Question
A nurse at the public health department is participating in the development of emergency response plans for their
community. Exhibit 1 Erib't 2 Committee Notes 1 month ago: A committee met to re-evaluate community needs for
emergency response plans. Nationally notifiable conditions were reviewed. Plans were established for prevention and
management of communicable illness outbreaks in the community. No current emergency response plans are in place
for surveillance and management of agents of bioterrorism. Today: A committee meeting was held today to address
community needs for emergency response plans for agents of bioterrorism. Current surveillance indicates increased
risk for bioterrorism. The committee will establish a plan and procedures for smallpox outbreak today.Committee Plan
1 month ago: A committee determined the need for creation of emergency response plans for agents of bioterrorism.
A plan was formed to begin surveillance for agents of bioterrorism. Will establish disaster plan for smallpox outbreak
at meeting in one month.Select 2 interventions the nurse should plan to include when creating the disaster response
plan. 0 coco 000‘ 0000000 oo o I E] Teach health care workers how to distinguish the disease from chickenpox. E]
Implement routine vaccination for the disease for the general public population. D Vaccinate laboratory workers
against the disease. E] Obtain standing orders to treat infected individuals with ciprofloxacin. E] Perform routine
screening to identify infected animals.
Answer
Answer
When creating a disaster response plan for a smallpox outbreak, as described in the committee notes, the
interventions selected should directly address the unique aspects of the threat, including its transmission, severity,
and the current state of public immunity against the disease. Based on these considerations, the following two
interventions are critical:
1. Teach health care workers how to distinguish the disease from chickenpox. This intervention is crucial because
the early symptoms of smallpox, such as fever, fatigue, and a characteristic rash, can be similar to those of chickenpox,
but the management and containment strategies for these two diseases are significantly different. Smallpox has a
higher mortality rate and requires more stringent isolation and control measures. Educating healthcare workers on
how to accurately identify smallpox will ensure prompt and appropriate medical responses, thereby limiting the
spread of the disease.
2. Vaccinate laboratory workers against the disease. Laboratory workers who might handle smallpox (variola virus) or
other high-risk pathogens as part of their surveillance and diagnostic duties are at increased risk of exposure.
Vaccinating these individuals not only protects them from infection but also prevents them from becoming
inadvertent vectors of the disease. Given that smallpox has been eradicated and the general public is no longer
routinely vaccinated, maintaining immunity among those most likely to encounter the virus is a critical line of defense
against an outbreak stemming from bioterrorism.
The other listed interventions, while potentially valuable in specific contexts, are less universally applicable to a
smallpox bioterrorism response plan:
• Implement routine vaccination for the disease for the general public population. Since smallpox has been
eradicated and the vaccine has associated risks, mass vaccination is not recommended except in situations of
imminent outbreak. This approach would only be considered if there were a significant and immediate threat.
• Obtain standing orders to treat infected individuals with ciprofloxacin. Ciprofloxacin is an antibiotic and would
not be effective against smallpox, which is caused by a virus. Treatment for smallpox would focus on supportive care
and possibly antiviral medications, not antibiotics.
• Perform routine screening to identify infected animals. Smallpox is a human disease; there are no animal
reservoirs. This intervention would not be applicable to a smallpox outbreak and is more relevant to diseases that are
zoonotic (transmitted from animals to humans).
Question
, Answers only for each today questions. No explanations
Answer
Answer
• Teach health care workers how to distinguish the disease from chickenpox.
• Vaccinate laboratory workers against the disease.
Question
Nurses' Notes 1 week old: Newborn referred for home weight checks. Newborn is breastfeeding well. Parent reports
newborn is having 8 to 10 wet and dirty diapers per clay. Newborn fell asleep after feeding. Parent placed newborn in
bassinet in supine position. 3 weeks old: Follow up newborn weight check. Parent is smoking a cigarette in the living
room while infant sleeps. Parent reports the newborn is breastfeeding well. The newborn is asleep in their bassinet in
the living room. Newborn currently asleep in prone position. Parent reports that the newborn sleeps in their bassinet
in the parents' bedroom overnight.Vital Sigfi 1 week old: Temperature 36.8° C (982° F) Heart rate 14S/min Respiratory
rate SO/min 3 weeks old: Q Temperature 36.9° C (984° F) Heart rate 138/min Respiratory rate 42/minClick to highlight
the findings that require further intervention. To deselect a finding. click on the finding again. 0 0000 000 000000. .0 0
U Nurses' Notes 3 weeks old: Follow up newborn weight check. Parent is smoking a cigarette in the living room while
infant sleeps. Parent reports the newborn is breastfeeding well. The newborn is asleep in their bassinet in the living
room. Newborn currently asleep in prone position. Parent reports that the newborn sleeps in their bassinet in the
parents' bedroom overnight. Vital Sign_§ 3 weeks old: Temperature 36.9” C (984° F) Heart rate 1381mm Respiratory
rate 42/min
Answer
Answer
• Parent is smoking a cigarette in the living room while infant sleeps.
