Disaster planning EAQ
pdf
School
Queens University Of Charlotte *
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Course
370
Subject
Health Science
Date
Feb 20, 2024
Type
Pages
87
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Rationale
Response to MCIs often requires the aid of a federal agency. The National
Incident Management System (NIMS) is a section within the U.S.
Department of Homeland Security. NIMS is responsible for coordinating
federal, state, and local government efforts to respond to and manage
domestic MCIs. Local emergency management systems may communicate
with the hospital from the field to determine how many clients the hospital
can accept.
Test-Taking Tip:
Choose the best
answer for questions asking for a single
answer. More than one answer may be correct, but one answer may
contain more information or more important information than another
answer.
Report content error
Which disaster management team provides voluntary medical
service to people?
State emergency management system
Federal emergency management agency
Hospital-level emergency management system
Medical Reserve Corps (MRC)
Disaster Medical Assistance Team (DMAT)
National Veterinary Response Teams (NVRT)
Disaster Mortuary Operational Response Teams (DMORT)
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Rationale
MRCs are groups of volunteers, consisting of medical and public health
professionals, who offer voluntary support and aid during disaster
management. DMAT, NVRT and DMORT are part of the National Disaster
Medical System (NDMS), which deploys personnel from other regions.
Report content error
Who is responsible for triaging the victims of a multiple
motor vehicle crash on a major interstate?
Rationale
For a mass casualty incident, triaging will occur in the field or at the site of
the incident. In this case, the emergency first responders will triage the
victims of the crash. Nurses in the acute care areas may or may not have
victims admitted for care. The victims should be triaged before arriving in
the emergency department, so it would be incorrect to expect the nurses
and health care providers in the emergency department to perform triage.
Emergency first responders
Nurses in the acute care areas
Nurses in the emergency department
Health care providers in the emergency department
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Report content error
Which medical relief team would the nurse expect to help
health care facilities that face personnel shortages during a
mass casualty event?
Rationale
MRC is a group of volunteer medical and public health care professionals.
MRC helps health care settings that face personnel shortages in a mass
casualty event. DMAT is a team of civilian medical, paraprofessional, and
support personnel that supplies medical equipment to sustain operations
for 72 hours. HICS is a facility-level organizational model to standardize
disaster operations. IMSRTs provide fully functional field surgical facilities
in a mass casualty event whenever needed.
Report content error
Which system or level of government is essential for ensuring
disaster readiness in a community?
Medical Reserve Corps (MRC)
Disaster Medical Assistance Team (DMAT)
Hospital Incident Command System (HICS)
International Medical-Surgical Response Teams (IMSRTs)
Trauma system
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Rationale
A well-functioning trauma system is essential to general public health and
safety. It provides the structure necessary for disaster readiness and
community emergency preparedness. Although most states now have at
least some basic elements of a trauma system in place, significant gaps
still exist in many regions. The federal government may provide oversight
for disaster readiness; however, it does provide the fundamental structure.
The emergency response system is one aspect of disaster readiness;
however, it does not provide the structure.
Report content error
Which disaster triage tag would the nurse find on victims of a
mass causality event with minor injuries who arrived to a
hospital in a private vehicle?
Rationale
State government
Federal government
Emergency response system
Red
Black
Green
Yellow
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The green-tagged victims have minor injuries, can move themselves to the
hospital from a mass causality scene in a private vehicle, and are also called
"walking-wounded" victims. Red-tagged victims can’t ambulate themselves
because they are severely injured. The black-tagged victims are dead or
expected to die and require ambulances to transfer them. The yellow-
tagged victims can have large wounds that require assistance to ambulate.
Report content error
Which health care personnel working at an emergency
operation center (EOC) is responsible for calling the infectious
disease health care provider during a mass casualty swine flu
outbreak if the need is identified?
Rationale
Medical command physician in the EOC is responsible for identifying the
need for and calling in specialty providers such as an infectious disease
health care provider. The triage officer evaluates each client to determine
priorities for treatment. The public information officer serves as a liaison
between the health care facility and the media. The hospital incident
commander assumes leadership for implementing the institutional plan.
Test-Taking Tip:
You have at least a 25% chance of selecting the correct
Triage officer
Public information officer
Medical command physician
Hospital incident commander
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response in multiple-choice items. If you are uncertain about a question,
eliminate the choices that you believe are wrong and then call on your
knowledge, skills, and abilities to choose from the remaining responses.
Correct (93)
Report content error
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Which team member acts as a liaison between the health care
facility and the media?
Rationale
The public information officer
acts as a liaison between the health care
facility and the media. The triage officer applies disaster triage tags after
evaluating the client’s condition. The medical command physician decides
the number, acuity, and resource needs of clients. The hospital incident
commander assumes overall leadership for implementing the emergency
plan.
Test-Taking Tip:
Do not panic while taking an exam! Panic will only
increase your anxiety. Stop for a moment, close your eyes, take a few deep
breaths, and resume review of the question.
Report content error
Which hospital department plays a primary role in disaster
preparedness?
Triage officer
Public information officer
Medical command physician
Hospital incident commander
Medical department
Surgical department
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Rationale
The emergency department plays a primary role in emergency disaster
preparedness. Although all departments in the hospital contribute to
disaster planning, the only department that plays a primary role is the
emergency department.
Report content error
Which color tag would be given to "walking wounded" clients
according to the disaster triage tag system?
Rationale
Green tagged clients are referred to as "walking wounded" because they
may evacuate themselves from the mass casualty scene and go to the
hospital in a private vehicle. Clients with life-threatening conditions that
need immediate treatment are given red tags. Black-tagged clients are
expected to die or may be dead. Clients with major injuries are tagged with
yellow. They may require urgent treatment but can wait a short time for
care because their injuries are not life threatening.
Emergency department
Mental health department
Red
Black
Green
Yellow
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Report content error
Which colors are often included in an organizational disaster
plan for use during triage? Select all that apply. One, some,
or all responses may be correct.
Rationale
Colors that are often used for triage purposes in an organizational disaster
plan include red, black, green, yellow, and blue. White is not a color that is
used during the triage process.
Report content error
Red
Black
Green
White
Yellow
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Which activity would the nurse manager complete during an
emergency event when acting as the triage officer according
to the Hospital Incident Command System (HICS)?
Rationale
In the role of triage officer, the nurse would rapidly evaluate each person
who comes to the hospital, including those triaged in the field. The
hospital incident commander facilitates client movement through the
system and brings in personnel and resources to meet needs. The medical
command physician identifies the need for and calls in needed specialty
providers.
Report content error
Which emergency medical service agency offers service such
as first aid stations and special-need shelters during a disaster
or pandemic disease outbreak?
Facilitating client movement through the system
Bringing in personnel and supply resources to meet needs
Rapidly evaluating each person who comes to the hospital
Identifying the need for and call in specialty providers
Medical Reserve Corps (MRC)
National Disaster Medical System (NDMS)
Disaster Medical Assistance Team (DMAT)
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Rationale
The MRC may help staff hospitals or community health settings that face
shortages and provide first aid stations or special-need shelters. The
NDMS manages mass fatalities, emergency animal care, and establishes
fully functional field surgical facilities. A DMAT is a medical relief team
deployed to a disaster area with enough medical equipment and supplies
to sustain operations for 72 hours. FEMA provides Community Emergency
Response Team (CERT) training so that people are better prepared for
disasters and hazard situations in their own communities.
Test-Taking Tip:
Choose the best
answer for questions asking for a single
answer. More than one answer may be correct, but one answer may
contain more information or more important information than another
answer.
Report content error
To which disaster triage class would the nurse infer a client
with a green triage tag belongs?
Federal Emergency Management Agency (FEMA)
Class I
Class II
Class III
Class IV
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Rationale
The green disaster triage tag is issued to nonurgent or "walking-wounded"
clients who belong to class III. A red disaster triage tag is issued to clients
who require immediate treatment and belong to class I. Clients with yellow
and black tags belong to class II and IV respectively.
Test-Taking Tip:
Identify option components as correct or incorrect. This
may help you identify a wrong answer.
