HUMANIDADE 115 Evolve community exam questions & answers 2022 update| 100 % correct

Which entity is responsible for activating the disaster plan during a mass casualty incident (MCI)? 1 Local emergency management system Incorrect2 State emergency management system Correct3 Federal emergency management agency 4 Hospital-level emergency management system 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. An emergency nursing staff member is performing defibrillation/cardioversion and special resuscitation for clients who sustained injuries in a tsunami. Which certification does the emergency nursing staff member possess? 1 Basic Life Support(BLS) 2 Certified Emergency Nurse (CEN) Correct3 Advanced Cardiac Life Support (ACLS) 4 Pediatric Advanced Life Support (PALS) Advanced Cardiac Life Support (ACLS) certification allows nurses to perform electrical therapies, special resuscitation, and invasive airway management. Basic Life Support(BLS) certification is granted when the nurse performs airway maintenance or cardiopulmonary resuscitation. Certified Emergency Nurse (CEN) certification indicates that a nurse has core emergency nursing skill and knowledge. Pediatric Advanced Life Support (PALS) certification is needed to perform neonatal and pediatric resuscitation. Which medical relief team would the nurse explain provides relief services ranging from primary healthcare and triage to evacuation and staffing to assist healthcare facilities in a massive disaster? 1 Medical Reserve Corps (MRC) Correct2 Disaster Medical Assistance Team (DMAT) 3 Hospital Incident Command System (HICS) 4 International Medical Surgical Response Teams (IMSuRTs) The DMAT is a team of civilian, medical, and paraprofessionals who are deployed to a disaster area. They provide relief services ranging from primary healthcare and triage to evacuation and staffing to assist healthcare facilities in a massive disaster. The MRC is a group of volunteer medical and public healthcare professionals. The MRC helps healthcare settings that face personnel shortages in a mass casualty event. The HICS is a facility-level organizational model to homogenize disaster operations. The IMSuRTs provide fully functional field surgical facilities in a mass casualty event whenever needed. What type of healthcare does a person who is "worried well" require? Select all that apply. Correct1 Evaluation Correct2 Reassurance 3 Hospitalization 4 Diagnostic tests Correct5 Preventive treatment A person who is "worried well" wants evaluation, reassurance, and preventive treatment. This person does not ask for hospitalization or diagnostic tests. What is the role of the "doorkeeper" in a critical incident stress debriefing (CISD) team? 1 Helping dispel any feelings of blame or guilt in the participants 2 Encouraging group discussion through asking a series of questions 3 Educating participants about self-care concepts and coping strategies to use immediately Correct4 Talking with anyone who leaves the session early in an effort to have him or her return or accept follow-up The role of the "doorkeeper" is to keep inappropriate people like the media and spectators out and to talk with anyone who leaves the session early in an effort to have him or her return or accept follow-up. The CISD group leader helps dispel any feelings of blame or guilt in the participants, encourages group discussion through asking a series of questions, and educates participants about self-care concepts and coping strategies to use immediately. The emergency department nurse is triaging clients according to the emergency service index (ESI). On further evaluation the nurse reassigned some clients to other ESI levels. Which assessments made by the nurse helped in reassigning the clients? 1 Temperature of 98˚F (37˚C) 2 Pulse rate of 70 beats/min Correct3 Blood pressure of 190/90mm Hg 4 Respiratory rate of 18 breaths/min According to the emergency service index (ESI), all clients who do not meet criteria of ESI level 1 (life threat) and ESI level 2 (high risk situation) are assigned to other levels such as ESI levels 3, 4, 5. After further assessment, clients with abnormal vital signs in ESI level 3 are reassigned to ESI level 2. If blood pressure is higher than normal (90/60 to 120/80 mm hg), the client is What is the purpose of an administrative review debriefing session after a disaster? 1 Change responsibility roles 2 Prevent the development of burnout 3 Analyze the amount of resources used Correct4 Determine what went right and what went wrong The goal of the administrative review debriefing is to discern what went right and what went wrong during activation and implementation of the emergency preparedness plan. This debriefing is not used to change responsibility roles. Preventing the development of burnout is the goal of critical incident stress debriefing (CISD). Analyzing resource use would occur after the disaster plan is discontinued. The nurse is reassessing level of consciousness and mental status in a client who survived a fire. Which type of emergency assessment of the trauma client is the nurse performing? Incorrect1 Airway Correct2 Disability 3 Breathing 4 Full set of vital signs Reassessing the level of consciousness and mental status in a client would provide baseline assessment of neurologic status, which is an aspect of emergency assessment of disability performed in a primary survey as a life-saving intervention. Emergency assessment of the airway is performed to assess respiratory distress, bleeding, and edema. Emergency assessment of breathing is performed to assess normal airway passage, tension pneumothorax, or the need for mechanical ventilation. Assessing the full set of vital signs involves monitoring temperature, heart rate and, respiratory rate. Which color tagged clients usually make up the greatest number in most large-scale multi-casualty situations, based on the disaster triage tag system? Incorrect1 Red 2 Black Correct3 Green 4 Yellow Green-tags clients usually make up the greatest number in most large-scale multi-casualty situations. These clients have minor injuries and they may actually evacuate themselves from the mass casualty scene and go to the hospital in a private vehicle. Red-tagged clients have major injuries, black-tagged clients are expected and allowed to die, and yellow-tagged clients have major injuries. Clients belonging to these three categories usually do not make up the greatest number in most large-scale multi-casualty situations. A group of clients injured in a cyclone are admitted to an emergency department. The hospital management wants to caution people living in those areas through radio and news and notify other healthcare facilities. Which personnel would the nurse consider are appropriate in this situation? 