Chapter 10: Concepts of Emergency and Disaster Preparedness Ignatavicius

Chapter 10: Concepts of Emergency and Disaster Preparedness Ignatavicius

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A hospital responds to a local mass casualty event. Which action should the nurse supervisor take to prevent staff post-traumatic stress disorder during a mass casualty event?
   1. Provide water and healthy snacks for energy throughout the event.
   2. Schedule 16-hour shifts to allow for greater rest between shifts.
   3. Encourage counseling upon deactivation of the emergency response plan.
   4. Assign staff to different roles and units within the medical facility.

ANS:   A

To prevent staff post-traumatic stress disorder during a mass casualty event, the nurses should use available counseling, encourage and support co-workers, monitor each other’s stress level and performance, take breaks when needed, talk about feelings with staff and managers, and drink plenty of water and eat healthy snacks for energy. Nurses should also keep in touch with family, friends, and significant others, and not work for more than 12 hours per day. Encouraging counseling upon deactivation of the plan, or after the emergency response is over, does not prevent stress during the casualty event. Assigning staff to unfamiliar roles or units may increase situational stress and is not an approach to prevent post-traumatic stress disorder.

DIF:     Remembering/Knowledge                 REF: 145

KEY:   Post-traumatic stress disorder

MSC:   Integrated Process: Communication and Documentation  NOT:     Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

2. A client who is hospitalized with burns after losing the family home in a fire becomes angry and screams at a nurse when dinner is served late. How should the nurse respond?
   1. “Do you need something for pain right now?”
   2. “Please stop yelling. I brought dinner as soon as I could.”
   3. “I suggest that you get control of yourself.”
   4. “You seem upset. I have time to talk if you’d like.”

ANS:   D

Clients should be allowed to ventilate their feelings of anger and despair after a catastrophic event. The nurse establishes rapport through active listening and honest communication and by recognizing cues that the client wishes to talk. Asking whether the client is in pain as the first response closes the door to open communication and limits the client’s options. Simply telling the client to stop yelling and to gain control does nothing to promote therapeutic communication.

DIF:     Applying/Application                         REF: 146

KEY:   Psychosocial response| crisis intervention

MSC:   Integrated Process: Communication and Documentation

NOT:   Client Needs Category: Psychosocial Integrity

3. A nurse is field-triaging clients after an industrial accident. Which client condition should the nurse triage with a red tag?
   1. Dislocated right hip and an open fracture of the right lower leg
   2. Large contusion to the forehead and a bloody nose
   3. Closed fracture of the right clavicle and arm numbness
   4. Multiple fractured ribs and shortness of breath

ANS:           D

Clients who have an immediate threat to life are given the highest priority, are placed in the emergent or class I category, and are given a red triage tag. The client with multiple rib fractures and shortness of breath most likely has developed a pneumothorax, which may be fatal if not treated immediately. The client with the hip and leg problem and the client with the clavicle fracture would be classified as class II; these major but stable injuries can wait 30 minutes to 2 hours for definitive care. The client with facial wounds would be considered the “walking wounded” and classified as nonurgent.

DIF:            Analyzing/Analysis                            REF: 141

KEY:          Triage| emergency nursing

MSC:          Integrated Process: Nursing Process: Assessment                 NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care

4. An emergency department (ED) charge nurse prepares to receive clients from a mass casualty within the community. What is the role of this nurse during the event?
   1. Ask ED staff to discharge clients from the medical-surgical units in order to make room for critically injured victims.
   2. Call additional medical-surgical and critical care nursing staff to come to the hospital to assist when victims are brought in.
   3. Inform the incident commander at the mass casualty scene about how many victims may be handled by the ED.
   4. Direct medical-surgical and critical care nurses to assist with clients currently in

the ED while emergency staff prepare to receive the mass casualty victims.

ANS:           D

The ED charge nurse should direct additional nursing staff to help care for current ED clients while the ED staff prepares to receive mass casualty victims; however, they should not be assigned to the most critically ill or injured clients. The house supervisor and unit directors would collaborate to discharge stable clients. The hospital incident commander is responsible for mobilizing resources and would have the responsibility for calling in staff. The medical command physician would be the person best able to communicate with on-scene personnel regarding the ability to take more clients.

DIF:            Applying/Application                         REF: 144

KEY:          Emergency nursing

MSC:          Integrated Process: Nursing Process: Planning                      NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care