Ch7 | Full Test Bank – Nursing Care Of Patients Experiencing - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 7 Nursing Care of Patients Experiencing Disasters
1) A school bus transporting approximately 60 students crashed on the side of the road. Which classification should the nurse use to describe the situation?
1. Multiple-casualty incident
2. Natural disaster
3. Human-generated disaster
4. Mass-casualty incident
Page Ref: 160
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.1 Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
2) A patient received injuries during an earthquake. Which type of incident should the nurse identify as causing this patient's injuries?
1. Natural disaster
2. Human-generated disaster
3. Emergency
4. Multiple-casualty incident
Page Ref: 160
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.1 Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
3) A small commuter plane crashed into a shopping mall, injuring approximately 500 people. Which classification of incident should the nurse use when determining the care needed for these victims?
1. Mass-casualty incident
2. Multiple-casualty incident
3. Accidental natural disaster
4. Intentional human-generated disaster
Page Ref: 160
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.1 Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
4) A derailed train caused a hazardous spill with noxious gasses released into the environment. Local and surrounding fire control and Hazmat teams are controlling the event. For which type of situation should the nurse prepare?
1. Emergency
2. Disaster
3. Human-generated accidental disaster
4. Intentional emergency
Page Ref: 160
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.1 Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
5) The nurse is caring for patients when a dirty bomb detonates at a nearby shopping mall. Which types of injuries should the nurse expect to see in the victims?
1. Radiation sickness
2. Fractured limbs and spinal injury
3. Thermal burns
4. Overexertion and exhaustion
Page Ref: 164
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.3 Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 3. Differentiate between the types of terrorism and associated injuries.
6) A patient with injuries from an explosion at a nuclear power plant is confused and keeps repeating "I'm on fire." What does this information indicate to the nurse?
1. The patient may not recover.
2. The patient's clothing is burning his skin.
3. There is gastrointestinal system involvement and the patient will survive if he receives fluids.
4. There is bone marrow damage, and the patient needs oxygen for the confusion.
Page Ref: 165
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
7) A patient is brought into the emergency department complaining of blindness after an explosion at an atomic power plant. What should the nurse explain to this patient?
1. "The effects of the blast will disappear with time."
2. "I'm afraid the blast has caused permanent blindness."
3. "I will contact Social Services so that resources can be identified to help you with your disability."
4. "There is a variety of resources available for those who are unable to see."
Page Ref: 165
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
8) The nurse is caring for a patient who experienced a blast injury to the eye. Which intervention would be appropriate?
1. Flush the eye with eyewash.
2. Encourage the patient to rub the eye to get out specks of dust.
3. Apply a warm compress to the eye.
4. Remove debris lodged in the eye.
Page Ref: 164
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 3. Differentiate between the types of terrorism and associated injuries.
9) The nurse is admitting the second patient in 2 days who is experiencing malaise, high fever, and headache. Both patients attended a local air show the previous weekend. What should the nurse do?
1. Discuss the need to contact public health authorities regarding the similarity of the cases.
2. Plan to place the patients in the same room.
3. Ask the patients for permission to talk with family members regarding other symptoms.
4. Assess the patients for what foods they ate while at the air show.
Page Ref: 164
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.4. Communicate observations or concerns related to hazards and errors to patients, families and the healthcare team | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.3 Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 3. Differentiate between the types of terrorism and associated injuries.
10) An individual with injuries sustained in a natural gas explosion is unable to respond to questions and keeps repeating "I can't hear." For what should the nurse assess this patient?
1. Tympanic membrane rupture
2. Air embolism
3. Oxygen saturation level
4. Confusion
Page Ref: 165
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
11) A victim of a chemical plant explosion is unconscious and brought into the emergency department. For what should the nurse assess this patient?
1. Central nervous system injury
2. Respiratory system injury
3. Pulmonary emboli
4. Radiation sickness
Page Ref: 165
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
12) Victims of a school bus crash are being triaged at the accident site. What principle should be followed when implementing reverse triage? Select all that apply.
1. Used when there is a mass casualty event with more than 100 victims.
2. Works on the principle of the greatest good for the greatest number.
3. Categorizes victims needing the most support and emergency care as red, so they can be treated first.
4. Color-codes victims most likely to survive as black to be treated first.
5. Works on the principle of the greatest good for the most critically ill.
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
13) After a serious highway accident involving 22 vehicles, ambulatory victims with minor injuries are transported home. For which reason were these victims triaged first?
