first was to

A)do the greatest good for the greatest number of people.
B)remove them so they did not see the critically injured victims.
C)secure the site in case the vehicles became overheated and ignited.
D)improve traffic conditions to clear the accident quickly.

Question 10

The nurse is caring for a patient who experienced a blast injury to the eye. Which of the following interventions would be appropriate for this patient?

A)Flush the eye with eyewash.
B)Encourage the patient to rub the eye to get out specks of dust.
C)Apply a warm compress to the eye.
D)Remove debris lodged in the eye.

Question 11

A victim of a chemical plant explosion is unconscious and brought into the emergency department. For which of the following should the patient be assessed?

A)central nervous system injury
B)respiratory system injury
C)pulmonary emboli
D)radiation sickness

Question 12

A school bus transporting a local university's basketball team has just crashed in the rain on the side of the road. The bus was transporting approximately 60 people. Which classification would the nurse use to describe the situation?

A)a multiple-casualty incident
B)a natural disaster
C)a manmade disaster
D)a mass-casualty incident

Question 13

Emergency response personnel are wearing gowns, gloves, goggles, and masks. In which decontamination zone are these personnel most likely working?

A)hot
B)warm
C)cold
D)yellow

Question 14

A victim of a plane crash exits the plane and runs to an emergency provider to tell him that his mother is trapped inside and is unable to walk out on her own. Which of the following should the emergency provider do?

A)Assist with clearing all of the victims who are ambulatory first and then locate the trapped victim.
B)Enter the plane to locate the trapped victim.
C)Tell the victim's son that his mother will be fine and gotten out of the plane as soon as possible.
D)Tell the victim to go back inside and try to get his mother on her feet.

Question 15

An individual arrives to the emergency department with injuries sustained from a natural gas explosion. The patient is unable to respond to questions and keeps repeating "I can't hear." For which of the following should this patient be assessed?

A)tympanic membrane rupture
B)air embolism
C)oxygen saturation level
D)confusion

Question 16

Emergency response personnel arrive to the site of a collapsed building. There are victims walking away from the building while others are lying on the ground around the perimeter. If implementing reverse triage, which of the following should the emergency personnel do first?

A)Identify one safe location for all ambulatory victims to be assessed and observed.
B)Systematically assess each victim who is lying on the ground and assign a color.
C)Enter the building to locate other victims who might not have been able to leave before the collapse.
D)Transfer the victims on the ground to stretchers and send to the local emergency department.

Question 17

Several patients are admitted after a being exposed to a substance that was released in their manufacturing plant. The patients are demonstrating flu-like symptoms, unproductive cough, and fever. These patients should be assessed for which of the following types of exposure?

A)anthrax
B)smallpox
C)dirty bomb
D)nuclear detonation

Question 18

A patient is brought into the emergency department explaining of blindness after an explosion at an atomic power plant. Which of the following should the nurse explain to this patient?

A)"The effects of the blast will disappear with time."
B)"I believe that the blast has caused you to be permanently blind."
C)"I will contact Social Services so that resources can be identified to help you with your disability."
D)"There are a variety of resources available for those who are unable to see."

Question 19

The nurse is caring for a patient who was brought into the emergency department after an explosion at a nuclear power plant. The patient is confused and keeps repeating that his skin is "on fire." Which of the following does this information provide to the nurse?

A)There is nervous system involvement and the patient may not recover.
B)The patient's clothing is burning his skin.
C)There is gastrointestinal system involvement and the patient will survive if receives fluids.
D)There is bone marrow damage and the patient needs oxygen for the confusion.

Question 20

A train derailed in a local community. The contents of the train caused a hazardous spill and noxious gasses are being released into the environment. All local and surrounding fire control and Hazmat teams have been mobilized and the event is considered under control. This situation would be considered as being which of the following?

A)emergency
B)disaster
C)man-made accidental disaster
D)intentional emergency

Question 21

The hospital has been notified of a subway derailment with approximately 250 passengers. Many of the passengers are reported to be injured. This situation would be classified as being which of the following?

A)a natural disaster
B)a multiple casualty incident
C)a mass casualty incident
D)an accidental disaster

Question 22

A community patient arrives to the site of a disaster, hysterically crying because she was in the building that had collapsed just minutes before the disaster. Which of the following should be done with this patient?

A)Advise her to go home with her family.
B)Triage this patient and transport to the hospital.
C)Have a nurse talk with the patient.
D)Ask psychiatric service personnel to talk with this patient.

Question 23

A patient says to the nurse, "I'm scared about a terrorist attack since I live so close to the airport." Which of the following would be an appropriate response for the nurse to make to this patient?

