A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply.)
Botulism is acquired through direct contact with an infected person.
Notify the Centers for Disease Control and Prevention (CDC) when more than three cases are confirmed.
Botulism can produce paralysis within 12 to 72 hours following exposure.
Vomiting and diarrhea are expected findings following exposure.
Botulism is a toxin found in castor beans.
Correct Answer : C,D
Choice A reason: Botulism is Acquired Through Direct Contact with an Infected Person
Botulism is not acquired through direct contact with an infected person. It is caused by a toxin produced by the bacterium Clostridium botulinum. The most common forms of botulism are foodborne, wound, and infant botulism. Foodborne botulism occurs when a person ingests food containing the toxin, while wound botulism occurs when the bacteria infect a wound and produce the toxin. Infant botulism occurs when infants ingest spores of the bacteria, which then grow and produce the toxin in their intestines.
Choice B reason: Notify the Centers for Disease Control and Prevention (CDC) When More Than Three Cases Are Confirmed
While notifying the CDC is crucial in the event of a botulism outbreak, the specific threshold for notification can vary. Generally, any suspected case of botulism should be reported to public health authorities immediately due to the severity of the disease and the potential for outbreaks. The CDC provides guidelines for reporting and managing botulism cases.
Choice C reason: Botulism Can Produce Paralysis Within 12 to 72 Hours Following Exposure
Botulism can indeed produce paralysis within 12 to 72 hours following exposure. The toxin affects the nervous system, leading to muscle paralysis. Early symptoms include weakness, dizziness, and dry mouth, followed by more severe symptoms such as blurred vision, difficulty swallowing, and muscle weakness. If left untreated, botulism can lead to respiratory failure and death.
Choice D reason: Vomiting and Diarrhea Are Expected Findings Following Exposure
Vomiting and diarrhea may occur early, especially in foodborne or inhalational exposures, before neurologic signs appear
Choice E reason: Botulism is a Toxin Found in Castor Beans
Botulism is not a toxin found in castor beans. The toxin found in castor beans is ricin, which is a different type of bioterrorism agent. Botulism is caused by the botulinum toxin produced by Clostridium botulinum bacteria.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Place a pillow under the client’s head: During a tonic-clonic seizure, it is crucial to protect the client’s head from injury. Placing a pillow or any soft object under the head can help prevent head trauma caused by the convulsions. Ensuring the client’s safety by protecting their head is a primary concern during a seizure.
Choice B reason:
Insert a padded tongue blade into the client’s mouth: This action is incorrect and potentially dangerous. Inserting any object into the mouth during a seizure can cause injury to the teeth, gums, or jaw. It can also obstruct the airway. The myth that a person can swallow their tongue during a seizure is false, and no object should be placed in the mouth.
Choice C reason:
Apply a face mask for oxygen administration: While providing oxygen can be beneficial after the seizure has ended, during the seizure, the priority is to ensure the client’s safety and prevent injury. Applying a face mask during the active phase of a seizure is not practical and can interfere with managing the seizure safely.
Choice D reason:
Gently restrain the client’s extremities: Restraining the client’s extremities during a seizure is not recommended. Attempting to restrain the movements can cause injury to both the client and the nurse. The focus should be on protecting the client from harm without restricting their movements.
Correct Answer is B
Explanation
Choice A reason: Induce Sedation
Pancuronium is not used to induce sedation. It is a neuromuscular blocking agent (NMBA) that causes paralysis of skeletal muscles. Sedation is typically achieved using medications such as benzodiazepines or propofol, which act on the central nervous system to produce a calming effect.
Choice B reason: Suppress Respiratory Effort
Pancuronium is used to suppress respiratory effort in patients with ARDS who require mechanical ventilation. By causing muscle paralysis, pancuronium helps to synchronize the patient’s breathing with the ventilator, reducing the risk of ventilator-induced lung injury and improving oxygenation. This is particularly important in severe cases of ARDS where patient-ventilator dyssynchrony can be detrimental.
Choice C reason: Decrease Chest Wall Compliance
Decreasing chest wall compliance is not a purpose of pancuronium. In fact, pancuronium does not directly affect chest wall compliance. Instead, it works by blocking the transmission of nerve impulses to the muscles, leading to muscle relaxation and paralysis.
Choice D reason: Decrease Respiratory Secretions
Pancuronium does not decrease respiratory secretions. Medications such as anticholinergics (e.g., atropine) are used to reduce secretions. Pancuronium’s primary role is to facilitate mechanical ventilation by ensuring complete muscle relaxation.

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