Chapter 22 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
Chapter 22

Question 1

Type: MCSA

A nurse manager is working on a task force to develop policy for man-made disasters. There is some discussion in the committee about whether fire should be included in the policy. Which suggestion by a task force member would be most useful?

1. Fire is a natural occurrence, so we should not address it.

2. Fires are not generally a real disaster, so we should not include it.

3. We should only focus on wildfires.

4. We should only focus on arson fires.

Correct Answer: 4

Rationale 1: Fire is natural, but not all are from a natural source.

Rationale 2: Fires can be a major disaster.

Rationale 3: Wildfires are natural disasters.

Rationale 4: Since arson fires are man-made, they would be included in this plan.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-1: Identify examples of disasters that require preparation.

Question 2

Type: MCMA

Health care providers are preparing for a worldwide outbreak of H1N1 influenza. How would this outbreak be classified in planning literature?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. A man-made disaster

2. As a pandemic

3. As a health disaster

4. As a natural disaster

5. As an epidemic

Correct Answer: 2,3,4

Rationale 1: H1N1 occurs naturally and is therefore a natural disaster.

Rationale 2: If H1N1 spreads around the world, it is a pandemic.

Rationale 3: H1N1 that spreads around the world would be a health disaster.

Rationale 4: H1N1 is naturally occurring and is therefore a natural disaster.

Rationale 5: If the illness spreads around the world, it is considered a pandemic.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-1: Identify examples of disasters that require preparation.

Question 3

Type: FIB

A tornado destroyed 65% of the businesses and homes in a small midwestern city. Aid would be requested based on categorization as a level ______ disaster.

Standard Text: 

Correct Answer: 3

Rationale : Tornado damage of this magnitude would require statewide or national assistance, which is the definition of a level 3 disaster.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-1: Identify examples of disasters that require preparation.

Question 4

Type: FIB

A small creek has flooded, requiring the rescue of one person from a stranded automobile. Electrical service was interrupted for a short period and traffic will be diverted around flooded roads for a period of several hours. Local law enforcement and fire departments have been well equipped to manage the disaster. The newspaper should report that the town suffered a level ______ disaster.

Standard Text: 

Correct Answer: true

Rationale : If the response at the local level is sufficient, the disaster is categorized as level 1.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-1: Identify examples of disasters that require preparation.

Question 5

Type: FIB

Fire departments from a three county area have responded to a wildfire that has threatened several homes and a hospital in a wooded area. The fire is now under control and the fire chief is completing paperwork on the response. The disaster should be classified at level ______.

Standard Text: 

Correct Answer: 2

Rationale : A level 2 disaster is one that requires a regional responsein this case, fire departments from three counties.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-1: Identify examples of disasters that require preparation.

Question 6

Type: MCSA

The nurse executive of a hospital is surveying hospitals in a four-state area in regard to their disaster preparedness. The nurse would expect to hear which response to the question What have you done to prepare for a disaster?

1. We have conducted a drive to get area health care professionals registered so they can be contacted in case of a disaster.

2. We have a designated place with beds and equipment so that staff can be directed to an alternate care area.

3. We have not prepared for a disaster.

4. We conduct practice disaster drills.

Correct Answer: 4

Rationale 1: Only half of the hospitals in the United States have conducted health care professional registration.

Rationale 2: Only about half of hospitals report having plans for an alternative care delivery site with beds and equipment.

Rationale 3: Most hospitals have at least some level of preparation for a disaster.

Rationale 4: Over half of U.S. hospitals report conducting practice disaster drills.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-2: Describe potential emergency situations.

Question 7

Type: MCMA

A nurse is working with a hospital team to create an emergency response plan that will meet Joint Commission requirements. Which sections should be included in this plan?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. A method to predict when a disaster will occur through close attention to news and weather reports

2. A method to recognize that a disaster is imminent or occurring with plans to reduce the disasters impact

3. A plan whereby policies and procedures as well as equipment and personnel are in place to handle disasters

4. Policies and procedures that operationalize actual activities during the disaster

5. Policies and procedures describing what will occur immediately after the disaster

Correct Answer: 2,3,4,5

Rationale 1: It is not possible to predict when a disaster will occur.