1 Triage officer Correct2 Public information officer 3 Medical command physician 4 Hospital incident commander The public information officer is the healthcare team member who serves as a liaison between the media and the healthcare facility. The triage officer is a member of the healthcare team who may be a physician or nurse who evaluates every client rapidly based on priorities to provide treatment. The medical command physician is the healthcare team member who has a role in deciding acuity, the number, and resource needs of clients. The hospital incident commander is an administrator who assumes overall leadership for implementing the emergency plan. After a mass casualty incident related to an accidental fire in a residential area, the medical care team is assessing clients who were affected by this disaster. The nurse notices that many of the clients are incoherent and have panic attacks and exaggerated startle responses. What condition are the clients experiencing? 1 Ineffective coping Correct2 Post-trauma syndrome 3 Compromised resilience 4 Disturbed personal identity Incoherence, panic attacks, and exaggerated startle responses are symptoms of post-trauma syndrome. Ineffective coping and compromised resilience is 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. Which disaster can be categorized as an internal disaster? 1 Hurricane in a state Correct2 Explosion in a hospital 3 Earthquake in a country 4 Flooding in a town 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. The victims of a large scale near-drowning incident are brought to the emergency department. What is the minimum length of time all such victims should be kept under observation in the hospital? 1 12 hours 2 18 hours Correct3 23 hours Incorrect4 48 hours Complications can develop in victims who are essentially free of symptoms immediately after a near-drowning episode. This secondary drowning refers to delayed death from drowning due to pulmonary complications. Consequently, all victims of near-drowning should be observed in a hospital for a minimum of 23 hours, and longer if they have co-morbidities. Twelve hours and 18 hours are too soon to rule out secondary drowning. The clients need not be kept under observation for 48 hours if they do not have co-morbidities. Which biologic agent of terrorism is treated with antitoxin? 1 Plague 2 Anthrax Correct3 Botulism 4 Smallpox Botulism is treated with antitoxin, though several vaccines are being studied. Plague and anthrax can be treated effectively with antibiotics if sufficient supplies are available and the organisms are not resistant. Smallpox can be prevented or the incidence reduced by vaccination, even when first given after exposure. The nursing student is learning about submersion injuries. Which component of sea water does the nurse know to be responsible for making it hypertonic compared to body fluids? Correct1 Salt 2 Mud 3 Algae 4 Chlorine Salt makes sea water hypertonic compared to body fluids. Mud, algae, and chlorine are present in abundance in freshwater, which is hypotonic. Which color tag will be given by the triage nurse to a client assigned to class IV, during a mass casualty situation? 1 Red Correct2 Black 3 Green 4 Yellow A client considered class IV during triage in a mass casualty situation will be given a black tag. The red tag is associated with class I, green tag with class III, and yellow tag with class II While caring for a group of clients injured in a fire, the nurse finds that there is a need for airway maintenance, electrical therapies, and specialized resuscitation. Which invasive assessment trained team and management skills certification is required in this situation? 1 Basic Life Support (BLS) 2 Certified Emergency Nurse (CEN) Correct3 Advanced Cardiac Life Support (ACLS) 4 Pediatric Advanced Life Support (PALS) ACLS is the certification for emergency nurses who are trained with invasive airway management skills, pharmacology, electrical therapies, and special resuscitation for caring for the client in the emergency department after disasters. BLS is the certification for emergency nursing that includes assessment and management skills for airway maintenance and cardiopulmonary resuscitation (CPR). All registered nurses maintain BLS certification. CEN is emergency nursing certification that validates core emergency nursing knowledge. PALS is the certification for neonatal and pediatric resuscitation. What is the function of the emergency department nurse leader? Incorrect1 Providing care for stable emergency department (ED) clients 2 Assisting in monitored care of the client 3 Transporting the clients to the critical care unit Correct4 Directing ancillary departments to deliver resources to meet service demands 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. During an external disaster, which member of the hospital incident command system has the authority to rapidly expand hospital capacity and ensure the availability of medical supplies to the nurse as a function of an emergency response plan? 1 Triage officer 2 Medical command physician Correct3 Hospital incident commander 4 Community public information officer The hospital incident commander is a physician or administrator who assumes overall leadership for implementing the emergency response plan. He or she has the authority to rapidly expand hospital capacity, recruit paid or volunteer staff, and ensure the availability of medical supplies as a function of an emergency response plan during an external disaster. A triage officer is a physician or nurse who rapidly evaluates each client to determine priorities for treatment. A medical command physician is the personnel who decides the number, acuity, and resource needs of the clients. A community public information officer is a person who serves as a liaison between the healthcare facility and the media. The victims of a terrorist attack involving sarin are brought to the emergency department. Which statement does the nurse know to be true regarding the characteristics of sarin? 1 Sarin causes skin burns and blisters. Correct2 Sarin can cause death within minutes of exposure. 3 A garlic-like odor and brown color are characteristics of sarin. 4 A single dose of pralidoxime chloride (2-PAM chloride) reverses the effects of long-term sarin exposure. 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 and brown color are characteristics of mustard gas. While 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. Which treatment for anthrax should be included in the biologic agent portion of a disaster plan for terrorist attacks? 