Chapter 50 Terrorism Flashcards

1
Q
  1. Which of the following statements regarding terrorism is NOT correct?
    A) Terrorism violates the criminal laws of the United States.
    B) Individuals commit acts of terrorism to further a political or social objective.
    C) Terrorism intimidates a government or the civilian population.
    D) The majority of terrorist attacks are impulsive and unplanned.
A

Ans: D
Page: 2289-2290, 2293
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
2.  In order to draw attention to their cause, \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ attack a population's technological infrastructure.
A)  ecoterrorists
B)  cyberterrorists
C)  doomsday cults
D)  extremist political groups
A

Ans: B
Page: 2292
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
3.  An attack on an abortion clinic would MOST likely be carried out by a/an:
A)  single-issue group.
B)  technology terrorist.
C)  violent religious group.
D)  extremist political group.
A

Ans: A
Page: 2292-2293
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
4.  All of the following are examples of domestic terrorism, EXCEPT the:
A)  Oklahoma City bombing.
B)  Centennial Park bombing.
C)  World Trade Center attack.
D)  Atlanta abortion clinic attacks.
A

Ans: C
Page: 2290-2291
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
5.  To date, the preferred weapons of mass destruction for terrorists have been:
A)  nuclear.
B)  chemical.
C)  explosive.
D)  biologic.
A

Ans: C
Page: 2297
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. Biologic agents are:
    A) synthetically manufactured and weaponized by mixing the synthetic component with an organism.
    B) least preferred by terrorists because they are difficult to disseminate over a large population.
    C) the ideal weapons of mass destruction if the terrorist’s objective is to affect a small geographic area.
    D) naturally occurring organisms that are cultivated in a laboratory.
A

Ans: D
Page: 2303
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
7.  The terrorism carried out by groups that have close ties with a national government is referred to as:
A)  international terrorism.
B)  state-sponsored terrorism.
C)  foreign-funded terrorism.
D)  intercontinental terrorism.
A

Ans: B
Page: 2290
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. Which of the following statements regarding chemical agents is correct?
    A) Chemical agents are manmade substances that destroy living organisms.
    B) There is no effective antidote for any chemical agent at the present time.
    C) Chemical agents can be weaponized only in the form of liquid or vapor.
    D) The majority of chemical agents used by terrorists are naturally occurring.
A

Ans: A
Page: 2298
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
9.  A suicide bomber typically uses a(n) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ to achieve his or her objective.
A)  dirty bomb
B)  metabolic agent
C)  incendiary weapon
D)  industrial chemical
A

Ans: C
Page: 2297
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. When the National Terrorism Advisory System alerts responders to the potential for a terrorist attack:
    A) you should take appropriate precautions while continuing to perform daily duties and responding to EMS calls.
    B) the Department of Homeland Security will release general information regarding the reason for the current threat level.
    C) specific information regarding the source of the current threat will be disclosed to EMS supervisory personnel only.
    D) you should generally avoid nonemergent transports and only transport patients who are critically ill or injured.
A

Ans: A
Page: 2294
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. Which of the following should make you the MOST suspicious of a terrorist attack or an incident involving a weapon of mass destruction?
    A) You respond to a temple, church, or mosque for a patient who was assaulted.
    B) You receive a call involving multiple patients with similar signs and symptoms.
    C) A public building is evacuated when an employee notices the smell of natural gas.
    D) A government employee presents with an acute onset of a cough and dyspnea.
A

Ans: B
Page: 2294
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. Which of the following is a preincident indicator of terrorism?
    A) Upcoming national summit meeting
    B) Explosion reported at the court house
    C) Increase in violent political activism
    D) Sudden increase in calls to 9-1-1
A

Ans: C
Page: 2294
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Upon arriving at a scene involving a weapon of mass destruction, you should:
    A) stage upwind and uphill from the incident.
    B) move any bystanders away from the scene.
    C) don gloves, a mask, and a protective gown.
    D) begin functioning as the incident commander.
A

Ans: A
Page: 2294
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
14.  If you are at the scene of an incident that potentially involves a weapon of mass destruction and other emergency resources are en route, it is MOST important for you to give the dispatcher information regarding the:
A)  optimal route of approach.
B)  specific resources required.
C)  suspected weapon involved.
D)  estimated number of patients.
A

Ans: A
Page: 2296
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. Requesting a hazardous materials team as early as possible to a scene involving a weapon of mass destruction is MOST important because:
    A) a member of the hazardous materials team must function as the incident commander.
    B) the hazardous materials team must quickly identify the type of weapon that was used.
    C) you must be decontaminated prior to initiating care for any injured patients.
    D) it takes time for the hazardous materials team to assemble their personnel and equipment.
A

