Disaster Prevention and Preparedness

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. If a disaster results from earthquakes and tsunamis, how could the disaster then be best classified?

a) Slow onset manmade disaster
b) Slow onset natural disaster
c) Sudden onset natural disaster
d) Sudden onset technological disaster

2. The most frequently occurring of all natural disasters is __________

a) Fire
b) Flooding
c) Tornados
d) Tsunamis

3. Which disaster scenario concept is related to treatment of acute radiation syndrome or internal radiation contamination?

a) Capacity
b) Hazard
c) Risk
d) Vulnerability

4. Which of the following is an example of a compartmentalized disaster?

a) House fire
b) Small aircraft crash
c) Small chemical explosion
d) Statewide flood

5. Which of the following is an example of a localized disaster?

a) Blizzard covering four states.
b) Earthquake and tsunamis in three countries.
c) Fire covering five square city blocks.
d) Winter storms covering five states.

6. In a multiple casualty situation, you quickly assess the first victim and note an open fracture of the femur. The victim is unconscious and has no palpable radial pulse and respirations are 40 breaths/minute. The triage classification for this patient is?

a) Immediate
b) Urgent
c) Nonurgent
d) Delayed

7. Obtaining vital signs is part of which assessment?

a) First assessment
b) Initial assessment
c) Primary assessment
d) Secondary assessment

8. A small community in the western area of the country is flattened by a severe, widespread tornado. You find a woman lying next to a broken natural gas main. She is not breathing and is bleeding heavily from a wound on the ankle. Your first action would be to __________

a) Apply direct pressure to the ankle wound.
b) Remove her from the immediate vicinity.
c) Start rescue breathing immediately.
d) Treat her for shock.

9. Which of the following skills are relevant to disaster preparedness addressed by public health training?

a) Case identification
b) Crisis counseling
c) Risk communication
d) All of the above

10. What is the leading cause of fatal injury due to trauma?

a) Burns
b) Falls
c) Motor vehicle accidents
d) Poisoning

11. Waterborne diseases present primarily as __________

a) Chest pain
b) Flu-like symptoms
c) Infectious gastroenteritis or diarrhea
d) Sudden shock

12. Which level trauma center is fully staffed and ready to provide complete trauma care to patients 24 hours a day?

a) Level I
b) Level II
c) Level III
d) Level IV

13. You find a young girl under the wreckage of a house. She is conscious, breathing satisfactorily, and lying on her back. She complains of pain in her back and is unable to move her legs. Your first action would be to __________

a) Gently lift her onto a flat peace of lumbar and rush her to medical help.
b) Gently raise her to a sitting position to see if the pain increases in intensity.
c) Leave her lying on her back, give her instructions not to move, and seek additional help.
d) Place a pad under her head, and cover her.

14. What is the first step in attempting to open an obstructed airway in an injured patient?

a) Inflate the lungs with two quick breaths.
b) Insert an oral airway.
c) Pierce the cricothyroid membrane and start jet ventilation.
d) Use the chin lift or jaw thrust to lift the tongue off the back of the throat.

15. You find an injured man, obviously in shock. You would keep him lying on his back and __________

a) Allow the patient to walk around if injuries permit.
b) Elevate the head higher than the rest of the body, and give him small sips of water.
c) Place the head lower than the rest of the body, prevent chilling, and give fluids if possible.
d) Surround the body with heating pads if available.

16. A man has received multiple injuries in a motor vehicle accident. His heart rate is 136 beats per minute, his blood pressure is 70/40 mm Hg, and his respiration is 34 breaths/minute. He is confused and he has an estimated blood loss of 30-40% of his total blood volume. What type of shock is likely in this patient?

a) Cardiogenic shock
b) Hypovolemic shock, class III
c) Neurogenic shock
d) Septic shock

17. A driver runs his car into a tree in front of the hospital. He gets out of the car but then collapses. You can only feel a carotid pulse. You estimate that his systolic blood pressure is __________

a) 110 mm Hg
b) 90 mm Hg
c) 80 mm Hg
d) 70 mm Hg

18. Which of the following is not considered a sign of shock?

a) Decreased urine output
b) Hypertension
c) Pale skin
d) Tachycardia

19. Which of the following is not considered a colloid solution?

a) Albumin
b) Dextran
c) Hetastarches
d) Normal saline

20. Bulging, distended neck veins in a patient with thoracic injury may indicate which of the following?

a) Aortic rupture
b) Hypovolemia
c) Pneumothorax
d) Tracheobronchial disruption

21. A flutter-valve dressing is used to treat which of the following thoracic injuries?

a) Cardiac tamponade
b) Flail chest
c) Massive hemothorax
d) Open pneumothorax

22. A car strikes a motorcyclist. He is conscious and cooperative when you reach him, but suddenly he becomes anxious, dyspneic, restless, and cyanotic. You expose the upper part of his body and note an obvious flail chest. You suspect which of the following injuries?