Rationale 2: This section of the plan would address mitigation of the disaster.

Rationale 3: This section would be titled Preparedness.

Rationale 4: This is the response section.

Rationale 5: This is the recovery section.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-2: Describe potential emergency situations.

Question 8

Type: MCSA

A hospital has sustained massive destruction after being struck by a tornado. The disaster plan has been activated. The administrator would expect help from which agency to coordinate the disaster efforts?

1. The Federal Emergency Management Agency (FEMA)

2. The Joint Commission

3. The Office of Homeland Security

4. Congress

Correct Answer: 1

Rationale 1: Congress directed FEMA to coordinate disaster efforts.

Rationale 2: The Joint Commission does not coordinate disaster efforts, but does ensure that the hospital has a plan.

Rationale 3: The Office of Homeland Security would be part of the disaster recovery effort, but would not be the coordinating service.

Rationale 4: Congress has designated organizations to coordinate relief efforts, but would not direct those efforts.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-2: Describe potential emergency situations.

Question 9

Type: MCMA

A hospital on the Gulf Coast of the United States would list which situations among its top vulnerabilities?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Flooding

2. Hurricane

3. Earthquake

4. Tornado

5. Industrial accident

Correct Answer: 1,2,4,5

Rationale 1: Flooding would be a big concern for a hospital on the gulf coast.

Rationale 2: Hurricane would be a big concern for a hospital on the gulf coast.

Rationale 3: Earthquakes may occur on any fault line, but this is not a primary concern on the gulf coast.

Rationale 4: Tornadoes often accompany hurricanes and would be a big concern on the gulf coast.

Rationale 5: Industrial accidents would be of concern related to the large oil production capacity of the gulf waters.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-2: Describe potential emergency situations.

Question 10

Type: MCSA

The hospital is preparing for a tabletop test of its emergency operations plan. What is the potential for an interruption in services from this drill?

1. There is little potential for interruption as the drill is all done in a meeting.

2. There is some potential for interruption of non-client-care services such as billing and scheduling.

3. There will be interruption in some services that generally occupy the area where the enormous table is set up for the drill.

4. Normal services will probably be interrupted by the simulated situations and simulated clients.

Correct Answer: 1

Rationale 1: A tabletop drill occurs when key players in the EOP gather and walk through a drill.

Rationale 2: There is no expected interruption in these services.

Rationale 3: There is no requirement for an enormous table for this drill.

Rationale 4: There are no simulated clients or real scenarios in this drill.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-2: Describe potential emergency situations.

Question 11

Type: MCSA

The hospital is conducting a drill of its emergency operations plan (EOP). A nurse is acting as triage officer. Which client would be triaged for immediate care?

1. A client with a minor forearm laceration that will require a simple bandage and tetanus immunization

2. A child with a severe, penetrating head wound

3. A man complaining of chest pain that radiates to his jaw

4. A woman with a compound fracture of the femur

Correct Answer: 1

Rationale 1: The least serious people are seen first in a disaster.

Rationale 2: This child is unlikely to survive and would be triaged as last.

Rationale 3: This client may be having a myocardial infarction, but would not be triaged as high as another client.

Rationale 4: A compound fracture is complicated and therefore this client would be triaged later than another client.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-3: Explain triage in disaster situations.

Question 12

Type: MCSA

A nurse manager is leading an education session regarding disaster triage for emergency department nurses. Which statement should the manager include in this instruction?

1. Follow your current triage system.

2. Your triage system will be reversed during a disaster.

3. Triage is not necessary during disasters.

4. Your triage system will basically be first-come, first-served.

Correct Answer: 2

Rationale 1: Triage in a disaster is vastly different than normal triage.

Rationale 2: Triage is reversed during a disaster. The least injured clients are seen first.

Rationale 3: Triage is essential during disasters.

