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An emergency department charge nurse notes an increase in sick calls and bickering among the staff after a week with multiple trauma incidents. Which action should the nurse take?
- A. Organize a pizza party for each shift.
- B. Remind the staff of the facility's sick-leave policy.
- C. Arrange for critical incident stress debriefing.
- D. Talk individually with staff members.
Correct Answer: C
Rationale: Arranging a critical incident stress debriefing addresses potential critical incident stress, providing group support to mitigate long-term stress consequences.
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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 nurse cares for clients during a community-wide disaster drill. One of the clients asks, 'Why are the individuals with black tags not receiving any care?' How should the nurse respond?
- A. Not everyone will survive a disaster; it is necessary to sacrifice some.
- B. Not everyone will survive a disaster, so it is best to identify those people early and move on.
- C. In a disaster, extensive resources are not used for one person at the expense of many others.
- D. With black tags, volunteers can identify those who are dying and can give them comfort care.
Correct Answer: C
Rationale: In a disaster, military-style triage is used, identifying the dead or expectant dead with black tags to prioritize resources for those with a reasonable expectation of survival, maximizing the good for the most people.
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.
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.
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.