Disaster 1
Which statement of the nurse is true regarding disasters?
A. "Multicasualty and mass casualty disaster events are the same."
B. "An internal disaster creates a need for evacuation or relocation."
C. "External disasters, rather than internal disasters, result in death."
D. "Multicasualty events require the collaboration of multiple agencies."
An internal disaster is an event that occurs inside a health care facility and endangers the safety of staff or clients. It creates a need for evacuation or relocation. Multicasualty and mass casualty disaster events are not the same. Both external and internal disasters may result in deaths. Multicasualty events are managed by a hospital using local resources.
Which intervention is a part of the response phase of disaster planning?
A. Stabilizing the community
B. Limiting the impact of disaster
C. Implementing the disaster plan
D. Evaluating the events of disaster management
The response phase of disaster management deals with the implementation of the disaster plan. The recovery phase of disaster management involves stabilizing the community. Mitigation focuses on limiting the impact of a disaster. The last phase of disaster management focuses on evaluation of the plan.
Which event would the nurse state is an example of a natural disaster?
A. Floods
B. Terrorism
C. Fire explosion
D. Building collapse
External disasters can be natural, such as floods, earthquakes, or tornadoes. Acts of terrorism are external disasters that use technology such as explosive devices or a malfunction of a nuclear reactor. A fire explosion is an internal disaster. A building collapse is a consequence of internal or external disaster.
Which event would the nurse consider to be an example of a potential internal disaster?
A. Hospital fire
B. Fertilizer plant explosion
C. Nuclear reactor explosion
D. Terrorist device explosion
An internal disaster is any kind of event inside a health care facility or campus that could endanger the safety of clients or health care staff. A fire in a hospital is an example of an internal disaster that can cause harm to the clients and the staff. A fertilizer plant explosion is an external disaster. A nuclear reactor explosion may cause radiation exposure to the external environment. Terrorism with explosive devices is an external disaster.
Which activity is priority in preparing health care professionals for any type of disaster?
A. Identification of hazards
B. Cooperation with state authorities
C. Collaboration with local authorities
D. Implementation of federal mandates
Identification of hazards is the priority in the preparedness of health care professionals in any type of disaster plan. Although cooperation with state authorities, collaboration with local authorities, and implementation of federal mandates also play a role in being prepared for a disaster, these are not the priority because it is essential to identify the specific hazard to implement the most appropriate portion of the disaster plan.
Which phase of disaster management occurs when the community health nurse in a community that is geographically vulnerable to storms teaches the community about safety measures to be taken during a storm?
A. Recovery
B. Response
C. Mitigation
D. Preparedness
Preparedness is the phase in which a plan is designed before the disaster event to best structure the response. Teaching safety measures to the people of a locality is the preparedness phase. The recovery phase involves stabilizing the community after a disaster event. Response is the implementation of the disaster plan. Mitigation is a phase of disaster management in which attempts are made to limit the disaster’s impact.
Who is responsible for triaging the victims of a multiple motor vehicle crash on a major interstate?
A. Emergency first responders
B. Nurses in the acute care areas
C. Nurses in the emergency department
D. Health care providers in the emergency department
For a mass casualty incident, triaging will occur in the field or at the site of the incident. In this case, the emergency first responders will triage the victims of the crash. Nurses in the acute care areas may or may not have victims admitted for care. The victims should be triaged before arriving in the emergency department, so it would be incorrect to expect the nurses and health care providers in the emergency department to perform triage.
Applying the emergency severity index (ESI) criteria, which client condition would the nurse consider least severe?
A. Cardiac arrest
B. Abdominal pain
C. Multiple trauma
D. Closed extremity trauma
Care for a client with closed extremity trauma could be delayed because it is considered less severe when compared with other client conditions and triaged in emergency severity index (ESI-4). This client is given least priority. The client with cardiac arrest is triaged under ESI-1 and should be seen immediately because the condition is more severe. The client with abdominal pain is triaged under ESI-3 and should be seen within 1 hour. The client with multiple trauma should be seen within 1 hour and is triaged under ESI-2.
Based on their condition, which client would be triaged first according to the 3-tiered triage system?
A. Chest pain
B. Displaced or multiple fractures
C. Renal colic
D. Sprains and strains
Client A reporting chest pain is considered to have a life-threatening condition and is triaged as emergent. Clients B and C having displaced or multiple fractures and renal colic need quick treatment but are not considered to have immediately life-threatening conditions, particularly when compared with client A’s condition. They are triaged in the urgent tier level. Client D with strains and sprains is triaged as nonurgent because this client can wait for treatment.
Which client would be treated immediately according to the disaster triage tag system?
