Disaster Nursing: 2026 Emergency Response
1. A hospital is responding to a mass casualty incident following a building collapse. The facility
activates the Hospital Incident Command System (HICS). Which of the following best describes the
primary purpose of HICS?
A. To establish a rigid hierarchy that prevents staff nurses from taking initiative.
B. To provide a standardized, scalable organizational structure that facilitates emergency communication,
resource allocation, and management.
C. To replace all local hospital policies with federal government protocols.
D. To reduce hospital liability by delegating medical authority to external agencies.
Correct Answer: B. To provide a standardized, scalable organizational structure that facilitates emergency
communication, resource allocation, and management.
Rationale: HICS is an emergency management system based on the National Incident Management System
(NIMS) Incident Command System (ICS). Its purpose is to help hospitals respond to emergencies of any size by
establishing standard roles, clear communication channels, and a scalable hierarchy that integrates with
community emergency services.
2. Within the HICS structure, a nurse is assigned to the command staff role of Safety Officer. Which of
the following responsibilities falls under this nurse's scope?
A. Managing all clinical operations and nursing care in the emergency department.
B. Identifying and mitigating hazardous conditions to ensure the safety of hospital staff, patients, and visitors.
C. Issuing press releases and managing media inquiries at the hospital entrance.
D. Tracking all financial expenditures and staff overtime costs during the response.
Correct Answer: B. Identifying and mitigating hazardous conditions to ensure the safety of hospital staff,
patients, and visitors.
Rationale: The Safety Officer is a command staff role responsible for monitoring emergency operations,
identifying potential hazards (e.g., chemical spills, structural dangers, PPE breaches), and taking corrective action
to protect responders and patients. Clinical operations are managed by the Operations Section (A). Media is
managed by the Public Information Officer (C). Cost tracking is managed by the Finance/Administration Section
(D).
3. A massive flood has caused power outages and structural damage at a regional medical center. The
Incident Commander activates the HICS command staff. A nurse manager is assigned to serve as the
Public Information Officer (PIO). What is the primary duty of the PIO?
A. Requesting additional medical supplies from the state stockpile.
B. Formulating the clinical nursing schedule for the next 48 hours.
C. Serving as the single point of contact for the media, coordinating public information releases, and managing
press conferences.
, D. Negotiating inter-facility transfer agreements with nearby hospitals.
Correct Answer: C. Serving as the single point of contact for the media, coordinating public information
releases, and managing press conferences.
Rationale: The Public Information Officer (PIO) is responsible for interface with the media and public, ensuring
that accurate, approved information is released. This prevents conflicting statements and rumor spread, which can
compromise public safety. Logistics handles supplies (A). Planning handles schedules (B). The Liaison Officer
coordinates with external facilities (D).
4. During a disaster response, the Chief Nursing Officer is assigned as the Operations Section Chief.
What is the main function of the Operations Section in the HICS framework?
A. Writing the Incident Action Plan (IAP) and tracking patient locations.
B. Directing and coordinating all tactical actions and resources to execute the medical and clinical services of
the response.
C. Procuring food, medical equipment, and water for staff and patients.
D. Processing insurance claims and workers' compensation paperwork.
Correct Answer: B. Directing and coordinating all tactical actions and resources to execute the medical and
clinical services of the response.
Rationale: The Operations Section is responsible for carrying out the tactical objectives of the Incident Action
Plan. In a hospital, this includes direct patient care, triage, decontamination, surgical services, and nursing care.
Planning writes the IAP (A). Logistics procures supplies and food (C). Finance handles costs and claims (D).
5. A nurse working in the emergency department needs to request additional intravenous fluids and
medication administration sets during a mass casualty surge. To which HICS section should this
request be routed?
A. Planning Section
B. Operations Section
C. Logistics Section
D. Finance/Administration Section
Correct Answer: C. Logistics Section
Rationale: The Logistics Section is responsible for providing facilities, services, materials, and support systems to
meet the needs of the incident, including medical supplies, food, transportation, and communication systems.
6. During a protracted disaster response, the Incident Commander asks for a projection of resource
needs for the upcoming 12-hour operational period. Which HICS section is responsible for gathering
data, predicting future needs, and drafting the next Incident Action Plan (IAP)?