1. Do the greatest good for the greatest number of people.
2. Remove them so they do not see the critically injured victims.
3. Secure the site in case the vehicles become overheated and ignite.
4. Improve traffic conditions to clear the accident site quickly.
Page Ref: 169
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
14) At the site of a collapsed building, some victims are walking away from the building, while others are lying on the ground around the perimeter. What should be done first when implementing reverse triage?
1. Identify one safe location for all ambulatory victims to be assessed and observed.
2. Systematically assess each victim lying on the ground and assign a color.
3. Enter the building to locate other victims who might not have been able to leave before the collapse.
4. Transfer the victims on the ground to stretchers and send them to the local emergency department.
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
15) A victim of a plane crash exits the plane and tells emergency personnel that a family member is inside and unable to walk. Which action should be taken?
1. Assist with clearing all the victims who are ambulatory first, then locate the trapped victim.
2. Enter the plane to locate the trapped victim.
3. Tell the victim that the family member will be fine and will be removed from the plane as soon as possible.
4. Tell the victim to go back inside and try to get the family member to walk.
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
16) The nurse arrives at the site of a bombed building. When preparing to triage victims, in which zone should the nurse conduct decontamination?
1. Warm
2. Hot
3. Cold
4. Green
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
17) Emergency response personnel are wearing gowns, gloves, goggles, and masks. In which decontamination zone are these personnel most likely working?
1. Hot
2. Warm
3. Cold
4. Yellow
Page Ref: 169
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
18) Several victims of a suspected biologic attack are brought into the emergency department. Which type of personal protective equipment should be provided to these victims?
1. Mask
2. Gown
3. Gloves
4. Goggles
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
19) At the site of a building collapse, ambulances are nearby and a shelter has been set up with carts, chairs, tables, and refreshments for the victims. Within which decontamination zone are the victims being assessed?
1. Cold
2. Warm
3. Control
4. Hot
Page Ref: 169
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
20) The nurse is reviewing the stages and phases of a disaster as part of a continuing education program in the hospital. In which order should the nurse list the stages of disaster management?
1. Preparedness, mitigation, response, recovery, and evaluation
2. Mitigation, preparedness, response, recovery, and evaluation
3. Mitigation, response, recovery, preparedness, and evaluation
4. Response, mitigation, evaluation, recovery, and preparedness
Page Ref: 161
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.2 Outline the five phases of the disaster continuum and discuss the nurse's role in each.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
21) The nurse is planning a program to address disaster mitigation activities in the community. What should the nurse consult when preparing this program?
1. Community disaster preparedness plan
2. Hospital administrators
3. Physicians with practices in the community
4. Schools and day care centers
Page Ref: 171
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
22) The nurse is presenting a program to residents of a local senior citizen housing facility about preparations in the event of a disaster. What should the nurse instruct the participants to do regarding essential preparations?
1. Have a list of medications, emergency contact numbers, and necessary survival items readily available.
2. Turn off all electrical devices before leaving the premises.
3. Pack enough nonperishable food items to last for several days.
4. Bring recreational items such as puzzles and card games for entertainment.
Page Ref: 172
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
23) A group of nurses are attending a meeting to discuss the outcome and results of care provided to victims of a recent building collapse. In which phase of the disaster planning process are the nurses participating?
1. Evaluation
2. Recovery
3. Restoration
4. Response
Page Ref: 163
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 7.2 Outline the five phases of the disaster continuum and discuss the nurse's role in each.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
24) The nurse is planning to attend a program to learn how to respond to mass casualty incidents. Which core competencies should the nurse expect to learn during this program? Select all that apply.
1. Risk reduction, disease prevention, and health promotion
2. Nursing process
3. Policy development and planning
4. Community care
5. Ethical and legal practice
Page Ref: 160
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 7.1 Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
25) A subway derailed injuring approximately 250 passengers. For which type of situation should the emergency department manager prepare?
1. Natural disaster
2. Multiple-casualty incident
3. Mass-casualty incident
4. Accidental disaster
Page Ref: 160
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.1 Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
26) An organization has been alerted to a possible illness associated with the tainting of a popular over-the-counter pain reliever. For which type of event should the facility plan?