A. Red
B. Yellow
C. Black
D. Green
According to the disaster triage tag system, the red tag is used to label the clients who require immediate treatment; therefore client A should be seen immediately. The yellow tag is applied to clients who can wait for a short time for the treatment. A black tag is issued to the clients who are dead or expected to die. Green tags are issued to clients who can ambulate on their own.
Which client condition would the triage nurse assign the lowest nursing care priority?
A. Stroke
B. Skin rash
C. Renal colic pain
D. Displaced tendon
The three-tiered triage system in an ED includes emergent, urgent, and nonurgent levels in which clients should receive care accordingly. Clients with skin rashes indicate a nonurgent situation in which the client can be treated even after a few hours because there is no life-threatening problem. The client with a stroke has an emergent situation and requires immediate intervention. The client with renal colic pain has an urgent situation but can wait for some time, as does a client with a displaced tendon.
Which color according to the disaster triage tag system would be assigned to a client who has an immediate threat to life?
A. Red
B. Black
C. Green
D. Yellow
According to the disaster triage tag system, a red tag is used for a client who has an immediate threat to life. A black tag is used for a client who is expected to die or is dead. Green tags are used for a client who has minor injuries. A yellow tag is used for a client who has major injuries and is requiring immediate treatment.
Which event is an example of an internal disaster that must be accounted for when formulating a disaster response plan? Select all that apply.
A. Fire
B. Hurricane
C. Earthquake
D. Power outage
E. Act of terrorism
Examples of internal disasters that must be accounted for when formulating a disaster plan include fire and power outage. A hurricane and earthquake, both natural disasters, are classified as external disasters. An act of terrorism is also considered an external disaster.
Which emergency response team is involved in emotional recovery of victims after a disaster?
A. American Red Cross
B. Disaster Medical Assistance Team (DMAT)
C. Community Emergency Response Team
D. Federal Emergency Management Agency
The American Red Cross has a critical incident stress management unit. This unit arranges group discussions to allow participants to share and validate their feelings and emotions about the experience. DMAT is a medical relief team made up of civilian medical, paraprofessional, and support personnel that is deployed to a disaster area with enough medical equipment and supplies to sustain operations for 72 hours, and they are part of the National Disaster Medical System (NDMS) in the United States. A community emergency response team and the Federal Emergency Management Agency train citizens to understand their personal responsibility in preparing for a natural or man-made disaster.
Which client condition would the triage nurse provide care for first?
A. Chest pain with diaphoresis
B. Bruises and superficial lacerations
C. Severe pain as a result of displaced tendons
D. Complex lacerations associated with moderate hemorrhage
The three-tiered triage system in an emergency department includes emergent, urgent, and nonurgent levels in which care should be provided to the clients accordingly. The client with chest pain and diaphoresis has a life-threatening situation and requires immediate intervention. The client with bruises and superficial lacerations and the client with severe pain resulting from a displaced tendon have urgent situations but can wait for some time. Clients with complex lacerations but with moderate hemorrhage have an urgent situation but can be treated even after some time because there is no life-threatening problem.
Which factors will influence the amount of psychological stress community members might experience after flooding and building damage caused by a category 4 hurricane? Select all that apply.
A. Type of disaster
B. Age of the community members
C. Financial status and employment
D. Previous medical and psychological histories
E. Preexisting mechanisms to cope with disasters
All disasters result in psychological stress, which is influenced by the type of disaster, the age of the individuals who are affected by the disaster, the medical and psychological histories of the people affected by the disaster, and preexisting coping mechanisms of the people affected by the disaster. Financial status and employment are not identified as influencing factors of psychological response after a disaster.
After a bomb blast in a city, why would the federal government send the Medical Reserve Corps (MRC) to the site?
A. To provide advanced Disaster Life Support training
B. To establish first aid stations or special-needs shelters
C. To establish fully functional field surgical facilities to victims
D. To provide medical equipment sufficient for 72 hours to victims
The MRC helps establish first aid stations or special-needs shelters to victims of a disaster. The National Disaster Life Support Foundation renders core, basic, and advanced disaster life support training courses. International Medical-Surgical Response Teams (IMSRTs) establish fully functional field surgical facilities. A Disaster Medical Assistance Team (DMAT) is a medical relief team that is deployed to a disaster area with enough medical equipment and supplies to sustain operations for 72 hours.
Which statement by the nurse is true regarding mass casualty events related to disasters?
A. "They can be managed by a hospital using local resources."
B. "They are incidents inside a health care facility that could endanger the safety of clients."
C. "They may require the association of multiple agencies and health care facilities to handle the crisis."
D. "They are events outside the health care facility requiring the activation of the facility’s emergency management plan."
