Chapter 23

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1. Which statement about disas- ANS: A

ters is true?
a. They can be natural or hu-
man-made.
b. They can be relieved without
assistance.
c. There is always injury and
death when a disaster occurs.
d. The timing of a disaster
does not influence the types of
injuries that will occur.
A disaster is any natural or human-made
incident that causes disruption, destruc-
tion, and/or devastation requiring external
assistance. Although natural incidents like
earthquakes of hurricanes trigger many
disasters, predictable and preventable hu-
man-made factors can further affect the dis-
aster. In the disaster response phase, the
incident type and time predict subsequent
injuries and illnesses.

2. Acts of bioterrorism or nat- ANS: B

ural disasters, such as earth-
quakes, will often have more The use of weapons of mass destruction or
casualties because: natural disasters, such as earthquakes, will
a. they cause the most wide- often have more casualties because victims
spread destruction. have little time to make evacuation prepara-
b. victims have little time tions. The other answers are false.
to make evacuation prepara-
tions.
c. those with chronic condi-
tions cannot escape in time.
d. the early warning systems
are not effective.

3. A nurse responds to a natural ANS: C

disaster. Which of the follow-
ing is the nurse most likely re- A communicable disease epidemic would
sponding to? be considered a natural disaster. Trans-
a. Transportation accident portations accidents, pollution, and fire are
b. Pollution considered human-made disasters.
c. Communicable disease epi-
demic
d. Fire

4. A nurse responds to a hu- ANS: A

man-made disaster. Which of
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the following describes what A structural collapse would be considered a
the nurse is responding to? human-made disaster. Communicable dis-
a. Structural collapse ease epidemics, mud slides, and floods are
b. Communicable disease epi- considered to be natural disasters.
demics
c. Mud slides
d. Floods

5. A nurse is working with an old- ANS: B

er person following a disaster.
Which of the following emo- A common reaction of older persons ex-
tions of the client should be periencing disaster may be fear of loss of
anticipated by the nurse? independence. Young children may respond
a. Anger with regression. The community in general
b. Fear of loss of indepen- may respond will feelings of anger, sorrow,
dence guilt, and perceived blame for the disaster
c. Violence or the outcomes of the disaster. Violence
d. Regression should not be anticipated with any of the
populations discussed in the text.

6. A nurse experiences a stress ANS: D

reaction while working with
the survivors of a disaster.
Which of the following best de-
scribes what has happened?
a. The nurse makes decisions
to assist with care coordina-
tion of the survivors.
b. The nurse tells the supervi-
sor of the disaster the details
of the care that was provided.
c. The nurse cries after return-
ing home at the end of the day.
d. The nurse refuses to follow
orders.
Symptoms that may signal a need for stress
management assistance include the follow-
ing: being reluctant or refusing to leave the
scene until the work is finished; denying
needed rest and recovery time; feelings of
overriding stress and fatigue; engaging in
unnecessary risk-taking activities; difficulty
communicating thoughts, remembering in-
structions, making decisions, or concentrat-
ing; engaging in unnecessary arguments;
having a limited attention span; and refusing
to follow orders.

7. A nurse is working in a tempo- ANS: A

rary shelter for victims follow-
ing a natural disaster. Which Causes of stress can be the shock of the

