BCEN Disaster Preparedness 2 — Questions and Answers
Question 1: During a mass casualty incident, a patient tagged BLACK under the START triage system should receive which intervention?
- Immediate airway repositioning and transport
- Expectant care with comfort measures only (Correct answer)
- Delayed treatment after red and yellow patients
- Rapid IV fluid resuscitation
Correct answer: Expectant care with comfort measures only
Black-tagged patients are expectant — injuries are unsurvivable or resources are insufficient, so only comfort care is provided.
Question 2: Which federal agency coordinates overall domestic incident management and is the primary federal department for disaster response in the US?
- FEMA (Correct answer)
- CDC
- OSHA
- HHS
Correct answer: FEMA
FEMA (Federal Emergency Management Agency) is the primary federal agency for coordinating disaster response and recovery.
Question 3: A hospital activates its Incident Command System (ICS) during a mass casualty event. Who serves as the Hospital Incident Commander?
- The senior emergency physician on duty
- The designated individual responsible for overall hospital response (Correct answer)
- The charge nurse in the ED
- The state health department liaison
Correct answer: The designated individual responsible for overall hospital response
The Hospital Incident Commander is the designated leader responsible for overall incident management, not necessarily a physician.
Question 4: During a chemical disaster involving a nerve agent, which antidote combination is administered as first-line treatment?
- Sodium bicarbonate and calcium gluconate
- Atropine and pralidoxime (2-PAM) (Correct answer)
- Epinephrine and diphenhydramine
- Naloxone and flumazenil
Correct answer: Atropine and pralidoxime (2-PAM)
Atropine blocks muscarinic effects and pralidoxime reactivates acetylcholinesterase, making them the standard nerve agent antidotes.
Question 5: Which radiation exposure scenario poses the GREATEST immediate contamination risk to emergency department staff?
- A patient who was in a building during a dirty bomb explosion and has not been decontaminated (Correct answer)
- A patient who received internal radiation therapy 24 hours ago
- A patient transported by EMS after a nuclear power plant alarm
- A patient with a cardiac pacemaker exposed to a non-ionizing radiation source
Correct answer: A patient who was in a building during a dirty bomb explosion and has not been decontaminated
An undecontaminated dirty bomb victim may carry radioactive particulate matter that poses direct contamination risk to staff.
Question 6: Under the National Incident Management System (NIMS), the concept of 'unity of command' means:
- All agencies report to the federal government during a disaster
- Each person reports to only one designated supervisor (Correct answer)
- The incident commander controls all resources regardless of agency
- Medical personnel follow only physician orders during disasters
Correct answer: Each person reports to only one designated supervisor
Unity of command ensures each responder has one clearly identified supervisor, preventing conflicting orders.
Question 7: A hospital receives notification of an incoming surge of 200 patients from a building collapse. The FIRST priority action by the ED charge nurse is to:
- Call in all off-duty nursing staff immediately
- Activate the hospital's Emergency Operations Plan (Correct answer)
- Begin discharging stable ED patients to create capacity
- Set up a field triage area outside the ED entrance
Correct answer: Activate the hospital's Emergency Operations Plan
Activating the Emergency Operations Plan initiates the coordinated hospital-wide response, which then drives all subsequent actions.
BCEN Disaster Preparedness 2
During a mass casualty incident, a patient tagged BLACK under the START triage system should receive which intervention?