A)"Have you thought about moving?"
B)"That's silly to be so worried."
C)"What do you have in your home to help you in the event of a terrorist attack?"
D)"I would be concerned, too."

Question 24

The nursing staff is planning to attend a disaster prevention presentation. The purpose of this education is

A)to learn the organization's disaster plan.
B)to have the nurses participate in the plan for handling a disaster.
C)to educate the nurses about recognizing possible terrorists.
D)to learn how the nurse will participate in mitigation.

Question 25

The nurse is planning to attend a program to learn how to respond to mass casualty incidents. There are core competencies within this program. The nurse knows that these competencies are which of the following? Select all that apply.

A)critical thinking
B)nursing process
C)technical skills
D)communication
E)assessment

Question 26

The care area has been alerted to a possible illness associated with the tainting of a popular over-the-counter pain reliever. The nurse realizes the tainting of this pain reliever could be classified as being which of the following?

A)a non-conventional terrorist attack
B)a conventional terrorist attack
C)an accidental disaster.
D)a natural disaster

Question 27

The nurse is providing a program to residents of a local senior citizen housing facility about preparations in the event of a disaster. Which of the following should the nurse instruct the participants to do regarding essential preparations?

A)Have a list of medications, emergency contact numbers, and needed survival items readily available.
B)Turn off all electrical devices before leaving the premises.
C)Pack enough nonperishable food items to last for several days.
D)Bring recreational items such as puzzles and card games for entertainment.

Question 28

During the disaster preparedness presentation, the nurse learns about the harmful effects of a dirty bomb. Which of the following treatments will preserve life in the event of this disaster?

A)supporting the patient who will develop radiation sickness
B)heart-lung transplant
C)liver transplant
D)bone marrow transplant

Question 29

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

A)mitigation
B)recovery
C)restoration
D)rehabilitation

Question 30

A patient who was exposed to a thermal nuclear blast is experiencing blindness. Which of the following can the nurse instruct this patient about the eye injury?

A)The blindness is permanent.
B)The blindness will last for several years.
C)The blindness will resolve in time.The intense light from the blast caused the temporary blindness.
D)The blindness will resolve somewhat in time; however, the patient will always have vision changes afterwards.

Question 31

A patient comes into the clinic with the onset of itching after opening a letter received about a week ago that contained "quite a bit of white powder." It is suspected that this patient has had an anthrax exposure. Which medication can the nurse anticipate that this patient will most likely be prescribed?

A)normal saline solution flush to the skin
B)penicillin
C)acetaminophen
D)Solu-Medrol

Question 32

The nurse is planning a program to address disaster mitigation activities in the community. Which of the following should the nurse consult when preparing this program?

A)community disaster preparedness plan
B)hospital administrators
C)physicians with practices in the community
D)schools and day care centers

Question 33

The community is holding a memorial service to honor those members whose lives were lost in a flood one year ago. In which stage of the disaster recovery process is this community?

A)restoration
B)reconstitution
C)mitigation
D)disaster reflection

Question 34

An elderly patient asks the nurse, "What can we do to be prepared if there's a disaster in our community?" With which of the following can the nurse respond to this patient?

A)"There is not really much we can do to be prepared."
B)"Plan to evacuate your home at a moment's notice."
C)"Make sure all of your important papers, health information, medication information, and next-of-kin information is in one place."
D)"Make sure you can call your family to come and pick you up if this happens."

Question 35

The nurse is reviewing the stages and phases of a disaster as part of a routine continuing education program in the hospital. Which of the following correctly lists the order of the stages of a disaster?

A)The nondisaster stage, the predisaster stage, the impact stage, the emergency stage, and the reconstruction stage
B)The predisaster stage, the nondisaster stage, the impact stage, the emergency stage, and the reconstruction stage
C)The emergency stage, the predisaster stage, the nondisaster stage, the emergency stage, and the reconstruction stage
D)The impact stage, the nondisaster stage, the predisaster stage, the emergency stage, and the reconstruction stage

Question 36

A patient is brought into the emergency department with chemical burns. Which of the following should the nurse do to help this patient?

A)Check to see if all of the clothing has been removed and begin flushing the patient's skin with water.
B)Begin flushing the patient's clothes and skin with warm water.
C)Do not remove any jewelry.
D)Keep the patient's contact lenses in place and flush only with warm water.

Question 37

The emergency response team is setting up an area to triage victims of a building blast in a major metropolitan area. Which of the following areas can be used to set up this triage location?

A)hot zone
B)warm zone
C)cold zone
D)clean zone

Question 38

The emergency department nurses are noting an unusually high number of patients coming in with complaints of nausea, vomiting, and severe headache. What should be done with this information?

A)No further action is needed at this time.
B)Contact the Infection Control Department and Laboratory Medicine.
C)Close the emergency department.
D)Call for more staffing to handle all of the patients.

