Correct answer—B. Rationales: The triage classification of disasters occurs in three tiers. The first is a multipleclient incident, which is a common occurrence involving fewer than 10 casualties. The next is a multiple-casualty incident, which involves fires, natural occurrences (hurricanes and tornadoes), radiation or biochemical accidents, and air, train, and bus crashes. Casualties number 100 or fewer. A multiple-casualty incident strains the existing emergency medical system but doesn’t overwhelm the components. A mass-casualty incident is the least common. It occurs with major earthquakes, explosions, structural failures, and largescale fires. Casualties number more than 100. There are many deaths and injuries; property damage is extensive as well. The emergency medical system and health care facilities are overwhelmed. Mass-client incidents are not part of the triage classification of disasters.

Nursing process step: Assessment

Correct answer—A. Rationales: Analysis, intervention, and reassimilation aren’t part of the four key components of an emergency preparedness program. The four components include:

Nursing process step: Analysis

Correct answer—B. Rationales: The Emergency department is the interface between the hospital and the disaster scene and is the institution’s first “clinical domino” to sustain the burden of client care. The staff’s performance during the initial disaster response affects the entire hospital. Administration’s role is to support the emergency department by setting up command operations and securing adequate staff to care for incoming casualties. The morgue’s role is to hold casualties triaged as mortally injured or dead on arrival. The operating room is the second most critical area for handling incoming casualties; many of the victims may need surgical intervention.

Nursing process step: Analysis

Correct answer—A. Rationales: NIMS integrates emergency preparedness and response into a national framework for incident management. Incident Command Structures are based on a three-organization system: incident command, multiagency coordination, and public information. The Federal Response Plan was created as a guide for an all-hazards approach to domestic incidents and how to group them. The Disaster Relief and Emergency Assistance Act was enacted as statutory author for most federal disaster response activities and created the Federal Response Plan.

Nursing process step: Analysis

Correct answer—A. Rationales: The Joint Commission requires each hospital to describe its role in the community-wide emergency preparedness plan. Each hospital must also be able to show evidence of staff education and training and of semiannual disaster plan implementation. The classification system used in triage is the job of the hospital Incident Command System, not The Joint Commission. The National Disaster Management System, not The Joint Commission, assesses the need for additional personnel in a disaster area.

Nursing process step: Evaluation

Correct answer—D. Rationales: The use of alcohol and drugs is considered a delayed reaction to the stress of a disaster. Anxiety manifests itself almost immediately after the staff learns of a disaster. Frustration and anger occur as the victims arrive and the staff deals with the pain and suffering of innocent casualties. This emotion is intensified if the disaster was caused deliberately.