Deck 23: Preparing for Emergencies

Question 1

The hospital is preparing for a tabletop test of its emergency operations plan. What is the potential for an interruption in services from this drill?

A) There is little potential for interruption because the drill is all done in a meeting.
B) There is some potential for interruption of non-client-care services, such as billing and scheduling.
C) There will be interruption in some services that generally occupy the area where the enormous table is set up for the drill.
D) Normal services will probably be interrupted by the simulated situations and simulated clients.

Answer 1

There is little potential for interruption because the drill is all done in a meeting.

Question 2

A hospital's disaster management team is reviewing the disaster plan after reading about a hospital that was hit directly and destroyed by a tornado. What questions should team members ask themselves? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "What are our current capabilities for evacuation?"
B) "Do we have sufficient resources in any other areas to continue operations if this happens to us?"
C) "Are there physical training needs that we have not filled?"
D) "What education should we provide to the staff and community?"
E) "Would we eventually rebuild if the hospital was destroyed?"

Answer 2

"What are our current capabilities for evacuation?"
"Do we have sufficient resources in any other areas to continue operations if this happens to us?"
"Are there physical training needs that we have not filled?"
"What education should we provide to the staff and community?"

Question 3

A small creek has flooded, requiring the rescue of one person from a stranded automobile. Electrical service was interrupted for a short period, and traffic will be diverted around flooded roads for several hours. Local law enforcement and fire departments have been well equipped to manage the disaster. The newspaper should report that the town suffered a level ________ disaster.

Answer 3

I
Explanation: If the response at the local level is sufficient, the disaster is categorized as level I.

Question 4

A hospital has sustained massive destruction after being struck by a tornado. The disaster plan has been activated. The administrator would expect help from which agency to coordinate the disaster efforts?

A) The Federal Emergency Management Agency (FEMA)
B) The Joint Commission
C) The Office of Homeland Security
D) Congress

Question 5

During discussion about the hospital's disaster plan, the administrator says, "I am concerned about our current surge capacity." How should the members of the group interpret this concern?

A) The administrator is worried about the ability of the hospital's electrical system to handle the power fluctuation common during physical disasters.
B) The administrator is concerned that flood waters following a storm surge might overwhelm the hospital infrastructure.
C) The administrator is worried about the hospital's ability to respond to a large influx of clients from a disaster.
D) The administrator is concerned that a disaster would bring about the influx of media and frightened family.

Question 6

Which statements would the nurse manager interpret as indicating a nurse understands the critical thinking skills necessary for disaster management? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "It is just like critical thinking in the emergency department or critical care unit, only done faster."
B) "The nurse's prioritization will be different in a disaster."
C) "Clinical judgment skills will be an essential part of nursing's contribution to disaster management."
D) "Decision making will basically be done by following established protocols."
E) "The nurse's abilities will make the difference in successful management of a disaster."

Question 7

An emergency department has been notified that hundreds of injuries have occurred following the collapse of bleachers at a football game. The emergency department nurses should prepare to make which types of assessments? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Physical
B) Self
C) Situational
D) Family
E) Community

Question 8

Multiple casualties have arrived at the emergency department following a tornado. Which instruction from the manager to staff is incorrect?

A) "There is no time to worry about using personal protective equipment, just try to be safe."
B) "Be aware that some of these victims may have been exposed to hazardous substances."
C) "Don't let client safety considerations be lost in all of the activity."
D) "Feel free to use isolation techniques if required."

Question 9

A hospital on the Gulf Coast of the United States would list which situations among its top vulnerabilities? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Flooding
B) Hurricane
C) Earthquake
D) Tornado
E) Industrial accident

Question 10

The nurse executive of a hospital is surveying hospitals in a four-state area regarding their disaster preparedness. The nurse would expect to hear which response to the question, "What have you done to prepare for a disaster?"

A) "We have conducted a drive to get area healthcare professionals registered so they can be contacted in case of a disaster."
B) "We have a designated place with beds and equipment so that staff can be directed to an alternate care area."
C) "We have not prepared for a disaster."
D) "We conduct practice disaster drills."

Question 11

A disaster planning task force has been asked to focus on communication. Which instruction should this group provide to nursing staff?

A) Limit your communication to physicians and other nurses.
B) Be certain to maintain the client tracking system.
C) All communication with law enforcement will be conducted through the public resource officers.
D) Communication is likely to follow the standard daily pattern.

Question 12

Fire departments from a three county area have responded to a wildfire that has threatened several homes and a hospital in a wooded area. The fire is now under control, and the fire chief is completing paperwork on the response. The disaster should be classified at level ________.

Question 13

The hospital is conducting a drill of its emergency operations plan (EOP). A nurse is acting as triage officer. Which client would be triaged for immediate care?

A) A client with a minor forearm laceration that will require a simple bandage and tetanus immunization
B) A child with a severe, penetrating head wound
C) A man complaining of chest pain that radiates to his jaw
D) A woman with a compound fracture of the femur

Question 14

A nurse manager is leading an education session regarding disaster triage for emergency department nurses. Which statement should the manager include in this instruction?

A) "Follow your current triage system."
B) "Your triage system will be reversed during a disaster."
C) "Triage is not necessary during disasters."
D) "Your triage system will basically be first-come, first-served."

Question 15

A nurse manager is working on a task force to develop policy for man-made disasters. There is some discussion in the committee about whether fire should be included in the policy. Which suggestion by a task force member would be most useful?

A) "Fire is a natural occurrence, so we should not address it."
B) "Fires are not generally a real disaster, so we should not include it."
C) "We should only focus on wildfires."
D) "We should only focus on arson fires."