1 Antivirals 2 Antitoxins Correct3 Antibiotics 4 Vaccinations 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. Which internal disaster would the nurse explain requires a need for evacuation or relocation? 1 Tornado 2 Hurricane Correct3 Facility gas explosion 4 Terrorism with explosive devices 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. Which nursing behavior helps establish rapport with survivors of a disaster? 1 Evaluating 2 Assessment 3 Collaboration Correct4 Active listening Rapport can be established through active listening. Evaluating and assessment are steps in the nursing process and are not helpful to establish rapport. Collaboration is a behavior best used when working with others during the active stages of a disaster. Which would the nurse consider to be an example of a potential internal disaster? Correct1 Hospital fire 2 Fertilizer plant explosion 3 Nuclear reactor explosion 4 Terrorist device explosion An internal disaster is any kind of event inside a healthcare facility or campus that could endanger the safety of clients or healthcare 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 nuclear reactor explosion may cause radiation exposure to the external environment. Terrorism with explosive devices is an external disaster. What type of trauma center would the nurse consider to be most appropriate for a client who survived an accidental fire and has multiple injuries? 1 Level I Correct2 Level II 3 Level III Incorrect4 Level IV Level II trauma centers provide care to the most injured clients. Level III trauma centers stabilize clients with multiple injuries. Level I trauma centers provide a full continuum of trauma services for all clients. Level IV provides advanced life support and basic trauma client stabilization. What 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. Correct1 Drinking plenty of water Correct2 Encouraging co-workers Correct3 Monitoring each other`s stress levels 4 Being quiet and isolated from others 5 Working for more than 12 hours each day It is recommended to drink plenty of water and eat healthy snacks for energy to overcome PTSD. It is essential to encourage and support co-workers who are suffering from PTSD. It is suggested that co-workers 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 important not to work for more than 12 hours each day because it will increase stress and lead to PTSD. The nurse is triaging clients arriving at the hospital after a large-scale disaster. Which condition is most likely to be categorized with a black tag? 1 Contusions 2 Air-way obstruction Correct3 Massive head trauma 4 Open fracture with distal pulse 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. Which emergency response team helps set up shelters for victims who lost their homes due to a disaster? CorrectA American Red Cross B Disaster Medical Assistance Team C International Medical Surgical Response Teams D Disaster Mortuary Operational Response Teams 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 Disaster Medical Assistance Team (DMAT) provides medical equipment that is sufficient for at least 72 hours. International Medical Surgical Response Teams (IMSuRTs) establish fully functional field surgical facilities wherever they are needed in the world. Disaster Mortuary Operational Response Teams (DMORTs) manage mass fatalities at the disaster site. Which color tag should be given to "walking wounded" clients according to the disaster triage tag system? 1 Red 2 Black Correct3 Green 4 Yellow 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. Blacktagged 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 as injuries are not life threatening. In a mass casualty situation, which is the facility-level organizational model for disaster management used by the hospital or long-term care facility? Incorrect1 Emergency operations center (EOC) Correct2 Hospital Incident Command System (HICS) 3 National Incident Management System (NIMS) 4 Federal Emergency Management Agency (FEMA) The facility-level organizational model for disaster management is the Hospital Incident Command System (HICS). It attempts to standardize disaster operations by formally structuring roles under the hospital or long-term care facility incident commander with clear lines of authority and accountability for specific resources. The EOC, NIMS, and FEMA are not facility-level organizational models for disaster management. The EOC is established by the HICS personnel in a designated location with accessible communication technology to manage the overall incident. The NIMS is the overall system for incident management of which the HICS is a part; it is implemented by the Department of Homeland Security and FEMA. The FEMA provides numerous online resources so that people are better prepared for disasters and are able to respond more self-sufficiently to incidents and hazard situations in their own communities. What services can be provided by level II trauma care centers during mass causality events? 1 Stabilize clients with major injuries. Correct2 Provide care to most injured clients. 3 Provide a full continuum of trauma services for all clients. 4 Provide basic trauma client stabilization and advanced life support. Level II trauma centers are community-based trauma centers that can provide most trauma care to clients. Level III trauma centers can provide care up to the stabilization of clients. A full continuum of trauma services for all clients is provided in Level I trauma centers. Basic trauma client stabilization and advanced life support are provided in Level IV trauma centers. Which intervention is a part of the response phase of disaster planning? 1 Stabilizing the community 2 Limiting the impact of disaster Correct3 Implementing the disaster plan 4 Evaluating the events of disaster management 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 focuses on evaluation of the plan. 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? 1 Triage officer 2 Medical command physician Correct3 Prehospital care providers Incorrect4 Emergency medicine physician 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 physicians have specialized education and training in emergency client management. During a critical incident stress debriefing (CISD) session conducted by the nurse for clients affected by a natural disaster, a client 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." Which phase of CISD does this indicate? 