A nurse is participating in a biological disaster simulation where citizens are exposed to pneumonic plague. Which of the following interventions should the nurse plan to use while caring for these clients?

Choice A: Provide a brightly lit environment is not an intervention that the nurse should take. A brightly lit environment can stimulate the brain and increase intracranial pressure. The nurse should provide a quiet and dimly lit environment to reduce sensory stimuli and promote rest.

Choice B: Elevate the head of the bed is an intervention that the nurse should take. Elevating the head of the bed to 30 degrees can help reduce intracranial pressure by facilitating venous drainage from the brain and decreasing cerebral blood volume. The nurse should avoid flexing or extending the neck, which can impede blood flow and increase intracranial pressure.

Choice C: Encourage a minimum intake of 2000 mL (67.6 oz) of clear fluids per day is not an intervention that the nurse should take. A high fluid intake can increase intracranial pressure by increasing blood volume and cerebral edema. The nurse should monitor fluid balance and restrict fluid intake as prescribed to maintain normal osmolality and prevent fluid overload.

Choice D: Teach controlled coughing and deep breathing is not an intervention that the nurse should take. Coughing and deep breathing can increase intrathoracic pressure, which can increase intracranial pressure by reducing venous return from the brain. The nurse should avoid activities that can increase intrathoracic pressure, such as straining, sneezing, or blowing the nose. The nurse should also administer oxygen as prescribed to maintain adequate oxygenation and perfusion of the brain.

Choice A Reason: This is correct because smallpox is a highly contagious and deadly viral disease that can be used as a biological weapon. Smallpox was eradicated in 1980, but some samples of the virus are still stored in laboratories. If released intentionally, smallpox could cause a global pandemic.

Choice B Reason: This is incorrect because hydrogen cyanide is a chemical weapon of mass destruction, not a biological one. Hydrogen cyanide is a colorless gas that interferes with cellular respiration and causes rapid death.

Choice C Reason: This is correct because botulism is a serious and potentially fatal illness caused by a toxin produced by the bacterium Clostridium botulinum. Botulism can be used as a biological weapon by contaminating food or water supplies or by aerosolizing the toxin.

Choice D Reason: This is correct because anthrax is an infection caused by the spore-forming bacterium Bacillus anthracis. Anthrax can be used as a biological weapon by releasing the spores into the air or by contaminating food or water sources.

Choice E Reason: This is incorrect because sarin is a chemical weapon of mass destruction, not a biological one. Sarin is a nerve agent that blocks the transmission of nerve impulses and causes respiratory failure and death.