a) Cardiac tamponade
b) Myocardial contusion
c) Pulmonary contusion
d) Tension pneumothorax

23. Which thoracic injury is characterized by the triad of hypotension, distended neck veins, and muffled heart sounds?

a) Aortic rupture
b) Cardiac tamponade
c) Esophageal disruption
d) Tension pneumothorax

24. What are the two most common mechanisms of injury in abdominal trauma?

a) Blunt and penetrating injuries
b) Deceleration and acceleration injuries
c) Motor vehicle accidents and falls
d) Torsion and shearing injuries

25. What is the most important part of abdominal assessment?

a) Inspection
b) Palpation
c) Auscultation
d) Percussion

26. Bruising and discoloration around the umbilicus are called __________

a) Beck’s sign
b) Cullen’s sign
c) Grey Turner’s sign
d) Kehr’s sign

27. The most commonly injured organ in blunt abdominal trauma is the __________

a) Bladder
b) Liver
c) Spleen
d) Stomach

28. A teenage victim has an object impaled in his abdomen. He is lying on the ground in pain and begging you to pull it out. What do you do after you tell the others to call for help?

a) Ask close ones to locate the victim’s immunization records.
b) Gently loosen and remove the object, and then apply pressure.
c) Stabilize the object in place with towels or a bulky dressing and reassure him while waiting for an ambulance.
d) Quickly remove the object, and apply pressure to the wound.

29. Blunt injury that fractures the pelvis is often associated with damage to which organ or organs?

a) Bladder and urethra
b) Colon
c) Spleen and left lung
d) Liver

30. Patients with genitourinary trauma should not be catheterized until they have been evaluated by a physician because catheterization could aggravate which of the following?

a) Bladder spasms
b) Kidney failure
c) Ureteral injury
d) Urethral trauma

31. Which one of the following combinations of symptom is indicative of increased intracranial pressure?

a) Rapid weak pulse, fall in blood pressure, low temperature, restlessness.
b) Rapid weak pulse, normal blood pressure, intermittent fever, lethargy.
c) Slow bounding pulse, fall in blood pressure, low temperature, stupor.
d) Slow bounding pulse, rising blood pressure, elevated temperature, stupor.

32. A patient who is able to open his/her eyes spontaneously, able to move extremities on command and who is confused would get what score on the Glasgow Coma Scale?

a) 15
b) 14
c) 13
d) 12

33. One possible sign of a basilar skull fracture is?

a) Avascular necrosis
b) Battle’s sign
c) Carotid artery injury
d) Obvious deformity of the crown

34. Insertion of tubes into the nose should be avoided in patients with head injuries until which of the following has been ruled out?

a) Basilar skull fracture
b) Cerebral contusion
c) Optic nerve damage
d) Tentorium tear

35. A patient is complaining of a headache, nausea and vomiting. She mentions that she was involved in a motor vehicle accident three weeks ago in which she hit her head on the steering wheel but had only brief loss of consciousness. What is a likely head injury in this patient?

a) Cerebral contusion
b) Epidural hematoma
c) Scalp laceration
d) Subdural hematoma

36. An arterial bleed in the cranium is known as an/a __________

a) Epidural bleed
b) Meningeal bleed
c) Parietal bleed
d) Subdural bleed

37. Lowering the pCO2 in a patient with head injury does which of the following?

a) Blocks increases in intracranial pressure.
b) Increases oxygenation in the cerebral arteries through vasodilation.
c) Lowers intracranial pressure by increasing vasoconstriction.
d) Reduces intracranial hemorrhage.

