BCEN Triage Systems 5

Question 1

A hospital activates its internal disaster plan. The primary goal of in-hospital triage during a mass casualty event differs from field triage in that it focuses on:

Accepted Answer

Allocating definitive hospital resources to maximize survival outcomes

Answer

Using START triage exclusively regardless of patient age

Answer

Tagging all patients Black who arrive without field triage tags

Answer

Prioritizing patients based on insurance status

Question 2

Which finding would cause a nurse using the ESI algorithm to assign a level 2 rather than level 3?

Accepted Answer

The patient is in active labor at 38 weeks gestation with contractions every 3 minutes

Answer

The patient has a sprained ankle and needs an X-ray

Answer

The patient has a UTI and needs urinalysis and antibiotics

Answer

The patient has a mild headache with no other symptoms

Question 3

During surge capacity triage, 'reverse triage' refers to:

Accepted Answer

Rapidly discharging stable inpatients to free capacity for incoming casualties

Answer

Prioritizing the most critically ill patients for all available resources

Answer

Triaging patients in the order they arrived regardless of acuity

Answer

Assigning the least experienced nurses to the highest-acuity patients

Question 4

A triage nurse is using the Australasian Triage Scale (ATS). Category 3 means the patient should be seen within:

Accepted Answer

30 minutes

Answer

2 minutes

Answer

10 minutes

Answer

60 minutes

Question 5

Which patient presentation would be INCORRECTLY triaged if a nurse fails to account for pediatric vital sign norms at triage?

Accepted Answer

A 6-year-old with HR 105 and RR 26 who is alert and playful

Answer

An adult with HR 105 and RR 26 who is alert

Answer

A 6-year-old with HR 180 and RR 10 who is lethargic

Answer

An adult with HR 180 and RR 10 who is lethargic

Question 6

The CTAS level assigned to a patient with moderate abdominal pain, stable vitals, and no high-risk features is:

Accepted Answer

Level 3

Answer

Level 1

Answer

Level 2

Answer

Level 5

Question 7

A triage nurse is assessing a patient during a chemical exposure mass casualty event. Which action is the nurse's FIRST priority before initiating triage assessment?

Accepted Answer

Ensure the patient has been decontaminated

Answer

Obtain IV access and administer antidote

Answer

Apply a triage tag and move the patient inside

Answer

Document the patient's exposure history