Which of the following definitions is incorrect?
External disaster occurs outside of a health care facility or campus
Internal disasters occur inside a health care facility or campus
Mass casualty disasters overwhelm local medical capabilities
Multi-casualty disasters cannot be managed by a hospital
The Correct Answer is D
Rationale:
A. External disasters are incidents that happen outside the hospital or healthcare campus, such as natural disasters (e.g., earthquakes, hurricanes), transportation accidents, industrial accidents, or acts of terrorism. These events require hospitals to respond by activating emergency plans to treat incoming patients and allocate resources appropriately.
B. Internal disasters originate within the hospital itself and can disrupt operations. Examples include fires, chemical spills, structural damage, equipment failure, or power outages. Internal disaster plans focus on staff safety, evacuation procedures, and maintaining patient care during facility emergencies.
C. A mass casualty incident (MCI) occurs when the number of casualties exceeds the immediate capacity of local medical facilities, requiring triage, prioritization of care, and sometimes external assistance from other hospitals, emergency medical services, or disaster response teams.
D. Multi-casualty incidents (MCIts) involve multiple patients but generally remain within the hospital’s capacity to manage. Unlike mass casualty incidents, where local resources are overwhelmed, multi-casualty events can usually be handled with existing staff, supplies, and facilities. Hospitals often activate standard emergency procedures but do not require external support to manage patient care. Therefore, this definition misrepresents the distinction between multi-casualty and mass casualty disasters.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. This describes tissue being drawn inward, which is not the definition of stippling. Stippling is related to surface skin findings from a firearm discharge, not tissue movement into the wound.
B. Cavitation refers to the temporary cavity created by the bullet as it passes through tissue, causing internal damage. This is a separate ballistic concept and not related to stippling.
C. An exit wound is where the bullet leaves the body and is typically larger and more irregular than the entrance wound. Stippling is associated with the entrance wound, not the exit wound.
D. Stippling (also called powder tattooing) occurs when unburnt gunpowder and other residues from the firearm are driven into the skin. This indicates a close-range or intermediate-range gunshot wound, and the pattern can help estimate the distance between the firearm and the victim at the time of injury.
Correct Answer is ["A","C","D","E","G","H"]
Explanation
Rationale:
A. Mr. Snowden was submerged in icy water, which puts him at high risk for hypothermia. Hypothermia can worsen coagulopathy, impair cardiac function, and affect drug metabolism. Maintaining normothermia through warming blankets, warmed IV fluids, and environmental temperature control is essential for stabilization and to prevent secondary complications.
B. There is no indication of a urinary tract infection in the current assessment. Administering antibiotics for a UTI would be unnecessary and not a priority in the acute stabilization phase. Priority interventions should focus on immediate life-threatening issues and injuries sustained from the accident.
C. With a complete T10 spinal cord injury, frequent neurologic assessments are vital to monitor for changes in motor function, sensation, and reflexes above the level of injury. Hourly checks help detect complications such as autonomic dysreflexia, spinal shock, or evolving cord edema. Monitoring the Glasgow Coma Scale (even with intubation), voluntary movements in extremities, and sensory response is part of these assessments.
D. Spinal precautions are critical due to the complete T10 injury. The log-roll technique maintains spinal alignment and prevents further cord damage while turning, repositioning, or performing hygiene care. All staff must coordinate movements to prevent rotation or flexion of the spine.
E. The large abrasion/laceration on the scalp could lead to significant bleeding, infection, or indicate underlying skull fracture. Assessment includes checking for active bleeding, signs of hematoma or swelling, neuro changes, and proper wound care. This is important to prevent secondary complications and infection.
F. Mr. Snowden’s vital signs (heart rate 72 bpm, respiratory rate 16, oxygen saturation 99%) are currently stable. There is no evidence of hypovolemia or shock, so IV fluid bolus is not immediately indicated. Fluids may be considered later if hypotension develops or in response to lab values.
G. Collecting accurate information about the accident helps determine timing of submersion, duration of CPR, previous medical conditions, medications, allergies, and baseline neurologic function. This informs ongoing care decisions, prognostication, and potential complications such as hypoxic brain injury or organ damage.
H. Mr. Snowden is intubated and fully dependent on mechanical ventilation. Continuous monitoring of airway patency, ventilator settings, oxygenation, and tidal volumes is a life-saving priority. Ensuring suctioning is performed as needed and preventing ventilator-associated complications (e.g., pneumonia) are also part of stabilization.
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