A. Logistics Section
B. Operations Section
, C. Finance/Administration Section
D. Planning Section
Correct Answer: D. Planning Section
Rationale: The Planning Section is responsible for collecting, evaluating, and disseminating information about the
incident's status and resources. They look ahead to anticipate needs and write the Incident Action Plan (IAP) for
the next operational shift.
7. A hospital nurse manager is tracking the hours worked by staff nurses during a disaster response
and documenting damaged hospital property for insurance reimbursement. Under which HICS section
does this task fall?
A. Planning Section
B. Logistics Section
C. Finance/Administration Section
D. Operations Section
Correct Answer: C. Finance/Administration Section
Rationale: The Finance/Administration Section is responsible for tracking personnel time, financial costs,
purchasing contracts, compensation claims, and documentation of property damage or loss during the emergency.
8. What is the primary function of the hospital's Emergency Operations Center (EOC) during a
disaster?
A. To serve as the primary site for performing patient surgeries.
B. To act as a centralized location for command, coordination, and information management to support the
hospital's response.
C. To house family members of patients who are seeking information.
D. To serve as a media center for reporters.
Correct Answer: B. To act as a centralized location for command, coordination, and information
management to support the hospital's response.
Rationale: The EOC is the central hub where the command team gathers to make strategic decisions, coordinate
resources, communicate with external partners, and manage information during a crisis. It is not a clinical
treatment area.
9. During a declared state of emergency, a nurse is asked to perform a clinical procedure that is outside
of the nurse's standard daily duties but falls within the state's nursing practice act. How are nurse
liability and scope of practice affected during a disaster?
A. All licensing laws are suspended; nurses can perform any medical task.
B. Nurses are protected from liability for malpractice under all circumstances.
, C. The scope of practice remains defined by the state Board of Nursing, but emergency protocols may allow
nurses to assume expanded roles and adapt care standards to fit the crisis context.
D. Nurses cannot perform any tasks they do not perform on their standard unit.
Correct Answer: C. The scope of practice remains defined by the state Board of Nursing, but emergency
protocols may allow nurses to assume expanded roles and adapt care standards to fit the crisis context.
Rationale: Licensing laws and scope of practice remain in effect during disasters. However, crisis standards of
care and hospital disaster protocols may expand a nurse's functional role (e.g., cross-training to assist in ICU or
triage). Nurses must still practice within the broad limits of the state's Nursing Practice Act and use clinical
judgment to ensure patient safety. Protection from liability is governed by emergency declarations (like the
Stafford Act or Good Samaritan laws), but does not excuse gross negligence.
10. During a disaster drill, the communications officer reminds the staff to use "clear text" over the
radios. What is the reason for avoiding 10-codes (e.g., "10-4") or hospital-specific codes during a
disaster?
A. Codes are copyrighted and expensive to use.
B. Using clear text (plain language) ensures that all participating agencies (police, fire, EMS, and hospital
staff) understand communications without confusion, promoting interoperability.
C. Codes take longer to speak over the radio than plain language.
D. Clear text is easier to encrypt from the media.
Correct Answer: B. Using clear text (plain language) ensures that all participating agencies (police, fire,
EMS, and hospital staff) understand communications without confusion, promoting interoperability.
Rationale: National incident management standards (NIMS) require using plain language (clear text) rather than
radio codes because different agencies utilize different codes (e.g., a "Code Blue" or "10-50" may mean different
things to police vs. hospital staff). Plain language prevents misunderstandings during inter-agency responses.
11. A hospital is preparing for a potential pandemic. The planning committee evaluates the facility's
"surge capacity." What are the four traditional pillars of surge capacity?
A. Doctors, Nurses, Medicine, Beds
B. Staff (personnel), Stuff (supplies/equipment), Space (physical areas), and Systems (policies/procedures)
C. Funding, Triage, Decontamination, Discharge
D. Communication, Security, Logistics, Command
Correct Answer: B. Staff (personnel), Stuff (supplies/equipment), Space (physical areas), and Systems
(policies/procedures)
Rationale: Surge capacity is the ability of a healthcare system to expand rapidly to meet an increased demand for
services. The four "S" pillars represent: Staff (mobilizing personnel), Stuff (procuring equipment, ventilators,
PPE), Space (converting lobbies or tents into care areas), and Systems (implementing disaster plans, billing
overrides, and documentation modifications).