Question 39

The National Weather Service has announced the likelihood of a large snow event in a major metropolitan area. Which of the following is most likely to occur with this weather event?

A)stress-related injuries
B)crushing injuries
C)myocardial infarctions
D)burns

Question 40

The nurse is planning the coding for a triage disaster plan. What are the colors most associated with triage? Select all that apply.

A)white
B)red
C)yellow
D)black
E)green

Question 41

A patient exposed to smallpox would present with a vesicular/pustular rash over which areas of their body? Place an "X" over the areas where the rash would initially present.

Question 42

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

Question 43

A train derailment results in mass causalities. The triage nurse is tagging patients as they arrive. Her first patient has a sucking chest wound, BP 90/50, Resp 32, and she is alert and able to respond to 11ea992e_0a8b_c9f9_9f38_fb5950442c01

A)red, Immediate threat to life
B)yellow, requiring medical attention but no threat to loss of life
C)green, ambulatory with minor injuries
D)black, not expected to survive

Question 44

The local hospital has joined with the county emergency management team to plan and conduct disaster drills on a monthly basis. This would be considered a component of which of the states and phases of a disaster? (See figure above.) 11ea992e_0a8b_f10a_9f38_0798874d440b

A)predisaster stage
B)nondisaster stage
C)reconstruction stage
D)emergency stage

Question 45

Atropine is ordered for a patient who has been exposed to nerve gas. When preparing to give the medication, the nurse would select which site for the injection? Place an "X" on the site above.

Question 46

On confirmation of anthrax exposure, Cipro prophylaxis would be initiated. You have received an order for 400 mg ciprofloxacin to be given over 60 minutes. The pharmacy has sent a 1 gram vial of Cipro to the nursing unit to be diluted with 10 mL of sodium chloride. The nurse should administer ____ mL.

Question 47

A mass casualty accident has occurred. The nurse has received a list of terms to use for the Alternate Triage 5-Category System. The first patient the nurse receives has a color code of red. The nurse knows that this patient needs

A)to be sent home.
B)to be evaluated in the next few hours.
C)to be evaluated for immediate intervention.
D)to be sent with his or her family for privacy during the dying process.

Question 48

Considering the risk of biological threat infections, healthcare providers need to be alert to illness patterns that could indicate an unusual infectious disease process. Which of the following would indicate a possible biological infection? Select all that apply.

A)Patients present with symptoms of a rare disease.
B)The disease pattern is inconsistent with the age of the patient.
C)Multiple patients presenting with viral like symptoms.
D)Patients are all coming from the same geographic area.
E)Patients are all over the age of 39, indicating a smallpox exposure.

Question 49

A train full of railroad cars filled with toxic chemicals and a full school bus with 90 children on board collides in a populated area. A huge explosion occurs and a fire develops in a nearby factory. When you arrive on the scene, the victim count is well above 200. Utilizing the chart above, which plan of care should be implemented? 11ea992e_0a8c_181b_9f38_93eb37ece4f1

A)emergency; use conventional triage
B)emergency; evacuate all ambulatory patients first
C)disaster; employ reverse triage
D)disaster; evacuate critically injured patients first

Question 50

You are sent to the scene of a radioactive explosion and instructed to do in-depth triage of the patients. Place an "X" in the zone where you would expect to perform this task.

Question 51

The CDC requires that a Mass Trauma Data Instrument be completed on each victim of a disaster. This data tool contains which of the following information? Select all that apply. Select all that apply.

A)identification of chemical agent exposed to
B)circumstances of the injury
C)documentation of agencies notified or incident
D)disposition of patient
E)triage tag color

Question 52

Utilizing the simple triage and rapid transport (START) system, in what order would the nurse prioritize the following patients? Click and drag the options below to move them up or down.

A)A 67-year-old male complaining of chest pain.His heart rate is 120 beats/minute, his blood pressure is 100/68 mmHg, and his respiratory rate is 20 breaths/min.
B)A 27-year-old woman presenting with a respiratory rate of 36 breaths/min, and capillary refill of 4 seconds.
C)A 58-year-old woman able to walk on her own and states over and over, " I don't know what happened."
D)A 30-year-old male with a collapsed airway and multiple chest trauma; he does not have a palpable carotid pulse and you are unable to assess respiratory movement.

Question 53

There is a radiologic dispersion bomb (dirty bomb) explosion in a nearby subway station. In what order would the nurse deliver patient care at the scene of the explosion? Click and drag the options below to move them up or down.

A)Begin direct patient care for complaints of fatigue and nausea.
B)Decontaminate clothing of patients.
C)Assess patients for burns and blunt trauma.
D)Evacuate patients from the exposure area.