Report content error
Which amount of time is appropriate for the nurse to spend
triaging each client during a mass casualty incident (MCI)?
Rationale
Triage of victims of an emergency or an MCI must be conducted in less
than 15 seconds. The other time frames, 10 seconds, 30 seconds, and 60
seconds, are not accurate.
Less than 10 seconds
Less than 15 seconds
Less than 30 seconds
Less than 60 seconds
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Report content error
Which disaster can be categorized as an internal disaster?
Rationale
An internal disaster is any event inside a health care facility or campus that
could endanger the safety of clients or staff. An explosion inside a hospital
is an example of internal disaster. A hurricane, earthquake, or flooding in a
town, all occurring out of the hospital setting but requiring an emergency
management plan from the hospital, can be categorized as external
disasters.
Report content error
Which color tag would the nurse use to triage a victim of a
train derailment who is able to walk independently to the first
aid station?
Hurricane in a state
Explosion in a hospital
Earthquake in a country
Flooding in a town
Red
Black
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Rationale
An emergency triage system uses colored tags to designate both the
seriousness of the injury and the likelihood of survival. Green would be
used for minor injuries such as the victim who is able to ambulate
independently. Red indicates life-threatening injuries requiring immediate
attention. Black indicates that the victim is expected to die. Yellow
indicates urgent but not life-threatening injuries.
Test-Taking Tip:
Identify option components as correct or incorrect. This
may help you identify a wrong answer.
Report content error
Which functional level of trauma center is involved in
providing a full continuum of trauma services?
Rationale
Level I trauma centers
provide a full continuum of trauma services for all
clients. Level II trauma centers provide care for most injured clients. Level
Green
Yellow
Level I
Level II
Level III
Level IV
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III centers are able to stabilize clients with major injuries, but must
transport clients if needs exceed resource capabilities. Level IV trauma
centers are usually involved in providing basic trauma client stabilization
and advanced life support within the resource capabilities. They are also
responsible for the transfer of clients if need exceeds the resource
competencies.
Test-Taking Tip:
Be alert for details. Details provided in the stem of the
item, such as behavioral changes
or clinical changes
(or both) within a
certain time period
, can provide a clue to the most appropriate response
or, in some cases, responses.
Report content error
Which emergency response team helps set up shelters for
victims who lost their homes due to a disaster?
Rationale
The American Red Cross sets up shelters for people who have lost their
homes or have been evacuated from their homes after an external disaster.
A DMAT provides medical equipment that is sufficient for at least 72
hours. IMSRTs establish fully functional field surgical facilities wherever
they are needed in the world. DMORTs manage mass fatalities at the
disaster site.
American Red Cross
Disaster Medical Assistance Team (DMAT)
International Medical-Surgical Response Teams (IMSRTs)
Disaster Mortuary Operational Response Teams (DMORTs)
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STUDY TIP:
Avoid planning other activities that will add stress to your life
between now and the time you take the licensure examination. Enough
will happen spontaneously; do not plan to add to it.
Report content error
Which is the minimum number of disaster drills the hospital
disaster plan committee must plan and implement each year?
Rationale
Although it is appropriate to have more than the minimum number of
disaster drills each year, the minimum that must be implemented per The
Joint Commission (TJC) requirements is twice per calendar year. Three,
four, and five are too many.
Report content error
Two
Three
Four
Five
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Which emergency medical service (EMS) health care
professional provides advanced life support to the clients who
survived a large-scale disaster?
Rationale
Paramedics provide advanced life support such as cardiac monitoring and
establishing intravenous access to the clients who survived a large-scale
disaster. A triage officer rapidly evaluates each client to determine priorities
for treatment. Prehospital care providers are the first caregivers that clients
see before transport to the emergency department (ED) by an ambulance
or helicopter. Emergency medical technicians provide basic life support
interventions such as oxygen and basic wound care to the clients who
survived large-scale disaster.
Report content error
Which agent of terrorism can cause death within a few
minutes?
Paramedics
Triage officer
Prehospital care providers
Emergency medical technicians
Sarin gas
Uranium
Iodine-131
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Rationale
Sarin gas is an agent for bioterrorism that can cause death within minutes
of exposure by paralyzing respiratory muscles. Uranium and iodine-131
can be dangerous in close proximities but are not as harmful as sarin gas.
Mustard gas causes blisters on the skin but does not cause death within a
few minutes.
Report content error
Which threats included in the term "NBC" led to the
implementation of improved emergency medical services
(EMS) and hospital safety programs? Select all that apply.
One, some, or all responses may be correct.
Rationale
The term "NBC" was coined to describe n
uclear, b
iological, and c
hemical
threats. In response, EMS agencies and hospitals improved safety by
upgrading their decontamination facilities, equipment, and all levels of
Mustard gas
Nuclear
Biological
Botulism
Chemical
Nipah virus
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personal protective equipment to better protect staff. Botulism and Nipah
virus are two specific examples of biological threats.
Report content error
Which method of delivering client care works well in disaster
situations?
Rationale
The functional method of delivering care works well in emergency and
disaster situations. Each care provider knows the expectations of the
assigned role and completes the tasks quickly and efficiently. Team
nursing, primary nursing, and total client care nursing are not the ideal
models for delivering client care during disaster situations.
Report content error
Team nursing
Primary nursing
Functional nursing
Total client care nursing
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Which health care team member is a first responder when an
emergency or mass casualty incident (MCI) occurs?
Rationale
Critical care nurses are often considered emergency medical personnel
that respond to emergency or MCIs. Medical unit nurses, while members
of the health care team, are not first responders. Firemen and police
officers are first responders but are not members of the health care team.
Unlicensed assistive personnel are not first responders.
Report content error
Which behavioral response to a disaster would the nurse treat
first
, in an attempt to avoid mass hysteria?
Medical unit nurse
Police officer
Critical care nurse
Unlicensed assistive personnel
Panic
Coma
Euphoria
Depression
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Rationale
People in a panic may initiate a group panic reaction or mass hysteria,
even in those who appear to be in control. Comatose individuals will not
cause panic in others. Euphoric individuals will not adversely affect others.
Depressed people will be quiet and not affect others.
STUDY TIP:
A word of warning: do not
expect to achieve the maximum
benefits of this review tool by cramming a few days before the
examination. It doesn’t work!
Instead, organize planned study sessions in
an environment that you find relaxing, free of stress, and supportive of the
learning process.
Report content error
Which team would be mobilized to manage the deceased at
the earthquake zone where many people lost their lives?
Rationale
DMORTs are a part of the DMAT. This team is specialized in managing
mass fatalities during a disaster. The MRC helps staff hospitals or
community health care settings that face shortages of nurses. They
establish first aid stations and special-needs shelters in disasters. NVRTs
provide emergency care to animals. IMSRTs provide fully functional field
surgical facilities all over the world, wherever it is required.
Medical Reserve Corps (MRC)
National Veterinary Response Teams (NVRTs)
International Medical-Surgical Response Teams (IMSRTs)
Disaster Mortuary Operational Response Teams (DMORTs)
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Report content error
Which health care professional serves as the liaison between
hospital administration and the media to release only
appropriate and accurate information in the event of a mass
casualty event or disaster?
Rationale
Mass casualty incidents tend to attract a large amount of media attention.
The community relations or public information officer can serve as the
liaison between hospital administration and the media to release only
appropriate and accurate information. The triage officer is a primary health
care provider or nurse who rapidly evaluates each client to determine
priorities for treatment. The medical command physician decides the
number, acuity, and resource needs of clients arriving from the incident
scene to the hospital and organizing the emergency health care team
response to the injured or ill clients. The hospital incident commander is a
primary health care provider or administrator who assumes overall
leadership for implementing the emergency plan.
Triage officer
Community relations officer
Medical command physician
Hospital incident commander
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Report content error
According to the disaster triage tag system, which color tag
would the nurse feel is most
suitable for a client who died in
an earthquake?