1. A hospital is responding to a mass casualty incident following a building collapse. The facility
activates the Hospital Incident Command System (HICS). Which of the following best describes the
primary purpose of HICS?
A. To establish a rigid hierarchy that prevents staff nurses from taking initiative.
B. To provide a standardized, scalable organizational structure that facilitates emergency communication,
resource allocation, and management.
C. To replace all local hospital policies with federal government protocols.
D. To reduce hospital liability by delegating medical authority to external agencies.
Correct Answer: B. To provide a standardized, scalable organizational structure that facilitates emergency
communication, resource allocation, and management.
Rationale: HICS is an emergency management system based on the National Incident Management System
(NIMS) Incident Command System (ICS). Its purpose is to help hospitals respond to emergencies of any size by
establishing standard roles, clear communication channels, and a scalable hierarchy that integrates with
community emergency services.
2. Within the HICS structure, a nurse is assigned to the command staff role of Safety Officer. Which of
the following responsibilities falls under this nurse's scope?
A. Managing all clinical operations and nursing care in the emergency department.
B. Identifying and mitigating hazardous conditions to ensure the safety of hospital staff, patients, and visitors.
C. Issuing press releases and managing media inquiries at the hospital entrance.
D. Tracking all financial expenditures and staff overtime costs during the response.
Correct Answer: B. Identifying and mitigating hazardous conditions to ensure the safety of hospital staff,
patients, and visitors.
Rationale: The Safety Officer is a command staff role responsible for monitoring emergency operations,
identifying potential hazards (e.g., chemical spills, structural dangers, PPE breaches), and taking corrective action
to protect responders and patients. Clinical operations are managed by the Operations Section (A). Media is
managed by the Public Information Officer (C). Cost tracking is managed by the Finance/Administration Section
(D).
3. A massive flood has caused power outages and structural damage at a regional medical center. The
Incident Commander activates the HICS command staff. A nurse manager is assigned to serve as the
Public Information Officer (PIO). What is the primary duty of the PIO?
A. Requesting additional medical supplies from the state stockpile.
B. Formulating the clinical nursing schedule for the next 48 hours.
C. Serving as the single point of contact for the media, coordinating public information releases, and managing
press conferences.
, D. Negotiating inter-facility transfer agreements with nearby hospitals.
Correct Answer: C. Serving as the single point of contact for the media, coordinating public information
releases, and managing press conferences.
Rationale: The Public Information Officer (PIO) is responsible for interface with the media and public, ensuring
that accurate, approved information is released. This prevents conflicting statements and rumor spread, which can
compromise public safety. Logistics handles supplies (A). Planning handles schedules (B). The Liaison Officer
coordinates with external facilities (D).
4. During a disaster response, the Chief Nursing Officer is assigned as the Operations Section Chief.
What is the main function of the Operations Section in the HICS framework?
A. Writing the Incident Action Plan (IAP) and tracking patient locations.
B. Directing and coordinating all tactical actions and resources to execute the medical and clinical services of
the response.
C. Procuring food, medical equipment, and water for staff and patients.
D. Processing insurance claims and workers' compensation paperwork.
Correct Answer: B. Directing and coordinating all tactical actions and resources to execute the medical and
clinical services of the response.
Rationale: The Operations Section is responsible for carrying out the tactical objectives of the Incident Action
Plan. In a hospital, this includes direct patient care, triage, decontamination, surgical services, and nursing care.
Planning writes the IAP (A). Logistics procures supplies and food (C). Finance handles costs and claims (D).
5. A nurse working in the emergency department needs to request additional intravenous fluids and
medication administration sets during a mass casualty surge. To which HICS section should this
request be routed?
A. Planning Section
B. Operations Section
C. Logistics Section
D. Finance/Administration Section
Correct Answer: C. Logistics Section
Rationale: The Logistics Section is responsible for providing facilities, services, materials, and support systems to
meet the needs of the incident, including medical supplies, food, transportation, and communication systems.
6. During a protracted disaster response, the Incident Commander asks for a projection of resource
needs for the upcoming 12-hour operational period. Which HICS section is responsible for gathering
data, predicting future needs, and drafting the next Incident Action Plan (IAP)?
