NRS 450 EXAM 4 QUESTIONS WITH ANSWERS
100% CORRECT
emergency vs mass casualty incidence - ANSWER -emergency is rapid response of
existing resources example would be like a car crash
-mass casualty is when the community does not have the resources to handle what is
happening and they require outside help like red cross, FEMA or CERT
triage - ANSWER -less than 15 seconds
-happens at the site of the disaster and is color coded
-black: dead
-blue: impending death, not worth the resources i.e brain injury or head wound
-red: immediate treatment needed within at least 1 hr i.e open abdominal wound, chest
wound, decreased LOC or shock
-yellow: urgent, but not life threatening i.e burns without shock
-green: walking wounded, no immediate help i.e sprains/fractures
nursing management in disasters - ANSWER -aid in disaster plan development
-hands on treatment of casualties
-evaluation of response activities
-participate in emergency drills
-know limits in knowledge and skill i.e during emergency dont intubate people, outside
scope
bioterrosim - ANSWER -intentional release of biologic agent like anthrax, botulism,
hemorrhagic fever
-these agents are chosen because they are easy to get ahold, easy to disperse
(aerolize), and high mortality and hard to treat
,Bioterrosim surveillance - ANSWER -goal is early recognition to prevent spreading
-key signs is if there is a rapid influx on similar s/s and it needs to be reported ASAP
-understand the PPE or isolation precautions needed
-perform lab test, sent to national lab
anthrax - ANSWER -comes from bacillus anthracis, a spore forming bacterium that
replicates and creates endotoxins that lead to edema, necrosis and hemorrhage
-it can be aerosolized so it can spread over a large area
-exposure can happen from inhaling spores or handling/eating an infected animal
-it is not spread person to person so standard precautions
-3 types
3 types of anthrax - ANSWER 1. inhalation: most serious, early s/s look like the cold/flu
and then late s/s include respiratory failure and shock
2. cutaneous: 1-7 days to develop s/s. rash develops and turns into blisters, the blister
becomes an ulcer with a blackened center and its painless
3. gastrointestinal: happens from eating infected meat, bloody diarrhea, fever, severe
abdominal pain. generalized toxemia and sepsis will occur without treatment
treatment for anthrax - ANSWER -ABX for 60 days to make sure all spores are gone
-doxycycline, ciprofloxacin, levofloxacin
-prevention after exposure can use ABX, vaccine
nursing management of anthrax - ANSWER 1. inhalation type: monitor **gas exchange
and acid base. monitor RR, O2 and work of breathing, listen to lungs, ABG, EtCO2,
mechanical vent if needed
2. cutaneous: **scrub exposed areas
3. gastrointestinal: worry about **fluid volume deficit. monitor vitals, administer fluids,
manage pain (hypotension and tachycardia)
,botulsim - ANSWER -muscle paralyzing disease, death results from respiratory failure
and paralysis
-from clostridum botulinum that produces toxins
-can be spread via foodborne, wound, aerosolized
-not transmitted person to person
-can die within 24 hr if not treated
botulsim manifestations - ANSWER -descending muscle weakness (starts in head,
moves down)
-eyes, speech, swallowing compromised then should and upper arms
-if makes it to the respiratory muscles they will die from respiratory dysfunction
-pt is alert throughout the paralyzing process
-happens bilaterally not unilateral like a stroke
botulsim treatment - ANSWER -give antitoxin, need to give ASAP
-the antitoxin will stop the paraylsis but not reverse what has already been done
-supportive cares since they are alert the whole time, want to sedate them
nursing management with botulsim - ANSWER -ineffective breathing pattern: need to
maintain patent airway and measure NIF. NIF is normally greater than 60, if less than 20
intubate
-ventilation assistance with positioning, suctioning, monitor the need for mechanical
vent
-test cranial nerve function
hemorrhagic fever - ANSWER -causes are marbug, ebola, lassa fever, yellow fever, Rift
valley fever (dont need to memorize these)
-**infection that leads to thrombocytopenia and platelet dysfunction. have fever,
conjunctivitis, headache and hypotension (initial s/s)
-transmission is through rodents, mosquito, or infected animal carcass
, -**there is DIRECT person to person via body fluids
-can be aerosolized
treatment for hemorrhagic fever - ANSWER -no treatment for the viruses that cause it,
just have to do supportive care
-there is a vaccine for yellow fever, that is the only one
nursing management with hemorrhagic fever - ANSWER -isolation
-NO IM injections
-NO anticoagulants
-supportive treatment like fluids/electrolyte balance, vasopressors, blood products
new diseases vs re-emerging existing disease (emerging disease) - ANSWER -infectious
disease is the #1 killer world wide
-new diseases: evolution of existing organisms they are adapting, diseases spread to
new geographic regions due to increase travel, unrecognized diseases emerge with
new exposure to new insects/animal
-re-emerging existing disease: resistance to ABX and the breakdown of public health i.e
antivaccination
Ebola transmission and diagnosis - ANSWER -hemorrhagic fever
-transmitted through direct contact with infected body fluids i.e blood, vomit, sweat,
feces, saliva
-need a bio-containment unit, airborne precautions, Tyvek suits with powered air
purifying respiratory hoods, no visitors
-diagnosed based on recent travel to a country with ebola, fever greater than 101.5, lab
sent to national lab
ebola manifestations - ANSWER -s/s appear 2-21 days after exposure