1. Nonconventional terrorist attack
2. Conventional terrorist attack
3. Accidental disaster
4. Natural disaster
Page Ref: 163
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.3 Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 3. Differentiate between the types of terrorism and associated injuries.
27) An unusually high number of patients are coming into the emergency department with complaints of nausea, vomiting, and severe headache. What should be done with this information?
1. No further action is needed at this time.
2. Contact the Infection Control Department and Laboratory Medicine.
3. Close the emergency department.
4. Call for more staffing to handle all the patients.
Page Ref: 164
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.3 Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 3. Differentiate between the types of terrorism and associated injuries.
28) A patient is concerned about a terrorist attack because of living near the airport. Which response should the nurse make?
1. "Have you thought about moving?"
2. "That's silly to be so worried."
3. "What do you have in your home to help you in the event of a terrorist attack?"
4. "I would be concerned, too."
Page Ref: 161
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.2 Outline the five phases of the disaster continuum and discuss the nurse's role in each.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
29) The nursing staff is planning to attend a presentation on disaster prevention. What should the nurse expect the purpose of this education to be?
1. Learn the organization's disaster plan
2. Participate in the plan for handling a disaster
3. Educate on how to recognize possible terrorists
4. Learn how to participate in mitigation
Page Ref: 170
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
30) The community is holding a memorial service to honor members whose lives were lost in a flood one year ago. In which stage of the disaster recovery process is this community?
1. Restoration
2. Recovery
3. Mitigation
4. Evaluation
Page Ref: 163
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.2 Outline the five phases of the disaster continuum and discuss the nurse's role in each.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
31) During a disaster preparedness presentation, the nurse learns about the harmful effects of a dirty bomb. Which treatment should the nurse realize will preserve life in the event of this disaster?
1. Support for the patient who will develop radiation sickness
2. Heart-lung transplant
3. Liver transplant
4. Bone marrow transplant
Page Ref: 167
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
32) A patient is brought into the emergency department with chemical burns. What should the nurse do to help this patient?
1. Check to see if all clothing has been removed and begin flushing the patient's skin with water.
2. Begin flushing the patient's clothes and skin with warm water.
3. Do not remove any jewelry.
4. Keep the patient's contact lenses in place and flush only with warm water.
Page Ref: 165
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
33) The National Weather Service has announced the likelihood of a large snow event in a major metropolitan area. For which type of health problem should the nurses in the emergency department prepare?
1. Stress-related injuries
2. Crushing injuries
3. Myocardial infarctions
4. Burns
Page Ref: 167
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
34) The emergency response team is setting up an area in which to triage victims of a building blast in a major metropolitan area. Which zone should the nurse identify to set up the location for triage?
1. Hot
2. Warm
3. Cold
4. Clean
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
35) The nurse is planning the coding for a triage disaster plan. Which colors should the nurse use for this plan? Select all that apply.
1. White
2. Red
3. Yellow
4. Black
5. Green
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
36) A female arrives at the site of a disaster, hysterically crying because of being in the building that collapsed just minutes earlier. What should the nurse do with this patient?
1. Advise to go home and be with family.
2. Triage the patient and transport to the hospital.
3. Have a nurse talk with the patient.
4. Ask psychiatric service personnel to talk with this patient.
Page Ref: 170
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Crisis Intervention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
37) An older patient asks what can be done to prepare for a disaster in the community. How should the nurse respond?
1. "There is not really much we can do to be prepared."
2. "Plan to evacuate your home at a moment's notice."
3. "Make sure all your important papers, health information, medication information, and next-of-kin information is in one place."
4. "Make sure you can call your family to come and pick you up if this happens."
Page Ref: 172
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
38) A patient is coded red after a mass casualty accident. What care should the nurse provide to this patient?
1. Send the patient home.
2. Evaluate the patient in the next few hours.
3. Immediately evaluate this patient.
4. Permit the family to be with the patient as death approaches.
Page Ref: 169
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.2. Demonstrate effective use of strategies to reduce risk of harm to self or others | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Quality and Safety; Practice-Know-How; Use technologies that contribute to safety | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
39) Utilizing the simple triage and rapid transport (START) system, in what order should the nurse prioritize the following patients? Place in order the steps of the process.