1 Reentry phase Incorrect2 Thought phase Correct3 Reaction phase 4 Symptom phase 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. Which phase of disaster management involves attempts to limit the disaster's impact on the population? 1 Recovery 2 Response Correct3 Mitigation Incorrect4 Preparedness 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 and evaluates the damage. Which amount of time is appropriate for a nurse to spend triaging each patient during a mass casualty incident? 1 Less than 10 seconds Correct2 Less than 15 seconds 3 Less than 30 seconds Incorrect4 Less than 60 seconds 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. Which health care team member is a first responder when an emergency or mass casualty incident (MCI) occurs? Incorrect1 Medical unit nurse 2 Police officer Correct3 Critical care nurse 4 Unlicensed assistive personnel Critical care nurses are often considered emergency medical personnel that respond to emergency or MCIs. Firemen and police officers are first responders but are not members of the health care team. Unlicensed assistive personnel are not first responders. Which personnel of the institutional emergency response plan serves as a liaison between hospital administration and the media during a mass casualty incident such as an earthquake or a terrorist attack? 1 Triage officer 2 Medical command physician 3 Hospital incident commander Correct4 Community relations information officer The community public information officer is a person who serves as a liaison between the healthcare facility and the media releasing only appropriate or accurate information about the incident. A triage officer is a physician or nurse who rapidly evaluates each client to determine priorities for treatment. A medical command physician is the personnel who decides the number, acuity, and resource needs of the clients. A hospital incident commander is a physician or administrator who assumes overall leadership for implementing the emergency plan. Which situation does not cover nurses who respond to a mass casualty incident (MCI) for malpractice or negligent lawsuits under the Good Samaritan Act? Correct1 Terrorist act 2 Neighborhood fire Incorrect3 Roadside car accident 4 High school sporting event 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. Which statement by the nurse is true regarding mass casualty events related to disasters? 1 "They can be managed by a hospital using local resources." 2 "They are incidents inside a healthcare facility that could endanger the safety of clients." Correct3 "They may require the association of multiple agencies and healthcare facilities to handle the crisis." Incorrect4 "They are events outside the healthcare facility requiring the activation of the facility’s emergency management plan." A mass casualty event overwhelms local medical capabilities and may require the collaboration of multiple agencies and healthcare 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 healthcare facility or campus that could endanger the safety of clients or staff. An external disaster is an event outside the healthcare facility or campus, somewhere in the community, that may require the activation of the facility’s emergency management plan. What is a common metabolic cause of hypothermia? 1 Seizure 2 Dehydration Correct3 Hypoglycemia 4 Hyperthyroidism Hypoglycemia is a common metabolic cause of hypothermia. Seizure does not cause hypothermia. Dehydration can cause hyperthermia. Hypothyroidism, not hyperthyroidism, can lead to hypothermia. Which colors are often included in an organizational disaster plan for use during triage? Select all that apply. Correct1 Red Correct2 Black Correct3 Green Incorrect4 White Correct5 Yellow 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. Which disasters would the nurse categorize as natural events? Select all that apply. Correct1 Blizzard Correct2 Droughts Correct3 Wildfires 4 Nuclear explosion 5 Industrial accidents Natural disasters include weather-related events that inflict significant damage to life and property, exceeding the resource capabilities of local communities. Blizzards, droughts, and wildfires are a few examples of natural disasters. Man-made occurrences are related to identifiable human actions and also include technological events such as nuclear explosions and major industrial accidents. Which statement is true about the disaster triage tag system? 1 Yellow tags are given to "walking wounded clients." 2 Clients who are in shock are given a black tag. Correct3 Clients with airway obstruction, who require immediate attention, are given a red tag. 4 Green tags are given to clients who require treatment within 30 minutes to 2 hours of admission. 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. Which disaster management team provides voluntary medical service to people? Correct1 Medical Reserve Corps (MRC) 2 Disaster Medical Assistance Team (DMAT) 3 National Veterinary Response Teams (NVRT) 4 Disaster Mortuary Operational Response Teams (DMORT) 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 various other regions. Which events can result in adventitious crisis? Select all that apply. Incorrect1 Divorce 2 Marriage Correct3 Terrorism Correct4 Earthquake Incorrect5 Mental illness 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 situational crisis. Clients in which class are given a yellow tag according to the disaster triage tag system? 1 Class I Correct2 Class II 3 Class III 4 Class IV 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 III clients are nonurgent clients with minor injuries that do not require immediate treatment. Thus they are given green tags. Class I clients are emergent clients. They require immediate treatment and are identified with red tags. Class IV clients are expected to die and they are issued black tags. Which functional level of trauma center is involved in providing a full continuum of trauma services? Correct1 Level I 2 Level II 3 Level III 4 Level IV 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 III centers are able to stabilize clients with major injuries, but must transport clients if needs exceeds 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. Which is the function of the medical command physician according to the Emergency Preparedness and Response Plan? Correct1 Deciding the number, acuity, and resource needs of clients 2 Serving as a liaison between the healthcare facility and the media 3 Assuming overall leadership for implementing the emergency plan 4 Evaluating each client rapidly to determine priorities for treatment The function of the medical command physician, according to the Emergency Preparedness and Preparedness Plan, is deciding the number, acuity, and resource needs of clients. The function of the community relations or public information officer is serving as a liaison between the healthcare facility and the media. The function of the hospital incident commander is assuming overall leadership for implementing the emergency plan. The function of the triage officer is evaluating each client rapidly to determine priorities for treatment. Which personnel are responsible for identifying the need for and calling in specialty trained providers in emergencies? 