Chapter 66Mass Casualty Care My Nursing Test Banks

Chapter 66Mass Casualty Care

MULTIPLE CHOICE

1.The nurse in the emergency department is using a triage system because this system ranks clients by:

1.

severity of illness or injury.

2.

body systems involved.

3.

name.

4.

age.

ANS: 1

No one can predict when the next patient will arrive or the severity of their injury or illness; this is why emergency departments utilize a triage system, which is a method to rank or classify patients illnesses and the severity of their injuries. The triage system does not rank clients by body systems involved, name, or age.

PTS: 1 DIF: Apply REF: Triage

2.In the event of a mass casualty situation, the best triage nurse is:

1.

the recently graduated registered nurse (RN).

2.

the licensed vocational nurse (LVN) with 5 years experience.

3.

the registered nurse (RN) with the most experience and best assessment skills.

4.

the recently graduated licensed vocational nurse (LVN).

ANS: 3

Triage is usually performed by an RN who is experienced and can complete a rapid assessment. Triage nurses are challenged with assessing the order in which clients need to be evaluated by an emergency department doctor. The recently graduated registered nurse does not have the experience necessary to perform adequate triage. The recently graduated licensed vocational nurse and the licensed vocation nurse with 5 years experience do not have the appropriate education on client assessment to serve as a triage nurse.

PTS: 1 DIF: Analyze REF: Triage

3.The nurse, triaging victims of a mass casualty incident, will focus attention on the victims who are color coded as:

1.

green.

2.

yellow.

3.

red.

4.

black.

ANS: 3

Victims coded green will do well with minimal care, and victims coded black will most likely die even with care. The focus is on the red-coded victims, then the yellow, using immediate resources and rapid intervention for those who will benefit the most.

PTS: 1 DIF: Apply REF: START Method of Triage

4.The emergency room nurse is utilizing a triage approach for a mass casualty incident that is different from traditional triage. The difference between these two triage approaches is that:

1.

mass casualty is first come, first served; traditional is most critical first.

2.

mass casualty is most likely to survive first; traditional is first come, first served.

3.

mass casualty is most critical first; traditional is most likely to survive first.

4.

mass casualty is most likely to survive first; traditional is most critical first.

ANS: 4

In traditional triaging the most critical come first, but in mass casualties the number of people and limits of supplies have to be taken into consideration. This means the clients who are most likely to survive are treated first and the most critical are treated last.

PTS: 1 DIF: Apply REF: START Method of Triage

5.The emergency department nurse is preparing to triage victims of an internal event. Which of the following would be considered an internal event?

1.

Bus crash in front of the hospital

2.

Train crash 5 miles away

3.

Fire in the hospital

4.

Explosion in a nearby oil station

ANS: 3

An internal event is an event inside the facility, such as a fire in the building or a water pipe breaking. All the other events are outside the facility and would be external.

PTS:1DIF:AnalyzeREF:HEICS Activator

6.The Emergency Preparedness Committee in a health care organization is reviewing available supplies for a mass casualty event since supplies need to be able to support the organizations functioning for:

1.

24 hours.

2.

48 hours.

3.

96 hours.

4.

1 week.

ANS: 3

The plan must incorporate strategies to care for a large influx of clients for up to 96 hours because it may be this long before assistance from the government can arrive. The other choices are incorrect lengths of time for the organization to prepare for supplies.

PTS: 1 DIF: Apply REF: Hospital Operations Plan

7.When reviewing the potential for biological warfare, the nurse realizes that one of the greatest bioterrorism threats in the world today is:

1.

chickenpox.

2.

smallpox.

3.

rabies.

4.

influenza.

ANS: 2

Smallpox was considered eradicated worldwide, and much of the vaccine was destroyed. Much of the current population has not been vaccinated or received booster shots. As a result, the number of casualties would be great. The other communicable diseases listed would not cause a great number of casualties.

PTS: 1 DIF: Analyze REF: Smallpox

8.The nurse is a member of the emergency preparedness committee, and she learns that anthrax is a bioterrorism threat that could infect and kill large numbers of people. Because of this, the organization should have which of the following on stock to treat anthrax?

1.

No treatment available

2.

Adrenaline injections

3.

Intravenous or oral ciprofloxacin

4.

Oral Benadryl

ANS: 3

If anthrax is suspected, ciprofloxacin IV is recommended. Oral ciprofloxacin is recommended for postexposure treatment. Adrenaline and oral Benadryl are not treatments for anthrax. There is a treatment for anthrax and the health care organization should be prepared for clients admitted with this disease.

PTS: 1 DIF: Apply REF: Anthrax: Pharmacology

9.A client is diagnosed with West Nile virus. The nurse should instruct the client that the most common carriers of this virus are:

1.

rats.

2.

birds.

3.

mosquitoes.

4.

cows.

ANS: 3

The nurse can help provide education to clients about decreasing their risk of exposure to infected mosquitoes. Rats and cows do not carry the West Nile virus. Birds are the main reservoir for this virus.

PTS: 1 DIF: Apply REF: West Nile Virus: Etiology

10.Victims of a chemical spill are brought to the hospital for treatment. The nurse learns that 50 victims will be arriving within the hour. When preparing for these victims, the nurse should ensure that which of the following is available?