Rationale
Clients who are dead or are expected to die are issued a black tag
according to the disaster triage tag system. A red tag is issued to the
clients who have an immediate threat to life. A green tag is issued to the
nonurgent or "walking wounded" clients. A yellow tag is issued to clients
who can wait a short time to receive care.
Report content error
Which event would the nurse state is an example of a natural
disaster?
Red
Black
Green
Yellow
Floods
Terrorism
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Rationale
External disasters can be natural, such as floods, earthquakes, or
tornadoes. Acts of terrorism are external disasters that use technology such
as explosive devices or a malfunction of a nuclear reactor. A fire explosion
is an internal disaster. A building collapse is a consequence of internal or
external disaster.
Report content error
Which action would the nurse identify as a potential
contributor to staff post-traumatic stress disorder (PTSD)
during a mass casualty assessment?
Rationale
Working continuously without any breaks will result in increased stress.
Working less than 12 hours may reduce stress. By motivating team
members, PTSD can be prevented. By discussing feelings with team
members or nurse managers, stress can be reduced.
Fire explosion
Building collapse
Working less than 12 hours
Encouraging and motivating team members
Working continuously without any breaks
Discussing feelings with the team members
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Report content error
Which event would the nurse describe as an example of an
internal disaster?
Rationale
An internal disaster refers to an event that impairs the hospital’s normal
functioning and disrupts normal client care activities. Examples include a
fire or explosion and the loss of critical utilities. Tornado, hurricanes, and
terrorist attacks are external disasters that result in the loss of lives and
property.
Report content error
How often should a health care facility that is Joint
Commission accredited plan to test the emergency
preparedness plan?
Tornado
Hurricanes
Fire or explosion
Terrorism attacks
Annually
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Rationale
The Joint Commission mandates that hospitals have an emergency
preparedness plan that is tested through drills or actual participation in a
real event at least twice yearly. Annually or every 2 years is not frequent
enough to test the emergency preparedness plan. It is not necessary to test
the plan as frequently as every 3 months.
Report content error
Which event would the nurse consider to be an example of a
potential internal disaster?
Rationale
An internal disaster is any kind of event inside a health care facility or
campus that could endanger the safety of clients or health care staff. A fire
in a hospital
is an example of an internal disaster that can cause harm to
the clients and the staff. A fertilizer plant explosion is an external disaster. A
Twice a year
Every 2 years
Every 3 months
Hospital fire
Fertilizer plant explosion
Nuclear reactor explosion
Terrorist device explosion
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nuclear reactor explosion may cause radiation exposure to the external
environment. Terrorism with explosive devices is an external disaster.
Report content error
Clients with which tag are referred to as "walking wounded"
clients while managing a disaster?
Rationale
Clients who sustained minor injuries during a disaster and can evacuate
themselves are referred to as "walking wounded" clients and are green-
tagged. Red tags are given to clients who have immediate threats to their
life and should be treated immediately. Black tags are given to clients who
are not expected to live or are dead. Yellow tags are given to clients who
sustained major injuries and need treatment within 30 minutes to 2 hours.
Report content error
Red
Black
Green
Yellow
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Which behavioral response to a disaster would the nurse treat
first
, in an attempt to avoid mass hysteria?
Rationale
People in a panic may initiate a group panic reaction or mass hysteria,
even in those who appear to be in control. Comatose individuals will not
cause panic in others. Euphoric individuals will not adversely affect others.
Depressed people will be quiet and not affect others.
STUDY TIP:
A word of warning: do not
expect to achieve the maximum
benefits of this review tool by cramming a few days before the
examination. It doesn’t work!
Instead, organize planned study sessions in
an environment that you find relaxing, free of stress, and supportive of the
learning process.
Report content error
Which nursing resource must be available to effectively meet
potential needs during a disaster? Select all that apply. One,
some, or all responses may be correct.
Panic
Coma
Euphoria
Depression
Staff
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Rationale
Preparation for disasters includes ensuring resources are available to meet
potential needs. The nurse leader must ensure there is adequate staff,
medication, hospital beds, medical devices such as mechanical ventilators,
and personal protective equipment available to address potential needs
during a disaster.
Report content error
Which element is the critical factor among health care
professionals, state agencies, and federal agencies to
determine when and how to evacuate safely during a natural
disaster?
Rationale
Medication
Hospital beds
Mechanical ventilators
Personal protective equipment
Cooperation
Classification
Collaboration
Communication
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Communication is the critical factor among health care professionals, state
agencies, and federal agencies to determine when and how to evacuate
safely during a natural disaster. Cooperation, classification, and
collaboration, although important, are not the critical factors to determine
when and how to safely evacuate during a natural disaster.
Report content error
A group of bomb blast victims needs to be transported to the
hospital immediately. Which staff members of an emergency
unit are most
appropriate to handle this situation?
Rationale
Prehospital care providers are the first caregivers who provide transport to
the emergency department by ambulance or helicopter for clients in an
emergency situation. Triage officers are responsible for evaluating each
client to determine priorities for treatment. The medical command
physician decides the number, acuity, and resource needs of clients.
Emergency medicine health care providers have specialized education and
training in emergency client management.
STUDY TIP:
Establish your study priorities and the goals by which to
achieve these priorities. Write them out and review the goals during each
of your study periods to ensure focused preparation efforts.
Triage officer
Medical command physician
Prehospital care providers
Emergency medicine physician
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Report content error
The client with which treatment needs belongs to class I
according to the disaster triage tag system?
Rationale
Emergent clients are identified with red tags and belong to class I
according to the disaster triage tag system. Clients who can wait a short
time for treatment are identified by yellow tags and belong to class II
according to the disaster triage tag system. Clients who are expected to die
or are dead are given a black tag and belong to class IV in the disaster
triage tag system. Clients who have no urgency for treatment are issued
green tags and belong to class III.
Test-Taking Tip:
Make certain that the answer you select is reasonable and
obtainable under ordinary circumstances and that the action can be carried
out in the given situation.
Can wait a short time for treatment
Is dead or expected to die
Needs emergency treatment
Has no urgent need for treatment
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Report content error
When writing a disaster plan for implementation during a
mass casualty incident (MCI), which percentage of victims
often require admission to the hospital for further treatment?
Rationale
The disaster plan should include provisions for approximately 30% of the
victims of an MCI requiring hospital admission. The other percentages, 25,
35, and 40 are not accurate numbers to include in the disaster plan.
Test-Taking Tip:
You have at least a 25% chance of selecting the correct
response in multiple-choice items. If you are uncertain about a question,
eliminate the choices that you believe are wrong and then call on your
knowledge, skills, and abilities to choose from the remaining responses.
Report content error
25%
30%
35%
40%
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Which situation would not cover nurses who respond to a
mass casualty incident (MCI) for malpractice or negligent
lawsuits under the Good Samaritan Act?
Rationale
When terrorist acts occur, nurses are often required to go to an assigned
site to offer aid. When this occurs, the nurse is not covered from
malpractice or negligent lawsuits. Nurses who respond to injuries that
occur in a neighborhood fire, roadside car accident, or a high school
sporting event are covered under the Good Samaritan Act.
Test-Taking Tip:
Multiple-choice questions can be challenging, because
students think that they will recognize the right answer when they see it or
that the right answer will somehow stand out from the other choices. This
is a dangerous misconception. The more carefully the question is
constructed, the more each of the choices will seem like the correct
response.
Report content error
Which statement is true about the disaster triage tag system?
Terrorist act
Neighborhood fire
Roadside car accident
High school sporting event
Yellow tags are given to "walking-wounded clients."
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Rationale
Red tags are given to clients with conditions such as airway obstruction
and shock
, who have immediate threats to life and should be treated
immediately. Shock is a condition requiring immediate care and therefore
should be given a red, not black, tag. "Walking-wounded clients" are given
a green tag. Clients who are not expected to live or are dead are given a
black tag. Clients who sustained major injuries and need to be treated in
30 minutes to 2 hours should be given a yellow tag.
Report content error
Which phase of disaster management involves attempts to
limit the disaster’s impact on the population?
Rationale
Clients who are in shock are given a black tag.
Clients with airway obstruction, who require immediate attention,
are given a red tag.