Ans: D
Page: 2296
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. Upon arriving at a scene in which the incident command system has already been established, you should:
    A) report to the treatment section and begin secondary triage.
    B) locate the medical staging officer to receive your assignment.
    C) notify the incident commander and request further instructions.
    D) immediately report to the triage section and begin triaging patients.
A

Ans: B
Page: 2296
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
  1. When triaging patients at the scene of an explosion, you should be especially aware of the fact that:
    A) the terrorist may still be present at the scene.
    B) a secondary explosive device may be present.
    C) wind direction and speed may change quickly.
    D) many explosions involve radioactive material.
A

Ans: B
Page: 2296-2297
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  1. In contrast to volatile chemical agents, nonvolatile chemical agents:
    A) evaporate fast when left on a surface in the optimal temperature range.
    B) include sarin and will turn from liquid to gas within seconds to minutes.
    C) include all nerve gases and remain in the environment for weeks to months.
    D) can remain on surfaces for long periods of time, usually longer than 24 hours.
A

Ans: D
Page: 2298
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
  1. Vesicant agents inflict injury by causing:
    A) central nervous system depression and respiratory failure.
    B) parasympathetic nervous system stimulation and bradycardia.
    C) burn-like blisters to form on the skin and in the respiratory tract.
    D) destruction of the platelets, resulting in spontaneous hemorrhage.
A

Ans: C
Page: 2298
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
20.  All of the following chemicals are vesicant agents, EXCEPT:
A)  chlorine.
B)  lewisite.
C)  phosgene oxime.
D)  sulfur mustard.
A

Ans: A
Page: 2298
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
21.  Gray discoloration of the skin is a sign of permanent damage seen following exposure to:
A)  lewisite and phosgene oxime.
B)  chlorine and sulfur mustard.
C)  phosgene, soman, and tabun.
D)  V agent and sulfur mustard.
A

Ans: A
Page: 2298-2299
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
  1. Following exposure to sulfur mustard:
    A) the patient experiences immediate intense pain, indicating rapid damage to the underlying cells and tissues.
    B) the patient experiences a progressive reddening of the affected area, which will gradually develop into large blisters.
    C) signs and symptoms typically appear within 1 to 2 minutes, reflecting rapid entry of the chemical into the bloodstream.
    D) the patient often develops a grayish discoloration at the contaminated site, even though secondary cellular injury does not occur.
A

Ans: B
Page: 2299
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
  1. In contrast to sulfur mustard, lewisite and phosgene oxime exposures:
    A) do not result in the formation of blisters.
    B) have a delayed onset of signs and symptoms.
    C) cause a change in the structure of the cells.
    D) cause a rapid onset of signs and symptoms.
A

Ans: D
Page: 2299
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q
  1. Which of the following statements regarding vesicant agent treatment is correct?
    A) British anti-lewisite is carried by civilian EMS units.
    B) Aggressive airway support must occur prior to decontamination.
    C) No antidotes exist for sulfur mustard or phosgene oxime exposure.
    D) IV access should be deferred until the patient is at a burn center.
A

Ans: C
Page: 2299
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q
25.  Initial exposure to \_\_\_\_\_\_\_\_\_\_ produces upper airway irritation and a choking sensation.
A)  soman
B)  chlorine
C)  phosgene
D)  phosgene oxime
A

Ans: B
Page: 2299
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q
  1. Which of the following statements regarding phosgene is correct?
    A) Phosgene is a product of combustion and may be encountered at a fire involving a textile factory or the burning of freon.
    B) Initial signs and symptoms of phosgene exposure include abdominal pain, hematemesis, exertional dyspnea, and a cough.
    C) Phosgene is a rapidly acting chemical that produces immediate airway irritation, nausea, a severe cough, and profound pulmonary edema.
    D) Because phosgene is an odorless chemical, the patient may remain in the contaminated area for an extended period of time.
A

Ans: A
Page: 2299-2300
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q
27.  Nerve agents block \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, an essential enzyme of the nervous system.
A)  epinephrine
B)  acetylcholine
C)  norepinephrine
D)  cholinesterase
A

Ans: D
Page: 2300
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q
  1. When sarin is on clothing, it has the effect of off-gassing, which means that:
    A) it rapidly transforms from a vapor to a liquid.
    B) contamination of the patient is limited to a short period.
    C) its vapors are continuously released over a period of time.
    D) the chemical soaks through clothing and penetrates the skin.
A

