Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition by Priscilla T LeMone , Karen M. Burke, Gerene Bauldoff , Paula Gubrud Test Bank

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Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition by Priscilla T LeMone , Karen M. Burke, Gerene Bauldoff , Paula Gubrud Test Bank

Description

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Chapter 7

Question 1
Type: MCSA
A school bus transporting a local universitys basketball team has just crashed in the rain on the side of the road. The bus was transporting approximately 60 people. 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
Correct Answer: 1
Rationale 1: A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care.
Rationale 2: Natural disasters are caused by acts of nature or emerging diseases.
Rationale 3: Human-generated disasters are either accidental or intentional.
Rationale 4: A mass-casualty incident occurs quickly and suddenly and overwhelms local resources with many seriously ill or injured victims needing care.
Global Rationale: A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care. Natural disasters are caused by acts of nature or emerging diseases. Human-generated disasters are either accidental or intentional. A mass-casualty incident occurs quickly and suddenly and overwhelms local resources with many seriously ill or injured victims needing care.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1. Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 119

Question 2
Type: MCSA
The nurse is caring for a patient with injuries received in an earthquake. Which type of incident should the nurse identify as causing this patients injuries?
1. natural disaster
2. human-generated disaster
3. emergency
4. multiple-casualty incident
Correct Answer: 1
Rationale 1: Natural disasters are caused by acts of nature and may be predictable, through advanced meteorological technologies, or unexpected. An earthquake is an example of a natural disaster.
Rationale 2: A human-generated disaster can be either accidental or intentional. An example of a human-generated disaster is war or biological warfare.
Rationale 3: An emergency can generally be handled within the emergency management system.
Rationale 4: A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care.
Global Rationale: Natural disasters are caused by acts of nature and may be predictable through advanced meteorological technologies or unexpected. An earthquake is an example of a natural disaster. A human-generated disaster can be either accidental or intention. An example of a human-generated disaster is war or biological warfare. An emergency can generally be handled within the emergency management system. A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1. Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 118

Question 3
Type: MCSA
A small commuter plane lost an engine and crashed into a shopping mall. The estimated number of injured people from this accident is 500. 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
Correct Answer: 1
Rationale 1: A mass-casualty incident occurs quickly and suddenly and overwhelms local resources with many seriously ill or injured victims needing care.
Rationale 2: A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care.
Rationale 3: Natural disasters are caused by acts of nature or emerging diseases.
Rationale 4: An intentional human-generated disaster is done with specific intent.
Global Rationale: A mass-casualty incident occurs quickly and suddenly and overwhelms local resources with many seriously ill or injured victims needing care. A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care. Natural disasters are caused by acts of nature or emerging diseases. An intentional human-generated disaster is done with specific intent.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1. Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 119

Question 4
Type: MCSA
A train derailed in a local community. The contents of the train caused a hazardous spill, and noxious gasses are being released into the environment. All local and surrounding fire control and Hazmat teams have been mobilized and the event is considered under control. Which type of situation should the nurse prepare for?
1. emergency
2. disaster
3. human-generated accidental disaster
4. intentional emergency
Correct Answer: 1
Rationale 1: The difference between an emergency and a disaster is that an emergency can be handled by the management systems in place. Because the fire and Hazmat teams handled the event, it is considered an emergency.
Rationale 2: A disaster would overwhelm the management systems in place.
Rationale 3: Because the management systems in place were able to handle the event, this is not a disaster.
Rationale 4: Intentional emergency is not a classification used for these types of event.
Global Rationale: The difference between an emergency and a disaster is that an emergency can be handled by the management systems in place. Because the fire and Hazmat teams handled the event, it is considered an emergency rather than a disaster. A disaster would overwhelm the management systems in place. Intentional emergency is not a classification used for these types of event.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1. Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 118

Question 5
Type: MCSA
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
Correct Answer: 1
Rationale 1: Radiation sickness commonly occurs with a radiological dispersion bomb or dirty bomb blast.
Rationale 2: Fractured limbs and spinal injury can occur with blunt trauma.
Rationale 3: Thermal burns occur with nuclear detonation.
Rationale 4: Overexertion and exhaustion occur in other types of injuries, such as snowstorm-related injuries.
Global Rationale: Radiation sickness commonly occurs with a radiological dispersion bomb or dirty bomb blast. Fractured limbs and spinal injury can occur with blunt trauma. Thermal burns occur with nuclear detonation. Overexertion and exhaustion occur in other types of injuries, such as snowstorm-related injuries.

Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2. Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 121, 124

Question 6
Type: MCSA
Several patients are admitted after being exposed to a substance that was released in their manufacturing plant. The patients are demonstrating flu-like symptoms, unproductive cough, and fever. These patients should be assessed for which type of exposure?
1. anthrax
2. smallpox
3. dirty bomb
4. nuclear detonation
Correct Answer: 1
Rationale 1: Inhalation anthrax carries the highest mortality rate among biologic weapons. The patient initially exhibits influenza-like symptoms such as fever, nonproductive cough, headache, and malaise that advance to respiratory distress, mediastinal widening, and hemodynamic collapse in 3 to 5 days. Death may occur shortly thereafter. Untreated patients die in 2 to 3 days.
Rationale 2: Smallpox spreads by direct contact or by inhalation of respiratory droplets. Symptoms include a high fever, headache, and malaise, followed by a vesicular/pustular rash appearing simultaneously on the face and extremities.
Rationale 3: A dirty bomb causes radiation sickness.
Rationale 4: Nuclear detonation causes thermal burns.
Global Rationale: Inhalation anthrax carries the highest mortality rate among biologic weapons. The patient initially exhibits influenza-like symptoms such as fever, nonproductive cough, headache, and malaise that advance to respiratory distress, mediastinal widening, and hemodynamic collapse in 3 to 5 days. Death may occur shortly thereafter. Untreated patients die in 2 to 3 days. Smallpox spreads by direct contact or by inhalation of respiratory droplets. Symptoms include a high fever, headache, and malaise, followed by a vesicular/pustular rash appearing simultaneously on the face and extremities. A dirty bomb causes radiation sickness. Nuclear detonation causes thermal burns.

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2. Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.4. Identify high risk biological pathogens mode of transmission and symptoms.
Page Number: 121

Question 7
Type: MCSA
The nurse is caring for a patient who was brought into the emergency department after an explosion at a nuclear power plant. The patient is confused and keeps repeating that his skin is on fire. What does this information indicate to the nurse?
1. The patient may not recover.
2. The patients 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.
Correct Answer: 1
Rationale 1: For victims of a nuclear detonation, comfort measures, such as psychologic support and empathy, are given.
Rationale 2: The patients clothing would be burning his skin if he had experienced a chemical injury.
Rationale 3: Evidence of gastrointestinal system involvement would be nausea, loss of appetite, diarrhea, and malaise.
Rationale 4: Evidence of bone marrow damage would be nausea, fatigue, malaise, clotting disorders, and hemorrhage.
Global Rationale: For victims of a nuclear detonation, comfort measures, such as psychologic support and empathy, are given. The patients clothing would be burning his skin if he had experienced a chemical injury. Evidence of gastrointestinal system involvement would be nausea, loss of appetite, diarrhea, and malaise. Evidence of bone marrow damage would be nausea, fatigue, malaise, clotting disorders, and hemorrhage.