• Newborn currently asleep in prone position.
Question
Nurses' Notes 2 years ago: Toddler brought to the clinic for a routine physical examination. Developmental screening
performed. Parent reports concerns the toddler’s speech is delayed. The toddler is not developing new words and is
not speaking in two-word phrases. Parent reports the toddler is a picky eater and they struggle to encourage the
toddler to try new foods. Lead risk assessment performed. Family lives in a home built in 1945. Parent states there is
chipping paint on the windowsills. and they have pulled paint chips out of the toddler’s mouth on a few occasions.
Today: Preschooler brought to the office for a routine physical examination. Medical history significant for elevated
lead levels. Parent reports the preschooler had a recent hearing screening and was diagnosed with mild hearing loss.
The preschooler is receiving speech therapy two times per week. Parent reports the preschooler’s teacher is
concerned the child is unable to focus at school and is hyperactive. Parent states, "they are | always full of energy and
have trouble listening."% Vital Sigfi 2 years ago: Temperature 37° C (986° F) Heart rate 110/min Respiratory rate
26/min SpO2 98% on room air Today: Temperature 387° F (98° F) Heart rate 98/min Respiratory rate 24/min Sp02
99% on room airLaboratog Results 2 years ago: Lead level 38% mcg/dL (less than 3.5 mcg/dL) Today: Lead level 3.0
mcg/dL (less than 3.5 mcg/dL)Which of the following findings should the nurse identify as long-term complications of
elevated lead levels? Select All That Apply I 0000 000 0000000 00 0 I D Behaviorfindings D Eating history [3 Speech
history I:] Attention findings E] Hearingfindings E] Vital signs
Answer
Answer
• Behavior findings
• Speech history
• Attention findings
• Hearing findings
Question
A nurse at the public health department is participating in the development of emergency response plans for their
community. Exhibit 1 Erib't 2 Committee Notes 1 month ago: A committee met to re-evaluate community needs for
emergency response plans. Nationally notifiable conditions were reviewed. Plans were established for prevention and
management of communicable illness outbreaks in the community. No current emergency response plans are in place
for surveillance and management of agents of bioterrorism. Today: A committee meeting was held today to address
community needs for emergency response plans for agents of bioterrorism. Current surveillance indicates increased
risk for bioterrorism. The committee will establish a plan and procedures for smallpox outbreak today.Committee Plan
1 month ago: A committee determined the need for creation of emergency response plans for agents of bioterrorism.
A plan was formed to begin surveillance for agents of bioterrorism. Will establish disaster plan for smallpox outbreak
at meeting in one month.Select 2 interventions the nurse should plan to include when creating the disaster response
plan. 0 coco 000‘ 0000000 oo o I E] Teach health care workers how to distinguish the disease from chickenpox. E]
Implement routine vaccination for the disease for the general public population. D Vaccinate laboratory workers
against the disease. E] Obtain standing orders to treat infected individuals with ciprofloxacin. E] Perform routine
screening to identify infected animals.
Answer
Answer
When creating a disaster response plan for a smallpox outbreak, as described in the committee notes, the
interventions selected should directly address the unique aspects of the threat, including its transmission, severity,
and the current state of public immunity against the disease. Based on these considerations, the following two
interventions are critical:
1. Teach health care workers how to distinguish the disease from chickenpox. This intervention is crucial because
the early symptoms of smallpox, such as fever, fatigue, and a characteristic rash, can be similar to those of chickenpox,
but the management and containment strategies for these two diseases are significantly different. Smallpox has a
higher mortality rate and requires more stringent isolation and control measures. Educating healthcare workers on
how to accurately identify smallpox will ensure prompt and appropriate medical responses, thereby limiting the
spread of the disease.
2. Vaccinate laboratory workers against the disease. Laboratory workers who might handle smallpox (variola virus) or
other high-risk pathogens as part of their surveillance and diagnostic duties are at increased risk of exposure.