38. Which type of injury of the cervical spinal cord is likely in a patient involved in a head-on motor vehicle accident?

a) Compression
b) Hyperextension
c) Hyperflexion
d) Rotational

39. A patient who has a spinal injury has an onset of hypotension and bradycardia. The patient’s skin feels warm. Which of the following conditions is most likely?

a) Cardiogenic shock
b) Neurogenic bladder
c) Pump failure
d) Spinal shock

40. Life-threatening hemorrhage may develop after fracture of which of the following?

a) Elbow
b) Femur
c) Knee
d) Tibia

41. A man, 67 years old, falls during a severe weather and is unable to get up. He is brought to the emergency room, where it is found that he has a fracture of the neck of the right femur. On examination you would expect to find __________

a) Abduction with external rotation.
b) Adduction with internal rotation.
c) Shortening of the effected extremity, with external rotation.
d) Shortening of the effected extremity, with internal rotation.

42. You find a hiker in a park who has fallen and her left lower extremity has an obvious deformity. Which of the following should you do before transporting her?

a) Apply an ice pack to her left leg.
b) Return the affected leg to proper alignment.
c) Splint the extremity the way you find it.
d) Straighten the leg and secure it with sticks.

43. Chances for revascularization and replantation of amputed limbs are improved when the part is __________

a) Placed in a container of normal saline.
b) Put directly on ice.
c) Soaked in povodine iodine solution.
d) Wrapped in a normal saline-moistened gauze and placed in a sterile container placed on ice.

44. Compression from casts or splints can lead to which of the following?

a) Adult respiratory distress syndrome
b) Compartment syndrome
c) Fat embolism
d) Shock

45. If you see a person suffering from heatstroke, all of the following is appropriate steps, except?

a) Apply ice packs
b) Massage the skin
c) Spray the person with water
d) Wrap the body in a blanket

46. The most common cause of trauma in infants and children is?

a) Burns
b) Falls
c) Motor vehicle accidents
d) Sport accidents

47. In an emergency, the best way to deliver drugs and fluids to a child is __________

a) Orally
b) Through a nasogatric tube
c) Through intraosseus line
d) Through intravenous line

48. Which of the following is considered a direct form of lung injury that can cause adult respiratory distress syndrome (ARDS)?

a) Aspiration
b) Hypothermia
c) Multiple fractures
d) Sepsis

49. The primary problem associated with disseminated intravascular coagulation (DIC) is?

a) Antibodies
b) Bleeding
c) Clotting
d) Fever

50. In penetrating injury, gunshot wounds, important information includes the following __________

a) At what distance and angle the victim was shot.
b) The type and caliber of weapon that was used.
c) Where the entrance and exit wounds are located.
d) All of the above.

51. When injury from high-order explosives (HE) over-pressurization force (blast wave) impacting the body surface, the blast injury can be categorized by which of these four basic mechanisms?

a) Primary
b) Secondary
c) Tertiary
d) Quaternary

52. Any body part may be affected by blasts. Which injury should be suspected in anyone with dyspnea, cough, hemoptysis, or chest pain following blast?

a) Aortic rupture
b) Blast liver
c) Blast lung
d) Myocardial contusion

53. Following injury from a high velocity projectile, soft tissue wounds will usually need __________

a) Debridement
b) Fasciotomy
c) Primary closure
d) Skin graft

54. One complication of hypothermia is that the heart becomes very sensitive and can be easily jolted into an irregular rhythm. These patients must be handled very gently. Which arrhythmia frequently occurs at 82.4ºF (<28ºC)?

a) Asystole
b) Second degree AV Block, Morbitz II
c) Tachyarrhythmia
d) Ventricular fibrillation

55. Which of the following may develop rapidly in a burn patient who initially appeared stable?

a) Airway edema
b) Hypothermia
c) Infection
d) Reduced mobility

56. As a result of an industrial accident, a man has suffered second- and third-degree burns on his left leg, left arm, and face. Using the rule of nines what percent of his total skin surface has been burned?

a) 18%
b) 27%
c) 36%
d) 45%

57. A woman, 32 years old, is admitted to the emergency room with second-degree burns over 40% of her body and face, which she received in a house fire. Her condition would be considered __________

a) Critical
b) Fair
c) Good
d) Poor

58. One difficult problem for the nurse to deal with concerning a recently admitted burned patient is __________

a) Alteration in body image
b) Frequent dressing changes
c) Maintenance of sterility
d) Severe pain

59. Which of the following medications should a burned patient receive as soon after admission as possible?

a) Gamma globulin
b) Isoproterenol (Isuprel)
c) Phytonadione (Aquamephyton)
d) Tetanus toxoid