Ans: C
Page: 2301
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q
  1. In contrast to sarin, soman:
    A) is much less persistent and is odorless.
    B) is five times as lethal and has a fruity odor.
    C) is a clear, oily agent that looks like baby oil.
    D) enters the body exclusively through the skin.
A

Ans: B
Page: 2301
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q
  1. Which of the following statements regarding tabun is correct?
    A) The primary route of exposure to tabun is through the skin.
    B) Tabun has a fruity smell and an appearance similar to sarin.
    C) Tabun is twice as lethal as sarin and 50 times less persistent.
    D) The components used to manufacture tabun are hard to acquire.
A

Ans: B
Page: 2301
Type: General Knowledge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q
  1. Unlike G-series agents, VX is:
    A) not classified as a nerve agent, although its effects are similar to those produced by nerve agents.
    B) less lethal and persistent and is easily removed from the skin through decontamination.
    C) has a fruity odor, is significantly less lethal than sarin, and contains components that are easy to acquire.
    D) so persistent that, given the proper conditions, it will remain relatively unchanged for weeks to months.
A

Ans: D
Page: 2301
Type: General Knowledge

32
Q
32.  Signs and symptoms of nerve agent exposure include all of the following, EXCEPT:
A)  tachycardia.
B)  bronchorrhea.
C)  constricted pupils.
D)  excessive salivation.
A

Ans: A
Page: 2301
Type: General Knowledge

33
Q
  1. The seizures associated with nerve agent exposure:
    A) cannot be reversed with any pharmacologic agent.
    B) are often more severe in patients with a seizure history.
    C) will continue until a MARK 1 antidote is administered.
    D) should be treated with large quantities of a benzodiazepine.
A

Ans: C
Page: 2302
Type: General Knowledge

34
Q
  1. MARK 1 and DuoDote antidote kits contain:
    A) lorazepam and 2-PAM chloride.
    B) midazolam and atropine sulfate.
    C) atropine and pralidoxime chloride.
    D) pralidoxime chloride and epinephrine.
A

Ans: C
Page: 2302
Type: General Knowledge

35
Q
  1. What do tabun, sarin, soman, and V agent all have in common?
    A) They all enter the body through the respiratory tract.
    B) The onset of symptoms following exposure is immediate.
    C) They are all colorless and odorless chemical nerve agents.
    D) They all possess the same level of volatility and persistence.
A

Ans: B
Page: 2302
Type: General Knowledge

36
Q
36.  The symptoms and medical management of patients poisoned by \_\_\_\_\_\_\_\_\_\_\_\_\_ are identical to those of the nerve agents.
A)  cyanogen chloride
B)  organophosphate insecticides
C)  pulmonary or choking agents
D)  phosgene oxime and lewisite
A

Ans: B
Page: 2302
Type: General Knowledge

37
Q
37.  Signs and symptoms of significant cyanide exposure include:
A)  tachypnea.
B)  bradycardia.
C)  hypertension.
D)  hot, dry skin.
A

Ans: A
Page: 2303
Type: General Knowledge

38
Q
  1. Mild effects of cyanide exposure:
    A) include slow, shallow respirations and generally require positive-pressure ventilatory assistance.
    B) can only be reversed with high doses of amyl nitrate and high-flow oxygen via nonrebreathing mask.
    C) include hemoptysis and hematemesis, and mandate immediate treatment with hyperbaric oxygen.
    D) generally resolve by simply removing the victim from the environment and administering oxygen.
A

Ans: D
Page: 2303
Type: General Knowledge

39
Q
39.  Which of the following chemical agents has the smell of freshly cut grass?
A)  Tabun
B)  Lewisite
C)  Phosgene
D)  Hydrogen cyanide
A

Ans: C
Page: 2300, 2304
Type: General Knowledge

40
Q
  1. A biologic agent’s incubation period is especially important for the paramedic to understand because:
    A) the incubation period is directly related to the duration of the illness.
    B) most biologic agents have an incubation period of less than 24 hours.
    C) the patient may be contagious despite the absence of signs and symptoms.
    D) the incubation period determines how easily another person can be infected.
A

Ans: C
Page: 2303
Type: General Knowledge

41
Q
41.  Smallpox is in its MOST contagious phase when:
A)  a rash develops.
B)  blisters begin to form.
C)  the patient becomes febrile.
D)  a headache and body aches develop.
A

