A nurse working on a medical-surgical unit is notified about a mass casualty event that recently took place in the community.
Which of the following assignments should the nurse anticipate?
Assist in discharging stable clients to home.
Determine the acuity and number of casualties arriving at the facility.
Delegate tasks to emergency health care specialists.
Provide informational updates to members of the media.
The Correct Answer is A
Choice A rationale: In a mass casualty event, the hospital must rapidly create capacity for incoming victims. Discharging stable clients who no longer require acute care is a primary nursing responsibility to free up beds and resources.
Choice B rationale: Determining the acuity and number of incoming casualties is typically the role of a triage officer or the incident commander at the scene or hospital entrance, not a floor nurse on a medical-surgical unit.
Choice C rationale: Delegating tasks to specialists or coordinating the overall medical response is the responsibility of the medical director or the designated leader in the Hospital Incident Command System (HICS), not the staff nurse.
Choice D rationale: Communication with the media is strictly handled by the Public Information Officer (PIO) to ensure accuracy and maintain client confidentiality. Staff nurses are prohibited from providing unauthorized updates to external media outlets.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
History of vomiting at home for 3 days prior to surgery. Rationale: This information is relevant to the client's surgical history and may impact their current condition. It is essential to inform the receiving nurse about this history to ensure appropriate postoperative care.
Choice B rationale:
Soft abdomen, absent bowel sounds, no bleeding on dressing. Rationale: While this information is important for assessing the client's postoperative status, it is less urgent than the history of vomiting. The abdominal assessment suggests normal findings after surgery.
Choice C rationale:
Declining to take ice chips for complaints of dry mouth. Rationale: While this information indicates the client's complaint of dry mouth, it is not as critical as the history of vomiting or the assessment of surgical outcomes.
Choice D rationale:
Peripheral pulses present with full range of motion of both legs. Rationale: This information is important but primarily related to the client's vascular and neurological status. It may not be as immediately relevant as the history of vomiting in the context of a recent surgery.
Correct Answer is B
Explanation
The correct answer is choice b. Respiratory alkalosis.
Choice A rationale:
Metabolic alkalosis occurs when there is a loss of acid or an increase in bicarbonate in the body. This can be due to vomiting, diuretic use, or excessive bicarbonate intake. It is not typically associated with hyperventilation.
Choice B rationale:
Respiratory alkalosis is caused by hyperventilation, which leads to a decrease in carbon dioxide (CO2) levels in the blood. This condition is often triggered by anxiety, fear, pain, or fever, all of which are present in this adolescent.
Choice C rationale:
Metabolic acidosis occurs when there is an accumulation of acid or a loss of bicarbonate in the body. This can be due to conditions like diabetic ketoacidosis, renal failure, or severe diarrhea. It is not typically associated with hyperventilation.
Choice D rationale:
Respiratory acidosis occurs when there is an accumulation of CO2 in the blood due to hypoventilation or impaired lung function. This condition is not consistent with hyperventilation, which reduces CO2 levels.
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