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condition is the nurse most
likely to encounter?
a. Stress
b. Communicable disease
c. Depression
d. Injuries requiring first aid
8. A riverfront community builds
a retaining wall to divert flood
water away from the town.
Which term describes what
has happened?
a. Mitigation
b. A natural disaster
c. Community resilience
d. Rapid needs assessment
9. Community preparedness is
being used to plan for a dis-
aster. Which of the following
tasks is being implemented?
a. Assembling emergency
supplies
b. Understanding the work-
place disaster plan
c. Taking a disaster training
course
d. Developing an evacuation
disaster itself, loss of personal possessions,
fear of the unknown, living in close proximity
to total strangers, and boredom. Illnesses
requiring first aid and communicable dis-
eases are not the primary concern of the
nurse working in the shelter. Immediately
following the disaster, it is unlikely that the
victims will immediately encounter depres-
sion because of the shock of the disaster.
ANS: A
Mitigation is defined as actions or measures
that can either prevent the occurrence of a
disaster or reduce the severity of the effects.
A natural disaster, such as an earthquake
or hurricane, causes disruption, destruction,
and/or devastation requiring external assis-
tance. Community resilience is defined as
the sustained ability of a community to with-
stand and recover from adversity. A rapid
needs assessment is based on the tradition-
al model of community assessment where
there is a rapid appraisal of a sector or re-
gion's population, social systems, and geo-
physical features.
ANS: D
Community preparedness involves develop-
ing an evacuation plan to remove individuals
from danger. Assembling emergency sup-
plies is an example of individual prepared-
ness. Understanding the workplace disaster
plan is an example of preparedness in the
workplace within the community. Taking a
disaster training course is an example of
professional preparedness.
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plan to remove individuals
from danger
10. A nurse is participating in the
preparedness stage of disas-
ter management. Which of the
following describes what is
happening?
a. Heightened inspection and
increased security in the com-
munity
b. Incorporation of provision
of pets into local disaster
plans
c. Purchase of personal pro-
tective equipment for all citi-
zens
d. Assembly of disaster kits for
the home, workplace, and car
11. A public health nurse (PHN)
is working with a community
during the recovery phase of
a disaster. Which of the follow-
ing attributes would be most
important for the nurse to pos-
sess?
a. Flexibility
b. Organization skills
c. Personable
d. Sense of humor
12. A nurse is working in a com-
munity that is experiencing
the Honeymoon Phase after
a disaster. Which of the fol-
ANS: D
Disaster kit assembly for the home, work-
place, and car, especially by nurses, occurs
during the preparedness phase. Height-
ened inspection and increased security in
the community is part of the prevention
activities. Purchase of personal protective
equipment for all citizens and incorporation
of provision of pets into local disaster plans
are not realistic plans for preparedness.
ANS: A
Flexibility is key to a successful recovery
operation. The role of the PHN in the re-
covery phase of a disaster is as varied as
in the preparedness and response phases,
but the PHN's connection to the community
puts the PHN in an incredible position of
knowledge and awareness on the interpro-
fessional recovery team. The attributes of
being organized, personable, and having a
sense of humor are not as important as
flexibility when dealing with this phase of the
disaster.
ANS: B
During the Honeymoon Phase, survivors re-
joice for their survival and may share their
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lowing is characteristic of this
phase?
a. First responders work tire-
lessly to save others.
b. Survivors share their sto-
ries.
c. Medical personnel experi-
ence exhaustion.
d. Community organizations
rebuild the community.
13. A nurse is assessing persons
arriving at an alternate care
center following a disaster.
Which of the following actions
should the nurse take first?
a. Assess the amount of equip-
ment and medications needed
for each client
b. Determine if the client has
a psychological condition re-
quiring special attention
c. Assess whether this type of
facility is appropriate for the
client
d. Determine if the client has a
support system to assist with
additional care needs
14. A nurse is triaging victims fol-
lowing a disaster. Which of the
following describes the action
the nurse would take?
a. Allocation of treatment
based on the victim's potential
for survival
b. Assignment of tasks to the
appropriate disaster response
personnel
experiences and stories. First responders
work tirelessly to save others during the
Heroic Phase. Medical personnel experi-
ence exhaustion during the Disillusionment
Phase. The community begins to rebuild
during the Reconstruction Phase.
ANS: C
Alternate care centers may be used to shel-
ter patients with medical needs designated
as "non-ambulatory care/hospital overflow"
e.g., care of non-ambulatory patients with
less intense medical needs. After determi-
nation of the appropriateness of the facility,
the nurse can then provide medical care as
needed. It should not be necessary to initial-
ly determine if the client has a psychological
condition or limit the amount of equipment
or medications.
ANS: A
The triage process in disaster involves sep-
arating the casualties and allocating treat-
ment based on the victim's potential for sur-
vival. Assignment of tasks to the appropriate
disaster response personnel, determination
of the level of disaster and agency involve-
ment, and participation in community pre-
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c. Determination of the level of paredness for the disaster response are not
disaster and agency involve- part of the triage process.
ment
d. Participation in community
preparedness for the disaster
response

15. A nurse is volunteering on ANS: B

a disaster medical assistant
team as a first responder.
Which of the following tasks
would the nurse be prepared
to perform?
a. Set up immunization clinics
b. Assist in triaging disaster
victims
c. Provide all the medical care
for disaster victims
d. Complete a needs assess-
ment of the community
As a first responder arriving on the scene,
the plans for triaging of disaster victims
should begin immediately. Setting up immu-
nization clinics would not be a priority follow-
ing a disaster. In responding to a disaster,
it may be impossible to provide all of the
medical care for disaster victims. It would
not be appropriate to start with completing a
needs assessment of the community follow-
ing a disaster; this should be done before
the disaster occurs.

16. A public health worker had ANS: A

displayed a competency in
disaster medicine and public
health. Which of the following
describes what the worker has
done?
a. Communicate effectively
with others
b. Get involved in the chain of
command
c. Use a set of preplanned ac-
tivities for every disaster
d. Implement a community as-
sessment
Communicating effectively with others in a
disaster or public health emergency is one
of the competencies demonstrated in disas-
ter medicine and public health. Involvement
in the chain of command, using a set of
preplanned activities for every disaster, and
implementing a community assessment are
not part of these competencies.