Question 16

A nurse manager has provided education to emergency department nurses regarding disaster management. Which statement would the manager interpret as indicating understanding of this education?

A) "We should treat as many clients as possible as quickly as possible."
B) "Quick separation of any victim with bleeding wounds from those who are not bleeding is essential."
C) "Our goal is to treat those with serious injuries first."
D) "We should send those with less serious injuries home without treatment."

Question 17

As part of the disaster plan, the nurse executive is planning an education session on the core competencies for nurses established by the National Emergency Preparedness Education Coalition. Which topics should be included in the handout being written for this session? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Cost control
B) Managing conflict with other disciplines
C) Communication
D) Handling the media
E) Technical skills

Question 18

A nurse is working with a hospital team to create an emergency response plan that will meet Joint Commission requirements. Which sections should be included in this plan? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) A method to predict when a disaster will occur through close attention to news and weather reports
B) A method to recognize that a disaster is imminent or occurring with plans to reduce the disaster's impact
C) A plan whereby policies and procedures as well as equipment and personnel are in place to handle disasters
D) Policies and procedures that operationalize actual activities during the disaster
E) Policies and procedures describing what will occur immediately after the disaster

Question 19

Healthcare providers are bracing for a worldwide outbreak of H1N1 influenza. How would this outbreak be classified in planning literature? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) A man-made disaster
B) As a pandemic
C) As a health disaster
D) As a natural disaster
E) As an epidemic

Question 20

A tornado destroyed 65% of the businesses and homes in a small midwestern city. Aid would be requested based on categorization as a level ________ disaster.

Question 21

A hospital emergency operations plan (EOP) includes what components?

A) Activation response
B) Practice drills
C) Security plan
D) Communication plan
E) Community vulnerability

Question 22

A hospital has written a well-defined surge call-back system for employees to use in case of a disaster. What are key vulnerabilities of this system? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Employees may be unwilling to come back into the disaster.
B) Employees may be personally affected by the disaster.
C) Many employees will request additional pay for shifts worked during disasters.
D) There may be no way to contact employees for call-back.
E) The employee may not physically be able to return to the hospital.

Question 23

Why is post-disaster follow-up an essential part of disaster planning? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) To assure staff members of their personal safety
B) To evaluate the performance of those involved
C) To initiate any improvements needed
D) To evaluate the overall effectiveness of the plan
E) To complete critical incident forms

Question 24

A hospital administrator receives a call that shootings resulting in mass casualties have occurred at several different locations within the city. Early information indicates that up to 50 victims may be arriving at the hospital starting within minutes. What action should the administrator take? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Mobilize the hospital incident command system.
B) Notify other administrators and order a rapid needs assessment in all critical areas.
C) Authorize the implementation of the hospital's disaster plan.
D) Call the emergency department and ask the charge nurse if the department has received any clients.
E) Conduct a risk assessment to see if the hospital is vulnerable to attack.

Question 25

How are disasters categorized?

A) Level I-municipal response
B) Level I-local response
C) Level III-statewide response
D) Level III-continental response
E) Level II-regional response

Question 26

Hospital administration is aware that staff may be reluctant to be called back to work in a disaster. How can the hospital be proactive in encouraging staff to make the decision to serve?

A) Develop a caring relationship with staff during normal times.
B) Develop a pay scale that offers double pay for all those who work during disasters.
C) Offer additional time off to those who work during a disaster.
D) Focus on the skills advancement opportunities that occur when working in a disaster.

Question 27

A hospital administrator on a disaster planning team says, "I am worried about our liability in using volunteers to provide care during a disaster." What should this team consider?

A) In disaster situations, no liability exists.
B) The hospital would have liability for what a volunteer does, but not for anything that happens to the volunteer.
C) The hospital could have liability for the volunteer's performance and for his or her safety.
D) Hospital liability would be limited to any injuries sustained by the volunteer.

Question 28

A level III disaster has occurred and the hospital is receiving clients by ambulance and those who have walked in to the emergency department. The wife of a man who is critically injured screams, "Why doesn't someone do something for my husband? He is dying!" How should the nurse manager respond?

A) "Ma'am, you should not be back here. You will have to leave."
B) "I'm so sorry, but your husband's injuries are very severe. We have to take care of the others first."
C) "Is there someone who can stay with this woman? She is distraught."
D) "He doesn't pass the triage screen for someone we can save."

Question 29

A nurse executive is assigned to a task force working on a surge system for the hospital in case of a disaster. This group should write strategies to cover which procedures? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Postincident follow-up
B) Supplies
C) Physical space
D) Management infrastructure
E) Personnel

Question 30

A hospital administrator initiated the emergency operations plan (EOP) after being notified that a tornado struck a nearby community. Thirty minutes later law enforcement calls to report that while significant damage was done, there were only minor injuries. What should the administrator do now?

A) Follow the EOP to deactivate the plan.
B) Let the plan continue for another hour to ensure that no victims arrive.
C) Call the emergency department and tell the staff that the plan is discontinued.
D) Notify local media that the EOP was discontinued.

Question 31

An outbreak of smallpox has followed a national sporting event. Terrorist activity is suspected. How would this event be categorized?

A) As a natural, biologic disaster
B) As a man-made, chemical disaster
C) As a natural, radiological disaster
D) As a man-made, biologic disaster

Question 32

A hospital successfully implemented its disaster plan to manage providing care during a massive three-day snow storm. What is the most likely way additional costs for this service will be paid?

A) Medicare will increase reimbursement for any client age 65 or over who was hospitalized during the disaster.
B) The federal government will pay any costs over and above the normal operating expenses for the period.
C) The hospital will absorb the additional costs.
D) State and county governments have reserve funds to reimburse for such expenses.