A. Logistics Section
B. Operations Section
, C. Finance/Administration Section
D. Planning Section
Correct Answer: D. Planning Section
Rationale: The Planning Section is responsible for collecting, evaluating, and disseminating information about the
incident's status and resources. They look ahead to anticipate needs and write the Incident Action Plan (IAP) for
the next operational shift.
7. A hospital nurse manager is tracking the hours worked by staff nurses during a disaster response
and documenting damaged hospital property for insurance reimbursement. Under which HICS section
does this task fall?
A. Planning Section
B. Logistics Section
C. Finance/Administration Section
D. Operations Section
Correct Answer: C. Finance/Administration Section
Rationale: The Finance/Administration Section is responsible for tracking personnel time, financial costs,
purchasing contracts, compensation claims, and documentation of property damage or loss during the emergency.
8. What is the primary function of the hospital's Emergency Operations Center (EOC) during a
disaster?
A. To serve as the primary site for performing patient surgeries.
B. To act as a centralized location for command, coordination, and information management to support the
hospital's response.
C. To house family members of patients who are seeking information.
D. To serve as a media center for reporters.
Correct Answer: B. To act as a centralized location for command, coordination, and information
management to support the hospital's response.
Rationale: The EOC is the central hub where the command team gathers to make strategic decisions, coordinate
resources, communicate with external partners, and manage information during a crisis. It is not a clinical
treatment area.
9. During a declared state of emergency, a nurse is asked to perform a clinical procedure that is outside
of the nurse's standard daily duties but falls within the state's nursing practice act. How are nurse
liability and scope of practice affected during a disaster?
A. All licensing laws are suspended; nurses can perform any medical task.
B. Nurses are protected from liability for malpractice under all circumstances.
, C. The scope of practice remains defined by the state Board of Nursing, but emergency protocols may allow
nurses to assume expanded roles and adapt care standards to fit the crisis context.
D. Nurses cannot perform any tasks they do not perform on their standard unit.
Correct Answer: C. The scope of practice remains defined by the state Board of Nursing, but emergency
protocols may allow nurses to assume expanded roles and adapt care standards to fit the crisis context.
Rationale: Licensing laws and scope of practice remain in effect during disasters. However, crisis standards of
care and hospital disaster protocols may expand a nurse's functional role (e.g., cross-training to assist in ICU or
triage). Nurses must still practice within the broad limits of the state's Nursing Practice Act and use clinical
judgment to ensure patient safety. Protection from liability is governed by emergency declarations (like the
Stafford Act or Good Samaritan laws), but does not excuse gross negligence.
10. During a disaster drill, the communications officer reminds the staff to use "clear text" over the
radios. What is the reason for avoiding 10-codes (e.g., "10-4") or hospital-specific codes during a
disaster?
A. Codes are copyrighted and expensive to use.
B. Using clear text (plain language) ensures that all participating agencies (police, fire, EMS, and hospital
staff) understand communications without confusion, promoting interoperability.
C. Codes take longer to speak over the radio than plain language.
D. Clear text is easier to encrypt from the media.
Correct Answer: B. Using clear text (plain language) ensures that all participating agencies (police, fire,
EMS, and hospital staff) understand communications without confusion, promoting interoperability.
Rationale: National incident management standards (NIMS) require using plain language (clear text) rather than
radio codes because different agencies utilize different codes (e.g., a "Code Blue" or "10-50" may mean different
things to police vs. hospital staff). Plain language prevents misunderstandings during inter-agency responses.
11. A hospital is preparing for a potential pandemic. The planning committee evaluates the facility's
"surge capacity." What are the four traditional pillars of surge capacity?
A. Doctors, Nurses, Medicine, Beds
B. Staff (personnel), Stuff (supplies/equipment), Space (physical areas), and Systems (policies/procedures)
C. Funding, Triage, Decontamination, Discharge
D. Communication, Security, Logistics, Command
Correct Answer: B. Staff (personnel), Stuff (supplies/equipment), Space (physical areas), and Systems
(policies/procedures)
Rationale: Surge capacity is the ability of a healthcare system to expand rapidly to meet an increased demand for
services. The four "S" pillars represent: Staff (mobilizing personnel), Stuff (procuring equipment, ventilators,
PPE), Space (converting lobbies or tents into care areas), and Systems (implementing disaster plans, billing
overrides, and documentation modifications).