Rationale 4: Triage follows a designated plan and is not first-come, first-served.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-3: Explain triage in disaster situations.

Question 13

Type: MCSA

A nurse manager has provided education to emergency department nurses regarding disaster management. Which statement would the manager interpret as indicating understanding of this education?

1. We should treat as many clients as possible as quickly as possible.

2. Quick separation of any victim with bleeding wounds from those who are not bleeding is essential.

3. Our goal is to treat those with serious injuries first.

4. We should send those with less serious injuries home without treatment.

Correct Answer: 1

Rationale 1: This is the goal of emergency treatment in a disaster.

Rationale 2: There is no indication to take the time to do this separation.

Rationale 3: In a disaster those with minor injuries are treated first.

Rationale 4: There is no indication that clients would be sent home without treatment.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 22-3: Explain triage in disaster situations.

Question 14

Type: MCMA

Which statements would the nurse manager interpret as indicating a nurse understands the critical thinking skills necessary for disaster management?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. It is just like critical thinking in the emergency department or critical care unit, only done faster.

2. The nurses prioritization will be different in a disaster.

3. Clinical judgment skills will be an essential part of nursings contribution to disaster management.

4. Decision making will basically be done by following established protocols.

5. The nurses abilities will make the difference in successful management of a disaster.

Correct Answer: 2,3,5

Rationale 1: Critical thinking in disasters is different than in normal health care situations. For example, the triage system is reversed.

Rationale 2: Normal prioritization will not be helpful in a disaster.

Rationale 3: The nurses clinical judgment will be essential in making rapid assessments and treatment decisions.

Rationale 4: Disaster situations cannot be scripted with protocols. Decisions must be made quickly and accurately based upon the situation and may change in a moment-to-moment fashion.

Rationale 5: Nursing will be a big part of management of a disaster and good nursing skills will make a difference.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 22-4: Discuss the core competencies nurses must have to be prepared for emergencies.

Question 15

Type: MCMA

An emergency department has been notified that hundreds of injuries have occurred following the collapse of bleachers at a football game. The emergency department nurses should prepare to make which types of assessments?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Physical

2. Self

3. Situational

4. Family

5. Community

Correct Answer: 1,2,3,4

Rationale 1: Physical assessment skills will be necessary as victims injuries are assessed.

Rationale 2: The nurse must be able to conduct a self-assessment of abilities to manage a victim and of personal reaction to the disaster.

Rationale 3: The nurse must be making situational assessments at all times during the disaster to ensure a flow of clients, equipment, personnel, and information. The nurse must also assess the safety of the situation.

Rationale 4: Victim families are also involved in the disaster. The nurse must assess the families coping abilities.

Rationale 5: The nurse will not be involved in community assessment at the time of the disaster, but may be called on for this skill in the days and weeks to follow.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-4: Discuss the core competencies nurses must have to be prepared for emergencies.

Question 16

Type: MCSA

Multiple casualties have arrived at the emergency department following a tornado. Which instruction from the manager to staff is incorrect?

1. There is no time to worry about using personal protective equipment, just try to be safe.

2. Be aware that some of these victims may have been exposed to hazardous substances.

3. Dont let client safety considerations be lost in all of the activity.

4. Feel free to use isolation techniques if required.

Correct Answer: 1

Rationale 1: This is an essential time to use personal protective equipment.

Rationale 2: In a tornado, many structures are damaged or destroyed, including those housing hazardous chemicals. The victims may have been exposed to those substances.

Rationale 3: Client safety must continue to be an important consideration.

Rationale 4: Some clients may require isolation and these techniques should be used if necessary.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-4: Discuss the core competencies nurses must have to be prepared for emergencies.

Question 17

Type: MCSA

A disaster planning task force has been asked to focus on communication. Which instruction should this group provide to nursing staff?

1. Limit your communication to physicians and other nurses.

2. Be certain to maintain the client tracking system.

3. All communication with law enforcement will be conducted through the public resources officers.

4. Communication is likely to follow the standard daily pattern.

Correct Answer: 2

Rationale 1: The nurse will be communicating with multiple people in multiple roles during the disaster.

