A nurse triages clients arriving at the hospital after a mass casualty. Which clients are correctly classified? (Select all that apply.)
- A. A 5-year-old female with severe chest pain: red tag
- B. A 42-year-old male with full-thickness body burns: green tag
- C. A 55-year-old female with a scalp laceration: black tag
- D. A 30-year-old male with stable vital signs and a broken arm: yellow tag
- E. A 60-year-old female with minor cuts and abrasions: green tag
- F. A 25-year-old male with massive internal bleeding: red tag
Correct Answer: A,D,E,F
Rationale: Red tags are for life-threatening injuries requiring immediate care, such as severe chest pain and massive internal bleeding. Yellow tags are for major injuries treatable within 30 minutes to 2 hours, like a stable broken arm. Green tags are for minor injuries, such as cuts and abrasions. Full-thickness burns and scalp lacerations are incorrectly classified as green and black, respectively.
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Emergency medical services (EMS) brings a large number of clients to the emergency department following a serious incident. The nurse identifies the clients with which injuries with yellow tags. (Select all that apply.)
- A. Partial-thickness burns covering both legs
- B. Open fractures with good distal pulses
- C. Neck injury and numbness of both legs
- D. Small pieces of shrapnel embedded in both eyes
- E. Head injury and difficult to arouse
- F. Bruising and pain in the right lower abdomen
Correct Answer: A,C,D,F
Rationale: Clients with burns, spine injuries, eye injuries, and stable abdominal injuries should be treated within 30 minutes to 2 hours and are classified with yellow tags. Open fractures with good distal pulses and head injuries with difficulty arousing require immediate care and would receive red tags.
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?
- A. Provide water and healthy snacks for energy throughout the event.
- B. Schedule 16-hour shifts to allow for greater rest between shifts.
- C. Encourage counseling upon deactivation of the emergency response plan.
- D. Assign staff to different roles and units within the medical facility.
Correct Answer: A
Rationale: To prevent staff post-traumatic stress disorder during a mass casualty event, 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.
After a hospital's emergency department (ED) has efficiently triaged, treated, and transferred clients from a community disaster to appropriate units, the hospital incident command officer wants to stand down from the emergency plan. Which question should the nursing supervisor ask at this time?
- A. Are you sure no more victims are coming into the ED?
- B. What will happen to the needs of other hospital departments?
- C. Have all ED staff had the chance to eat and rest recently?
- D. Does the Chief Medical Officer agree this disaster is under control?
Correct Answer: B
Rationale: Before standing down, the incident command officer must ensure that other hospital departments' needs are met, as they may require continued support to maintain operations.
The hospital administration arranges for critical incident stress debriefing for the staff after a mass casualty incident. Which statement by the debriefing team leader is most appropriate for this situation?
- A. You are safe now and the event is over.
- B. Let's evaluate what went wrong and develop policies for future incidents.
- C. This session is only for nursing and medical staff, not for ancillary personnel.
- D. Let's pass around the written policy compliance form for everyone.
Correct Answer: A
Rationale: The most appropriate statement is to reassure staff that they are safe and the event is over, helping to reduce anxiety and facilitate emotional processing during the debriefing.
A hospital prepares for a mass casualty event. Which functions are correctly paired with the personnel role? (Select all that apply.)
- A. Hospital incident commander: Decides the number, acuity, and resource needs of clients
- B. Hospital incident commander: Assumes overall leadership for implementing the emergency plan
- C. Public information officer: Provides advanced life support during transportation to the hospital
- D. Triage officer: Rapidly evaluates each client to determine priorities for treatment
- E. Medical command physician: Serves as a liaison between the health care facility and the media
Correct Answer: B,D
Rationale: The hospital incident commander leads the emergency plan implementation, and the triage officer evaluates clients for treatment priorities. The medical command physician, not the incident commander, assesses client numbers and needs, and the public information officer, not the medical command physician, liaises with the media.
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