Medical-Surgical Nursing
11th Edition
Author(s)Donna D. Ignatavicius;
Cherie R. Rebar; Nicole M.
Heimgartner
Publisher Published by Elsevier
UK Copyright© 2024
Print ISBN: 9780323878265
TEST BANK
,Below is a 20-question original Medical-Surgical Nursing exam
revision question bank for Chapter 71: Disasters, Mass
Casualty Incidents, and Complex Emergencies.
I used a balanced mix of item types to reflect NCLEX-style
clinical judgment and disaster nursing practice.
Chapter 71: Disasters, Mass Casualty Incidents, and Complex
Emergencies
Question Bank: 20 Original Exam Revision Items
1. MCQ
Clinical Scenario
A nurse is working in an emergency department when a bus
collision brings in multiple injured clients at once. One client
has a closed fracture of the femur with severe pain, one has a
small scalp laceration and is walking, one is apneic after airway
repositioning, and one has minor abrasions.
Question Stem
Which client should the nurse identify as the highest priority
during initial disaster triage?
Answer Options
A. Client with minor abrasions
B. Client with closed femur fracture and severe pain
,C. Client with small scalp laceration who is walking
D. Client who remains apneic after airway repositioning
Correct Answer
D. Client who remains apneic after airway repositioning
Detailed Rationale
In mass casualty triage, the nurse prioritizes clients who have
the greatest chance of survival with immediate intervention. A
client who remains apneic after airway repositioning is
generally classified as expectant/black in many triage systems
if resources are limited, but in a disaster scene the first step is
to assess whether airway repositioning restores breathing. If
breathing does not resume, the client is not the highest priority
for limited resources compared with clients who are
salvageable with rapid care. In a true triage context, priority is
directed toward clients whose condition is unstable yet
potentially treatable. The key clinical judgment is that disaster
triage differs from routine ED care and focuses on the greatest
good for the greatest number.
Incorrect Option Analysis
A. Minor abrasions — Incorrect because this client is stable and
low priority.
B. Closed femur fracture with severe pain — Incorrect because
painful and serious, but not more urgent than an airway
problem.
, C. Small scalp laceration who is walking — Incorrect because
this client is ambulatory and likely minor priority.
D. Apneic after airway repositioning — Best answer because
airway and breathing are the first triage focus; however, in
some disaster systems, persistent apnea may be categorized
expectant if resources are scarce.
Nursing Process Linkage
Assessment
NCJMM Clinical Judgment Competencies
Recognize Cues, Analyze Cues, Prioritize Hypotheses, Take
Action
QSEN Competency Alignment
Safety
Difficulty Level
Moderate
Bloom’s Cognitive Level
Analyze
NCLEX Client Needs Category
Management of Care
Key Learning Objective
Apply disaster triage principles to identify clients requiring
rapid prioritization based on survivability and urgency.
11th Edition
Author(s)Donna D. Ignatavicius;
Cherie R. Rebar; Nicole M.
Heimgartner
Publisher Published by Elsevier
UK Copyright© 2024
Print ISBN: 9780323878265
TEST BANK
,Below is a 20-question original Medical-Surgical Nursing exam
revision question bank for Chapter 71: Disasters, Mass
Casualty Incidents, and Complex Emergencies.
I used a balanced mix of item types to reflect NCLEX-style
clinical judgment and disaster nursing practice.
Chapter 71: Disasters, Mass Casualty Incidents, and Complex
Emergencies
Question Bank: 20 Original Exam Revision Items
1. MCQ
Clinical Scenario
A nurse is working in an emergency department when a bus
collision brings in multiple injured clients at once. One client
has a closed fracture of the femur with severe pain, one has a
small scalp laceration and is walking, one is apneic after airway
repositioning, and one has minor abrasions.
Question Stem
Which client should the nurse identify as the highest priority
during initial disaster triage?
Answer Options
A. Client with minor abrasions
B. Client with closed femur fracture and severe pain
,C. Client with small scalp laceration who is walking
D. Client who remains apneic after airway repositioning
Correct Answer
D. Client who remains apneic after airway repositioning
Detailed Rationale
In mass casualty triage, the nurse prioritizes clients who have
the greatest chance of survival with immediate intervention. A
client who remains apneic after airway repositioning is
generally classified as expectant/black in many triage systems
if resources are limited, but in a disaster scene the first step is
to assess whether airway repositioning restores breathing. If
breathing does not resume, the client is not the highest priority
for limited resources compared with clients who are
salvageable with rapid care. In a true triage context, priority is
directed toward clients whose condition is unstable yet
potentially treatable. The key clinical judgment is that disaster
triage differs from routine ED care and focuses on the greatest
good for the greatest number.
Incorrect Option Analysis
A. Minor abrasions — Incorrect because this client is stable and
low priority.
B. Closed femur fracture with severe pain — Incorrect because
painful and serious, but not more urgent than an airway
problem.
, C. Small scalp laceration who is walking — Incorrect because
this client is ambulatory and likely minor priority.
D. Apneic after airway repositioning — Best answer because
airway and breathing are the first triage focus; however, in
some disaster systems, persistent apnea may be categorized
expectant if resources are scarce.
Nursing Process Linkage
Assessment
NCJMM Clinical Judgment Competencies
Recognize Cues, Analyze Cues, Prioritize Hypotheses, Take
Action
QSEN Competency Alignment
Safety
Difficulty Level
Moderate
Bloom’s Cognitive Level
Analyze
NCLEX Client Needs Category
Management of Care
Key Learning Objective
Apply disaster triage principles to identify clients requiring
rapid prioritization based on survivability and urgency.