Green tags are given to clients who require treatment within 30
minutes to 2 hours of admission.
Recovery
Response
Mitigation
Preparedness
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Mitigation is the phase of disaster management where attempts are made
to limit the impact of a disaster on human and community welfare. The
recovery phase is associated with stabilizing the community after a
disaster. The implementation phase of a disaster plan is the response
phase. Preparedness is the protective plan, which assesses the risk.
Report content error
Which emergency medical service agency offers service for a
group of clients admitted to the emergency unit with mass
fatalities?
Rationale
The National Disaster Medical System (NDMS) is responsible for
managing the Federal Government’s medical response to medical
emergencies and disasters. One of their additional services is the DMORT.
DMORTs manage mass fatalities. The MRC offers its services to health care
facilities or the community in a supportive to supplemental capacity during
times of need, such as a disaster or pandemic disease outbreak. HICS is a
part of National Incident Management System (NIMS) that standardizes
disaster operations. IMSRT establishes fully functional field surgical
facilities.
Test-Taking Tip:
On a test day, eat a normal meal before going to school. If
Medical Reserve Corps (MRC)
Hospital Incident Command System (HICS)
International Medical-Surgical Response Teams (IMSRT)
Disaster Mortuary Operational Response Teams (DMORT)
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the test is late in the morning, take a high-powered snack with you to eat
20 minutes before the examination. The brain works best when it has the
glucose necessary for cellular function.
Report content error
Which conditions are given a green tag according to triage
disaster tag system? Select all that apply. One, some, or all
responses may be correct.
Rationale
A green tag is issued for clients who are nonurgent or classified under
class III. Strains and abrasions are considered minor injuries and
nonurgent. Walking wounded clients with minor injuries are triaged under
this category. Clients with open fractures and who can wait some time for
care are issued yellow tags and triaged under class II. Clients with airway
obstruction are issued red tags and triaged under class I. Clients with high
cervical spinal cord injury are issued black tags because they are expected
to die and are categorized under class IV.
Strains
Abrasions
Open fractures
Airway obstruction
High cervical spinal cord injury
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Report content error
Which generation of nursing professionals, being exposed to
both terrorism and natural disasters, would be key members
for disaster planning initiatives?
Rationale
Generation Y nurses are the future of the profession and have grown up
with massive amounts of information and technology. They have
experienced terrorism and natural disasters. This generation of nurses
would be key members for disaster planning initiatives. Although
contributions from nurses from the Veteran, Generation X, and Baby
Boomer generations are important, these individuals do not have the
experience with these topics that the Generation Y possesses.
Test-Taking Tip:
If you are unable to answer a multiple-choice question
immediately, eliminate the alternatives that you know are incorrect and
proceed from that point. The same goes for a multiple-response question
that requires you to choose two or more of the given alternatives. If a fill-
in-the-blank question poses a problem, read the situation and essential
information carefully and then formulate your response.
Veteran
Generation X
Generation Y
Baby Boomer
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Report content error
Which treatment for anthrax would be included in the
biological agent portion of a disaster plan for terrorist attacks?
Rationale
Anthrax
is treated effectively with antibiotics if sufficient supplies are
available and the organisms are not resistant. Antivirals would not be
effective against anthrax, and there is no established treatment for most
viruses that cause hemorrhagic fever. Botulism is treated with antitoxin,
though several vaccines are being studied. Smallpox can be prevented or
the incidence reduced by vaccination, even when first given after exposure.
Report content error
Which phase of disaster management occurs when the
community health nurse in a community that is
geographically vulnerable to storms teaches the community
about safety measures to be taken during a storm?
Antivirals
Antitoxins
Antibiotics
Vaccinations
Recovery
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Rationale
Preparedness is the phase in which a plan is designed before the disaster
event to best structure the response. Teaching safety measures to the
people of a locality is the preparedness phase. The recovery phase involves
stabilizing the community after a disaster event. Response is the
implementation of the disaster plan. Mitigation is a phase of disaster
management in which attempts are made to limit the disaster’s impact.
Report content error
Which statement would the nurse know to be true regarding
the characteristics of sarin?
Rationale
Sarin is a highly toxic nerve gas that can cause death within minutes of
exposure. Mustard gas causes skin burns and blisters. A garlic-like odor
Response
Mitigation
Preparedness
Sarin causes skin burns and blisters.
Sarin can cause death within minutes of exposure.
A garlic-like odor and brown color are characteristics of sarin.
A single dose of pralidoxime chloride (2-PAM chloride) reverses
the effects of long-term sarin exposure.
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and brown color are characteristics of mustard gas. Although pralidoxime
chloride (2-PAM chloride) is used as an antidote for nerve agent poisoning,
multiple doses may be needed to reverse the effects of nerve agents; also,
sarin acts by paralyzing the respiratory muscles.
Report content error
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Which certification would the emergency nursing staff
member possess to perform defibrillation or cardioversion
and special resuscitation for clients who sustained injuries in a
tsunami?
Rationale
ACLS certification
allows nurses to perform electrical therapies, special
resuscitation, and invasive airway management. BLS certification is
granted when the nurse performs airway maintenance or cardiopulmonary
resuscitation. CEN certification indicates that the nurse has core
emergency nursing skill and knowledge. PALS certification is needed to
perform neonatal and pediatric resuscitation.
Test-Taking Tip:
Identify option components as correct or incorrect. This
may help you identify a wrong answer.
Report content error
Basic Life Support (BLS)
Certified Emergency Nurse (CEN)
Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
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Which training measure is most
effective to adequately
familiarize health care providers with emergency response
procedures?
Rationale
Hospital disaster drills are priority training measures to familiarize health
care providers with emergency response procedure. Other methods that
can also be used include tabletop exercises and computer simulations;
however, these methods will not provide immersive practice comparable to
well-planned drills. Access to the policy is important but will not provide
real world experience for emergency response procedures.
Report content error
Which event is an example of an internal disaster that must be
accounted for when formulating a disaster response plan?
Select all that apply. One, some, or all responses may be
correct.
Drills
Tabletop exercises
Access to the policy
Computer simulations
Fire
Hurricane
Earthquake
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Rationale
Examples of internal disasters that must be accounted for when
formulating a disaster plan include fire and power outage. A hurricane and
earthquake, both natural disasters, are classified as external disasters. An
act of terrorism is also considered an external disaster.
Report content error
Which features would the emergency department (ED) nurse
use from an automated tracking system for triage during
mass casualty incidents (MCIs)? Select all that apply. One,
some, or all responses may be correct.
Rationale
Automated tracking systems using infrared and radiofrequency technology
(RFT) are available in some EDs to track a client’s triage priority upon
arrival, location, and process of care. The interactions the client has with
Power outage
Act of terrorism
Priority upon arrival
Clinical manifestations
Interaction with caregivers
Priority per process of care
Priority according to location
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caregivers can also be tracked; this is an important safety strategy if the
client is later found to have contaminants or a disease that could pose a
risk to staff members who had close contact and require decontamination
or prophylaxis. Clinical manifestations cannot be tracked using this
system.
Test-Taking Tip:
On a test day, eat a normal meal before going to school. If
the test is late in the morning, take a high-powered snack with you to eat
20 minutes before the examination. The brain works best when it has the
glucose necessary for cellular function.
Report content error
Which responsibility would the nurse manager assume when
designated as a unit chief during the formulation of a
Hospital Incident Command System (HICS) for disaster
preparedness?
Rationale
The facility-level organizational model for disaster management is HICS,
which is a part of the National Incident Management System (NIMS)
implemented by the Department of Homeland Security and the Federal
Emergency Management Agency (FEMA) to standardize disaster
Public information
Medical command
Safety and security
Logistics and operation
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operations. In this system, roles are formally structured under the hospital
or long-term care facility incident commander with clear lines of authority
and accountability for specific resources. Chiefs are appointed to manage
logistics, planning, finance, and operations as appropriate to the type and
scale of the event. Officers, not chiefs, are named to oversee essential
emergency preparedness functions such as public information, safety and
security, and medical command.