Rationale 2: A system to track the clients presence in the facility should be a part of the disaster plan. It is essential to maintain this system so that victims can be accounted for by rescuers.

Rationale 3: The nurse may be communicating directly with law enforcement officers who bring victims to the hospital. All status reports should be given through PR.

Rationale 4: Communication is very unlikely to be like the daily pattern.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-4: Discuss the core competencies nurses must have to be prepared for emergencies.

Question 18

Type: MCMA

As part of the disaster plan, the nurse executive is planning an education session on the core competencies for nurses established by the National Emergency Preparedness Education Coalition. Which topics should be included in the handout being written for this session?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Cost control

2. Managing conflict with other disciplines

3. Communication

4. Handling the media

5. Technical skills

Correct Answer: 3,5

Rationale 1: Cost control is not one of the core competencies for nurses established by this group.

Rationale 2: Conflict management is not one of the core competencies for nurses established by this group.

Rationale 3: Communication is a core competency for nurses established by this group.

Rationale 4: Handling the media is not one of the core competencies for nurses established by this group.

Rationale 5: Technical skills are a core competency for nurses established by this group.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-4: Discuss the core competencies nurses must have to be prepared for emergencies.

Question 19

Type: MCMA

A hospitals disaster management team is reviewing the disaster plan after reading about a hospital that was destroyed by a tornados direct hit. What questions should team members ask themselves?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. What are our current capabilities for evacuation?

2. Do we have sufficient resources in any other areas to continue operations if this happens to us?

3. Are there physical training needs that we have not filled?

4. What education should we provide to the staff and community?

5. Would we eventually rebuild if the hospital was destroyed?

Correct Answer: 1,2,3,4

Rationale 1: Evacuation of clients, visitors, and staff should be of primary interest to this team.

Rationale 2: The team should consider its resources. What would happen if the hospital campus was damaged? Where are other resources available?

Rationale 3: Training for a disaster is essential.

Rationale 4: Education about disasters and training for a disaster are two different topics. Training involves physical skills as well as learning.

Rationale 5: This is a valid question, but is outside the scope of a disaster plan.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-5: Discuss how services can be continued during an emergency.

Question 20

Type: MCSA

During discussion about the hospitals disaster plan, the administrator says, I am concerned about our current surge capacity. How should the members of the group interpret this concern?

1. The administrator is worried about the ability of the hospitals electrical system to handle the power fluctuation common during physical disasters.

2. The administrator is concerned that flood waters following a storm surge might overwhelm the hospital infrastructure.

3. The administrator is worried about the hospitals ability to respond to a large influx of clients from a disaster.

4. The administrator is concerned that a disaster would bring about the influx of media and frightened family.

Correct Answer: 3

Rationale 1: In this context, surge capacity is not about electrical power.

Rationale 2: In this context, surge capacity is not about flood waters.

Rationale 3: Surge capacity, when discussed in disaster planning, describes the facilitys ability to mobilize when suddenly confronted with a vast increase in client demand.

Rationale 4: In this context, surge capacity is not only about media and family.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-5: Discuss how services can be continued during an emergency.

Question 21

Type: MCMA

A nurse executive is assigned to a task force working on a surge system for the hospital in case of a disaster. This group should write strategies to cover which procedures?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Post-incident follow-up

2. Supplies

3. Physical space

4. Management infrastructure

5. Personnel

Correct Answer: 2,3,4,5

Rationale 1: Post-incident follow-up is not a part of surge strategy.

Rationale 2: How to get supplies, how to know how many supplies are on hand, and how to distribute supplies are all part of a surge strategy.

Rationale 3: Allocation of physical space is a part of surge strategy.

Rationale 4: Whom to notify, how to communicate with community officials and media, and how to notify staff are all part of surge strategy concerning management infrastructure.

