Nokea
The nurse is taking a class on chemical disasters with the local emergency response team. What toxin(s) would the nurse be learning about? Select all that apply.
- A. Blistering agents
- B. Psychologic agents
- C. Contact emulsifiers
- D. Nerve agents
- E. Cyanide
Correct Answer: A,D,E
Rationale: Examples of extremely toxic chemicals include nerve agents, cyanide, respiratory toxins, and blistering agents. The nurse would not be learning about psychologic or nerve agents as toxins present in chemical disasters.
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The nurse is caring for a client with internal radiologic contamination from the fallout. The client states, 'I need to get this out of me, and then I will be done with it.' The nurse is most correct to reply which of the following?
- A. Yes, we need to assure that we clean any debris from your wound which may be contaminated.'
- B. Yes, but you may have lingering effects from the exposure to your body.'
- C. Yes, but you must also consider further exposure from contaminated food and water sources.'
- D. Yes, we need to continue to document your recovery process and further disease processes.'
Correct Answer: C
Rationale: Internal radiologic contamination occurs from exposure to fallout on the skin, in a wound, inhaled, or consumed through food and water. It is the nurse's responsibility to advise the client if further harm may occur and ways to decrease the risk.
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 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 evaluating a skin lesion on a client brought to the emergency department. The nurse notes characteristics of chickenpox but has the physician evaluate the lesion for which biologic disaster agent?
- A. Botulism
- B. Smallpox
- C. Rubella
- D. Anthrax
Correct Answer: B
Rationale: Smallpox may be mistaken for chickenpox due to the characteristics of the lesions. Botulism is a neurological toxin. Rubella is a communicable disease. Anthrax is a spore-forming bacterium that is inhaled or injected.
The nurse is orienting to the emergency department and finds cases of potassium iodide tablets located in the supply closet. The nurse asks the nurse manager, 'What is the purpose of this agent?' What is the nurse manager's best response?
- A. Potassium iodide is given to individuals who come to the emergency department dehydrated to replenish their potassium level.'
- B. Potassium iodide is given to individuals diagnosed with hypothyroidism in the emergency department.'
- C. Potassium iodide is given to individuals as a prophylaxis for protecting the thyroid gland from absorption of radiation in case of an accident at the local nuclear plant.'
- D. Potassium iodide is given to individuals who are given furosemide intravenously in the emergency department to replenish their potassium level.'
Correct Answer: C
Rationale: The nurse manager's best response is, 'Potassium iodide is given to individuals as a prophylaxis for protecting the thyroid gland from absorption of radiation in case of an accident at the local nuclear plant,' because this best describes the rationale for keeping the medication on hand. The US Nuclear Regulatory Commission (NRC) currently requires states with a population within 10 miles of a commercial nuclear plant to have immediate access to a supply of potassium iodide (KI) tablets.