17. What is the purpose of the ANS: C

National Incident Management
System (NIMS)? The National Response Framework is a uni-

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a. Create a new branch of gov-
ernment that deals with bioter-
rorism
b. Establish a way for the Red
Cross to carry out its mission
c. Develop a nationwide
all-hazards approach to do-
mestic incident management
d. Extend presidential power
to act quickly upon acts of
bioterrorism
18. A nurse is developing and co-
ordinating an emergency re-
sponse plan for a communi-
ty. With which of the following
organizations would the nurse
collaborate?
a. American Red Cross (ARC)
b. National Disaster Medical
System (NDMS)
c. Centers for Disease Control
and Prevention (CDC)
d. Emergency Management
Agency (EMA)
19. A nurse is responding to a dis-
aster. Which of the following is
the priority of the disaster re-
sponse?
a. Clean up the environment
b. Handle the stress reaction
of the victims
c. Bring in as many aid work-
ers and nurses as possible
d. Reestablish sanitary barri-
ers and focus on basic needs
fied, all-discipline, all-hazards approach to
domestic incident management. It is built
upon scalable, flexible, and adaptable co-
ordinating structures to align key roles and
responsibilities linking all levels of govern-
ment and organizations. The Homeland Se-
curity Act of 2002 created a new branch
of government that deals with bioterrorism,
the U.S. Department of Homeland Security.
The NIMS did not impact the Red Cross
or extend presidential power to act upon
bioterrorism.
ANS: D
The EMA is responsible for developing and
coordinating emergency response plans in
a defined area. The ARC works with com-
munities in the preparedness, response,
and recovery phases of a disaster. The CDC
studies the effect that disasters have on
population health and continuously devel-
ops new prevention strategies. The NDMS
provides nurses the opportunity to work on
specialized disaster response teams.
ANS: D
Reestablishing sanitary barriers and focus-
ing on water, food, waste disposal, vec-
tor control, shelter, and safety are the first
goals. After this has been established, the
nurse can address the cleanup of the envi-
ronment, the stress reactions of the victims,
and the need to bring in additional workers.
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20. A bioterrorism attack has oc-
curred in the United States.
Which of the following pro-
grams would be used to pro-
vide large quantities of med-
ications to the American pub-
lic?
a. Cities Readiness Initiative
b. Strategic National Stockpile
(SNS)
c. Public Health Information
Network (PHIN)
d. Project BioShield
21. A nurse is examining the fu-
ture of disaster management.
Which of the following should
the nurse anticipate?
a. Vague and unorganized fu-
ture due to constant emer-
gence of new disasters
b. Increasing sophistication in
technology and surveillance
c. Lack of involvement by na-
tional and state officials
d. Decreasing need for public
health workers to provide care
22. Which populations are at
greatest risk for disruption af-
ter a disaster? (Select all that
apply.)
a. Single-parent families
b. Children
c. Substance abusers
ANS: B
The SNS has the capacity to provide large
quantities of medicine and medical supplies
to protect the American public in a public
health emergency. The Cities Readiness Ini-
tiative aids cities in increasing their capacity
to deliver medicines and medical supplies
during a public health emergency. The PHIN
helps ensure information access and shar-
ing. Project BioShield is a program to de-
velop and produce new drugs and vaccines
against potential bioweapons.
ANS: B
The terrorist event of September 11, 2001,
and the anthrax cases have increased the
awareness for the need to plan for disasters.
Technology and surveillance will continue to
advance. Disaster management continues
to change and become more organized as
learning occurs after each incident, produc-
ing progressive best practices. National and
state officials are very involved in disaster
management. PHNs are particularly critical
members of the multidisciplinary disaster
health team given their population-based
nursing focus and specialty knowledge in
epidemiology and community assessment
skills.
ANS: A, B, C
Single-parent families, children, and sub-
stance abusers are all at greater risk for
disruption after disaster than a middle-class
family or young adults.
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d. Middle-class families
e. Young adults

23. Which organizations offer vol- ANS: A, B

unteer opportunities in disas-
ter work for nurses? (Select all ARC and Citizens Corps offer volunteer op-
that apply.) portunities. The American Nurses Associ-
a. ARC ation and National Public Health Training
b. Citizens Corps Centers offer education and training oppor-
c. American Nurses Associa- tunities. Sigma Theta Tau International is an
tion honor society for nurses.
d. National Public Health Train-
ing Centers
e. Sigma Theta Tau Internation-
al

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