Med-surg Success - Bioterrorism,
Disasters, Poisoning, and Abuse
The nurse in the emergency department has admitted five (5) clients in the last two (2)
hours with complaints of fever and gastrointestinal distress. Which question would be
most appropriate for the nurse to ask each client to determine if there is a bioterrorism
threat?
1. "Do you work or live near any large power lines?"
2. "Where were you immediately before you got sick?"
3. "Can you write down everything you ate today?"
4. "What other health problems do you have?" ANS:1. Power lines would not be a typical source of
biological terrorism, which is what these symptoms represent.
*2. The nurse should take note of any unusual illness for the time of year or clusters of clients coming
from a single geographical location who all exhibit signs/symptoms of possible biological terrorism.
3. This might be appropriate for gastroenteritis secondary to food poisoning but is not the nurse's first
thought to determine a biological threat. The nurse must determine if the clients have anything in
common.
4. This would be important information to obtain for all clients but is not pertinent to determine a
biological threat. TEST-TAKING HINT: Answer option "4" is a question that the nurse would ask to all
clients; therefore the test taker should eliminate it based on the specific question. Power lines are
electrical and most bioterrorism threats involve chemical or biological threats, so option "1" can be
eliminated.
The health-care facility has been notified that an alleged inhalation anthrax exposure
has occurred at the local post office. Which category of personal protective equipment
(PPE) would the response team wear?
1. Level A
2. Level B
3. Level C
,4. Level D ANS:*1. Level A protection is worn when the highest level of respiratory, skin, eye, and
mucous membrane protection is required. In this situation of possible inhalation of anthrax, such
protection is required.
2. Level B protection is similar to Level A protection, but it is used when a lesser level of skin and eye
protection is needed.
3. Level C protection requires an air-purified respirator (APR), which uses filters or absorbent materials
to remove harmful substances.
4. Level D is basically the work uniform. TEST-TAKING HINT: If the test taker was totally unaware of the
correct answer, then the choice should be either "1" or "4" because these would be at either end of the
spectrum. This gives the test taker a 50/50 chance of selecting the correct answer, instead of a 25%
chance.
The nurse is teaching a class on bioterrorism and is discussing personal protective
equipment (PPE). Which statement is the most important fact that must be shared
with the participants?
1. Health-care facilities should keep masks at entry doors.
2. The respondent should be trained in the proper use of PPE.
3. No single combination of PPE protects against all hazards.
4. The EPA has divided PPE into four levels of protection. ANS:1. Masks are kept at designated areas, not
at every entry door.
2. This is a true statement, but it is not the most important information; in an emergency situation the
respondent should use the equipment even if not trained.
*3. The health-care providers are not guaranteed absolute protection, even with all the training and
protective equipment.
4. This is a true statement, but it is not the most important statement. TEST-TAKING HINT: There are
very few questions where the test taker should select an option with the word "all." Option "3" is stating
that this is not an "always" situation. The test taker should not automatically assume that it is not a
possible answer until understanding the context.
The nurse is teaching a class on bioterrorism. What is the scientific rationale for designating
a specific area for decontamination?
1. Showers and privacy can be provided to the client in this area.
2. This area isolates the clients who have been exposed to the agent.
, 3. It provides a centralized area for stocking the needed supplies.
4. It prevents secondary contamination to the health-care providers. ANS:1. This is not a rationale; this is
a statement of what is done at the area.
2. This separates the clients until decontamination occurs, but the question is asking for the scientific
rationale.
3. This is false statement—the supplies should not be kept in the decontamination area.
*4. Avoiding cross contamination is a priority for personnel and equipment—the fewer number of
people exposed, the safer the community and area.
TEST-TAKING HINT: Options "1" and "2" are not rationales.
The triage nurse in a large trauma center has been notified of an explosion in a major
chemical manufacturing plant. Which action should the nurse implement first when
the clients arrive at the emergency department?
1. Triage the clients and send them to the appropriate areas.
2. Thoroughly wash the clients with soap and water and then rinse.
3. Remove the clients' clothing and have them shower.
4. Assume the clients have been decontaminated at the plant. ANS:1. In most situations this is the first
step, but with a potential chemical or biological exposure the first step must be the safety of the
hospital; therefore the client must be decontaminated.
2. This is the second step in the decontamination process.
*3. This is the first step. Depending on the type of exposure, this step alone can remove a large portion
of exposure.
4. This assumption could cost many people in the hospital staff, as well as clients, their lives. TEST-
TAKING HINT: If the test taker wants to select option "4" as the correct answer, be careful—assumptions
are dangerous. The test taker may want to choose option "1" because it involves assessment, which is
the first step of the nursing process, but the individual situation has to be evaluated. Bioterrorism
violates many of the accepted rules.
The nurse is teaching a class on biological warfare. Which information should the
nurse include in the presentation?
