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1. A hazard that affects a wide area over a long time, such as a pandemic, requires: A. Sustained response planning, workforce support and supply chain management B. A one-day response C. No planning D. Only local action Correct Answer: A. Sustained response planning, workforce support and supply chain management Rationale: Pandemics strain systems for months or years. Staff well-being matters. 2. Global disaster trends show that: A. Disasters are decreasing B. Disasters affect only we...

1. Clara Barton contributed to disaster nursing by: A. Founding the American Red Cross in 1881 and organizing disaster relief B. Writing the ICS manual C. Creating triage tags D. Founding FEMA Correct Answer: A. Founding the American Red Cross in 1881 and organizing disaster relief Rationale: She provided care during the Civil War and disasters such as the Johnstown Flood. The Red Cross remains central to disaster relief. 2. Surge capability differs from surge capacity in that surge capa...

1. A radiological dispersal device ("dirty bomb"): A. Is a nuclear detonation B. Causes mass radiation deaths in all cases C. Combines conventional explosives with radioactive material, with most casualties caused by the blast D. Contains no explosives Correct Answer: C. Combines conventional explosives with radioactive material, with most casualties caused by the blast Rationale: Radiation doses are usually low. Fear and contamination concerns are major issues. 2. Pregnant staff ...

1. Disaster drills improve readiness by: A. Wasting time B. Testing plans, identifying gaps and building staff familiarity C. Replacing plans D. Increasing confusion Correct Answer: B. Testing plans, identifying gaps and building staff familiarity Rationale: Exercises reveal weaknesses before real events. After-action reviews drive improvement. 2. Community vulnerability assessments help planners: A. Ignore risk B. Identify populations and areas at greatest risk to target preparedness ...

1. A disaster is best defined as: A. Any emergency department visit B. A single car crash C. An event that overwhelms a community's ability to respond with its own resources D. A routine hospital admission Correct Answer: C. An event that overwhelms a community's ability to respond with its own resources Rationale: The mismatch between needs and resources defines a disaster. The same event may be a disaster in one place and routine in another. 2. A mass casualty incident (MCI) occ...

1. Lessons learned from the COVID-19 pandemic for hospital preparedness include the need for: A. PPE stockpiles, staff protection, surge staffing and flexible space B. Fewer plans C. Less coordination D. No stockpiles Correct Answer: A. PPE stockpiles, staff protection, surge staffing and flexible space Rationale: The prolonged surge strained systems. Plans now address sustained events. 2. Severe weather preparedness for hospitals includes: A. Securing supplies, staffing plans for extend...

1. Disaster preparedness education for nurses is important because: A. Many nurses report feeling unprepared to respond to disasters B. All nurses are fully prepared C. Disasters never occur D. Training has no effect Correct Answer: A. Many nurses report feeling unprepared to respond to disasters Rationale: Studies show preparedness gaps. Education and drills improve readiness. 2. Slow-onset disasters differ from sudden-onset disasters in that they: A. Strike without warning B. Develop ...

1. Accountability for the overall nursing care of a patient during a shift rests with: A. The assistive personnel B. The unit clerk C. The patient D. The registered nurse assigned to that patient Correct Answer: D. The registered nurse assigned to that patient Rationale: Others may perform tasks. The RN coordinates and evaluates care. 2. Employer responsibilities in delegation include: A. Identifying a nurse leader responsible for delegation, establishing policies, providing training an...

1. Clinical decision-making in nursing involves: A. Guessing B. Choosing among alternatives based on assessment data, knowledge and priorities C. Following routine without thought D. Waiting for orders always Correct Answer: B. Choosing among alternatives based on assessment data, knowledge and priorities Rationale: Decisions are made continually. Clinical judgment underpins them. 2. Delegation differs from a handoff because: A. They are identical B. Handoff transfers responsibility an...

1. Before delegating, the licensed nurse must consider: A. Only staff preference B. Only the time of day C. Patient needs and stability, the delegatee's competence, the nurse's ability to supervise, staffing, acuity, state law and policy D. Only patient preference Correct Answer: C. Patient needs and stability, the delegatee's competence, the nurse's ability to supervise, staffing, acuity, state law and policy Rationale: If delegation is not appropriate, the nurse performs th...

