NR 442 COMMUNITY HEALTH NURSING
NR 442 NNA Bioterrorism Self-Study Exam
1. CASE: You are working as a first aid nurse in a large convention center. Approximately 500
people have been attending an all day community health conference. By mid-afternoon,
however, more than a hundred attendees have developed complaints of double vision, dry
mouth, and weakness. Some have even left to go to the hospital. What is the most likely
biological agent causing these symptoms?
2. CASE: You are a home health nurse in your hometown. You live in a rural suburb of a large
west coast city. You respond to a 911 call from a private residence where a 30 year old male
is complaining of fever, headache, and vomiting. Upon arrival, you find him with mild
shortness of breath. T= 101.2F, heart rate 98, blood pressure 112/68, respiratory rate 28. He
appears ill. Because you’ve seen a number of similar patients tonight, you suspect a
biological attack has taken place. After your initial assessment, your first course of action
should be to:
3. CASE: You work at a local clinic. Your co-worker has developed a fever, nonproductive
cough, headache, and skin lesions over the past day or two. They are primarily on his arms
and face. They are red, tender, and appear to have a very small bit of bleeding in their center.
Which of the following is the most likely cause of his symptoms?
Answers
1. The most likely biological agent is botulism toxin produced by Botulism.
Explanation:
• Symptoms of double vision, dry mouth, and muscle weakness are classic signs of
botulism.
• In a large group setting after shared food exposure, this strongly suggests foodborne
botulism.
• Botulinum toxin blocks acetylcholine release at nerve endings, causing:
o Blurred or double vision
NR 442 NNA Bioterrorism Self-Study Exam
1. CASE: You are working as a first aid nurse in a large convention center. Approximately 500
people have been attending an all day community health conference. By mid-afternoon,
however, more than a hundred attendees have developed complaints of double vision, dry
mouth, and weakness. Some have even left to go to the hospital. What is the most likely
biological agent causing these symptoms?
2. CASE: You are a home health nurse in your hometown. You live in a rural suburb of a large
west coast city. You respond to a 911 call from a private residence where a 30 year old male
is complaining of fever, headache, and vomiting. Upon arrival, you find him with mild
shortness of breath. T= 101.2F, heart rate 98, blood pressure 112/68, respiratory rate 28. He
appears ill. Because you’ve seen a number of similar patients tonight, you suspect a
biological attack has taken place. After your initial assessment, your first course of action
should be to:
3. CASE: You work at a local clinic. Your co-worker has developed a fever, nonproductive
cough, headache, and skin lesions over the past day or two. They are primarily on his arms
and face. They are red, tender, and appear to have a very small bit of bleeding in their center.
Which of the following is the most likely cause of his symptoms?
Answers
1. The most likely biological agent is botulism toxin produced by Botulism.
Explanation:
• Symptoms of double vision, dry mouth, and muscle weakness are classic signs of
botulism.
• In a large group setting after shared food exposure, this strongly suggests foodborne
botulism.
• Botulinum toxin blocks acetylcholine release at nerve endings, causing:
o Blurred or double vision
