444 exam 3 (second 100 questions)

triage:

- red = immediate, pt needs to be seen asap, see pt first

- yellow = delayed, medically stable but still need assistance

- green = minor, pt needs 1st aid care, see pt last

- black = dead

triage:

- red = immediate, pt needs to be seen asap, see pt first

- yellow = delayed, medically stable but still need assistance

- green = minor, pt needs 1st aid care, see pt last

- black = dead

What should every nurse have on them to respond to an emergency?:

-stethoscope

- money

- basic nursing equipment (pen light, tourniquet)

coalition

a group of individuals or union of individuals that share a common interest

best way to unify, get law passed, change something within a program

apathetic

emotionless

- don't act apathetic, show cultural competence

#1 cause of sentinel events according to the joint commission

miscommunication

Who is the number one accreditation place in the US?

DNV

focus assessments:

expand database w/ extra info

assessment on a priority area

enter the area of the pt care/condition being recorded

Strategic national stockpile (SNS):

works under CDC

federal program that stores large quantities of medicine/ medical products in case of natural disaster/emergency

no color code, use plain language for

- active shooters

armed, violent intruders

- hostage situation

2 types of disasters

natural and man-made

culture of civility

- respecting others

- honoring differences

- listening and seeking common ground

- engaging in social discourse

Bioterrorism agents/examples

- man-made agents

- anthrax

- botulism

- plague

- smallpox

- tularemia

- hemorrhagic fevers (ebola)

best way to organized, effective, safe, and practice efficient management controls is to:

plan

Who are you going to see first if you are driving and you see an accident with 5 people?

Confused patient who has a scratch on their head

. You have too many patients assigned, overwhelmed, and make a mistake. What do you do?

initiate a shared governance/coalition, speak to leadership or safety committees

What makes nurses stay in their job?

- flexible

- recognition

- magnet status

What is the first thing we need to do to solve the problem?

define problem

You find a nurse doing meds in the med room

report to supervisor

If a nurse hasn't broken the law, but they are doing something wrong

talk to the nurse and educate them

how to chart

be specific, clear, concise

When someone is upset or crying, what do you do?

comfort, console, listen

What are the categories of disasters in healthcare?

biological, chemical, nuclear

RN role in disaster

assess, triage, monitor physical and mental health

What is a hospitals first response to a disaster scenario?

triage and initial stabilization

What is the priority for disaster response?

infrastructure recovery and work with FEMA

what requires a disaster management plan?

HIPAA

which team is best to triage pts

experienced RN and advanced practice nurse

main role of nurse or first responder in a mass casualty event (MCI)

triage and color code victims

An active shooter incident occurs in the triage of a busy ED. What is the priority action for the triage nurse to take?

Locate a safe path and run to a safe place; take others if possible

You are caring for a client who is an athlete that is sweating and asking questions. What type of anxiety is displayed

mild

how does decision making occur in a shared governance workplace

happens through a committee or council

A nurse is documenting in a computerized MAR. Which of the following nursing actions may jeopardize confidentiality?

sharing passwords

- keeping chart open/not logging off

leadership style that uses groups to achieve goals and lead to good results

transformational

What are their state nurses association and the National Nurses United (NNU)?:

representative of nurses and how they participate in traditional or nontraditional collective bargaining

transactional leadership

keeps the place running, reacts to situations, doesn't focus on the future

how to minimize miscommunication and reduce barriers

SBAR

Laissez-faire leadership

no guidance from leader, permissive, team makes decisions on their own

What is collective bargaining in healthcare?:

Negotiates contracts with employees

In the work setting, what is the nurse's primary responsibility in preparing for the management of disasters, including natural disasters and bioterrorism incidents?

knowing the agency's emergency response plan

A group of people arrive at the emergency department by private car. The all have periorbital swelling, coughing and tightness in the throat. There is a strong odor emanating from their clothes. They report exposure to a "gas bomb" that was set off in their house. Which action is the priority?

direct patient to the decontamination area

The nurse is working in the triage area of an emergency department, and the following four patients approach the triage desk at the same time. List the order in which the nurse will assess these patients.

An irritable newborn with fever, petechiae, and nuchal ridgity

An ambulatory, dazed 25 year old with a bandaged head wound

A 50 year old woman with moderate abdominal pain and occasional vomiting

A 35 year old jogger with a twisted ankle who has a pedal pulse and no deformity

The charge nurse in an emergency department (ED) must assign two staff members to cover the triage area. Which team is best for this assignment?

an advanced practice nurse and an experienced RN

Which statement below is incorrect about the yellow triage tag color regarding a disaster situation?