Rationale 5: How to notify staff of the disaster, how to allocate staff in a disaster, how to allocate and manage volunteers, and how to provide for all these personnel is a part of surge strategy.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-5: Discuss how services can be continued during an emergency.

Question 22

Type: MCMA

A hospital administrator receives a call that mass casualty shootings have occurred at several different locations within the city. Early information indicates that up to 50 victims may be arriving at the hospital starting within minutes. What action should the administrator take?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Mobilize the hospital incident command system.

2. Notify other administrators and order a rapid needs assessment in all critical areas.

3. Authorize the implementation of the hospitals disaster plan.

4. Call the emergency department and ask the charge nurse if the department has received any clients.

5. Conduct a risk assessment to see if the hospital is vulnerable to attack.

Correct Answer: 1,2,3

Rationale 1: This is a disaster situation and incident command is essential.

Rationale 2: A rapid needs assessment is essential so that quick action can be taken to fill as many of those needs as possible.

Rationale 3: The administrator must be proactive in initiating the disaster plan.

Rationale 4: If this is a real disaster, it is unlikely that the charge nurse has time to come to the phone.

Rationale 5: This risk assessment should have already been done.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-5: Discuss how services can be continued during an emergency.

Question 23

Type: MCMA

Why is postdisaster follow-up an essential part of disaster planning?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. To assure staff members of their personal safety

2. To evaluate the performance of those involved

3. To initiate any improvements needed

4. To evaluate the overall effectiveness of the plan

5. To complete critical incident forms

Correct Answer: 2,3,4

Rationale 1: This is not the reason for the follow-up.

Rationale 2: Evaluating the performance of those involved helps to identify areas of need.

Rationale 3: Follow-up helps to identify areas where improvement is needed.

Rationale 4: The plan itself should be evaluated for effectiveness.

Rationale 5: This is not an appropriate use of critical incident forms.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 22-5: Discuss how services can be continued during an emergency.

Question 24

Type: MCSA

A level III disaster has occurred and the hospital is receiving clients by ambulance and those who have walked in to the emergency department. The wife of a man who is critically injured screams, Why doesnt someone do something for my husband? He is dying! How should the nurse manager respond?

1. Maam, you should not be back here. You will have to leave.

2. Im so sorry, but your husbands injuries are very severe. We have to take care of the others first.

3. Is there someone who can stay with this woman? She is distraught.

4. He doesnt pass the triage screen for someone we can save.

Correct Answer: 2

Rationale 1: The manager should take measures other than just making the woman leave.

Rationale 2: This is a kind statement of fact and is a good way to address this wife.

Rationale 3: This is a true statement, but does not explain to the wife why her husband is not being cared for.

Rationale 4: Even though this is a true statement, the wife will probably not understand what a triage screen is.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-3: Explain triage in disaster situations.

Question 25

Type: MCSA

Hospital administration is aware that staff may be reluctant to be called back to work in a disaster. How can the hospital be proactive in encouraging staff to make the decision to serve?

1. Develop a caring relationship with staff during normal times.

2. Develop a pay scale that offers double pay for all those who work during disasters.

3. Offer additional time off to those who work during a disaster.

4. Focus on the skills advancement opportunities that occur when working in a disaster.

Correct Answer: 1

Rationale 1: If staff members have a caring relationship and feel ownership of the hospital, they are more likely to respond in an emergency.

Rationale 2: Salary may not be a big enough incentive for those who are reluctant to leave family during a disaster.

Rationale 3: Time off in the future is not likely to be enough incentive to attract staff into a disaster situation.

Rationale 4: The opportunity to advance skills is not likely to attract many staff members back to work in a disaster.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-6: Identify the impact disasters may have on employees.

Question 26

Type: MCMA

A hospital has written a well-defined surge call-back system for employees to use in case of a disaster. What are key vulnerabilities of this system?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Employees may be unwilling to come back into the disaster.

2. Employees may be personally affected by the disaster.

3. Many employees will request additional pay for shifts worked during disasters.

4. There may be no way to contact employees for call-back.

5. The employee may not physically be able to return to the hospital.

Correct Answer: 1,2,4,5

Rationale 1: There is no assurance that employees will respond by returning to work once a disaster has happened.

