Understanding Disaster Management Teams and Their Functions

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 2/88 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)

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 3/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 4/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 5/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 6/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 7/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 8/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 9/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 10/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 11/88 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)

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 12/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 13/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 14/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 15/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 16/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 17/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 18/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 19/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 20/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 21/88 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

2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 22/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 23/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 24/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 25/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 26/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 27/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 28/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 29/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 30/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 31/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 32/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 33/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 34/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 35/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 36/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 37/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 38/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 39/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 40/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 41/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 42/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 43/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 44/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 45/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 46/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 47/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 48/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 49/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 50/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 51/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 52/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 53/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 54/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 55/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 56/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 57/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 58/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 59/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 60/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 61/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 62/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 63/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 64/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 65/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 66/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 67/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 68/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 69/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 70/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 71/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 72/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 73/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 74/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 75/88 Report content error

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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 76/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 77/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 78/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 79/88 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 80/88 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. Report content error 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 81/88 Report content error 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. Report content error Disaster triage tag system Automated tracking system Hospital Incident Command System (HICS) National Incident Management System (NIMS)

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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 82/88 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. Report content error American Red Cross Disaster Medical Assistance Team (DMAT) Community Emergency Response Team Federal Emergency Management Agency

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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 83/88 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. Report content error Red Black Green Yellow

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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 84/88 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. Report content error 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 85/88 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. Report content error 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 86/88 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. Report content error 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 87/88 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. Report content error 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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2/18/24, 6:51 PM Elsevier Adaptive Quizzing - Quiz performance https://eaqng.elsevier.com/#/quizPerformance/52496300 88/88 1 topics covered Disaster Planning RN Content Area / Leadership/Management Novice You Quiz me on this topic Novice Intermediate Proficient Questions answered 102

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Disaster planning EAQ

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