There has been a terrorist attack in the city. A nuclear detonation device has been used and there are many dead as the result of this attack.
How would the nurse direct the handling of the bodies of the dead?
Use of local funeral home morgues.
Use of refrigerated trucks.
Use of the hospital morgue.
Use of mass graves.
Correct Answer : B,D
Choice A rationale
Local funeral home morgues would be quickly overwhelmed and inadequate for mass casualties resulting from a nuclear detonation. The sheer volume of bodies would exceed their capacity, and they may lack the specialized facilities required for handling contaminated remains, posing significant public health and safety risks. Normal morgue capacity is designed for typical mortality rates.
Choice B rationale
Refrigerated trucks provide a temporary, scalable solution for storing a large number of bodies, helping to prevent decomposition and the spread of pathogens in a mass casualty event. This method allows for organized collection and identification processes to be established while awaiting more permanent arrangements, crucial in disaster response. Proper refrigeration maintains body integrity.
Choice C rationale
Hospital morgues, like local funeral home morgues, have limited capacity and are primarily designed for routine patient deaths. In a large-scale disaster, they would be rapidly overfilled, compromising their ability to manage current hospital fatalities and posing logistical challenges for body management and identification. Normal hospital morgues are equipped for standard operations.
Choice D rationale
Mass graves are a last resort in extreme mass casualty events when conventional methods of body disposal are overwhelmed or impractical due to scale, contamination, or resource limitations. While a somber decision, they can be a necessary measure to manage large numbers of deceased individuals safely and efficiently, preventing widespread public health crises. Proper procedures minimize environmental impact.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While clients with Cushing's syndrome may experience fatigue due to elevated cortisol levels affecting sleep patterns and muscle catabolism, clustering activities only in the morning may not adequately address the fluctuating energy levels or provide sufficient rest periods throughout the day. A more balanced approach involving rest periods and activity modification throughout the day is generally more beneficial.
Choice B rationale
Clients with Cushing's syndrome often experience fluid retention and edema due to the mineralocorticoid effects of excess cortisol. Therefore, increasing fluid intake would exacerbate fluid overload rather than alleviate symptoms. Fluid restriction and diuretic therapy may be necessary to manage fluid balance and prevent complications like hypertension and heart failure.
Choice C rationale
Cushing's syndrome is characterized by endogenous overproduction of cortisol, meaning the body already produces too much. Requesting a medical prescription for cortisol would further elevate cortisol levels, worsening the client's symptoms and potentially leading to adrenal crisis if exogenous cortisol is administered in addition to already elevated endogenous levels. Management focuses on reducing cortisol.
Choice D rationale
Assessing daily weights is crucial for clients with Cushing's syndrome due to the propensity for fluid retention and weight gain caused by increased mineralocorticoid activity of cortisol. Daily weights provide an objective measure of fluid balance and can indicate exacerbation or improvement of edema, helping guide interventions and monitor treatment effectiveness. Normal weight fluctuation should be within 1-2 kg in 24 hours.
Correct Answer is D
Explanation
Choice A rationale
Adjusting levothyroxine dosage daily based on blood levels is generally not appropriate due to the drug's long half-life, which necessitates stable drug concentrations before accurate assessment. Frequent adjustments risk inducing fluctuations in thyroid hormone levels, potentially leading to hyperthyroidism or continued hypothyroidism and making precise titration challenging for maintaining euthyroid state.
Choice B rationale
Remaining on the initial dosage throughout treatment is highly improbable for levothyroxine. Thyroid hormone replacement therapy requires individualized dosing due to variations in patient metabolism, weight, and the severity of hypothyroidism. Regular monitoring of thyroid stimulating hormone (TSH) levels is essential to titrate the dose, ensuring optimal therapeutic effect and avoiding complications.
Choice C rationale
Starting levothyroxine at a high dosage is contraindicated, particularly in older adults or those with cardiovascular comorbidities, due to the risk of precipitating adverse cardiac events such as arrhythmias or angina. High doses can overwhelm the cardiovascular system, demanding increased metabolic activity. Gradual titration minimizes these risks and allows for physiological adaptation.
Choice D rationale
Starting on a low dosage and gradually increasing levothyroxine is the standard and safest approach. This strategy allows the body to adapt to the exogenous thyroid hormone, minimizing the risk of adverse effects like cardiac arrhythmias, particularly in sensitive individuals. Gradual titration prevents rapid metabolic shifts and allows for careful monitoring of patient response and TSH levels.
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