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2. Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.4. Identify high risk biological pathogens mode of transmission and symptoms.
Page Number: 124-125

Question 8
Type: MCSA
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. Im 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.
Correct Answer: 1
Rationale 1: The bright flash of a nuclear detonation can cause temporary blindness, but vision returns in up to 30 minutes. The patient may need assistance until vision is restored. The nurse should explain that the effects of the blast will disappear with time.
Rationale 2: The nurse should not say that the patient is permanently blind.
Rationale 3: The nurse does not need to contact social services at this time for the patients temporary blindness.
Rationale 4: Suggesting resources for the vision-impaired is premature, as the blindness is temporary.
Global Rationale: The bright flash of a nuclear detonation can cause temporary blindness, but vision returns in up to 30 minutes. The patient may need assistance until vision is restored. The nurse should explain that the effects of the blast will disappear with time. The nurse should not say that the patient is permanently blind. The nurse does not need to contact social services at this time for the patients temporary blindness. Suggesting resources for the vision-impaired is premature, as the blindness is temporary.

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2. Describe the types of injuries and manifestations associated with biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.4. Identify high risk biological pathogens mode of transmission and symptoms.
Page Number: 124

Question 9
Type: MCSA
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.
Correct Answer: 1
Rationale 1: The nurse should flush the patients eye with eyewash.
Rationale 2: The patient should be cautioned not to rub the eye that has specks of dust or debris in it.
Rationale 3: A cool compress and not a warm compress should be applied to the eye.
Rationale 4: Debris lodged in the eye should be stabilized and not removed without medical attention.
Global Rationale: The nurse should flush the patients eye with eyewash. The patient should be cautioned not to rub the eye that has specks of dust or debris in it. A cool, not warm, compress should be applied to the eye. Debris lodged in the eye should be stabilized, not removed without medical attention.

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 6. Discuss common nursing interventions for the treatment of injuries related to biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 124

Question 10
Type: MCSA
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.
Correct Answer: 1
Rationale 1: The nurse should be alert to illness patterns that could indicate an unusual infectious disease outbreak. Indicators of a biologic agent release include an increased disease incidence among people who attended the same event. The presence of one or more indicators should be reported to public health authorities to determine the source of the infectious disease and prevent further exposure.
Rationale 2: Placing the patients in the same room may or may not be appropriate.
Rationale 3: The family members of the patients do not need to be assessed at this time.
Rationale 4: The foods ingested during the air show may not provide enough information about the patients exposure.
Global Rationale: The nurse should be alert to illness patterns that could indicate an unusual infectious disease outbreak. Indicators of a biologic agent release include an increased disease incidence among people who attended the same event. The presence of one or more indicators should be reported to public health authorities to determine the source of the infectious disease and prevent further exposure. Placing the patients in the same room may or may not be appropriate. The family members of the patients do not need to be assessed at this time. The foods ingested during the air show may not provide enough information about the patients exposure. The nurse should contact public health authorities.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
QSEN Competencies: V.B.4. Communicate observations or concerns related to hazards and errors to patients, families and the health care 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; 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: 6. Discuss common nursing interventions for the treatment of injuries related to biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 121

Question 11
Type: MCSA
An individual arrives at the emergency department with injuries sustained in a natural gas explosion. The patient is unable to respond to questions and keeps repeating I cant hear. For what should the nurse assess this patient?
1. tympanic membrane rupture
2. air embolism
3. oxygen saturation level
4. confusion
Correct Answer: 1
Rationale 1: After a blast injury, damage to the ear can include tympanic membrane rupture or damage to the cochlea. As the patient is expressing difficulty hearing, the tympanic membrane should be assessed.
Rationale 2: An air embolism would impact the patients respiratory status.
Rationale 3: There is no evidence to suggest the patients oxygen saturation level is impaired.
Rationale 4: There is no evidence of confusion.
Global Rationale: After a blast injury, damage to the ear can include tympanic membrane rupture or damage to the cochlea. As the patient is expressing difficulty hearing, the tympanic membrane should be assessed. An air embolism would impact the patients respiratory status. There is no evidence to suggest the patients oxygen saturation level is impaired. There is no evidence of confusion.