1 Triage officer 2 Public information officer Correct3 Medical command physician 4 Hospital incident commander The medical command physician is responsible for identifying the resource needs of the clients. Therefore 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 healthcare facility and the media. The hospital incident commander is the one who assumes overall leadership for implementing the emergency plan. Several emergency preparedness agencies are developing emergency response plans in case of an earthquake alert. In which phase of the disaster management continuum would the nurse state this activity is included? 1 Response 2 Recovery 3 Mitigation Correct4 Preparedness 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. Which psychosocial nursing actions are appropriate when providing client care after a community disaster? Select all that apply. Incorrect1 Performing triage of injuries 2 Administering first aid to wounds Correct3 Offering choices whenever possible Correct4 Establishing rapport through active listening Correct5 Requesting assistance from crisis counselors Psychosocial nursing actions appropriate when providing care after a community disaster include offering choices whenever possible, establishing rapport through active listening, and requesting assistance from crisis counselors. Performing triage of injuries and administering first aid to wounds are not psychosocial nursing actions. The healthcare team member working at an emergency operation center (EOC) during a mass casualty swine flu outbreak has identified the need to call the infectious disease physician. Which healthcare personnel is responsible for calling the infectious disease physician? 1 Triage officer 2 Public information officer Correct3 Medical command physician 4 Hospital incident commander Medical command physician in the EOC is responsible for identifying the need for and calling in specialty providers such as an infectious disease physician. The public information officer serves as a liaison between the healthcare facility and the media. The triage officer evaluates each client to determine priorities for treatment. The hospital incident commander assumes leadership for implementing the institutional plan. What should the nurse do when a disaster survivor receives a high score on one of the Impact of Event Scale-Revised (IES-R) subscales? 1 Repeat the test Correct2 Refer for further evaluation 3 Nothing since this is an expected score 4 Assess for a history of abuse or neglect A high score on any IES-R subscale indicates a need for further evaluation. The test does not need to be repeated. A high score is not an expected score. A high score on all subscales requires evaluation for current or past trauma such as abuse or neglect. Which disaster event involves an internal disaster compounded with an external disaster? Incorrect1 Fertilizer plant explosion in Texas 2 9/11 World Trade Center terrorist attack 3 Cocoanut Grove nightclub fire in Boston Correct4 St. John’s Regional Medical Center in Joplin, MO An internal disaster is an event inside a healthcare facility that could endanger the safety of clients or staff. St. John’s Regional Medical Center in Joplin experienced an internal disaster compounding an external disaster when it was directly hit by an EF-5 tornado. A large part of the town was destroyed (external disaster) and 6 people inside the hospital died (internal disaster). The fertilizer plant explosion in Texas, the 9/11 World Trade Center terrorist attack, and the Cocoanut Grove nightclub fire in Boston are external disasters. An external disaster is an event outside a healthcare facility The nurse manager is reviewing the hospital disaster plan with other members of the committee. Which is the minimum number of disaster drills the committee must plan and implement each year? Correct1 Two 2 Three 3 Four 4 Five While it is appropriate to have more than the minimum number of disaster drill each year, the minimum that must be implemented per The Joint Commission (TJC) requirements is twice per calendar year. A local emergency department (ED) recently implemented an automated tracking system for triage during mass casualty incidents (MCIs). Which items can the nurse track using this system? Select all that apply. Correct1 Priority upon arrival 2 Clinical manifestations Correct3 Interaction with caregivers Correct4 Priority per process of care Correct5 Priority according to location Automated tracking systems using infrared and radiofrequency technology (RFT) are available in some emergency departments to track a patient’s triage priority upon arrival, location, and process of care. The interactions the patient has with caregivers can also be tracked; this is an important safety strategy if the patient 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. Which injuries would likely be given a green tag after a disaster? Select all that apply. A Shock CorrectB Strains CorrectC Sprains CorrectD Abrasions E Airway obstruction 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. Which hospital department plays a primary role in disaster preparedness? 1 Medical department 2 Surgical department Correct3 Emergency department 4 Mental health department The emergency department plays a primary role in emergency disaster preparedness. While all departments in the hospital contribute to disaster planning, the only department that plays a primary role is the emergency department. After a fire, many people were expected to be admitted to the emergency department. There is a need for prehospital care providers to provide continuous cardiac monitoring, advanced airway management, and intubation in a group of clients who are severely injured. Which team is responsible for providing these services? Correct1 Paramedics 2 Ancillary nursing staff 3 Psychiatric crisis nurse team Incorrect4 Emergency medical technicians (EMTs) 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 drugs 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. Which emergency medical service (EMS) healthcare professional provides advanced life support to the clients who survived a large-scale disaster? Correct1 Paramedics 2 Triage officer 3 Prehospital care providers 4 Emergency medical technicians 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 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. The emergency department nurses are caring for a group of clients injured in a community disaster. Which action of the nurse needs correction? 