Bioterrorism and Emergency Disaster Exam 2023
Questions and Answers with complete solution
You are working in the triage area of an ED, and four patients approach the triage desk
at the same time. List the order in which you will assess these patients. a. An
ambulatory, dazed 25-year-old male with a bandaged head wound b. An irritable infant
with a fever, petechiae, and nuchal rigidity c. A 35-year-old jogger with a twisted ankle,
having pedal pulse and no deformity d. A 50-year-old female with moderate abdominal
pain and occasional vomiting
A. A B D C
B. B A D C
C. C D B A
D. C B A D
b
An irritable infant with fever and petechiae should be further assessed for other
meningeal signs. The patient with the head wound needs additional history and
assessment for intracranial pressure. The patient with moderate abdominal pain is
uncomfortable, but not unstable at this point. For the ankle injury, medical evaluation
can be delayed 24 - 48 hours if necessary.
In conducting a primary survey on a trauma patient, which of the following is considered
one of the priority elements of the primary survey?
A. Complete set of vital signs
B. Palpation and auscultation of the abdomen
C. Brief neurologic assessment
D. Initiation of pulse oximetry
C
A brief neurologic assessment to determine level of consciousness and pupil reaction is
part of the primary survey. Vital signs, assessment of the abdomen, and initiation of
pulse oximetry are considered part of the secondary survey.
A 56-year-old patient presents in triage with left-sided chest pain, diaphoresis, and
dizziness. This patient should be prioritized into which category?
A. High urgent
B. Urgent
C. Non-urgent
D. Emergent
D
Chest pain is considered an emergent priority, which is defined as potentially life-
threatening. Patients with urgent priority need treatment within 2 hours of triage (e.g.
kidney stones). Non-urgent conditions can wait for hours or even days. (High urgent is
not commonly used; however, in 5-tier triage systems, High urgent patients fall between
emergent and urgent in terms of the time lapsing prior to treatment).
, The physician has ordered cooling measures for a child with fever who is likely to be
discharged when the temperature comes down. Which of the following would be
appropriate to delegate to the nursing assistant?
A. Assist the child to remove outer clothing.
B. Advise the parent to use acetaminophen instead of aspirin.
C. Explain the need for cool fluids.
D. Prepare and administer a tepid bath
A
The nursing assistant can assist with the removal of the outer clothing, which allows the
heat to dissipate from the child's skin. Advising and explaining are teaching functions
that are the responsibility of the RN. Tepid baths are not usually performed because of
potential for rebound and shivering.
It is the summer season, and patients with signs and symptoms of heat-related illness
present in the ED. Which patient needs attention first?
A. An elderly person complains of dizziness and syncope after standing in the sun for
several hours to view a parade
B. A marathon runner complains of severe leg cramps and nausea. Tachycardia,
diaphoresis, pallor, and weakness are observed.
C. A previously healthy homemaker reports broken air conditioner for days. Tachypnea,
hypotension, fatigue, and profuse diaphoresis are observed.
D. A homeless person, poor historian, presents with altered mental status, poor muscle
coordination, and hot, dry, ashen skin. Duration of exposure is unknown.
D
The homeless person has symptoms of heat stroke, a medical emergency, which
increases risk for brain damage. Elderly patients are at risk for heat syncope and should
be educated to rest in cool area and avoid future similar situations. The runner is having
heat cramps, which can be managed with rest and fluids. The housewife is experiencing
heat exhaustion, and management includes fluids (IV or parenteral) and cooling
measures. The prognosis for recovery is good.
You respond to a call for help from the ED waiting room. There is an elderly patient lying
on the floor. List the order for the actions that you must perform.
a. Perform the chin lift or jaw thrust maneuver.
b. Establish unresponsiveness.
c. Initiate cardiopulmonary resuscitation (CPR).
d. Call for help and activate the code team.
e. Instruct a nursing assistant to get the crash cart.
