Chapter 109: Potential Weapons of Biologic, Radiologic, and Chemical Terrorism

Chapter 109: Potential Weapons of Biologic, Radiologic, and Chemical Terrorism

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse is driving home after work when he is flagged down by a neighbor in the country who says her husband was exposed to mustard gas. The victim’s skin is red and swollen with small blisters, and his eyes are red and tearing. The victim has a runny nose and a dry, barking cough. What should the nurse’s initial action be?

a.	Have the patient remove his clothes and bathe with soap and water three times.
b.	Rush the patient to the emergency department (ED).
c.	Ask the wife if anyone in the house is on oxygen.
d.	Ask the wife for eye drops and petroleum jelly to prevent the eyes from burning.

 

 

ANS:   A

Initial management is rapid decontamination, supportive care, and drug therapy. People exposed to sulfur mustard should undress immediately and wash three times with soap and water.

Rushing the patient to the ED should not be the initial action and may make matters worse, because it prolongs the patient’s exposure and exposes all those in the confined vehicle.

Asking the wife for oxygen may be a good idea, but not initially, because the patient does not show any signs of respiratory distress.

Eye drops and petroleum jelly would not be the primary considerations.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1285

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

 

2. A patient comes to a clinic with a large, fluid-filled vesicle on his right hand. The nurse practitioner diagnoses cutaneous anthrax and prescribes an antibiotic. Which statement by the patient demonstrates a need for further teaching by the nurse? “I should anticipate

a.	being on this antibiotic for 60 days.”
b.	that the area will be itchy, and I should not scratch it.”
c.	that the lesion will scab over and fall off within 2 weeks.”
d.	that I may develop a systemic infection.”

 

 

ANS:   D

The patient is highly unlikely to develop a systemic infection, because he will be taking an antibiotic. This statement indicates a need for further teaching.

The patient should take the antibiotic for 60 days; no further teaching is required.

The area will be itchy, and the patient should not scratch it: no further teaching is needed.

Seven to 10 days after the onset of symptoms, a black eschar (scablike structure) forms, which dries, loosens, and sloughs off by day 12 to 14; no further teaching is needed.

 

DIF:    Cognitive Level: Application             REF:    pp. 1280-1281

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Health Promotion and Maintenance

 

3. An Army nurse is preparing to administer BioThrax to a group of enlisted soldiers who are going to be deployed to an active combat area. The group of soldiers is receiving the first of a series of the anthrax vaccine, and the nurse provides thorough education. What statement by a marine about the vaccine best demonstrates the need for further teaching?

a.	“I may experience muscle and joint aches.”
b.	“I can expect my next vaccination in 2 weeks.”
c.	“I can expect a scar from this vaccine.”
d.	“I may experience a headache or feel fatigued.”

 

 

ANS:   C

The anthrax vaccine does not cause a scar; however, the smallpox vaccine does; further teaching is required.

The marine might experience muscle and joint aches, as well as a headache and fatigue; no further teaching is needed.

The pre-exposure vaccine for anthrax is BioThrax, which is provided by administration of three subcutaneous injections given 2 weeks apart, then again at 6, 12, and 18 months; no further teaching is needed.

 

DIF:    Cognitive Level: Application             REF:    p. 1280 | p. 1282

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Health Promotion and Maintenance

 

4. Clinical students are receiving instruction on Francisella tularensis (tularemia). Which statements about tularemia demonstrate understanding by the students? (Select all that apply.)

a.	“It begins with flulike symptoms.”
b.	“It can develop into pneumonia or pleuritis, or both.”
c.	“Tularemia can be treated with an antitoxin.”
d.	“The treatment of choice for tularemia is intravenous streptomycin.”
e.	“Tularemia is transmitted from person to person.”

 

 

ANS:   A, B

Individuals with symptoms of tularemia have acute, flulike symptoms that may develop into pneumonia and pleuritis.

Antitoxin is available only for botulism.

The treatment of choice for tularemia is intramuscular (IM) streptomycin, not IV streptomycin.

Tularemia cannot be transmitted from person to person. The infection is transmitted by a vector and is acquired through the skin, mucous membranes, gastrointestinal tract, or lungs.

 

DIF:    Cognitive Level: Application             REF:    pp. 1281

TOP:    Nursing Process: Evaluation