-fever
100% CORRECT
emergency vs mass casualty incidence - ANSWER -emergency is rapid response of
existing resources example would be like a car crash
-mass casualty is when the community does not have the resources to handle what is
happening and they require outside help like red cross, FEMA or CERT
triage - ANSWER -less than 15 seconds
-happens at the site of the disaster and is color coded
-black: dead
-blue: impending death, not worth the resources i.e brain injury or head wound
-red: immediate treatment needed within at least 1 hr i.e open abdominal wound, chest
wound, decreased LOC or shock
-yellow: urgent, but not life threatening i.e burns without shock
-green: walking wounded, no immediate help i.e sprains/fractures
nursing management in disasters - ANSWER -aid in disaster plan development
-hands on treatment of casualties
-evaluation of response activities
-participate in emergency drills
-know limits in knowledge and skill i.e during emergency dont intubate people, outside
scope
bioterrosim - ANSWER -intentional release of biologic agent like anthrax, botulism,
hemorrhagic fever
-these agents are chosen because they are easy to get ahold, easy to disperse
(aerolize), and high mortality and hard to treat
,Bioterrosim surveillance - ANSWER -goal is early recognition to prevent spreading
-key signs is if there is a rapid influx on similar s/s and it needs to be reported ASAP
-understand the PPE or isolation precautions needed
-perform lab test, sent to national lab
anthrax - ANSWER -comes from bacillus anthracis, a spore forming bacterium that
replicates and creates endotoxins that lead to edema, necrosis and hemorrhage
-it can be aerosolized so it can spread over a large area
-exposure can happen from inhaling spores or handling/eating an infected animal
-it is not spread person to person so standard precautions
-3 types
3 types of anthrax - ANSWER 1. inhalation: most serious, early s/s look like the cold/flu
and then late s/s include respiratory failure and shock
2. cutaneous: 1-7 days to develop s/s. rash develops and turns into blisters, the blister
becomes an ulcer with a blackened center and its painless
3. gastrointestinal: happens from eating infected meat, bloody diarrhea, fever, severe
abdominal pain. generalized toxemia and sepsis will occur without treatment
treatment for anthrax - ANSWER -ABX for 60 days to make sure all spores are gone
-doxycycline, ciprofloxacin, levofloxacin
-prevention after exposure can use ABX, vaccine
nursing management of anthrax - ANSWER 1. inhalation type: monitor **gas exchange
and acid base. monitor RR, O2 and work of breathing, listen to lungs, ABG, EtCO2,
mechanical vent if needed
2. cutaneous: **scrub exposed areas
3. gastrointestinal: worry about **fluid volume deficit. monitor vitals, administer fluids,
manage pain (hypotension and tachycardia)
,botulsim - ANSWER -muscle paralyzing disease, death results from respiratory failure
and paralysis
-from clostridum botulinum that produces toxins
-can be spread via foodborne, wound, aerosolized
-not transmitted person to person
-can die within 24 hr if not treated
botulsim manifestations - ANSWER -descending muscle weakness (starts in head,
moves down)
-eyes, speech, swallowing compromised then should and upper arms
-if makes it to the respiratory muscles they will die from respiratory dysfunction
-pt is alert throughout the paralyzing process
-happens bilaterally not unilateral like a stroke
botulsim treatment - ANSWER -give antitoxin, need to give ASAP
-the antitoxin will stop the paraylsis but not reverse what has already been done
-supportive cares since they are alert the whole time, want to sedate them
nursing management with botulsim - ANSWER -ineffective breathing pattern: need to
maintain patent airway and measure NIF. NIF is normally greater than 60, if less than 20
intubate
-ventilation assistance with positioning, suctioning, monitor the need for mechanical
vent
-test cranial nerve function
hemorrhagic fever - ANSWER -causes are marbug, ebola, lassa fever, yellow fever, Rift
valley fever (dont need to memorize these)
-**infection that leads to thrombocytopenia and platelet dysfunction. have fever,
conjunctivitis, headache and hypotension (initial s/s)
-transmission is through rodents, mosquito, or infected animal carcass
, -**there is DIRECT person to person via body fluids
-can be aerosolized
treatment for hemorrhagic fever - ANSWER -no treatment for the viruses that cause it,
just have to do supportive care
-there is a vaccine for yellow fever, that is the only one
nursing management with hemorrhagic fever - ANSWER -isolation
-NO IM injections
-NO anticoagulants
-supportive treatment like fluids/electrolyte balance, vasopressors, blood products
new diseases vs re-emerging existing disease (emerging disease) - ANSWER -infectious
disease is the #1 killer world wide
-new diseases: evolution of existing organisms they are adapting, diseases spread to
new geographic regions due to increase travel, unrecognized diseases emerge with
new exposure to new insects/animal
-re-emerging existing disease: resistance to ABX and the breakdown of public health i.e
antivaccination
Ebola transmission and diagnosis - ANSWER -hemorrhagic fever
-transmitted through direct contact with infected body fluids i.e blood, vomit, sweat,
feces, saliva
-need a bio-containment unit, airborne precautions, Tyvek suits with powered air
purifying respiratory hoods, no visitors
-diagnosed based on recent travel to a country with ebola, fever greater than 101.5, lab
sent to national lab
ebola manifestations - ANSWER -s/s appear 2-21 days after exposure
-fever