1. Setting realistic goals for a shift involves: A. Planning every minute rigidly B. Avoiding planning C. Identifying essential tasks and time frames while allowing flexibility for changes D. Delegating everything Correct Answer: C. Identifying essential tasks and time frames while allowing flexibility for changes Rationale: Flexibility is needed for emergencies. Goals keep work focused. 2. Daily, weekly or monthly non-time-critical medications per ISMP may be given within: A. 10 minute...

1. Task-oriented delegation differs from patient-centered delegation in that patient-centered delegation: A. Considers the whole patient's needs and condition when deciding what to delegate B. Focuses only on tasks C. Ignores patient condition D. Delegates everything Correct Answer: A. Considers the whole patient's needs and condition when deciding what to delegate Rationale: The same task may be safe for one patient but not another. Context matters. 2. Underdelegation occurs when...

1. The purpose of the 2019 National Guidelines for Nursing Delegation is to: A. Replace state law B. Eliminate assistive personnel C. Increase workloads D. Provide consistent guidance across practice settings for safe delegation Correct Answer: D. Provide consistent guidance across practice settings for safe delegation Rationale: The guidelines apply to all levels of nursing. State law still governs. 2. During a cardiac arrest, assistive personnel trained in CPR may: A. Lead the resuscit...

Exam (elaborations) Palliative & End-of-Life - 2026 Nursing Protocols: Midterm Exam (Units 1-7) - Questions with Correct Answers 4 Exam (elaborations) Palliative & End-of-Life - 2026 Nursing Protocols: Practice Test 1 (Units 1-7) - Questions with Correct Answers 5 Exam (elaborations) Palliative & End-of-Life - 2026 Nursing Protocols: Practice Test

1. Advanced practice registered nurses include: A. Only nurse practitioners B. Nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse-midwives C. CNAs and LPNs D. Only school nurses Correct Answer: B. Nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists and certified nurse-midwives Rationale: APRNs have graduate education and expanded scope. State law defines their authority. 2. An RN asked to per...

1. A healthy infant usually doubles birth weight by about: A. 1 month of age B. 12 months of age C. 2 years of age D. 4 to 6 months of age Correct Answer: D. 4 to 6 months of age Rationale: Birth weight typically doubles around 4 to 6 months and triples by 12 months. Doubling by 1 month would be excessive, and doubling at 12 months or later is too slow. 2. Failure to thrive in an infant is best described as: A. Normal small size in a child of short parents B. Rapid weight gain C. Inad...

1. A quick estimate of the number of teeth in a child aged 6 to 24 months is: A. Age in months plus 6 B. Age in years times 10 C. Age in months minus 6 D. Age in months divided by 2 Correct Answer: C. Age in months minus 6 Rationale: Subtracting 6 from age in months gives an approximate tooth count, so a 12-month-old has about 6 teeth. The other formulas give unrealistic numbers. 2. An asymmetric Moro reflex in a newborn may indicate: A. Normal development B. A fractured clavicle or br...

1. Nurses advocate for patients in palliative care by: A. Making decisions on behalf of competent patients B. Ensuring patient preferences are known and respected and that symptoms are addressed C. Withholding information D. Following family wishes over the patient's stated wishes Correct Answer: B. Ensuring patient preferences are known and respected and that symptoms are addressed Rationale: Advocacy centers the patient's voice. Competent patients make their own decisions. 2. A k...

1. Physical restraints in a delirious patient: A. Are the first-line treatment B. Should be avoided because they increase agitation, injury and distress C. Calm the patient D. Prevent all falls Correct Answer: B. Should be avoided because they increase agitation, injury and distress Rationale: Restraints worsen delirium and can cause harm. Close observation and addressing causes are preferred. 2. Mirtazapine may be a helpful antidepressant in palliative care because it can also: A. Impr...

1. The World Health Organization describes palliative care as an approach that: A. Hastens death B. Improves quality of life of patients and families facing life-threatening illness through prevention and relief of suffering, including physical, psychosocial and spiritual problems C. Postpones death at all costs D. Focuses only on physical pain Correct Answer: B. Improves quality of life of patients and families facing life-threatening illness through prevention and relief of suffering, i...