Test-Taking Tip:
Stay away from other nervous students before the test.
Stop reviewing at least 30 minutes before the test. Take a walk, go to the
library and read a magazine, listen to music, or do something else that is
relaxing. Go to the test room a few minutes before class time so that you
are not rushed in settling down in your seat. Tune out what others are
saying. Crowd tension is contagious, so stay away from it.
Report content error
Which action is appropriate for the nurse who is the triage
officer after a high-speed commuter train derailment?
Rationale
The triage officer
is a primary health care provider or nurse who rapidly
evaluates each client to determine priorities for treatment. The community
Evaluating each client to determine priorities for treatment
Being a liaison between the health care facility and the media
Deciding the number, acuity, and resource needs for client care
Assuming leadership for the implementation of the emergency
plan
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relations or public information officer is a liaison between the health care
facility and the media. The medical command health care provider decides
the number, acuity, and resource need for client care. The hospital incident
commander is a primary health care provider or administrator who
assumes leadership for implementation of the emergency plan.
STUDY TIP:
Try to decrease your workload and maximize your time by
handling items only once. Most of us spend a lot of time picking up things
we put down rather than putting them away when we have them in hand.
Going straight to the closet with your coat when you come in instead of
throwing it on a chair saves you the time of hanging it up later. Discarding
junk mail immediately and filing the rest of your bills and mail as they
come in rather than creating an ever-growing stack saves time when you
need to find something quickly. Filing all items requiring further attention
in some fashion helps you remember to take care of things on time rather
than being so engrossed in your schoolwork that you forget about them.
Many nursing students have had their power or telephone service cut off
because the bill simply was forgotten or buried in a pile of old mail.
Report content error
Which function is performed by the emergency department
nurse leader?
Providing care for stable emergency department (ED) clients
Assisting in monitored care of the client
Transporting the clients to the critical care unit
Directing ancillary departments to deliver resources to meet
service demands
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Rationale
Directing ancillary departments to deliver resources to meet service
demands is the function of the ED nurse leader. General staff nurses
provide care for stable ED clients. They also supplement the ED nurses to
assist in monitored care and transport to critical care units.
Report content error
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Which events can result in an adventitious crisis? Select all
that apply. One, some, or all responses may be correct.
Rationale
Adventitious crises result from events that are unplanned and that may be
accidental, caused by nature, or human-made. Terrorism and earthquakes
can result in adventitious crises. Situational crises arise from events that
are extraordinary, external rather than internal, and often unanticipated.
Divorce can precipitate situational crisis. As the maturation process occurs
across the life cycle each developmental stage represents a maturational
crisis. Marriage is an example that can precipitate maturational crisis.
Mental illness can also precipitate a situational crisis.
Report content error
Clients in which class are given a yellow tag according to the
disaster triage tag system?
Divorce
Marriage
Terrorism
Earthquake
Mental illness
Class I
Class II
Class III
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Rationale
Class II clients may have major injuries. Though they have major injuries,
they can wait a short time for treatment. They are issued a yellow tag
according to the disaster triage tag system. Class I clients are emergent
clients. They require immediate treatment and are identified with red tags.
Class III clients are nonurgent clients with minor injuries that do not
require immediate treatment. Thus they are given green tags. Class IV
clients are expected to die and they are issued black tags.
Report content error
Which role is the function of the hospital incident commander
in a mass casualty event?
Rationale
Assuming leadership for implementing the emergency plan is the function
of the hospital incident commander in a mass casualty event. A medical
command health care provider decides the number, acuity, and resource
needs of clients. Evaluating each client to determine priorities for
Class IV
Assuming leadership for implementing the emergency plan
Deciding the number, acuity, and resource needs of clients
Evaluating each client to determine priorities for treatment
Serving as a liaison between the health care facility and the media
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treatment is the role of the triage officer. The public information officer
serves as a liaison between the health care facility and the media.
Report content error
Which personnel are responsible for identifying the need for
and calling in specialty trained providers in emergencies?
Rationale
The medical command physician
is responsible for identifying the
resource needs of the clients. The medical command physician identifies
the need for and calls in the specialty trained providers in emergencies.
Triage officers are responsible for rapidly evaluating each client to
determine priorities for treatment. The public information officer serves as
a liaison between the health care facility and the media. The hospital
incident commander is the one who assumes overall leadership for
implementing the emergency plan.
Report content error
Triage officer
Public information officer
Medical command physician
Hospital incident commander
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Which statement is true regarding Community Emergency
Response Teams (CERTs)?
Rationale
The CERTs can organize untrained volunteers to assist until professional
services arrive at the disaster site. CERTs act as an extension of first
responder service to victims at the disaster site but do not provide first
responder service. Disaster Medical Assistance Teams (DMATs) are sent to
disaster sites with medical equipment and enough supplies to remain self-
sufficient for 72 hours. CERTs help citizens, not health care professionals,
understand their responsibility in preparing for a disaster.
STUDY TIP:
A helpful method for decreasing test stress is to practice self-
affirmation. After you have adequately studied and really know the
material, start looking in the mirror each time you pass one and say to
yourself—preferably out loud—"I know this material, and I will do well on
the test." After several times of watching and hearing yourself reaffirm your
knowledge, you will gain inner confidence and be able to perform much
better during the test period. This technique really works for students who
are adventurous enough to use it. It may feel silly at first, but if it works,
who cares? It will work for performing skills in clinical as well, as long as
you have practiced the skill sufficiently.
They provide first responder service to victims at the disaster site.
They provide equipment to remain self-sufficient for 72 hours at
the disaster site.
They help health care professionals understand their responsibility
in preparing for a disaster.
They organize untrained volunteers to assist until professional
services arrive at the disaster site.
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Report content error
Which scenario is an internal disaster that might delay a
specialist from providing on-time treatment to a client?
Rationale
An event inside the health care facility that could endanger the safety of
clients or staff indicates internal disaster. Other examples of internal
disasters include fire, explosion, and loss of critical utilities such as
electricity, water, and communications capabilities. The delay in treating
the client in the emergency department due to a damaged telephone
system indicates internal disaster. Tornados, earthquakes, and severe
flooding are external disasters that are responsible for delayed treatment.
Test-Taking Tip:
Answer the question that is asked. Read the situation and
the question carefully, looking for key words or phrases. Do not read
anything into the question or apply what you did in a similar situation
during one of your clinical experiences. Think of each question as being an
ideal, yet realistic, situation.
A tornado near the hospital
An earthquake near the hospital premises
Severe flooding
Lack of communication because of a damaged telephone system
in the hospital
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Report content error
The client with which tag color requires immediate treatment
in the emergency department according to disaster triage tag
system?
A
B
C
D
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Rationale
According to the disaster triage tag system, a red tag is applied to the
clients who require immediate treatment. The client B requires immediate
treatment. A yellow tag is applied to clients who can wait a short time for
treatment (30 minutes to 2 hours). Green tags are applied to clients who
can ambulate on their own and do not have serious injuries. Black tags are
applied to the clients who are dead or expected to die.
Test-Taking Tip:
Chart/exhibit items present a situation and ask a question.
A variety of objective and subjective information is presented about the
client in formats such as the hospital record (e.g., laboratory test results,
results of diagnostic procedures, progress notes, health care provider
orders, medication administration record, health history), physical
assessment data, and nurse/client interactions. After analyzing the
information presented, the test taker answers the question. These
questions usually reflect the analyzing level of cognitive thinking.
Report content error
Which public health risk became a major focus for hospitals
after the September 11, 2001, terrorist attacks?
Rationale
Anthrax exposure
Multicasualty incidents
Mass casualty incidents (MCIs)
Weapons of mass destruction (WMD)
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WMD rapidly became a focus of public health risk after the terrorist attacks
that occurred on September 11, 2001. Anthrax exposure occurred in the
aftermath of the terrorist attacks; however, this public health risk has not
become a major focus. Multicasualty and mass casualty incidents have
always been included in hospital response plans.