1 Triaging the victims Incorrect2 Supervising volunteers 3 Providing on-site first aid Correct4 Removing people from danger During a community disaster, removing people from danger is done by firefighters and other disaster trained emergency personnel. Nurses should not be involved in this process. After the removal of people from danger, the nurses triage the victims under triage categories. The nurses supervise volunteers and provide on-site first aid to victims. The emergency room nurse is training to be a member of a direct response team to respond to community emergencies. Which new triage level would this nurse be required to learn? 1 Urgent Incorrect2 Emergent Correct3 Expectant 4 Nonurgent The expectant classification is not a classification level in emergency room triage. The levels urgent, emergent, and nonurgent are all classification levels within an emergency room triage system. A group of clients is admitted with neurologic injury after hiking at high altitude. The nurse is assessing using the "AVPU" mnemonic. Which type of emergency assessment is the nurse performing? Correct1 Disability 2 Exposure 3 Breathing 4 Circulation Disability assessment is a part of the primary survey that is done to assess the level of consciousness that may occur due to a neurologic injury. In the mnemonic "AVPU," A indicates alert, V indicates response to voice, P stands for response to pain, and U indicates unresponsive. Exposure assessment is one of the priorities of a primary survey, which involves removing clothing for a complete assessment and preventing hypothermia using heat devices. Breathing assessment involves checking breath sounds and respiratory effort. Circulation assessment is performed in a primary survey to monitor blood pressure and pulse. Who should the nurse contact to receive training as a Community Emergency Response Team (CERT) member? 1 National Disaster Life Support Foundation Correct2 Federal Emergency Management Agency (FEMA) 3 Centers for Disease Control and Prevention (CDC) 4 Centers for Medicare and Medicaid Services (CMS) The Federal Emergency Management Agency (FEMA) provides Community Emergency Response Team (CERT) training. The National Disaster Life Support Foundation offers Core, Basic, and Advanced Disaster Life Support training courses. The Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS) do not provide disaster preparedness training. Which medical relief team would the nurse expect to help healthcare facilities that face personnel shortages during a mass casualty event? Correct1 Medical Reserve Corps (MRC) 2 Disaster Medical Assistance Team (DMAT) 3 Hospital Incident Command System (HICS) 4 International Medical Surgical Response Teams (IMSuRTs) MRC is a group of volunteer medical and public healthcare professionals. MRC helps healthcare 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. IMSuRTs provide fully functional field surgical facilities in a mass casualty event whenever needed. Level 2 The nurse is caring for the victims of a terrorist attack involving explosive devices. Which type of damage is most likely caused by a crush injury? Incorrect1 Middle ear injury Correct2 Blunt trauma to the head 3 Shrapnel injury in the abdomen 4 Damaged lungs due to shock wave Crush injuries often result from explosions in confined spaces causing structural collapse, such as falling debris. Blunt trauma to the head is an example of a crush injury. Middle ear injury is a common type of blast injury that results from the supersonic over pressurization shock wave caused by the explosion. Some explosive devices contain materials that are projected during the explosion, leading to penetrating injuries. Shrapnel injury in the abdomen is a type of penetrating injury. Lung damage due to a shock wave is a type of blast injury. Which would the registered nurse say is the priority action of first responders after a community disaster? 1 Providing on-site first aid 2 Providing emergency care Correct3 Removing the victims from danger 4 Categorizing victims using triage system First-responders in a disaster include other disaster-trained emergency personnel who had specific search and rescue training. The priority action of first responders is to remove injured and uninjured victims. The nursing staff provides on-site first aid and emergency care. After removing victims from danger, the healthcare personnel categorize victims using the triage system. The registered nurse is training the emergency department caregivers about types of disasters. Which statements made by the nurse would describe a mass casualty event? Select all that apply. Correct1 "In an aircraft explosion, nearly 112 persons died." Incorrect2 "There was a fire in a healthcare facility in Canada." Correct3 "In 2001, there was a terrorist attack on the World Trade Center." Incorrect4 "Five years ago there was a small chemical explosion at a medical college." Correct5 "The employees at a nuclear plant were severely injured by a radiation leak." Mass casualty events require the collaboration of multiple agencies and healthcare facilities to handle the crisis. An aircraft explosion, a terrorist attack, and a nuclear explosion are external disasters that will require the collaboration of multiple agencies. A fire in a healthcare facility and a small chemical explosion at a medical college are examples of multi-casualty events that can be managed using local resources. When a fire started in a healthcare setting, the charge nurse was instructed to take the responsibility of implementing a fire alarm evacuation policy. What is the role of the person that gave the nurse the instructions? 