A survivor with this tag color is seen after patients with the RED (not green) tag color

what phase of emergency management includes exercises and drills?

preparedness

During a disaster, the person responsible for leading the response effort in the incident

commander

What reference must be accessible at every workplace for each hazardous substance?

safety data sheet

The baby cries- you change the diaper- you feed the baby- the baby sleeps- the baby cries

feedback loop

Nurse rich is a nurse with lots of experience. People ask him to help or to answer questions all the time at work. He is this kind of leader...

informal leader

I know that I can't draw so it is no use in trying. This thinking is....

fixed mindset

I am a leader who allows them to make decisions on their own without any guidance from me. My leadership style is...:

Laissez faire

emotional intelligence

The ability to understand own and others feelings and use them to guide thinking and behavior.

I have 20 years experience with my patient population. I am intuitive and can react immediately to most situations. I am sought out by newer staff for help

expert nurse

I am a junior nursing student going to my clinical rotation.:

novice nurse

I am a newly graduated RN beginning my first job

advanced beginner

I have been nursing for 2 years I am comfortable with all tasks and am growing my skill in understanding complications my patients may have

competent nurse

I have been in my field of nursing for 6 years and I am very comfortable pre- dicting the potential complications and outcomes for my patients.

proficient nurse

My unit operation is the most important thing to me. I focus on these different things to accomplish this...

staffing, budgeting, unit operations

If my unit is understaffed, I must

find staff

What are the people who work for me?

subordinates

My perspective at work is

day to day operations

I work with others to find solutions to problems. A term for this is

collaborative or transformational

My process includes using groups to achieve goals. I work with people and guide them to a good result. My style of leadership is called...:

transformational

I like to see the big picture of how everything is operating. My process for fixing immediate staffing problems is to...:

delegate or find the staff myself

I like to help people improve their skills and knowledge so they can overcome their challenges. I use this technique.:

mentoring or inspiring

What are the people who work with me on improving things?:

followers

My leadership style is to keep the place running, I react to situations, and I don't focus on the future.:

transactional

System thinking involves

looking at the whole organization not just a sum of the different parts of it

A complex-adaptive system is...`:

evolving, changing, chaotic

SMART is a way of identifying goals. It stands for

specific, measurable, attainable/achievable, realistic/relevant, time related

The acronym OPQRST is used by nurses to provide a systematic way to chart the history of the patient's illness. What word does each letter represent?

O-Onset

P- Palliating or Provoking factors

Q-Quality

R-Region

S-Severity

T-Time

The following are common patient responses to illness. SATA

anger, guilt, stress

What type of report provides the most accurate information during hand- offs?

SBAR at bedside

what are the two major categories of public health preparedness?:

clinical preparedness

community-based preparedness

what does public health prepare for?:

chemical, biological, radiological, nu- clear and enhanced conventional weapons (CRBNE) events

what are some chemical agents

-nerve agents are the most severe and incapacitating(sarin, soman, tuban, and VX gas)

-choking or pulmonary agents(chlorine gas and phosgene gas)

what are some agents or actions of terrorism?:

dispensing of nuclear, biological or chemical agents as weapons to cause harm

. what are the four levels for protection against different agents?:

Level A-D

Level A:

same as level B but skin, eye, and mucous membrane protection also required

Level B

requires highest level of respiratory protection; initiated until causative agent identified

Level C

requires respiratory; airborne substance known

Level D

work uniform

emergency response plan

formal plan of action in the event of a disaster

what is triage

the system of sorting clients according to medical need when resources are unavailable for all persons to be treated

START system

Simple Triage and Rapid Treatment; is a strategy used to evaluate the severity of injury of each victim as quickly as possible and to tag the victims in about 30 to 60 seconds

deceased (black):

injured persons who are beyond the scope of medical assistance

immediate (red):

injured persons who must be assisted by advanced medical care immediately or within the next hour

delayed (yellow)

injured persons who are medically stable but require medical assistance

minor (green):

injured persons who do not need medical care for at least several hours; can usually walk with assistance, mainly consisting of bandages and acute first aid

what does the color blue in triage mean?:

expected to die

the Federal Emergency Management Agency (FEMA) identifies four disaster management phases

1) mitigation 2) preparedness 3) response 4) recovery

disaster

any human-made or natural event that causes destruction and devastation that cannot be alleviated without assistance

internal disasters

disasters that occur within a health care agency (e.g., health care agency fire, structural collapse, radiation spill)

external disasters

outside the health care agency (e.g., mass transit accident that could send hundreds of victims to the emergency departments)

multicasuality

limited number of victims or casualties and can be managed by a hospital with available resources

mass casualty incident (MCI):

involves a number of casualties that exceeds the resource capabilities of the hospital and is known as a disaster