Test-Taking Tip:
Anxiety leading to an exam is normal. Reduce your stress
by studying often, not long. Spend at least 15 minutes every day reviewing
the "old" material. This action alone will greatly reduce anxiety. The more
time you devote to reviewing past material, the more confident you will
feel about your knowledge of the topics. Start this review process on the
first day of the semester. Don’t wait until the middle to end of the
semester to try to cram information.
Report content error
Which intervention is a part of the response phase of disaster
planning?
Rationale
The response phase of disaster management deals with the
implementation of the disaster plan. The recovery phase of disaster
management involves stabilizing the community. Mitigation focuses on
limiting the impact of a disaster. The last phase of disaster management
Stabilizing the community
Limiting the impact of disaster
Implementing the disaster plan
Evaluating the events of disaster management
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focuses on evaluation of the plan.
Test-Taking Tip:
Do not worry if you select the same numbered answer
repeatedly, because there usually is no pattern to the answers.
Report content error
Which statement by the nurse is true regarding the disaster
triage tag system?
Rationale
Class II clients who can wait for a short time for care are marked with a
yellow tag. Class IV clients who are expected to die or are dead are issued a
black tag. Class III clients who require nonurgent care or "walking
wounded" are given a green tag. Class I clients who require emergency
care are identified with a red tag.
Report content error
Class IV clients are issued a red tag.
Class III clients are given a black tag.
Class II clients are marked with a yellow tag.
Class I clients are identified with a green tag.
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Which triage class client would the nurse plan to treat first
according to the disaster triage tag system?
Rationale
Class I clients are emergent clients who are marked with a red tag. These
clients have an immediate threat to life and need attention first. Class II
clients have major injuries and need treatment within 30 minutes to 2
hours. Class III clients have minor injuries and can be treated in a delayed
manner. Class IV clients are those who are expected to die or are dead.
Report content error
Which internal disaster would the nurse explain requires a
need for evacuation or relocation?
Class I
Class II
Class III
Class IV
Tornado
Hurricane
Facility gas explosion
Terrorism with explosive devices
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Rationale
A facility gas explosion is an internal disaster, which requires a need for
evacuation or relocation. Tornados and hurricanes are natural, external
disasters. Terrorism with the use of explosive devices is also an external
disaster.
Report content error
Which personnel would the nurse state are responsible for
deciding the number, acuity, and resources needed for clients
during a disaster?
Rationale
Medical command physicians have the authority to decide the number,
acuity, and resources needed for clients during a disaster. Triage officers
are the primary health care providers or nurses who are responsible for
evaluating the clients rapidly and determining the priority of treatment.
The community relations officer serves as a liaison between the health care
facility and the media. Hospital incident commanders act as leaders and
are responsible for implementing the emergency plan.
Triage officer
Community relations officer
Medical command physician
Hospital incident commander
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Report content error
Which certification course may be an elective for the nurse
qualified to care for clients in a disaster-related emergency
situation?
Rationale
A CEN course
is optional and it validates the knowledge of the nurse for
core emergency nursing. BLS is mandatory and training is given for
noninvasive assessment and management skills. This includes skills such
as airway maintenance and cardiopulmonary resuscitation. In ACLS,
invasive airway management skills such as pharmacology and special
resuscitation are taught. PALS is also mandatory and provides neonatal
and pediatric resuscitation procedure training to nurses.
Report content error
Basic Life Support (BLS)
Certified Emergency Nurse (CEN)
Advanced Cardiac Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
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In which phase of the disaster management continuum would
the nurse state are developing emergency response plans in
case of an earthquake alert is included?
Rationale
The first phase of the disaster management continuum is preparedness.
This is a protective plan designed before the event to structure the
response, assess the risk, and evaluate the response. The response phase
of the disaster continuum includes the actual implementation of the
disaster plan. The recovery phase is related to actions focusing on
stabilization of the community and returning it to the previous state. The
mitigation phase includes attempts to limit a disaster's impact on human
health and community function.
Test-Taking Tip:
Identify option components as correct or incorrect. This
may help you identify a wrong answer.
Report content error
Response
Recovery
Mitigation
Preparedness
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Which phase of critical incident stress debriefing (CISD) is
indicated during a CISD session when a client who survived a
natural disaster says, "The worst thing that happened on that
day was that my child was severely injured and I was not in a
position to help. I would like to forget that day as soon as
possible. It was the most painful experience of my life"?
Rationale
In the reaction phase, CISD participants talk about the worst thing of the
incident—what they would like to forget and what was most painful. In the
reentry phase, participants review materials discussed, ask questions, and
discuss how they would like to bring closure to the debriefing. In the
thought phase, participants discuss their first thoughts of the incident. In
the symptom phase, participants describe their physical, cognitive,
emotional, or behavioral experiences that happened at the incidence scene.
Test-Taking Tip:
Read the question carefully before looking at the answers:
(1) Determine what the question is really asking; look for key words; (2)
Read each answer thoroughly and see if it completely covers the material
asked by the question; (3) Narrow the choices by immediately eliminating
answers you know are incorrect.
Reentry phase
Thought phase
Reaction phase
Symptom phase
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Report content error
After a mass casualty incident related to an accidental fire in a
residential area, which condition are the clients experiencing
when they present with incoherence, panic attacks, and
exaggerated startle responses?
Rationale
Incoherence, panic attacks, and exaggerated startle responses are
symptoms of post-trauma syndrome. Ineffective coping and compromised
resilience are characterized by an inability to meet basic needs, inadequate
problem-solving, inability to attend to information, and isolation.
Disturbed personal identity is manifested as self-hatred, feelings of being
ineffectual, and perceived lack of control.
Report content error
Which statement by the nurse is true regarding mass casualty
events related to disasters?
Ineffective coping
Post-trauma syndrome
Compromised resilience
Disturbed personal identity
"They can be managed by a hospital using local resources."
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Rationale
A mass casualty event overwhelms local medical capabilities and may
require the collaboration of multiple agencies and health care facilities to
handle the disaster. Multicasualty events can be managed by the hospital
using local resources. An internal disaster is an event that occurs inside a
health care facility or campus that could endanger the safety of clients or
staff. An external disaster is an event outside the health care facility or
campus, somewhere in the community, that may require the activation of
the facility’s emergency management plan.
Report content error
Which condition is most
likely to be categorized with a black
tag among clients arriving at the hospital after a large-scale
disaster?
"They are incidents inside a health care facility that could
endanger the safety of clients."
"They may require the association of multiple agencies and health
care facilities to handle the crisis."
"They are events outside the health care facility requiring the
activation of the facility’s emergency management plan."
Contusions
Airway obstruction
Massive head trauma
Open fracture with distal pulse
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Rationale
Black-tagged clients
are those who are expected to die. Conditions such as
massive head trauma, extensive full-thickness body burns, or high cervical
spinal cord injuries requiring mechanical ventilation are categorized with a
black tag. Contusions are categorized with a green tag. Airway obstruction
is categorized with a red tag. An open fracture with a distal pulse is
categorized with a yellow tag.
Report content error
Which steps would the nurse explain are to be followed for
preventing post-traumatic stress disorder (PTSD) in hospital
staff during a mass casualty event? Select all that apply. One,
some, or all responses may be correct.
Rationale
It is recommended to drink plenty of water and eat healthy snacks for
energy to overcome PTSD. It is essential to encourage and support
coworkers who are suffering from PTSD. It is suggested that coworkers
monitor each other’s stress levels and performance during PTSD. It is
advised to talk about feelings with staff and managers and be in touch with
family, friends, and significant others, rather than isolating oneself. It is
Drinking plenty of water
Encouraging coworkers
Monitoring each other’s stress levels
Being quiet and isolated from others
Working for more than 12 hours each day
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important not to work for more than 12 hours each day because it will
increase stress and lead to PTSD.
Report content error
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Which team is responsible for providing prehospital care such
as continuous cardiac monitoring, advanced airway
management, and intubation in a group of clients who are
severely injured from a fire?
Rationale
Paramedics are advanced life support (ALS) providers who can perform
advanced techniques during prehospital care disaster management. This
includes cardiac monitoring, advanced airway management, intubation,
establishing intravenous access, and administering medications to clients.