1 Triage officer Incorrect2 Public information officer 3 Medical command physician Correct4 Hospital incident commander The hospital incident commander is a physician or administrator who assumes the overall leadership for implementing the emergency plan during a disaster. A triage officer is a physician or nurse who rapidly evaluates each client to determine priorities for treatment. A public information officer is a person who serves as a liaison between the healthcare facility and the media. The medical command physician decides the number, acuity, and resource needs of clients. Which colored tag has the nurse correctly identified while classifying triage care in mass casualty conditions? Incorrect1 Urgent-red tag 2 Expectant-white tag Correct3 Nonurgent-green tag 4 Emergent-yellow tag When any triage is required in mass casualty conditions, the healthcare team would classify the clients according to the situation. Nonurgent clients are class III who have minor injuries that do not require immediate treatment and are tagged with a green color. Urgent or class II clients are those who have major injuries that require treatment and are tagged with a yellow color. Expectant or class IV are tagged with a black color. These clients will not receive immediate attention as they are either dead or are expected to die. Emergent or class I clients are those who will receive immediate care due to their life threatening condition and are tagged with a red color. Which emergency response team is involved in emotional recovery of victims after a disaster? CorrectA American Red Cross IncorrectB Disaster Medical Assistance Team C community emergency response team D Federal Emergency Management Agency 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. hospital in an urban setting is located on two rivers which are spanned by several bridges. Resources arrive to this community via commercial trains or airplanes. Which credible threats should this hospital prepare for when constructing the emergency preparedness plan? Select all that apply. Correct1 Floods Incorrect2 Landslides Correct3 Bridge collapses Correct4 Boating accidents Correct5 Train derailments Preparedness activities must address all credible threats to the safety of the community that could result in a disaster situation. For this community, the rivers could cause flooding. The bridges that span the rivers could collapse. Community members who use boats on the rivers could have accidents. And the trains that service the community could derail. There is no information to support the potential for landslides. The nurse is caring for a client with injuries from a bomb blast. Which emergency assessments are performed by the nurse in a primary survey? Select all that apply. Correct1 Airway Correct2 Breathing Correct3 Circulation 4 Focused adjuncts Correct5 Identify deformities 6 Give comfort measures The primary survey focuses on airway, breathing, circulation (ABC), disability, and exposure or environmental control. Airway, breathing, circulation, and identifying deformities are performed in a primary survey to identify life-threatening conditions to analyze the appropriate interventions. Assessing focused adjuncts and giving comfort measures are performed during a secondary survey. After a large fire, many people were admitted to the emergency department. The nurse noticed many clients with moist blebs and blistered skin with a cherry red color that are hypersensitive to touch or air. What types of injuries are identified in these clients? 1 First-degree burns 2 Third-degree burns 3 Fourth-degree burns Correct4 Second-degree burns The characteristic findings in second-degree burns are moist blebs and blisters on the skin. The skin appears to be a mottled white, pink to cherry-red color. The skin is also hypersensitive to touch or air and there may be moderate to severe pain. Clients with firstdegree burns have redness, pain, moderate to severe tenderness, and minimal edema. In third- and fourth-degree burns, the skin is dry and leathery. The skin is waxy white, dark brown, or charred in appearance with a strong burn odor. The nurse is helping a triage officer evaluate the victims of a large scale disaster. Which client does the nurse anticipate will be given a black tag? 1 A client with a contusion 2 A client with airway obstruction 3 A client with open fractures and a distal pulse Correct4 A client with extensive full-thickness body burns A black-tagged client in a mass casualty triage situation is a critically ill client who is expected and allowed to die or is not treated until others have received care. This is done so that limited resources can be dedicated to saving the most lives, and not expended to save one life at the possible expense of many others. The client with extensive full-thickness body burns falls in this category. A client with a contusion would be green-tagged because a contusion is a minor injury that can be managed in a delayed fashion. A client with airway obstruction would be red-tagged. This client has an immediate threat to life and requires immediate attention. A client with open fractures with a distal pulse would be yellow-tagged. This is major injury that requires treatment within 30 minutes to two hours. While managing the aftermath of a massive fire in a rural area, a physician is quickly examining clients and shifting them to urban health centers if required. What are the other duties of the physician in this role? Select all that apply. Incorrect1 Determining priorities for treatment Correct2 Determining the resource needs of the clients Correct3 Deciding the number and acuity of the clients Incorrect4 Assuming leadership for implementing the emergency plan 5 Serving as a liaison between the media and health care facility The medical command physician serves to determine the resource needs of the client and decide the acuity and number of the clients. In addition to these responsibilities, they are also expected to determine which clients need to be moved to larger medical centers and who can be retained for treatment. This occurs especially in the small hospitals with limited facilities. Prioritizing treatment is the duty of the triage officer. Leadership and implementation of the emergency plan is the duty of the hospital incident commander. The community relations officer serves as a liaison between the health care facility and the media. A debriefing team is providing a session for healthcare professionals who are experiencing insomnia after working in a mass casualty incident. One of the healthcare professionals wants to leave the session. Which team member is responsible for intervening in this situation? 1 Police 2 Paramedic 3 Fire fighter Correct4 Doorkeeper The "doorkeeper" is responsible for keeping inappropriate people out of the session and talking with healthcare professionals who are leaving the session early in an effort to have him or her return. Police and paramedics are the debriefing team members who are used based on the needs of the group. Firefighters are first responders who rescue people from danger after a disaster event. 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? 