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Natural Disaster in a Small Community - HESI RN Case Studies Questions With Correct Answers.

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Natural Disaster in a Small Community - HESI RN Case Studies Questions With Correct Answers. A small community hospital that serves a population of 1100 is roughly 20 years old, has 4 critical care beds and 2 operating room suites, 20 medical surgical beds and 8 labor and delivery rooms. The staff members in the emergency department are exchanging report during change of shift at 0645 when they are interrupted by a loud sound resembling a thunderclap. Within seconds the ground shakes slightly then the overhead lights get very bright just before the power goes out. The charge nurse passes out flash lights while one of the nurses announces that the phone lines are down. The nurse manager tells everyone to remain calm; the generator will turn on any minute. Everyone rushes to check on their clients. The manager receives a call that due to an explosion at the nearby chemical plant, the power grid for the area is damaged and the hospital’s generator burned as a result of the power surge. The communication system is down, there is no running water, and there is no functioning sewage system. The hospital’s oxygen tank is malfunctioning. The manager is notified that the people injured at the plant will be arriving shortly. The hospital is placed on internal and external disaster mode. The manager quickly asks who is leading the hospital’s command center, the approximate number of injured people, and the identification of staff reassignments available to assist. The manager is told that 18 clients will arrive within a 45 minute window and that the explosion involved the following blistering agents: sulfur mustard, distilled mustard, and nitrogen mustard. Due to the proximity to the chemical plant, the hospital has historically prepared for a potential disaster such as this. The disaster team is paged, anticipating multiple casualties resulting from this disaster. The proximity of the chemical plant leaves little time for the emergency department to prepare for what is arriving. The charge nurse is aware that the hospital has a disaster preparedness plan for such incidents. Which key components should the nurse expect to be included in the plan? (Select all that apply. One, some, or all responses may be correct.) a. Effective triage strategy for clients. b. Reminding staff that they are not going home. c. Client care, communication, and safety. d. Security, documentation, and resource allocation. e. Placing an order for additional supplies. a. Effective triage strategy for clients. c. Client care, communication, and safety. d. Security, documentation, and resource allocation. The emergency department disaster preparedness plan must include detailed guidelines that explain how the hospital's plan collaborates with the community plans. The key components of the disaster plan include client care, communication, resources, safety or security, coordination, and documentation. The new graduate nurse that just started orientation 6 weeks ago in the Emergency room. After receiving disaster training, which statement indicates that the new nurse needs additional disaster orientation? a. An internal disaster is anything that may cause an influx of clients disrupting the normal shift without notice. b. An external disaster is anything that endangers clients, staff, or requires evacuation or relocation with or without notice. c. An internal disaster is anything that doesn't impair the operations of the hospital but disrupts normal client care. d. Any situation that creates an environment that endangers healthcare workers. d. Any situation that creates an environment that endangers healthcare workers. An Unlicensed Assistive Personnel (UAP), an Emergency Medical Technician (EMT), 2 Radiology Technicians, 1 Environmental Services employee, 2 nurses, 3 police officers, and 2 fire fighters arrive. They are members of the HAZMAT team and the team lead divides them into 3 teams. Team 1 goes to the parking lot to set up a fast track decontamination tent. To decrease the possibility of exposure to the staff and other clients in the hospital, the team sets up a triage tent in the hospital's parking lot. This triage tent is manned by staff and volunteers. The open-air environment allows social distancing and rapid evaluation, treatment, and discharge of low-acuity clients. When setting up decontamination tents, it is imperative to set up a flow that includes which areas? (Select all that apply. One, some, or all options may be correct.) a. Set up an initial triage, a decontamination area, second triage, and treatment area. b. Set up an area for clients not requiring decontamination. c. Set up a separate lane for clients arriving by EMS transport that have been decontaminated but did not sustain life threatening injuries. d. Set up a fast track area for clients with life threatening injuries that would allow delivering basic life-saving treatment during decontamination. e. The order of the decontamination does not matter because at that point nurses just want to quickly assess any life-threatening injuries. a. Set up an initial triage, a decontamination area, second triage, and treatment area. d. Set up a fast track area for clients with life threatening injuries that would allow delivering basic life-saving treatment during decontamination. Meanwhile, the leader of the response team meets with the nurses assigned to triage the victims and quickly reviews the S.T.A.R.T. adult triage algorithm with them. The nurses know that this triage method will assist them to rapidly determine who will need immediate assistance and whose care is not imminent. The S.T.A.R.T. adult triage is a system that contains four triage categories that are color-coded. The nurse explains that all clients are assessed, identified, and tagged according to 1 of 4 colors, each color representing the severity of injury. Which sequence indicates the nurses understand the triage process? (Select the appropriate order in each option from least to worst categories.) a. Black, yellow, green, red. b. Green, yellow, red, black. c. Yellow, black, green, red. d. Red, green, yellow, black. b. Green, yellow, red, black. After explaining the triage system, the nurse clarifies the clinical parameters that are used to evaluate each client before deciding what color of tag to use. Assessments and observations are categorized in four words; observe, palpate, listen, and smell. Based on the S.T.A.R.T. adult triage system, which assessments demonstrate the appropriate triage assignment? (Select all that apply. One, some, or all options may be correct.) a. Those who are able to ambulate by themselves and who have superficial lacerations = Green. b. Extensive body injuries or burns that impact the client's ability to survive = Black. c. Walking wounded carrying contaminants from the explosion = Yellow. d. Shock, airway obstruction, third-degree burns over 75% of body = Red. e. Presence of spontaneous breathing and respiratory rate less than 30 breaths per minute with an open fracture = Yellow. a. Those who are able to ambulate by themselves and who have superficial lacerations = Green. b. Extensive body injuries or burns that impact the client's ability to survive = Black. d. Shock, airway obstruction, third-degree burns over 75% of body = Red. e. Presence of spontaneous breathing and respiratory rate less than 30 breaths per minute with an open fracture = Yellow. The charge nurse explains to the hospital staff that they may be required decontaminate clients because it is the first step when responding to any chemical incident. Which statements accurately reflect the staff members' understanding of client decontamination? (Select all that apply. One, some, or all options may be correct.) a. Client decontamination is a process that leads to removal of something on a client that will affect the client or healthcare providers. b. Client decontamination means that the clients will be kept isolated at all times and so will the healthcare providers or first responders who come in contact with the client. c. Client decontamination is only done when healthcare providers are at risk. d. There are two types of client decontamination always performed by first responders to not affect the way the hospitals set up the triage. a. Client decontamination is a process that leads to removal of something on a client that will affect the client or healthcare providers. d. There are two types of client decontamination always performed by first responders to not affect the way the hospitals set up the triage. Most of the HAZMAT team is aware of the principles of decontamination: decontaminate as soon as possible, decontaminate by priority, and

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