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 6. Discuss common nursing interventions for the treatment of injuries related to biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 123

Question 12
Type: MCSA
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
Correct Answer: 1
Rationale 1: The patient who is unconscious after an explosion should be further assessed for concussion, closed and open brain injury, stroke, spinal cord injury, or air embolism-induced injury.
Rationale 2: Respiratory system injuries would manifest as hemothorax, pneumothorax, or pulmonary contusion and hemorrhage.
Rationale 3: Pulmonary emboli can occur with respiratory or cardiac system injuries.
Rationale 4: Evidence of radiation sickness includes nausea, diarrhea, and malaise.
Global Rationale: The patient who is unconscious after an explosion should be further assessed for a concussion, closed and open brain injury, stroke, spinal cord injury, or air embolism-induced injury. Respiratory system injuries would manifest as hemothorax, pneumothorax, or pulmonary contusion and hemorrhage. Pulmonary emboli can occur with respiratory or cardiac system injuries. Evidence of radiation sickness includes nausea, diarrhea, and malaise.

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 6. Discuss common nursing interventions for the treatment of injuries related to biologic, chemical, or radiologic terrorism.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 123

Question 13
Type: MCMA
Two school buses carrying 75 children each collide en route to an out-of-state field trip. The emergency department nurse knows that reverse triage will need to be instituted. What principles should the nurse follow when implementing reverse triage?
Standard Text: Select all that apply.
1. When there is a mass casualty event with more than 100 victims, reverse triage may be instituted.
2. Reverse triage works on the principle of the greatest good for the greatest number.
3. A very basic reverse triage system is to categorize or label victims needing the most support and emergency care as red, so they can be treated first.
4. Victims most likely to survive are color-coded black, and are treated first.
5. Reverse triage works on the principle of the greatest good for the most critically ill.
Correct Answer: 1,2
Rationale 1: This is a principle of reverse triage.
Rationale 2: This is a principle of reverse triage.
Rationale 3: This is a principle of basic triage.
Rationale 4: Victims who are color-coded black are not likely to survive.
Rationale 5: Basic triage works on the principle of the greatest good for the most critically ill.
Global Rationale: When there is a mass casualty event with more than 100 patients, reverse triage may be instituted. Reverse triage works on the principle of the greatest good for the greatest number. Labeling victims needing the most support and emergency care as red so they can be treated first is a principle of basic triage. Victims who are color-coded black are not likely to survive. Basic triage works on the principle of the greatest good for the most critically ill.

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3. Describe accepted triage principles used to manage multiple or mass casualty incidents and disasters.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 125

Question 14
Type: MCSA
A serious highway accident on a foggy night involves 22 vehicles. Several of the victims are ambulatory. The emergency personnel determine that their injuries are minor and arrange for transportation home. Why are these victims triaged first?
1. To do the greatest good for the greatest number of people
2. To remove them so they do not see the critically injured victims
3. To secure the site in case the vehicles become overheated and ignite
4. To improve traffic conditions to clear the accident site quickly
Correct Answer: 1
Rationale 1: Reverse triage works on the principle of the greatest good for the greatest number of people.
Rationale 2: Because these victims are ambulatory, with minor injuries, emergency personnel arrange for them to be transported home and away from the scene of the accident. The purpose of reverse triage is not to prevent them from seeing critically injured victims.
Rationale 3: The purpose of reverse triage is not to secure the accident site.
Rationale 4: The purpose of reverse triage is not to improve traffic conditions.
Global Rationale: Reverse triage works on the principle of the greatest good for the greatest number of people. Because victims are ambulatory, with minor injuries, emergency personnel arrange for them to be transported home and away from the scene of the accident. The purpose of reverse triage is not to prevent them from seeing critically injured victims, to secure the accident site, or improve traffic conditions.

Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3. Describe accepted triage principles used to manage multiple or mass casualty incidents and disasters.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 125

Question 15
Type: MCSA
Emergency response personnel arrive 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. If implementing reverse triage, what should the emergency personnel do first?
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.
Correct Answer: 1
Rationale 1: Reverse triage works on the principle of the greatest good for the greatest number of people. The emergency personnel should first identify one safe location for all ambulatory victims to be assessed and observed.
Rationale 2: Systematically assessing the victims on the ground and assigning colors is not following the principle of reverse triage.
Rationale 3: Entering the building to locate other victims would be done after all victims who are ambulatory or on the ground are assessed and treated.
Rationale 4: Transferring victims on the ground to stretchers and sending them to local emergency departments is done after systematic assessment.
Global Rationale: Reverse triage works on the principle of the greatest good for the greatest number of people. The emergency personnel should first identify one safe location for all ambulatory victims to be assessed and observed. Systematically assessing the victims on the ground and assigning colors is not following the principle of reverse triage. Entering the building to locate other victims would be done after all victims who are ambulatory or on the ground are assessed and treated. Transferring victims on the ground to stretches and sending them to local emergency departments is done after systematic assessment.

Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3. Describe accepted triage principles used to manage multiple or mass casualty incidents and disasters.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 125

Question 16
Type: MCSA
A victim of a plane crash exits the plane and runs to an emergency provider to tell him that his mother is trapped inside and is unable to walk out on her own. What should the emergency provider do?
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 victims son that his mother 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 his mother on her feet.
Correct Answer: 1
Rationale 1: If following the principles of reverse triage, emergency personnel should assist with clearing all victims who are ambulatory first and then locate the trapped victim.
Rationale 2: The emergency provider should not enter the plane to locate the trapped victim first.
Rationale 3: The emergency provider should not tell the son that his mother will be fine because there is no way of knowing the extent of her injuries.
Rationale 4: The emergency provider should not tell the son to go back inside the wreckage and get his mother on her feet.
Global Rationale: If following the principles of reverse triage, emergency personnel should assist with clearing all victims who are ambulatory first and then locate the trapped victim. The emergency provider should not enter the plane to locate the trapped victim first. The emergency provider should not tell the son that his mother will be fine because there is no way of knowing the extent of her injuries. The emergency provider should not tell the son to go back inside the wreckage and get his mother on her feet.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3. Describe accepted triage principles used to manage multiple or mass casualty incidents and disasters.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 125

Question 17
Type: MCSA
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
Correct Answer: 1
Rationale 1: The warm zone, or control zone, is adjacent to the hot zone. This is where the decontamination of victims or triage and emergency treatment takes place.
Rationale 2: The site where a weapon was released or where contamination occurred is called the hot zone. It is considered to be contaminated, and only those persons in the appropriate personal protective equipment may enter this zone.
Rationale 3: The cold zone is considered the safe zone.
Rationale 4: There is no green zone when working with decontamination.
Global Rationale: The warm zone, or control zone, is adjacent to the hot zone. This is where the decontamination of victims or triage and emergency treatment takes place. The site where a weapon was released or where contamination occurred is called the hot zone. It is considered to be contaminated, and only those persons in the appropriate personal protective equipment may enter this zone. The cold zone is considered the safe zone. There is no green zone when working with decontamination.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4. Recognize situations requiring the need for patient isolation or patient decontamination.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 125

Question 18
Type: MCSA
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
Correct Answer: 1
Rationale 1: The site of the disaster where a weapon was released or where contamination occurred is called the hot zone. It is considered contaminated, and only those persons in the appropriate personal protective equipment may enter this zone. This equipment includes gloves, masks, goggles, gowns, and biologic disposal bags.
Rationale 2: The warm zone is adjacent to the hot zone. This area is where decontamination of victims or triage and emergency treatment take place. The level of personal protective equipment required is based on the dynamic risk assessment of the threat and the agent involved.
Rationale 3: The cold zone is considered the safe zone. It is adjacent to the warm zone and is the area where a more in-depth triage of victims would occur. Personal protective equipment needs are minimal in this zone.
Rationale 4: There is no yellow decontamination zone.
Global Rationale: The site of the disaster where a weapon was released or where contamination occurred is called the hot zone. It is considered contaminated, and only those persons in the appropriate personal protective equipment may enter this zone. This equipment includes gloves, masks, goggles, gowns, and biologic disposal bags. The warm zone is adjacent to the hot zone. This area is where decontamination of victims or triage and emergency treatment take place. The level of personal protective equipment required is based on the dynamic risk assessment of the threat and the agent involved. The cold zone is considered the safe zone. It is adjacent to the warm zone and is the area where a more in-depth triage of victims would occur. Personal protective equipment needs are minimal in this zone. There is no yellow decontamination zone.

Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4. Recognize situations requiring the need for patient isolation or patient decontamination.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 125

Question 19
Type: MCSA
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
Correct Answer: 1
Rationale 1: In the event of a biologic attack, victims should be isolated from others or have some device to cover the nose and mouth to prevent the transmission of the organism. The victims should be wearing a mask.
Rationale 2: A gown would not be indicated at this time.
Rationale 3: Gloves would not be indicated at this time.
Rationale 4: Goggles would not be indicated at this time.
Global Rationale: In the event of a biologic attack, victims should be isolated from others or have some device to cover the nose and mouth to prevent the transmission of the organism. The victims should be wearing a mask. A gown, gloves, and goggles would not be indicated at this time.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4. Recognize situations requiring the need for patient isolation or patient decontamination.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 126

Question 20
Type: MCSA
The nurse is assessing victims of a building collapse. Ambulances are nearby and a shelter has been set up with carts, chairs, tables, and refreshments for the victims. The nurse is most likely working within which decontamination zone?
1. cold
2. warm
3. control
4. hot
Correct Answer: 1
Rationale 1: The cold zone is considered the safe zone. It is adjacent to the warm zone and is the area where a more in-depth triage of victims would occur. Survivors may find shelter in this area, and the command and control vehicles as well as emergency transport vehicles would be found here.
Rationale 2: The warm zone is adjacent to the hot zone. This is where decontamination of victims or triage and emergency treatment take place.
Rationale 3: Another name for the warm zone is the control zone. This is where decontamination of victims or triage and emergency treatment take place.
Rationale 4: The site where a weapon was released or contamination occurred is called the hot zone. It is considered to be contaminated, and only those persons in the appropriate personal protective equipment may enter this zone.
Global Rationale: The cold zone is considered the safe zone. It is adjacent to the warm zone and is the area where a more in-depth triage of victims would occur. Survivors may find shelter in this area, and the command and control vehicles as well as emergency transport vehicles would be found here. The warm zone is adjacent to the hot zone. This is where decontamination of victims or triage and emergency treatment take place. The site where a weapon was released or contamination occurred is called the hot zone. It is considered to be contaminated, and only those persons in the appropriate personal protective equipment may enter this zone.

Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4. Recognize situations requiring the need for patient isolation or patient decontamination.
MNL Learning Outcome: 0.2.3. Examine emergency response plans of care, triage, and site specific disaster zones.
Page Number: 125

Question 21
Type: MCSA
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, preparedness
Correct Answer: 1
Rationale 1: Disaster management is a cyclical process comprising preparedness, mitigation, response, recovery, and evaluation.
Rationale 2: The five basic stages of disaster management do not follow this sequence.
Rationale 3: The five basic stages of disaster management do not follow this sequence.
Rationale 4: The five basic stages of disaster management do not follow this sequence.
Global Rationale: Disaster management is a cyclical process comprising preparedness, mitigation, response, recovery, and evaluation.
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5. Discuss the role of the nurse in disaster preparedness, mitigation, response, and recovery.
MNL Learning Outcome: 0.2.2. Identify the required nursing educational competencies for responding to a mass casualty incident.
Page Number: 119