60. Emergency wound management are common interventions during disasters and Methicillin-Resistant Staphylococcus Aureus (MRSA) may occur. A disease produced when a Clostridium perfringens organism enter wounds and produces a toxin causing crepitus is __________

a) Anthrax
b) Botulism
c) Gas gangrene
d) Tetanus

61. Pandemic influenza is most likely to be caused by a __________

a) Type A virus
b) Type B virus
c) Type C virus
d) Swine flu virus

62. Which of the following potential bioterrorism agents is not transmissible person- to- person?

a) Bacillus anthracis (anthrax)
b) Ebola virus (viral hemorrhagic fever)
c) Variola virus (small pox)
d) Yersinia pestis (plaque)

63. Spread of the West Nile virus occurs via which of the following routes in the host?

a) By the bite of an infected mosquito
b) Direct inoculation
c) Through blood transfusion or transplantation
d) All of the above

64. By removal of outer clothing after a chemical exposure, what percent of decontamination is achieved?

a) 5%-10%
b) 25%-30%
c) 45%-50%
d) 85%-90%

65. An important action that may preserve vision in a patient with a chemical burn of the eye is __________

a) Bandaging both eyes.
b) Continuous flushing of the eyes.
c) Getting the victim to an ophthalmologist quickly.
d) Taping the eyes shut.

66. A driver transporting medical waste is seriously injured in a motor vehicle accident. The accident involving a rupture in the waste container with used radiotherapeutics. When he comes by EMS to the ER your first priority is __________

a) Find the identity of the medical waste he was transporting.
b) Implement the facility’s emergency plan.
c) Survey and decontamination before anything else.
d) Triage and stabilization of any life-threatening problems using protective clothing.

67. If a victim of a radiation emergency has received an acute dose greater than 1 Gy, efforts must be made to close wounds, cover burns, reduce fractures, and perform surgical definitive treatments within __________

a) 24 hours
b) 36 hours
c) 48 hours
d) 72 hours

68. What is the term used for a meeting held after a rescue when the members of the rescue team discuss the event, their responses, and their feelings?

a) Ethical discussion
b) Critical incident debriefing
c) Psychological seminar
d) Support group

69. As outlined by Elisabeth Kubler-Ross, what is the fourth of the five stages that persons go through when confronted with a loss or a potential loss?

a) Anger
b) Bargaining
c) Denial
d) Depression

70. Posttraumatic stress disorder (PTSD) is a disorder of?

a) Anger
b) Anxiety
c) Depression
d) Trauma

71. Primary symptoms of PTSD include __________

a) Anger, fear, and nightmares
b) Depression, anger, and fear
c) Insomnia, depression, and anorexia
d) Sleep disturbances, flashbacks, and anxiety

72. An acute post traumatic stress disorder can be distinguished from chronic post traumatic stress disorder because acute PTSD occurs within __________

a) One week of the traumatic event and lasts no longer than eight weeks.
b) Two weeks of the traumatic event and lasts no longer than seven weeks.
c) Three weeks of the traumatic event and lasts no longer than six weeks.
d) Four weeks of the traumatic event and lasts no longer than a month.

73. Strategies for treatment of PTSD include __________

a) Cognitive-behavioral therapy
b) Eye Movement Desensitization and Reprocessing (EMDR)
c) Medication given in combination with psychotherapy or group therapy
d) All of the above

74. Which government agency represents unique technological logistic capabilities that can be mobilized on short notice in a self-contained, self sufficient and highly mobile fashion, to support lifesaving disaster relief efforts and humanitarian assistance, nationally as well as internationally?

a) Center for Disease Control and Prevention (CDC)
b) Federal Emergency Management Agency (FEMA)
c) Military and Civil Defense Assets (MCDA)
d) National Disaster Medical Systems (NDMS)

75. Registered nurses have long been frontline responders during major disasters, and all need a basic level of clinical competence during emergency events common to all health professionals. To be prepared for weapons of mass destruction/terrorism (WMD/T) nurses also need which of these competencies?

a) Competence to recognize an illness or injury as potentially resulting from exposure to a biological, chemical or radiological agent.
b) Competence to recognize uncommon presentations of common diseases and distinguish these from common presentation of uncommon diseases.
c) Competence to recognize patterns or clusters of unusual presentations.
d) All of the above.