A. A B C E D
B. B D A C E
C. C A B E D
D. D C B E A
E. E C D B A
Questions and Answers with complete solution
You are working in the triage area of an ED, and four patients approach the triage desk
at the same time. List the order in which you will assess these patients. a. An
ambulatory, dazed 25-year-old male with a bandaged head wound b. An irritable infant
with a fever, petechiae, and nuchal rigidity c. A 35-year-old jogger with a twisted ankle,
having pedal pulse and no deformity d. A 50-year-old female with moderate abdominal
pain and occasional vomiting
A. A B D C
B. B A D C
C. C D B A
D. C B A D
b
An irritable infant with fever and petechiae should be further assessed for other
meningeal signs. The patient with the head wound needs additional history and
assessment for intracranial pressure. The patient with moderate abdominal pain is
uncomfortable, but not unstable at this point. For the ankle injury, medical evaluation
can be delayed 24 - 48 hours if necessary.
In conducting a primary survey on a trauma patient, which of the following is considered
one of the priority elements of the primary survey?
A. Complete set of vital signs
B. Palpation and auscultation of the abdomen
C. Brief neurologic assessment
D. Initiation of pulse oximetry
C
A brief neurologic assessment to determine level of consciousness and pupil reaction is
part of the primary survey. Vital signs, assessment of the abdomen, and initiation of
pulse oximetry are considered part of the secondary survey.
A 56-year-old patient presents in triage with left-sided chest pain, diaphoresis, and
dizziness. This patient should be prioritized into which category?
A. High urgent
B. Urgent
C. Non-urgent
D. Emergent
D
Chest pain is considered an emergent priority, which is defined as potentially life-
threatening. Patients with urgent priority need treatment within 2 hours of triage (e.g.
kidney stones). Non-urgent conditions can wait for hours or even days. (High urgent is
not commonly used; however, in 5-tier triage systems, High urgent patients fall between
emergent and urgent in terms of the time lapsing prior to treatment).
, The physician has ordered cooling measures for a child with fever who is likely to be
discharged when the temperature comes down. Which of the following would be
appropriate to delegate to the nursing assistant?
A. Assist the child to remove outer clothing.
B. Advise the parent to use acetaminophen instead of aspirin.
C. Explain the need for cool fluids.
D. Prepare and administer a tepid bath
A
The nursing assistant can assist with the removal of the outer clothing, which allows the
heat to dissipate from the child's skin. Advising and explaining are teaching functions
that are the responsibility of the RN. Tepid baths are not usually performed because of
potential for rebound and shivering.
It is the summer season, and patients with signs and symptoms of heat-related illness
present in the ED. Which patient needs attention first?
A. An elderly person complains of dizziness and syncope after standing in the sun for
several hours to view a parade
B. A marathon runner complains of severe leg cramps and nausea. Tachycardia,
diaphoresis, pallor, and weakness are observed.
C. A previously healthy homemaker reports broken air conditioner for days. Tachypnea,
hypotension, fatigue, and profuse diaphoresis are observed.
D. A homeless person, poor historian, presents with altered mental status, poor muscle
coordination, and hot, dry, ashen skin. Duration of exposure is unknown.
D
The homeless person has symptoms of heat stroke, a medical emergency, which
increases risk for brain damage. Elderly patients are at risk for heat syncope and should
be educated to rest in cool area and avoid future similar situations. The runner is having
heat cramps, which can be managed with rest and fluids. The housewife is experiencing
heat exhaustion, and management includes fluids (IV or parenteral) and cooling
measures. The prognosis for recovery is good.
You respond to a call for help from the ED waiting room. There is an elderly patient lying
on the floor. List the order for the actions that you must perform.
a. Perform the chin lift or jaw thrust maneuver.
b. Establish unresponsiveness.
c. Initiate cardiopulmonary resuscitation (CPR).
d. Call for help and activate the code team.
e. Instruct a nursing assistant to get the crash cart.
A. A B C E D
B. B D A C E
C. C A B E D
D. D C B E A
E. E C D B A