Ancillary nursing staff assists wherever needed and as qualified at the
primary care facility. The psychiatric crisis nurse team is one of the
specialized teams in the emergency department. Many clients with acute
health conditions may also have chronic mental disorders, and this team
will improve the quality of care to the clients with specialized interventions.
EMTs offer basic life support (BLS) interventions such as oxygen, basic
wound care, splinting, and spinal immobilization.
Report content error
Paramedics
Ancillary nursing staff
Psychiatric crisis nurse team
Emergency medical technicians (EMTs)
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While responding to a fire in a health care facility, which
intervention made by the facility personnel would the nurse
feel is inappropriate?
Rationale
While responding to a facility fire
, facility personnel should not risk injury
to self or staff members while moving clients or attempting to extinguish
the fire. The facility personnel are trained to direct the ambulatory clients
to walk to a safe location during any disaster. The immediate intervention
of the facility personnel during a fire disaster would be removing any
clients or staff from danger of fire or smoke. Immobile clients can be
moved by facility personnel and one or two staff members by carrying
them on blankets.
Report content error
Directing ambulatory clients to walk to a safe location
Exposing themselves to risk of injury by attempting to extinguish
the fire
Removing any client or staff from immediate danger due to fire or
smoke
Moving immobile clients on blankets along with one or two staff
members
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Which intervention would help facilitate communication and
coordination during a mass casualty event in a hospital using
the Hospital Incident Command System? Select all that apply.
One, some, or all responses may be correct.
Rationale
To facilitate communication and coordination during a mass casualty event
in a hospital using the Hospital Incident Command System,
communication equipment needs to be activated. In addition, a command
center needs to be created in a designated location. Key personnel need to
be easily identified, which can be done by providing distinctive clothing
that identifies their role. Job action sheets that identify reporting
relationships, tasks, and responsibilities will also help facilitate
communication and coordination at this time. Key personnel do not need
to be immunized or have a personal emergency plan when handling a
disaster within an organization.
Report content error
Activate communication equipment.
Establish a command center in a designated location.
Provide key personnel with distinctive clothing identifying their
role.
Ensure key personnel are properly immunized and have a personal
emergency plan.
Distribute job action sheets identifying reporting relationships,
tasks, and responsibilities.
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While conducting triage under mass casualty conditions,
which tag would the nurse use for a client who is experiencing
hypovolemic shock due to a penetrating wound?
Rationale
The nurse would use a red tag
for a client who has injuries that are an
immediate threat to life, such as hypovolemic shock, during mass casualty
conditions. A black tag is used for a client who is expected to die and
allowed to die. A green tag is used for a client with minor injuries that do
not require immediate treatment. A yellow tag is used for a client who has
major injuries requiring treatment.
Test-Taking Tip:
Note the number of questions and the total time allotted
for the test to calculate the times at which you should be halfway and
three-quarters finished with the test. Look at the clock only every 10
minutes or so.
Report content error
Red
Black
Green
Yellow
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Which type of event can often be handled by an individual
hospital disaster plan without collaboration with other
systems?
Rationale
A multicasualty event, such as a motor vehicle accident involving five cars,
is an event that can often be handled with the implementation of an
individual hospital disaster plan without collaboration with other systems.
Any mass casualty event, such as a tornado, an act of terrorism, or a
hurricane, often requires not only the implementation of the hospital
disaster plan but collaboration with other systems.
STUDY TIP:
Becoming a nursing student automatically increases stress
levels because of the complexity of the information to be learned and
applied and because of new constraints on time. One way to decrease
stress associated with school is to become very organized so that
assignment deadlines or tests do not come as sudden surprises. By
following a consistent plan for studying and completing assignments, you
can stay on top of requirements and thereby prevent added stress.
Report content error
A motor vehicle accident involving five cars
A tornado destroying 50 homes and businesses
An act of terrorism injuring and killing hundreds of people
A hurricane causing flooding and displacing thousands of people
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Which injuries would likely be given a green tag after a
disaster? Select all that apply. One, some, or all responses
may be correct.
Rationale
According to the disaster triage tag system, green tags are applied to
clients with strains, sprains, and abrasions. Clients with shock
and airway
obstruction are marked with red tags according to the disaster triage tag
system.
Report content error
Which groups may be activated by state and federal
government authorities to assist during a flooding situation
that results from a hurricane? Select all that apply. One,
some, or all responses may be correct.
Shock
Strains
Sprains
Abrasions
Airway obstruction
National Guard
American Red Cross
Medical Reserve Corps
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Rationale
During catastrophic mass casualty events, such as flooding that can occur
with a hurricane, the National Guard, the American Red Cross, the public
health department, various military units, a Medical Reserve Corps (MRC),
or a Disaster Medical Assistance Team (DMAT) can be activated by state
and federal government authorities. Although authorities may contact local
emergency departments for notification purposes, they do not have the
authority to activate a disaster preparedness plan for individual emergency
departments.
Report content error
Which factors affect the stress that first responders feel after a
mass casualty incident (MCI)? Select all that apply. One,
some, or all responses may be correct.
Rationale
Public health departments
Local emergency departments
Age
Gender
Nature of event
Coping mechanisms
Psychological history
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Stress that occurs for first responders after an MCI can persist for an
extended period and is influenced, in part, by the nature of the event, the
individual’s age, preexisting coping mechanisms, role in the event, and
medical and psychological history. Gender does not influence the effect
that stress has on the first responder after an MCI.
STUDY TIP:
Record the information you find to be most difficult to
remember on 3" × 5" cards and carry them with you in your pocket or
purse. When you are waiting in traffic or for an appointment, just pull out
the cards and review again. This "found" time may add points to your test
scores that you have lost in the past.
Report content error
Which medication would be listed as the antidote to a nerve
agent in the disaster plan for a terrorist attack?
Rationale
Atropine should be listed as the antidote for nerve agent poisoning in the
disaster plan for a terrorist attack. Nerve gases cause the client’s system to
be flooded with acetylcholine, which results in an overstimulation of the
nerve cell. Atropine works by blocking the acetylcholine receptors. The
receptors will not pick up the acetylcholine. Dopamine, epinephrine, and
norepinephrine are not medications used to treat nerve agent poisoning.
Atropine
Dopamine
Epinephrine
Norepinephrine
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Report content error
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Which unit in the hospital would be the priority
for
implementation and evaluation of a workplace violence
protection plan as one component of a hospital disaster plan?
Rationale
The Emergency Nursing Association (ENA) supports comprehensive
workplace violence prevention plans to be included as a component of the
organizational disaster plan. The ENA recommends that the
comprehensive workplace violence prevention plan be implemented and
evaluated in every emergency department. Medical units, surgical units,
and maternity departments may also require such plans; however, these
units have system barriers that decrease the risk for violence when
compared with emergency departments.
Test-Taking Tip:
Key words or phrases in the stem of the question such as
first, primary, early
, or best
are important. Similarly, words such as only,
always, never
, and all
in the alternatives are frequently evidence of a wrong
response. As in life, no real absolutes exist in nursing; however, every rule
has its exceptions, so answer with care.
Report content error
Medical unit
Surgical unit
Emergency department
Maternity department
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Which nursing actions contribute to a health care facility’s
emergency preparedness and response before a natural
disaster? Select all that apply. One, some, or all responses
may be correct.
Rationale
Nursing actions that contribute to a health care facility’s emergency
preparedness and response include participating in drills and evaluating
outcomes. Activating a telephone tree, performing a triage assessment,
and discharging clients who no longer require acute care are nursing
actions that occur during a health care facility’s response to an actual
natural disaster.
Test-Taking Tip:
Be alert for details about what you are being asked to do.
In this question type, you are asked to select all options that apply to a
given situation or client. All options likely relate to the situation, but only
some of the options may relate directly to the situation.
Report content error
Participating in drills
Evaluating outcomes
Activating a telephone tree
Performing a triage assessment
Discharging clients who no longer require acute care
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Which phase of disaster management is the nurse executing
when teaching hygiene practices and symptoms of various
infections to victims of a hurricane?