Choice 1. A 67-year-old male complaining of chest pain. His heart rate is 120 beats/minute, his blood pressure is 100/68 mmHg, and his respiratory rate is 20 breaths/min.
Choice 2. A 27-year-old woman presenting with a respiratory rate of 36 breaths/minute and capillary refill of 4 seconds.
Choice 3. A 58-year-old woman who is able to walk on her own and states over and over, "I don't know what happened."
Choice 4. A 30-year-old male with a collapsed airway and multiple chest trauma. He does not have a palpable carotid pulse and the nurse is unable to assess respiratory movement.
Page Ref: 169
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
40) There is a radiologic dispersion bomb (dirty bomb) explosion in a subway station. In what order should the nurse deliver patient care at the scene of the explosion? Place in order the steps of the process.
Choice 1. Begin direct patient care for complaints of fatigue and nausea.
Choice 2. Decontaminate clothing of patients.
Choice 3. Assess patients for burns and blunt trauma.
Choice 4. Evacuate patients from the exposure area.
Page Ref: 167
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 7.4 Differentiate the common injuries associated with various types of disasters.
MNL Learning Outcome: 2. Differentiate between the types of disasters and associated injuries.
41) A local hospital has coordinated with the county emergency management team to plan and conduct disaster drills on a monthly basis. In which phase of disaster management planning is this hospital functioning?
1. Preparedness
2. Mitigation
3. Response
4. Evaluation
Page Ref: 161
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.2 Outline the five phases of the disaster continuum and discuss the nurse's role in each.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
42) The administrator of a multihospital healthcare system contacts the National Response Framework (NRF) for help with managing care for victims of a flood. What assistance should the administrator expect to receive from this organization? Select all that apply.
1. Standing orders used when caring for victims of a flood
2. Information about local relief agencies available to assist
3. Frequency in which the area has flooded over the last 10 years
4. Amount of time a flood victim can withstand submersion in cold water
5. Names of organizations within the private sector that can help the victims
Page Ref: 162
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.2 Outline the five phases of the disaster continuum and discuss the nurse's role in each.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
43) A community hospital has been notified of a plane crash that occurred during a local air show. Which information will the hospital leadership need to prepare for the crash victims? Select all that apply.
1. Number of families who live in the community
2. Number of available beds in the hospital
3. Telephone list of staff to be called in to work immediately
4. Amount of intravenous fluids and emergency medications
5. List of current patients who can be immediately discharged
Page Ref: 162
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.2 Outline the five phases of the disaster continuum and discuss the nurse's role in each.
MNL Learning Outcome: 1. Demonstrate understanding of emergencies, disasters, and the disaster continuum.
44) The nurse notes that a large number of community members with diabetes have experienced insufficient glucose control and cold symptoms since a tornado ripped through the area a few weeks ago. What should the nurse consider as the cause for these symptoms? Select all that apply.
1. Blood stasis in extremities
2. Hindered immune response
3. Change in basal metabolic rate
4. Paralysis of gastrointestinal tract
5. Alteration in nutrient metabolism
Page Ref: 171
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
45) Survivors of a bioterrorist attack are receiving basic care and support in a local motel until further plans for placement can be made. Several of these victims have been receiving care for autoimmune disorders. What should the nurse consider when providing these victims with food over the next several hours? Select all that apply.
1. Offer fresh salads.
2. Ensure that fruit is fresh.
3. Provide bottled water.
4. Provide cooked or processed meals.
5. Fill pitchers with tap water.
Page Ref: 172
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
46) A series of thunderstorms ripped through a small town, causing massive power outages. The community nurse is reviewing the list of community members who might be adversely affected by the loss of power. For which residents should the nurse provide immediate care and support? Select all that apply.
1. 16-year-old male with asthma
2. 75-year-old male with sleep apnea
3. 72-year-old male with a pacemaker
4. 45-year-old female with multiple sclerosis
5. 86-year-old female who requires continuous oxygen 2 liters nasal cannula
Page Ref: 172
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.9. Use clinical judgment and decision-making skills in appropriate, timely nursing care during disaster, mass casualty, and other emergency situations | NLN Competencies: Context and Environment; Practice-Know-How; apply health promotion/disease prevention strategies | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7.5 Describe the interprofessional care and nursing care of patients in a disaster.
MNL Learning Outcome: 4. Utilize the nursing process in the care of patients in a disaster.
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