1 Disaster triage tag system Correct2 Automated tracking system 3 Hospital incident command system 4 National incident management system An automated tracking system is a valuable component of the hospital’s emergency preparedness infrastructure as 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 hospital incident command system (HICS) is a part of the national incident management system (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. The nursing student is comparing the causative agents of hyperthermia and hypothermia. Which causative agent is common to both conditions? Correct1 Alcohol Incorrect2 Barbiturates 3 Phenothiazines 4 Cardiovascular disease Alcohol is the causative agent that is common to both hyperthermia and hypothermia. Barbiturates and phenothiazines can cause hypothermia. Cardiovascular disease can cause hyperthermia. Which nursing actions contribute to a healthcare facility’s emergency preparedness and response prior to a natural disaster? Select all that apply. Correct1 Participating in drills Correct2 Evaluating outcomes 3 Activating a telephone tree Incorrect4 Performing a triage assessment 5 Discharging clients who no longer require acute care Nursing actions that contribute to a healthcare facility’s emergency preparedness and response include participating in drills and evaluating outcomes. Activating a telephone tree, preforming a triage assessment, and discharging clients who no longer require acute care are nursing actions that occur during a healthcare facility’s response to an actual natural disaster. The nurse is caring for different clients who were affected by a gas explosion. For which client should the nurse provide treatment immediately? 1 Client with multiple fractures 2 Client with strains and sprains Correct3 Client with unstable vital signs 4 Client with complex soft tissue injuries The three-tiered triage system sorts or classifies clients into priority levels depending on illness or injury severity. According to this system, the client with abnormal and unstable vital signs is classified in triage at the emergent level. This level indicates an immediate threat to life and requires urgent treatment. The clients with multiple fractures are classified at the urgent level. This level indicates a need for immediate treatment but the client’s condition is not immediately life threatening. Strains and sprains are classified at the nonurgent level, indicating that they could wait several hours for treatment without any fear of deterioration of the condition. Complex soft tissue injuries should be classified at the urgent level. The triage nurse assigns a red tag to a client who has been brought in following a massive earthquake in the region. Which statement best describes the client’s condition? 1 The client is expected and allowed to die. Correct2 The client has an immediate threat to life. 3 The client has major injuries that require treatment. 4 The client has minor injuries that do not require immediate treatment. A red tag indicates that the client has an immediate threat to life. A black tag indicates that the client is expected and allowed to die. The yellow tag indicates that the client has major injuries that require treatment. The green tag indicates that the client has minor injuries that do not require immediate treatment. While the nurse was caring for a client with chemical burns after a factory explosion, there was increased edema in the surrounding tissues. What might have led to increased edema? 1 Stabilizing the cervical spine Correct2 Lowering burned limbs below the heart 3 Brushing dry chemical from skin before irrigation Incorrect4 Flushing chemical from wound with saline solution The initial interventions for a client with a chemical burn include elevating the burned limbs above the heart. This helps in decreasing the edema of the localized tissue. Stabilizing the cervical spine is required as an immediate intervention for a client with chemical burns. Brushing any dry chemical from the skin before irrigation should be performed as a primary intervention. Flushing any chemicals from the wound with saline solution is done immediately and may not cause increased edema. A 60-year-old client is admitted with a head injury following a disaster. Which triage level should the nurse assign to the client? Correct1 Urgent 2 Emergent 3 Expectant 4 Nonurgent Clients with major injuries such as head or cervical injuries should be assigned urgent triage. Emergent should be assigned to clients with immediate life-threatening conditions such as airway obstruction. Expectant is assigned to clients who are dead or are expected to die. Nonurgent should be assigned to clients with minor injuries such as closed fractures or abrasions. There is a severe thunderstorm where a registered nurse is working at a camp in a rural area. Which actions should the nurse perform to prevent injuries to the clients from lightning strikes? Select all that apply. Correct1 Move the clients to the nearest buildings. 2 Ask the people to stand under isolated trees. Incorrect3 Move the clients who are unable to walk in wheelchairs. Correct4 Educate the clients to stay away from any bodies of water. Correct5 Ask everyone to stay away from open windows in the building. The clients should be moved to the nearest buildings to protect them from lightning strikes. The nurse should recommend that everyone stay away from bodies of water and open windows in the buildings to reduce the risk of being struck by lightning. Standing under isolated trees is not recommended; if outdoors is the only option, an area of dense trees offers better protection. During the thunderstorm, metal objects should be avoided, so moving clients in wheelchairs is not recommended. The nurse is caring for victims of a biologic terrorism incident that has caused them to develop hemorrhagic fever. What does the nurse know about the treatment of this condition? Correct1 There is no established treatment for this condition. Incorrect2 Antibiotics can be an effective treatment for hemorrhagic fever. 3 Multiple doses of atropine (AtroPen) can be used to control hemorrhagic fever. 4 Vaccination, even after first exposure, reduces the incidence of hemorrhagic fever. There is no established treatment for most viruses that cause hemorrhagic fever. Anthrax, plague, and tularemia are biologic agents of terrorism that can be treated effectively with antibiotics if sufficient supplies are available and the organisms are not resistant. Smallpox is a biologic agent of terrorism that can be prevented or the incidence reduced by vaccination, even when first given after exposure. Nerve agent poisoning is a chemical agent of terrorism; antidotes