1. Contaminated water is the only source of transmission of biological agents.
Disasters, Poisoning, and Abuse
The nurse in the emergency department has admitted five (5) clients in the last two (2)
hours with complaints of fever and gastrointestinal distress. Which question would be
most appropriate for the nurse to ask each client to determine if there is a bioterrorism
threat?
1. "Do you work or live near any large power lines?"
2. "Where were you immediately before you got sick?"
3. "Can you write down everything you ate today?"
4. "What other health problems do you have?" ANS:1. Power lines would not be a typical source of
biological terrorism, which is what these symptoms represent.
*2. The nurse should take note of any unusual illness for the time of year or clusters of clients coming
from a single geographical location who all exhibit signs/symptoms of possible biological terrorism.
3. This might be appropriate for gastroenteritis secondary to food poisoning but is not the nurse's first
thought to determine a biological threat. The nurse must determine if the clients have anything in
common.
4. This would be important information to obtain for all clients but is not pertinent to determine a
biological threat. TEST-TAKING HINT: Answer option "4" is a question that the nurse would ask to all
clients; therefore the test taker should eliminate it based on the specific question. Power lines are
electrical and most bioterrorism threats involve chemical or biological threats, so option "1" can be
eliminated.
The health-care facility has been notified that an alleged inhalation anthrax exposure
has occurred at the local post office. Which category of personal protective equipment
(PPE) would the response team wear?
1. Level A
2. Level B
3. Level C
,4. Level D ANS:*1. Level A protection is worn when the highest level of respiratory, skin, eye, and
mucous membrane protection is required. In this situation of possible inhalation of anthrax, such
protection is required.
2. Level B protection is similar to Level A protection, but it is used when a lesser level of skin and eye
protection is needed.
3. Level C protection requires an air-purified respirator (APR), which uses filters or absorbent materials
to remove harmful substances.
4. Level D is basically the work uniform. TEST-TAKING HINT: If the test taker was totally unaware of the
correct answer, then the choice should be either "1" or "4" because these would be at either end of the
spectrum. This gives the test taker a 50/50 chance of selecting the correct answer, instead of a 25%
chance.
The nurse is teaching a class on bioterrorism and is discussing personal protective
equipment (PPE). Which statement is the most important fact that must be shared
with the participants?
1. Health-care facilities should keep masks at entry doors.
2. The respondent should be trained in the proper use of PPE.
3. No single combination of PPE protects against all hazards.
4. The EPA has divided PPE into four levels of protection. ANS:1. Masks are kept at designated areas, not
at every entry door.
2. This is a true statement, but it is not the most important information; in an emergency situation the
respondent should use the equipment even if not trained.
*3. The health-care providers are not guaranteed absolute protection, even with all the training and
protective equipment.
4. This is a true statement, but it is not the most important statement. TEST-TAKING HINT: There are
very few questions where the test taker should select an option with the word "all." Option "3" is stating
that this is not an "always" situation. The test taker should not automatically assume that it is not a
possible answer until understanding the context.
The nurse is teaching a class on bioterrorism. What is the scientific rationale for designating
a specific area for decontamination?
1. Showers and privacy can be provided to the client in this area.
2. This area isolates the clients who have been exposed to the agent.
, 3. It provides a centralized area for stocking the needed supplies.
4. It prevents secondary contamination to the health-care providers. ANS:1. This is not a rationale; this is
a statement of what is done at the area.
2. This separates the clients until decontamination occurs, but the question is asking for the scientific
rationale.
3. This is false statement—the supplies should not be kept in the decontamination area.
*4. Avoiding cross contamination is a priority for personnel and equipment—the fewer number of
people exposed, the safer the community and area.
TEST-TAKING HINT: Options "1" and "2" are not rationales.
The triage nurse in a large trauma center has been notified of an explosion in a major
chemical manufacturing plant. Which action should the nurse implement first when
the clients arrive at the emergency department?
1. Triage the clients and send them to the appropriate areas.
2. Thoroughly wash the clients with soap and water and then rinse.
3. Remove the clients' clothing and have them shower.
4. Assume the clients have been decontaminated at the plant. ANS:1. In most situations this is the first
step, but with a potential chemical or biological exposure the first step must be the safety of the
hospital; therefore the client must be decontaminated.
2. This is the second step in the decontamination process.
*3. This is the first step. Depending on the type of exposure, this step alone can remove a large portion
of exposure.
4. This assumption could cost many people in the hospital staff, as well as clients, their lives. TEST-
TAKING HINT: If the test taker wants to select option "4" as the correct answer, be careful—assumptions
are dangerous. The test taker may want to choose option "1" because it involves assessment, which is
the first step of the nursing process, but the individual situation has to be evaluated. Bioterrorism
violates many of the accepted rules.
The nurse is teaching a class on biological warfare. Which information should the
nurse include in the presentation?
1. Contaminated water is the only source of transmission of biological agents.
