Prevention is a tool we all can use to decrease our potential for gamma radiation contamination in the event of a nuclear accident or attack. Being aware of ways to limit external contamination empowers individuals to feel safer and to protect themselves and their loved ones. If caught outside during such an event, which of the following is the most effective way to decrease the potential for external gamma radiation contamination by an individual?

Answer: Remove all garments and shoes before entering a house or public shelter.

Explanation:

Removing all garments can eliminate 90% of external radioactive contamination. To limit external contamination, you should turn off window fans, air conditioners, and forced-air heating units. This is a way to limit internal, not external, contamination. Exposure to gamma radiation may cause acute radiation syndrome (ARS) and lead to death. Long-term effects experienced by those exposed to radiologic disasters include thyroid cancer, leukemia, and non-Hodgkin's lymphoma.

A patient was involved in an avalanche that killed many people on a ski trip, including the patient's brother. The nurse is educating the patient about recognition of stress reactions and ways to manage stress. What type of process is the nurse introducing to the patient?

Answer: Defusing

Explanation:

Components of a management plan include education (preparedness) before an incident occurs about critical incident stress and coping strategies; field support (ensuring that staff get adequate rest, food, and fluids, and rotating workloads) during an incident; and defusings, debriefings, demobilization, supportive services to the family, and follow-up care after the incident (Veenema, 2013). Defusing is a process by which the person receives education about recognition of stress reactions and management strategies for handling stress. Debriefing is a more complicated intervention; it involves a 2- to 3-hour process during which participants are asked about their emotional reactions to the incident, what symptoms they may be experiencing (e.g., flashbacks, difficulty sleeping, intrusive thoughts), and other psychological ramifications.

All people who have household or face-to-face contact with the patient diagnosed with smallpox after the fever begins should be vaccinated within what timeframe to prevent infection and death?

Answer: 4 days

Explanation:

All people who have household or face-to-face contact with the patient after the fever begins should be vaccinated within 4 days to prevent infection and death.

During a disaster, the nurse triages a victim with a fractured wrist. Which color triage tag should the nurse apply?

Answer: Green

Explanation:

A green triage tag (priority 3 or minimal) indicates injuries that are minor and treatment can be delayed hours to days. A red triage tag (priority 1 or immediate) indicates injuries that are life threatening, but survivable with minimal intervention. A yellow triage tag (priority 2 or delayed) indicates injuries that are significant and require medical care, but can wait hours without threat to life or limb. A black triage tag (priority 4 or expectant) indicates injuries that are extensive and chances of survival are unlikely even with definitive care.

Several patients that have been involved in a bombing are unlikely to survive. What priority are these patients given during triage?

Answer: Priority 4

Explanation:

Triage category "Expectant" is priority 4 (black) and applies to patients with injuries that are extensive and whose chances of survival are unlikely even with definitive care, such as unresponsive patients with penetrating head wounds, high spinal cord injuries, and wounds involving multiple anatomic sites and organs.

A nuclear accident (intentional or unintentional) can cause significant harm to those living nearby or at a distance. Harmful levels of invisible gamma radiation penetrate the body, creating not only devastating injuries but the radioactive contamination can also be spread to contaminate others. What type of transmission precaution prevents this person-to-person contamination?

Answer: Contact

Explanation:

Invisible gamma radiation penetrates the body and can be eliminated in blood, sweat, urine, and feces. Consequently, a contaminated person can contaminate others through contact with body fluids or surfaces he or she touches. Airborne transmission requires the suspension and transport on air currents beyond 3 feet and is the way in which many pathogens or toxins are transmitted. Invisible gamma rays do not fall into this category, however. Gamma radiation does not travel in a liquid, or droplet, form. Standard precautions encompass more than person-to-person contamination.