Disaster Nursing-Chapter 68 Latest
Exam with Complete/Verified
Solutions.
1. The emergency department (ED) received news of a train derailment locally and the number
of clients injured is reported between 50 and 100. The hospital has determined that it can
accommodate 50 clients and still remain self-sufficient. What criteria is the hospital using to
project the number of clients it can support?
A. The understanding that the institution can rely on outside services after 3 days
B. Based on the emergency operations plan that incorporates assistance from the
Red Cross
C. Decided by the institution's ability to sustain core services for at least 96 hours
D. Based on the hospital's incident command system that updates the hospital on
the severity of injuries - Answer ANS: C
Decided by the institution's ability to sustain core services for at least 96 hour
Rationale: The emergency preparedness planning committee must have a realistic
understanding of its resources. The goal of each health care institution is to remain self-
sufficient to provide and sustain core services without the support of external assistance for at
least 96 hours from the inception of the incident; ideally, this self-sufficiency should last for 7
days. The institution cannot expect outside services to be available to help until after 96 hours,
which is 4 days. The emergency operations plan details how the facility will respond to a mass
casualty incident and may include criteria for utilizing external resources, but external
assistance from the Red Cross would not be a factor in determining how many clients the facility
can realistically care for immediately. External resources such as the Red Cross cannot be
accessed and utilized immediately. The field incident command, not the hospital's incident
command center, will provide an estimate of number of clients that will be arriving, though
severity of injuries and number of clients self-reporting may not be known.
2. A workplace explosion has left a 40-year-old client with full thickness burns over 75%
of the body. Despite these injuries, the client is conscious. How would this person be
triaged?
A. Green
B. Yellow
C. Red
D. Black - Answer D. Black
,Rationale: The purpose of triaging in a disaster is to do the greatest good for the greatest
number of people. The client would be triaged as black due to the unlikelihood of survival.
Persons triaged as green, yellow, or red have a higher chance of recovery.
3. A client has been witness to a disaster involving a large number of injuries. The client
appears upset, but states feeling capable of dealing with the emotions involved. What is
the nurse's most appropriate intervention?
A. Educate the client about the potential harm in denying their emotions.
B. Refer the client to social work or spiritual care.
C. Encourage the client to take a leave of absence from their job to facilitate
emotional healing.
D. Encourage the client to return to normal social roles when appropriate - Answer D.
Encourage the client to return to normal social roles when appropriate
Rationale: The client should be encouraged to return to normal social roles when appropriate if
confident and genuinely able to cope. The nurse should use active listening to the client's
concerns and emotions to enable the client to process the situation. The client is not necessarily
being unrealistic or dishonest. As a result, social work or spiritual care may not be needed. Time
away from work may not be required.
4. A nurse is caring for clients exposed to a terrorist attack involving chemicals. The nurse
has been advised that personal protective equipment must be worn in order to give the
highest level of respiratory protection with a lesser level of skin and eye protection. What
level protection is this considered?
A. Level A
B. Level B
C. Level C
D. Level D - Answer B.
Level B
Rationale: Level B personal protective equipment provides the highest level of respiratory
protection, with a lesser level of skin and eye protection. Level A provides the highest level of
respiratory, mucous membrane, skin, and eye protection. Level C incorporates the use of an air-
purified respirator, a chemical resistant coverall with splash hood, chemical resistant gloves, and
boots. Level D is the same as a work uniform.
, 5. A client who has been exposed to anthrax is being treated in the local hospital. The nurse
should prioritize what health assessments?
A. Integumentary assessment
B. Assessment for signs of hemorrhage
C. Neurologic assessment
D. Assessment of respiratory status - Answer D.
Assessment of respiratory status
Rationale: The second stage of anthrax infection by inhalation includes severe respiratory
distress, including stridor, cyanosis, hypoxia, diaphoresis, hypotension, and shock. The first stage
includes flu-like symptoms. The second stage of infection by inhalation does not include
headache, vomiting, or syncope.
6. When assessing clients who are victims of a chemical agent attack, the nurse is aware
that assessment findings vary based on the type of chemical agent. The chemical sulfur
mustard is an example of what type of chemical warfare agent?
A. Nerve agent
B. Blood agent
C. Pulmonary agent
D. Vesicant - Answer D.
Vesicant
Rationale: Sulfur mustard is a vesicant chemical that causes blistering and results in burning,
conjunctivitis, bronchitis, pneumonia, hematopoietic suppression, and death. Nerve agents
include sarin, soman, tabun, VX, and organophosphates (pesticides). Hydrogen cyanide is a
blood agent that has a direct effect on cellular metabolism, resulting in asphyxiation through
alterations in hemoglobin. Chlorine is a pulmonary agent, which destroys the pulmonary
membrane that separates the alveolus from the capillary bed.
7. A major earthquake has occurred within the vicinity of the local hospital. The nursing
supervisor working the night shift at the hospital receives information that the hospital disaster
plan will be activated. The supervisor will need to work with what organization responsible for
coordinating interagency relief assistance?