1.

A small designated area to decontaminate the victims

2.

A medium-sized area to decontaminate the victims

3.

A large area to decontaminate the victims

4.

The entire emergency department is available to decontaminate the victims

ANS: 3

The nurse is preparing to provide care to 50 victims. This is a large number to decontaminate, so the nurse should ensure that a large area is available to decontaminate the victims. A small area would be sufficient for a few victims. A medium-sized area would be sufficient for a slightly larger number of victims. It would not be reasonable to expect that the entire emergency department would be available to decontaminate the victims.

PTS:1DIF:ApplyREFecontamination

11.The nurse is told to wear a Level B Hazmat suit when decontaminating victims of a mass casualty incident. The nurse realizes that this suit will provide:

1.

the highest level of respiratory and skin protection.

2.

resistance to chemicals, and it is impermeable to gases and vapors.

3.

respiratory protection, but it will allow chemical vapors to permeate the suit.

4.

splash protection and chemical resistance.

ANS: 3

There are three levels of personal protective equipment. With a Level A suit, the highest level of respiratory and chemical protection is provided. This suit provides resistance to chemicals and is impermeable to gases and vapors. In a Level B suit, there is respiratory protection but chemical vapors are able to permeate the suit. The Level C suit provides splash protection and chemical resistance.

PTS: 1 DIF: Analyze REF: Box 66-4 OSHA PPE Levels

MULTIPLE RESPONSE

1.The nurse is preparing to assess a client who was a victim of a blast injury. Prior to assessing the client, which are the mechanisms of a blast injury that the nurse will review? (Select all that apply.)

1.

Primary

2.

Secondary

3.

Acute

4.

Tertiary

5.

Quaternary

6.

Chronic

ANS: 1, 2, 4, 5

The four mechanisms of a blast injury are primary, secondary, tertiary, and quaternary. Each of these mechanisms of injury have associated injuries. The nurse should review the mechanisms of injury prior to assessing the client. Acute and chronic are not mechanisms of a blast injury.

PTS:1DIF:ApplyREF:Blast Injuries

2.The nurse believes a client is experiencing a reaction to a traumatic event when which of the following is assessed? (Select all that apply.)

1.

Client is not responding verbally to assessment questions.

2.

Client complains of dizziness.

3.

Clients blood pressure is 120/80 mmHg.

4.

Client complains of nausea.

5.

Client asks for medication for a headache.

6.

Client asks for something to drink.

ANS: 1, 2, 4, 5

Common responses to a traumatic event include silence or not responding to verbal stimuli, dizziness, nausea, and headache. A blood pressure of 120/80 mmHg is considered normal. The client requesting something to drink is not a reaction to a traumatic event.

PTS:1DIF:Analyze

REF: Table 66-5 Common Responses to a Traumatic Event

3.The nurse is concerned about developing post-traumatic stress disorder after working for several years in the emergency department. Which of the following should the nurse do to ensure this disorder does not manifest? (Select all that apply.)

1.

Eat well-balanced meals.

2.

Drink water.

3.

Limit caffeine.

4.

Limit sugar intake.

5.

Exercise at least 4 times a week for 30 minutes.

6.

Ingest at least one alcoholic drink every evening.

ANS: 1, 2, 3, 4, 5

The nurse must learn to handle stress to reduce the onset of post-traumatic stress disorder by eating well-balanced meals, drinking water, limiting caffeine, limiting sugar intake, and exercising at least 4 times a week for 30 minutes. A daily intake of alcohol could be a sign that post-traumatic stress disorder is developing.

PTS:1DIF:Apply

REFost-traumatic Stress Disorder: Planning and Implementation

4.The nurse is participating in a debriefing session after participating in the care of victims of a mass casualty incident. Which of the following will occur during this debriefing session? (Select all that apply.)

1.

The process for the debriefing will be explained.

2.

Individual reactions to the event will be discussed.

3.

Symptoms that the nurse may experience will be reviewed.

4.

Stress reduction techniques will be provided.

5.

Prescriptions for antianxiety medications will be provided.

6.

Physician follow-up appointments will be made.

ANS: 1, 2, 3, 4

There are eight (8) phases to a debriefing session. During the introduction phase, the process for the debriefing will be explained. During the reaction phase, individual reactions to the event will be discussed. During the symptom phase, symptoms that the nurse may experience will be reviewed. During the teaching phase, stress reduction techniques will be provided. Prescriptions for medication and physician appointments are not a part of the debriefing session.

PTS: 1 DIF: Analyze REF: Box 66-9 The Eight Phases of a Debriefing

5.The nurse is a member of a committee designing the hospitals emergency incident command system. Which of the following are the four components of the committees design? (Select all that apply.)

1.

Relief support

2.

Staffing

3.

Planning

4.

Operations

5.

Logistics

6.

Finance

ANS: 3, 4, 5, 6

The hospital emergency incident command system has four components: 1) finance, 2) logistics, 3) operations, and 4) planning. Relief support and staffing are not parts of the hospital emergency incident command system.

PTS: 1 DIF: Apply REF: Hospital Emergency Incident Command System

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