Vaccinating these individuals not only protects them from infection but also prevents them from becoming
inadvertent vectors of the disease. Given that smallpox has been eradicated and the general public is no longer
routinely vaccinated, maintaining immunity among those most likely to encounter the virus is a critical line of defense
against an outbreak stemming from bioterrorism.
The other listed interventions, while potentially valuable in specific contexts, are less universally applicable to a
smallpox bioterrorism response plan:
• Implement routine vaccination for the disease for the general public population. Since smallpox has been
eradicated and the vaccine has associated risks, mass vaccination is not recommended except in situations of
imminent outbreak. This approach would only be considered if there were a significant and immediate threat.
• Obtain standing orders to treat infected individuals with ciprofloxacin. Ciprofloxacin is an antibiotic and would
not be effective against smallpox, which is caused by a virus. Treatment for smallpox would focus on supportive care
and possibly antiviral medications, not antibiotics.
• Perform routine screening to identify infected animals. Smallpox is a human disease; there are no animal
reservoirs. This intervention would not be applicable to a smallpox outbreak and is more relevant to diseases that are
zoonotic (transmitted from animals to humans).
Question
, Answers only for each today questions. No explanations
Answer
Answer
• Teach health care workers how to distinguish the disease from chickenpox.
• Vaccinate laboratory workers against the disease.
Question
Nurses' Notes 1 week old: Newborn referred for home weight checks. Newborn is breastfeeding well. Parent reports
newborn is having 8 to 10 wet and dirty diapers per clay. Newborn fell asleep after feeding. Parent placed newborn in
bassinet in supine position. 3 weeks old: Follow up newborn weight check. Parent is smoking a cigarette in the living
room while infant sleeps. Parent reports the newborn is breastfeeding well. The newborn is asleep in their bassinet in
the living room. Newborn currently asleep in prone position. Parent reports that the newborn sleeps in their bassinet
in the parents' bedroom overnight.Vital Sigfi 1 week old: Temperature 36.8° C (982° F) Heart rate 14S/min Respiratory
rate SO/min 3 weeks old: Q Temperature 36.9° C (984° F) Heart rate 138/min Respiratory rate 42/minClick to highlight
the findings that require further intervention. To deselect a finding. click on the finding again. 0 0000 000 000000. .0 0
U Nurses' Notes 3 weeks old: Follow up newborn weight check. Parent is smoking a cigarette in the living room while
infant sleeps. Parent reports the newborn is breastfeeding well. The newborn is asleep in their bassinet in the living
room. Newborn currently asleep in prone position. Parent reports that the newborn sleeps in their bassinet in the
parents' bedroom overnight. Vital Sign_§ 3 weeks old: Temperature 36.9” C (984° F) Heart rate 1381mm Respiratory
rate 42/min
Answer
Answer
• Parent is smoking a cigarette in the living room while infant sleeps.
• Newborn currently asleep in prone position.
Question
Nurses' Notes 2 years ago: Toddler brought to the clinic for a routine physical examination. Developmental screening
performed. Parent reports concerns the toddler’s speech is delayed. The toddler is not developing new words and is
not speaking in two-word phrases. Parent reports the toddler is a picky eater and they struggle to encourage the
toddler to try new foods. Lead risk assessment performed. Family lives in a home built in 1945. Parent states there is
chipping paint on the windowsills. and they have pulled paint chips out of the toddler’s mouth on a few occasions.
Today: Preschooler brought to the office for a routine physical examination. Medical history significant for elevated
lead levels. Parent reports the preschooler had a recent hearing screening and was diagnosed with mild hearing loss.
The preschooler is receiving speech therapy two times per week. Parent reports the preschooler’s teacher is
concerned the child is unable to focus at school and is hyperactive. Parent states, "they are | always full of energy and
have trouble listening."% Vital Sigfi 2 years ago: Temperature 37° C (986° F) Heart rate 110/min Respiratory rate
26/min SpO2 98% on room air Today: Temperature 387° F (98° F) Heart rate 98/min Respiratory rate 24/min Sp02
99% on room airLaboratog Results 2 years ago: Lead level 38% mcg/dL (less than 3.5 mcg/dL) Today: Lead level 3.0
mcg/dL (less than 3.5 mcg/dL)Which of the following findings should the nurse identify as long-term complications of
elevated lead levels? Select All That Apply I 0000 000 0000000 00 0 I D Behaviorfindings D Eating history [3 Speech
history I:] Attention findings E] Hearingfindings E] Vital signs
Answer
Answer
• Behavior findings
• Speech history
• Attention findings
• Hearing findings
Question