A. Office of Emergency Management
B. Incident Command System
Exam with Complete/Verified
Solutions.
1. The emergency department (ED) received news of a train derailment locally and the number
of clients injured is reported between 50 and 100. The hospital has determined that it can
accommodate 50 clients and still remain self-sufficient. What criteria is the hospital using to
project the number of clients it can support?
A. The understanding that the institution can rely on outside services after 3 days
B. Based on the emergency operations plan that incorporates assistance from the
Red Cross
C. Decided by the institution's ability to sustain core services for at least 96 hours
D. Based on the hospital's incident command system that updates the hospital on
the severity of injuries - Answer ANS: C
Decided by the institution's ability to sustain core services for at least 96 hour
Rationale: The emergency preparedness planning committee must have a realistic
understanding of its resources. The goal of each health care institution is to remain self-
sufficient to provide and sustain core services without the support of external assistance for at
least 96 hours from the inception of the incident; ideally, this self-sufficiency should last for 7
days. The institution cannot expect outside services to be available to help until after 96 hours,
which is 4 days. The emergency operations plan details how the facility will respond to a mass
casualty incident and may include criteria for utilizing external resources, but external
assistance from the Red Cross would not be a factor in determining how many clients the facility
can realistically care for immediately. External resources such as the Red Cross cannot be
accessed and utilized immediately. The field incident command, not the hospital's incident
command center, will provide an estimate of number of clients that will be arriving, though
severity of injuries and number of clients self-reporting may not be known.
2. A workplace explosion has left a 40-year-old client with full thickness burns over 75%
of the body. Despite these injuries, the client is conscious. How would this person be
triaged?
A. Green
B. Yellow
C. Red
D. Black - Answer D. Black
,Rationale: The purpose of triaging in a disaster is to do the greatest good for the greatest
number of people. The client would be triaged as black due to the unlikelihood of survival.
Persons triaged as green, yellow, or red have a higher chance of recovery.
3. A client has been witness to a disaster involving a large number of injuries. The client
appears upset, but states feeling capable of dealing with the emotions involved. What is
the nurse's most appropriate intervention?
A. Educate the client about the potential harm in denying their emotions.
B. Refer the client to social work or spiritual care.
C. Encourage the client to take a leave of absence from their job to facilitate
emotional healing.
D. Encourage the client to return to normal social roles when appropriate - Answer D.
Encourage the client to return to normal social roles when appropriate
Rationale: The client should be encouraged to return to normal social roles when appropriate if
confident and genuinely able to cope. The nurse should use active listening to the client's
concerns and emotions to enable the client to process the situation. The client is not necessarily
being unrealistic or dishonest. As a result, social work or spiritual care may not be needed. Time
away from work may not be required.
4. A nurse is caring for clients exposed to a terrorist attack involving chemicals. The nurse
has been advised that personal protective equipment must be worn in order to give the
highest level of respiratory protection with a lesser level of skin and eye protection. What
level protection is this considered?
A. Level A
B. Level B
C. Level C
D. Level D - Answer B.
Level B
Rationale: Level B personal protective equipment provides the highest level of respiratory
protection, with a lesser level of skin and eye protection. Level A provides the highest level of
respiratory, mucous membrane, skin, and eye protection. Level C incorporates the use of an air-
purified respirator, a chemical resistant coverall with splash hood, chemical resistant gloves, and
boots. Level D is the same as a work uniform.
, 5. A client who has been exposed to anthrax is being treated in the local hospital. The nurse
should prioritize what health assessments?
A. Integumentary assessment
B. Assessment for signs of hemorrhage
C. Neurologic assessment
D. Assessment of respiratory status - Answer D.
Assessment of respiratory status
Rationale: The second stage of anthrax infection by inhalation includes severe respiratory
distress, including stridor, cyanosis, hypoxia, diaphoresis, hypotension, and shock. The first stage
includes flu-like symptoms. The second stage of infection by inhalation does not include
headache, vomiting, or syncope.
6. When assessing clients who are victims of a chemical agent attack, the nurse is aware
that assessment findings vary based on the type of chemical agent. The chemical sulfur
mustard is an example of what type of chemical warfare agent?
A. Nerve agent
B. Blood agent
C. Pulmonary agent
D. Vesicant - Answer D.
Vesicant
Rationale: Sulfur mustard is a vesicant chemical that causes blistering and results in burning,
conjunctivitis, bronchitis, pneumonia, hematopoietic suppression, and death. Nerve agents
include sarin, soman, tabun, VX, and organophosphates (pesticides). Hydrogen cyanide is a
blood agent that has a direct effect on cellular metabolism, resulting in asphyxiation through
alterations in hemoglobin. Chlorine is a pulmonary agent, which destroys the pulmonary
membrane that separates the alveolus from the capillary bed.
7. A major earthquake has occurred within the vicinity of the local hospital. The nursing
supervisor working the night shift at the hospital receives information that the hospital disaster
plan will be activated. The supervisor will need to work with what organization responsible for
coordinating interagency relief assistance?
A. Office of Emergency Management
B. Incident Command System