Question 22
Type: MCSA
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
Correct Answer: 1
Rationale 1: One role of the nurse in disaster planning is to prepare self, families, friends, and communities for disasters in conjunction with the local disaster preparedness plan.
Rationale 2: The nurse does not need to consult hospital administrators when planning this program.
Rationale 3: The nurse does not need to consult physicians when planning this program.
Rationale 4: The nurse does not need to consult schools and day care centers when planning this program.
Global Rationale: One role of the nurse in disaster planning is to prepare self, families, friends, and communities for disasters in conjunction with the local disaster preparedness plan. The nurse does not need to consult hospital administrators, physicians, or schools and day care centers when planning this program.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 5. Discuss the role of the nurse in disaster preparedness, mitigation, response, and recovery.
MNL Learning Outcome: 0.2.2. Identify the required nursing educational competencies for responding to a mass casualty incident.
Page Number: 119

Question 23
Type: MCSA
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.
Correct Answer: 1
Rationale 1: The nurse should instruct older adults to prepare a current list of medications, doses, and times of administration. The names and phone numbers of significant persons, relatives, those with power of attorney, healthcare providers, and any others to be notified in case of emergency should also be kept in an easily accessible place. Additionally, the following materials should be considered essential should evacuation to a shelter be necessary: eyeglasses and eyeglass prescriptions, style and serial numbers of medical devices such as pacemakers, healthcare policies and numbers, identification, list of allergies, blood type, checkbook, credit cards, insurance agents name and number, drivers license, 72-hour supply of medications, dentures, list of special dietary needs, sturdy shoes, warm clothing, blankets, incontinence briefs, prostheses, hearing aids, hearing aid batteries, extra wheelchair batteries, oxygen, and other assistive devices.
Rationale 2: The residents of a senior facility do not need to be concerned with turning off electrical devices.
Rationale 3: The residents of a senior facility do not need to be concerned with packing food items.
Rationale 4: Recreational items are not considered survival items.
Global Rationale: The nurse should instruct older adults to prepare a current list of medications, doses, and times of administration. The names and phone numbers of significant persons, relatives, those with power of attorney, healthcare providers, and any others to be notified in case of emergency should also be kept in an easily accessible place. Additionally, the following materials should be considered essential should evacuation to a shelter be necessary: eyeglasses and eyeglass prescriptions, style and serial numbers of medical devices such as pacemakers, healthcare policies and numbers, identification, list of allergies, blood type, checkbook, credit cards, insurance agents name and number, drivers license, 72-hour supply of medications, dentures, list of special dietary needs, sturdy shoes, warm clothing, blankets, incontinence briefs, prostheses, hearing aids, hearing aid batteries, extra wheelchair batteries, oxygen, and other assistive devices. The residents of a senior facility do not need to be concerned with turning off electrical devices or packing food items. Recreational items are not considered survival items.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5. Discuss the role of the nurse in disaster preparedness, mitigation, response, and recovery.
MNL Learning Outcome: 0.2.2. Identify the required nursing educational competencies for responding to a mass casualty incident.
Page Number: 128

Question 24
Type: MCSA
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
Correct Answer: 1
Rationale 1: The final stage of recovery is evaluation, which is also an activity in the preparation and planning aspects of the nondisaster stage. Future-oriented activities take place to prevent subsequent disasters or to minimize their effects. Nurses participate by discussing suggestions to improve the response time to victims or ways to improve treatment.
Rationale 2: The recovery aspect of disaster response, also called reconstruction, involves rebuilding and returning to some semblance of normalcy.
Rationale 3: Restoration includes rebuilding, replacing lost or damaged property, returning to school and work, and continuing life without those who were killed in the disaster.
Rationale 4: The response phase involves the immediate response to the disaster.
Global Rationale: The final stage of recovery is evaluation, which is also an activity in the preparation and planning aspects of the nondisaster stage. Future-oriented activities take place to prevent subsequent disasters or to minimize their effects. Nurses participate by discussing suggestions to improve the response time to victims or ways to improve treatment. The recovery aspect of disaster response is also called reconstruction. The response phase involves the immediate response to the disaster. The recovery and reconstruction phase involves rebuilding and returning to some semblance of normalcy.

Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 5. Discuss the role of the nurse in disaster preparedness, mitigation, response, and recovery.
MNL Learning Outcome: 0.2.2. Identify the required nursing educational competencies for responding to a mass casualty incident.
Page Number: 120

Question 25
Type: MCMA
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?
Standard Text: 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
Correct Answer: 1,3,4,5
Rationale 1: Disaster nursing competencies include risk reduction, disease prevention, and health promotion.
Rationale 2: The nursing process is not considered a core competency for disaster nursing.
Rationale 3: Disaster nursing competencies include policy development and planning.
Rationale 4: Disaster nursing competencies include community care.
Rationale 5: Disaster nursing competencies include ethical and legal practice.
Global Rationale: Disaster nursing competencies include risk reduction, disease prevention, and health promotion; policy development and planning; community care; and ethical and legal practice. The nursing process is not considered a core competency for disaster nursing.
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 5. Discuss the role of the nurse in disaster preparedness, mitigation, response, and recovery.
MNL Learning Outcome: 0.2.2. Identify the required nursing educational competencies for responding to a mass casualty incident.
Page Number: 118

Question 26
Type: MCSA
The hospital has been notified of a subway derailment involving approximately 250 passengers. Many of the passengers are reported to be injured. For which type of situation should the emergency department manager prepare?
1. a natural disaster
2. a multiple-casualty incident
3. a mass-casualty incident
4. an accidental disaster
Correct Answer: 3
Rationale 1: Natural disasters are caused by acts of nature or emerging diseases.
Rationale 2: A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care.
Rationale 3: A mass-casualty incident occurs quickly and suddenly and overwhelms local resources with many seriously ill or injured victims needing care.
Rationale 4: An accidental disaster is human-generated.
Global Rationale: A mass-casualty incident occurs quickly and suddenly and overwhelms local resources with many seriously ill or injured victims needing care. Natural disasters are caused by acts of nature or emerging diseases. A multiple-casualty event does not exceed the capacity of local resources to provide needed medical care. An accidental disaster is human-generated.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
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; conduct population-based transcultural health assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1. Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 119

Question 27
Type: MCSA
The care area has been alerted to a possible illness associated with the tainting of a popular over-the-counter pain reliever. The nurse realizes the tainting of this product is what kind of event?
1. a nonconventional terrorist attack
2. a conventional terrorist attack
3. an accidental disaster
4. a natural disaster
Correct Answer: 1
Rationale 1: Nonconventional terrorism uses chemical, biological, and nuclear means to release a toxin, contaminate a food source, or contaminate some other product.
Rationale 2: This would not be classified as a conventional type of terrorist attack.
Rationale 3: This would not be classified as an accidental disaster.
Rationale 4: This would not be classified as a natural disaster.
Global Rationale: Nonconventional terrorism uses chemical, biological, and nuclear means to release a toxin, contaminate a food source, or contaminate some other product. This would not be classified as a disaster or a conventional type of terrorist attack.

Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
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; Use technologies that contribute to safety
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 1. Explain the difference between an emergency and a disaster.
MNL Learning Outcome: 0.2.1. Explain the four phases of emergency response and the nurses responsibility during each phase.
Page Number: 120

Question 28
Type: MCSA
The emergency department nurses are noting an unusually high number of patients coming in 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.
Correct Answer: 2
Rationale 1: Many people must be alerted at this time.
Rationale 2: Healthcare providers must be alert when there is a change in the trend of symptoms within patients. The infection control nurse should be contacted. Laboratory medicine will run tests on specimens that would otherwise be discarded. The public health department is also contacted with this information.
Rationale 3: Closing the emergency department would not be necessary.
Rationale 4: Staffing may need to be adjusted based on the number or acuity of patients, not just a trend in symptoms.
Global Rationale: Healthcare providers must be alert when there is a change in the trend of symptoms within patients. The infection control nurse should be contacted. Laboratory medicine will run tests on specimens that would otherwise be

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