Rationale
Mitigation is the attempt to limit a disaster’s impact on human health and
community functions. Educating the client about the rapid spread of
infectious diseases and various hygiene methods that can be adopted in
such conditions will help limit the impact of the disaster. Response is the
actual implementation of the disaster plan. Evaluation involves identifying
successes and failures of the response effort to prepare for the future.
Preparedness is the protective plan designed before the occurrence of a
disaster to assess the risk and evaluate the potential damage.
Report content error
After an earthquake has caused mass casualties, which color
tag would be given to the client with a massive head injury
who does not respond to stimulation and cannot breathe
independently?
Mitigation
Response
Evaluation
Preparedness
Red tag
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Rationale
In an incident that has caused mass casualties, a military form of triage is
performed to provide the best care for the most people. A client with a
massive head injury who is unable to respond to any kind of stimulus and
is unable to breathe independently would be classified with a black tag.
Clients needing emergency medical care are identified with red tags.
Green tags are given to the clients who sustained minimal injuries in the
disaster. Yellow tags are given to clients whose treatment can be delayed
for a short time.
Report content error
Which phase in the disaster management continuum would
the nurse understand as including the attempt to limit a
disaster’s impact on human health and community function?
Rationale
Black tag
Green tag
Yellow tag
Recovery
Response
Mitigation
Preparedness
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There are five phases in the disaster management continuum, which
include preparedness, mitigation, response, recovery, and evaluation. In
mitigation, there will be plans for attempting to limit a disaster’s impact
on human health and community function. Recovery includes focusing on
stabilizing the community and returning it to the previous status.
Response includes implementation of the disaster plan. Preparedness is
the preparation of a protective plan that is designed before the event has
occurred.
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Which resource can the staff educators use to assist with the
education of health care providers who work within the
system when implementing a Hospital Incident Command
System (HICS) for a disaster preparedness plan for the entire
health system?
Rationale
FEMA offers free courses on the NIMS model and HICS structure through
their website (www.training.fema.gov/IS/). CMS requires a certain number
of drills per year to be in compliance with their disaster preparedness
mandates. OSHA does not provide education for the implementation of a
disaster preparedness plan at the hospital level.
National Incident Management System (NIMS)
Centers for Medicare and Medicaid Services (CMS)
Occupational Safety and Health Administration (OSHA)
Federal Emergency Management Administration (FEMA)
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Which system would the nurse expect to determine the
number of casualties of a particular acuity level a hospital can
safely accept from the incident scene in a disaster situation?
Rationale
An automated tracking system is a valuable component of the hospital’s
emergency preparedness infrastructure because it is used to determine the
number of casualties of a particular level a hospital can safely accept from
the incident scene. The disaster triage tag system is used both by the mass
casualty response teams in the field and in the hospital setting to
categorize the clients for prioritizing care. The HICS is a part of the NIMS
in which roles are formally structured under the hospital or long-term care
facility incident commander; there are clear lines of authority and
accountability for specific resources.
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Disaster triage tag system
Automated tracking system
Hospital Incident Command System (HICS)
National Incident Management System (NIMS)
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Which emergency response team is involved in emotional
recovery of victims after a disaster?
Rationale
The American Red Cross has a critical incident stress management unit.
This unit arranges group discussions to allow participants to share and
validate their feelings and emotions about the experience. DMAT is a
medical relief team made up of civilian medical, paraprofessional, and
support personnel that is deployed to a disaster area with enough medical
equipment and supplies to sustain operations for 72 hours, and they are
part of the National Disaster Medical System (NDMS) in the United States.
A community emergency response team and the Federal Emergency
Management Agency train citizens to understand their personal
responsibility in preparing for a natural or man-made disaster.
STUDY TIP:
Focus your study time on the common health problems that
nurses most frequently encounter.
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American Red Cross
Disaster Medical Assistance Team (DMAT)
Community Emergency Response Team
Federal Emergency Management Agency
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Which disaster triage tag would the nurse apply to the group
of clients who have extensive full-thickness body burns and
severe head trauma after an apartment building fire and
clients who require mechanical ventilation for survival?
Rationale
Clients with extensive full-thickness body burns
, severe head trauma, and
high cervical spinal cord injury requiring mechanical ventilation are given
black tags because they are expected to die. Clients with airway obstruction
or shock are given red tags because they require immediate attention.
Clients with open fractures with a distal pulse and large wounds that need
treatment within 30 minutes to 2 hours are given yellow tags. Green tags
are issued to clients with minor injuries.
Test-Taking Tip:
Read the question carefully before looking at the answers:
(1) Determine what the question is really asking; look for key words; (2)
Read each answer thoroughly and see if it completely covers the material
asked by the question; (3) Narrow the choices by immediately eliminating
answers you know are incorrect.
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Red
Black
Green
Yellow
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Which agents of bioterrorism can be treated effectively with
antibiotics? Select all that apply. One, some, or all responses
may be correct.
Rationale
Bioterrorism agents such as plague, anthrax
, and tularemia are caused by
bacterial species and are treated effectively by antibiotics. Botulism is
treated with antitoxin though several vaccines are being studied. There are
no established antiviral medications for most viruses causing hemorrhagic
fever.
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After a bomb blast in a city, why would the federal
government send the Medical Reserve Corps (MRC) to the
site?
Plague
Anthrax
Botulism
Tularemia
Hemorrhagic fever
To provide advanced Disaster Life Support training
To establish first aid stations or special-needs shelters
To establish fully functional field surgical facilities to victims
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Rationale
The MRC helps establish first aid stations or special-needs shelters to
victims of a disaster. The National Disaster Life Support Foundation
renders core, basic, and advanced disaster life support training courses.
International Medical-Surgical Response Teams (IMSRTs) establish fully
functional field surgical facilities. A Disaster Medical Assistance Team
(DMAT) is a medical relief team that is deployed to a disaster area with
enough medical equipment and supplies to sustain operations for 72
hours.
Test-Taking Tip:
Identify option components as correct or incorrect. This
may help you identify a wrong answer.
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Which type of natural disaster will the nurse manager
recommend be included in the emergency response plan for a
hospital located in the Rocky Mountains?
Rationale
To provide medical equipment sufficient for 72 hours to victims
Tornado
Hurricane
Avalanche
Earthquake
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Disaster drills are ideally planned based on a risk assessment or
vulnerability analysis that identifies the events most likely to occur in a
particular community. For a hospital in the Rocky Mountains there is a
significant risk for an avalanche; meanwhile, there is not a significant risk
for tornados, hurricanes, or earthquakes. The nurse manager will,
therefore, recommend that avalanche planning be included in the hospital
disaster plan.
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Which statement regarding the role of the community
emergency response teams (CERTs) would the nurse include
in a presentation to the community regarding the need for
volunteers?
Rationale
CERTs are recognized by the Federal Emergency Management Agency
(FEMA) as important partners in emergency preparedness. As part of the
CERT team, members learn decision-making and rescuer safety skills.
CERTs are an extension of the first responder services. They can offer
immediate help to victims and organize untrained volunteers to assist
"You will learn triage skills during the training process."
"You will need to report to your nearest hospital in the event of a
natural disaster."
"You will learn decision-making and rescuer safety skills during
the training process."
"You will be required to submit your name as a first responder in
the event of a natural disaster."
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until professional services arrive. CERT team members are not taught
triage skills; they are not required to report to the nearest hospital in the
event of a natural disaster; they are not required to submit their names as
first responders.
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Which disaster management team member most
likely
engages to manage the aftermath of an accidental explosion
in a fertilizer plant and evacuate the injured and uninjured
victims from danger as first line of action?
Rationale
During a disaster, firefighters and other first responders such as police
officers are most likely to be involved in removing the injured and
uninjured victims from danger. Nurses are typically not involved in this
process, because they require special rescue training. Paramedics are
responsible for providing initial care to the victims. Volunteers are
supervised by nurses to provide care for the victims injured in disaster.
Nurse
Paramedic
Volunteers
Firefighter
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1 topics covered
Disaster Planning
RN Content Area / Leadership/Management
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