Rationale 2: It is impossible to know if employees will be personally affected by the disaster. For example, if the employees home is destroyed by a wildfire, that employee would have pressing family needs.

Rationale 3: This may occur, but is not a key impediment.

Rationale 4: If utilities such a telephone and cell phone towers are destroyed, there may be no way to contact the employee to come back to the hospital.

Rationale 5: There may be physical impediments such as washed out roads, snow-packed roads, or debris-covered roads that prevent employees from returning to the hospital.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-6: Identify the impact disasters may have on employees.

Question 27

Type: MCSA

A hospital administrator on a disaster planning team says, I am worried about our liability in using volunteers to provide care during a disaster. What should this team consider?

1. In disaster situations, no liability exists.

2. The hospital would have liability for what a volunteer does, but not for anything that happens to the volunteer.

3. The hospital could have liability for the volunteers performance and for his or her safety.

4. Hospital liability would be limited to any injuries sustained by the volunteer.

Correct Answer: 3

Rationale 1: Liability always exists and it may be heightened during a disaster.

Rationale 2: Liability for both the volunteers safety and actions may exist.

Rationale 3: Hospital liability could extend to actions taken by the volunteer and for anything that happens to the volunteer.

Rationale 4: The hospital could be liable for injury to the volunteer or injury caused by the volunteer.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-6: Identify the impact disasters may have on employees.

Question 28

Type: MCSA

A hospital successfully implemented its disaster plan to manage providing care during a massive 3-day snow storm. What is the most likely way additional costs for this service will be paid?

1. Medicare will increase reimbursement for any client age 65 or over who was hospitalized during the disaster.

2. The federal government will pay any costs over and above the normal operating expenses for the time period.

3. The hospital will absorb the additional costs.

4. State and county governments have reserve funds to reimburse for such expenses.

Correct Answer: 3

Rationale 1: Medicare will not increase reimbursement.

Rationale 2: There may or may not be federal reimbursement. If reimbursement is made it will likely not be at the full cost to the hospital.

Rationale 3: It is likely that the hospital will absorb the additional costs.

Rationale 4: There are likely no additional funds earmarked to reimburse the hospital for these expenses.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 22-6: Identify the impact disasters may have on employees.

Question 29

Type: MCSA

An outbreak of smallpox has followed a national sporting event. Terrorist activity is suspected. How would this event be categorized?

1. As a natural, biologic disaster

2. As a man-made, chemical disaster

3. As a natural, radiological disaster

4. As a man-made, biologic disaster

Correct Answer: 4

Rationale 1: Since terrorism is involved, it is not a natural disaster.

Rationale 2: Since the substance used was smallpox, it is not a chemical disaster.

Rationale 3: Since the substance used was smallpox, it is not a radiological disaster and it is not natural.

Rationale 4: The dispersion of the biologic agent in this case is thought to be man-made.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 22-2: Describe potential emergency situations.

Question 30

Type: MCSA

A hospital administrator initiated the emergency operations plan (EOP) after being notified that a tornado struck a nearby community. Thirty minutes later law enforcement calls to report that while significant damage was done, there were only minor injuries. What should the administrator do now?

1. Follow the EOP to deactivate the plan.

2. Let the plan continue for another hour to ensure that no victims arrive.

3. Call the emergency department and tell the staff that the plan is discontinued.

4. Notify local media that the EOP was discontinued.

Correct Answer: 1

Rationale 1: There should be specific information in the EOP to deactivate the plan.

Rationale 2: Instituting this plan is expensive and is an imposition on many employees. It should not be used if not needed.

Rationale 3: Unless this is the protocol established in the EOP, just calling the emergency department is not sufficient.

Rationale 4: There is no reason to notify the local media.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-2: Describe potential emergency situations.

Sullivan, Effective Leadership and Management, 8/e Test Bank

Copyright 2013 by Pearson Education, Inc.

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