2026-2027 Update | Scenario-Driven,
Evidence-Based Rationales Included | Emergency
Disaster Nursing
DOMAIN 1 – DISASTER PREPAREDNESS & MITIGATION (20 Qs)
Q1. A county health department is updating its Hazard Vulnerability Analysis (HVA).
Which single variable must be weighted most heavily when ranking hazards in the final
risk matrix?
A. Historical frequency of the hazard in the past 20 years
B. Probability of occurrence within the next 12 months
C. Potential of the hazard to overwhelm critical community services and healthcare
surge capacity
D. Eligibility for federal hazard-mitigation grant dollars
Correct: C
Rationale: HVA prioritizes impact on community infrastructure and health-system surge.
A high-impact/low-probability event (e.g., chlorine rail-car release) can outrank
high-probability/low-impact events (e.g., seasonal influenza). Funding eligibility (D) is
never a risk-scoring element.
,Q2. A hospital coalition drafts an Emergency Operations Plan (EOP) using the HSEEP
model. Which component satisfies the “capabilities-based planning” requirement?
A. A 48-hour inventory of PPE on hand at each member hospital
B. A pre-signed MOU with a regional dialysis chain for alternate-care space
C. A task list for each ICS position that is cross-walked to the 32 Core Capabilities in the
National Preparedness Goal
D. A schedule of quarterly tabletop exercises
Correct: C
Rationale: Capabilities-based planning links objectives to the universal 32 Core
Capabilities (e.g., medical surge, fatality management). Choice C is the only option that
maps tasks to capabilities; the others are resource or activity metrics.
Q3. A rural EMS agency has one ventilator. During a statewide surge test, the agency is
asked to accept six ICU patients. Which preparedness document determines the legal
authority to reallocate the ventilator?
A. State Emergency Operations Plan (SEOP)
B. Nurse Practice Act waiver provisions
C. Altered Standards of Care memorandum issued by the state health officer
D. Regional hospital mutual-aid compact
Correct: C
,Rationale: Only a formal altered-standards declaration (C) changes usual stewardship of
scarce equipment and provides liability protection. Mutual-aid compacts (D) address
sharing, not reallocation within one agency.
Q4. A city is designing a full-scale exercise that will simulate a 10-kiloton improvised
nuclear device. Which HSEEP best-practice ensures “evaluability” of medical surge
capability?
A. Embedding trained evaluators with pre-loaded capability targets and observable
indicators
B. Involving local media to broadcast the event for public education
C. Scheduling the drill during a national preparedness month to maximize participation
D. Using real patients from a nearby nursing home to increase realism
Correct: A
Rationale: Evaluators with target/indicator sheets produce data that can be scored
against the capability target. Real patients (D) violate HSEEP safety principles.
Q5. A hospital’s HVA identifies cyber-attack on electronic health records as a high-risk
hazard. Which mitigation action is most effective in the preparedness phase?
A. Daily encrypted back-ups stored off-network with tested restoration SOP
B. Contract with a courier service for paper chart delivery
C. Adding a “downtime” section to the hospital newsletter
D. Purchasing a satellite phone for the CIO
Correct: A
, Rationale: Back-ups with tested restoration directly reduce downtime impact—the
definition of mitigation. Paper charts (B) are a contingency, not a mitigation.
Q6. A county health department wants to include community representatives in
preparedness planning. Which stakeholder group best satisfies the “whole-community”
principle for vulnerable populations?
A. Local chapter of the American Red Cross
B. Independent-living center directors who serve clients with disabilities
C. Rotary Club
D. Regional hospital association
Correct: B
Rationale: Whole-community requires inclusion of those with access & functional
needs. Independent-living centers (B) represent persons with disabilities, a federally
defined at-risk group.
Q7. A state health department funds a hospital coalition to develop a “surge test drill.”
Which metric demonstrates compliance with the CMS Emergency Preparedness Rule?
A. ≥ 80 % of participating hospitals complete the drill
B. Drill scenario matches one of the hazards in the coalition HVA
C. Drill tests at least two objectives from the coalition’s Emergency Operations Plan
D. All hospitals use the same electronic documentation platform during the drill
Correct: C