A mass casualty event overwhelms local medical capabilities and may require the collaboration of multiple agencies and health care facilities to handle the disaster. Multicasualty events can be managed by the hospital using local resources. An internal disaster is an event that occurs inside a health care facility or campus that could endanger the safety of clients or staff. An external disaster is an event outside the health care facility or campus, somewhere in the community, that may require the activation of the facility’s emergency management plan.
Five victims of a shooting are identified as needing urgent care. Which initial action would the triage officer take when these victims arrive in the emergency department (ED)?
A. Triage the victims.
B. Send the victims to the operating room.
C. Type and cross match for blood transfusions.
D. Notify next of kin that the victims are in the ED.
The triage officer rapidly evaluates each person who presents to the hospital, even those who come in with triage tags in place. Client acuity is reevaluated for appropriate disposition to the area within the ED or hospital best suited to meet the client’s medical needs. The clients will need to be triaged before being sent to the operating room. The triage officer would not be responsible for conducting laboratory testing (type and cross match) or notifying the next of kin of the victims.
Which location would the nurse consider for triage of casualties when planning for a community disaster drill that will include a bombing in a shopping mall with hundreds of casualties?
A. In the hospital parking lot
B. At the scene of the disaster
C. In the emergency department
D. At the closest school gymnasium
Triage is initiated at the scene. After the scene is determined to be safe for the health care team to approach, providers at a mass casualty incident (MCI) must analyze the number and severity of clients. Regardless of the system used, the primary goal is to quickly sort the clients into transport categories and identify each of them with triage tags, colored tape or other means of priority. Mass casualty events have triage at the scene to prevent overwhelming the hospital with casualties, while at the same time preventing the hospital from becoming a secondary target of additional attacks. The hospital parking lot is too close to the hospital to provide safety from additional attacks. Performing triage in the emergency department will quickly overwhelm the department and will interfere with provision of care to clients who will benefit from interventions. The closest school gymnasium may be too far from the scene of the disaster and may become a target of secondary attack.
Which amount of time is appropriate for the nurse to spend triaging each client during a mass casualty incident (MCI)?
A. Less than 10 seconds
B. Less than 15 seconds
C. Less than 30 seconds
D. Less than 60 seconds
Triage of victims of an emergency or an MCI must be conducted in less than 15 seconds. The other time frames, 10 seconds, 30 seconds, and 60 seconds, are not accurate.
Which color tag would the nurse use to triage a victim of a train derailment who is able to walk independently to the first aid station?
A. Red
B. Black
C. Green
D. Yellow
An emergency triage system uses colored tags to designate both the seriousness of the injury and the likelihood of survival. Green would be used for minor injuries such as the victim who is able to ambulate independently. Red indicates life-threatening injuries requiring immediate attention. Black indicates that the victim is expected to die. Yellow indicates urgent but not life-threatening injuries.
Which emergency medical service (EMS) health care professional provides advanced life support to the clients who survived a large-scale disaster?
A. Paramedics
B. Triage officer
C. Prehospital care providers
D. Emergency medical technicians
Paramedics provide advanced life support such as cardiac monitoring and establishing intravenous access to the clients who survived a large-scale disaster. A triage officer rapidly evaluates each client to determine priorities for treatment. Prehospital care providers are the first caregivers that clients see before transport to the emergency department (ED) by an ambulance or helicopter. Emergency medical technicians provide basic life support interventions such as oxygen and basic wound care to the clients who survived large-scale disaster.
Which initial role would the registered nurse say is the priority action of first responders after a community disaster?
A. Providing on-site first aid
B. Providing emergency care
C. Removing the victims from danger
D. Categorizing victims using triage system
First-responders in a disaster include other disaster-trained emergency personnel who had specific search and rescue training. The priority action of first responders is to remove injured and uninjured victims. The nursing staff provides on-site first aid and emergency care. After removing victims from danger, the health care personnel categorize victims using the triage system.
Which activities would the nurse be prepared to perform as a member of a disaster preparedness team if a disaster were to occur? Select all that apply.
A. Triage
B. Palliative care
C. Home visits to newborns
D. Decontamination procedures
E. Evaluation of the disaster plan
If a disaster were to occur, the nurse may be required to work with hospitals and community disaster preparedness groups. The nurse must be prepared to triage mass casualties. The nurse may also be involved in decontamination procedures in case of a biological attack. The nurse must evaluate the strengths and weaknesses of the disaster management plan. The nurse provides palliative care to clients whose health status does not improve. This is not an aspect of working on a disaster preparedness team. The nurse provides community-based care by visiting the homes of newborns especially those of high-risk mothers.