Nokea
The emergency department nurse is caring for clients involved in a chlorine exposure accident at a local chemical plant. The nurse is aware that permanent damage can occur to which body systems?
- A. Cardiac
- B. Respiratory
- C. Renal
- D. Hepatic
Correct Answer: B
Rationale: The consequences of exposure to chlorine and other respiratory toxins are related to the amount, route, and length of chemical exposure. Death occurs as fluid infiltrates the pulmonary air spaces and terminal bronchioles interfering with gas exchange. Following recovery from an acute event, victims may develop chronic bronchitis and emphysema.
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The nurse is caring for a client exposed to a blistering agent. While the nurse is quickly decontaminating the client by showering and bagging all client clothing, what is the nurse simultaneously assessing for?
- A. Neurological compromise
- B. Respiratory compromise
- C. Cardiovascular compromise
- D. Sensory neglect
Correct Answer: B
Rationale: A person exposed to a blistering agent or vesicant must be decontaminated immediately, with clothing removed and bagged. Irrigation of the victim's eyes and application of topical analgesia, antibiotics, and lubricants to the skin occur. Simultaneously, the nurse is assessing the respiratory system for airway obstruction because blisters from inhaled toxics can swell obstructing respiratory passages.
The nurse is caring for a client affected by a nerve agent. The nurse quickly gives a tutorial on the neurotransmitters and nervous system affected. Which couplet is most correct?
- A. Acetylcholine, parasympathetic nervous system
- B. Serotonin, sympathetic nervous system
- C. Norepinephrine, sympathetic nervous system
- D. Dopamine, parasympathetic nervous system
Correct Answer: A
Rationale: Nerve agents cause fatal consequences by inhibiting acetyl cholinesterase. Acetyl cholinesterase is an enzyme that inactivates acetylcholine, a neurotransmitter of the parasympathetic nervous system. No other option is correct.
The nurse educator is preparing a presentation about the indicators of chemical terrorism. The nurse educator would include which indicator(s) in the presentation? Select all that apply.
- A. Fog-like or low-lying cloud in the atmosphere
- B. Numerous dead animals and birds
- C. Increase in temperature in area of the event
- D. Strong wind in area of the event
- E. Unexplained odor atypical for the location
Correct Answer: A,B,E
Rationale: The indicators that the nurse educator would include in the presentation are fog-like or low-lying cloud in the atmosphere, numerous dead animals and birds, and unexplained odor atypical for the location. The temperature in the area would not increase after a chemical event. There would be no wind associated with a chemical event.
The nurse is on a community awareness safety committee. When prioritizing biological agents according to potential morbidity and mortality, which cluster of biological agents hold the highest mortality?
- A. Hantavirus, tuberculosis
- B. Botulism, Salmonella
- C. Anthrax, smallpox
- D. Escherichia coli, Brucella species
Correct Answer: C
Rationale: The cluster of agents with the highest mortality includes anthrax and smallpox. The Hantavirus and tuberculosis agents are not presently used for bioterrorism. Botulism and Salmonella as well as Escherichia coli and Brucella species are of low mortality.
The student nurse is completing a simulation where a client is the victim of nerve gas. The instructions are for the student to set up the room and have all needed supplies available. Which medication does the student nurse ensure is in the medication administration system to control seizures?
- A. Phenobarbital intramuscular
- B. Neurontin tablets
- C. Valium intravenous injection
- D. Dilantin tablets
Correct Answer: C
Rationale: The student nurse is correct to have Valium intravenously on hand for seizure activity. When seizure activity occurs, the intravenous route is the best option to deliver the medication safely and rapidly into the system.