Ans: B
Page: 2304
Type: General Knowledge

42
Q
  1. In contrast to the lesions associated with other skin disorders, the lesions associated with smallpox:
    A) are identical in size and shape.
    B) remain isolated to the facial area.
    C) originate on the lower extremities.
    D) are in various stages of development.
A

Ans: A
Page: 2304
Type: General Knowledge

43
Q
43.  If an outbreak of smallpox were to occur, vaccinations would be offered to:
A)  anyone at risk of infection.
B)  emergency personnel only.
C)  the entire US population.
D)  immunocompromised people only.
A

Ans: A
Page: 2304
Type: General Knowledge

44
Q
44.  A terrorist would MOST likely disseminate smallpox via:
A)  a powder.
B)  an explosion.
C)  a dirty bomb.
D)  aerosolization.
A

Ans: D
Page: 2305
Type: General Knowledge

45
Q
45.  Signs and symptoms of smallpox generally appear within \_\_\_ days following exposure.
A)  2 to 5
B)  7 to 9
C)  10 to 12
D)  14 to 16
A

Ans: C
Page: 2305
Type: General Knowledge

46
Q
46.  Viral hemorrhagic fevers include all of the following, EXCEPT:
A)  Ebola.
B)  the plague.
C)  Rift Valley.
D)  yellow fever.
A

Ans: B
Page: 2304-2305
Type: General Knowledge

47
Q
  1. Infection with the Ebola virus is characterized by:
    A) a progressive onset of high fever.
    B) internal and external hemorrhage.
    C) the formation of cutaneous blisters.
    D) paralysis of the respiratory muscles.
A

Ans: B
Page: 2305
Type: General Knowledge

48
Q
  1. Anthrax is a bacterium that:
    A) lies dormant in a spore and is released when exposed to the optimal temperature and moisture.
    B) is generally not responsive to antibiotic therapy, even if the therapy is begun immediately.
    C) is highly communicable and would most likely be disseminated by a terrorist via a liquid medium.
    D) results in death more than 90% of the time, regardless of how the bacterium enters a person’s body.
A

Ans: A
Page: 2306
Type: General Knowledge

49
Q
49.  Although \_\_\_\_\_\_\_\_\_\_ anthrax is the most deadly, \_\_\_\_\_\_\_\_\_\_ anthrax is the only form that is communicable.
A)  cutaneous, inhalation
B)  gastrointestinal, pulmonary
C)  cutaneous, gastrointestinal
D)  pulmonary, cutaneous
A

Ans: D
Page: 2306
Type: General Knowledge

50
Q
  1. Bubonic plague is:
    A) also referred to as plague pneumonia.
    B) a highly communicable bacterial disease.
    C) characterized by lymph node enlargement.
    D) more contagious than pneumonic plague.
A

Ans: C
Page: 2306-2307
Type: General Knowledge

51
Q
  1. In contrast to viruses and bacteria, neurotoxins:
    A) can only enter the body through the inhalation route.
    B) are characterized by a slow, insidious onset of symptoms.
    C) are not contagious, but do have a faster onset of symptoms.
    D) have been used successfully as a weapon of mass destruction.
A

Ans: C
Page: 2307
Type: General Knowledge

52
Q
  1. Ricin is a neurotoxin that is derived from:
    A) a synthesized virus or bacterium.
    B) mash that is left from the castor bean.
    C) the leaves of the purple foxglove plant.
    D) the seeds from a wide variety of fruits.
A

Ans: B
Page: 2307-2308
Type: General Knowledge

53
Q
  1. Which of the following statements regarding ricin is correct?
    A) Ricin is five times more lethal than botulinum.
    B) Ricin is highly communicable only if it is inhaled.
    C) Calcium chloride is the preferred antidote for ricin.
    D) Ricin is extremely toxic by many routes of exposure.
A

Ans: D
Page: 2307-2308
Type: General Knowledge

54
Q
  1. Whether ingested or inhaled, ricin poisoning causes:
    A) fever, chills, and a headache.
    B) a productive cough and diaphoresis.
    C) convulsions, cyanosis, and hemorrhage.
    D) chest pain, muscle aches, and pulmonary edema.
A

Ans: A
Page: 2308
Type: General Knowledge

55
Q
55.  Which of the following biologic agents is highly transmittable from person to person?
A)  Smallpox
B)  Botulinum
C)  Bubonic plague
D)  Yellow fever virus
A

Ans: A
Page: 2309
Type: General Knowledge

56
Q
56.  When conducting syndromic surveillance, patients who present with signs and symptoms of \_\_\_\_\_\_\_\_\_\_ are especially significant.
A)  hepatitis
B)  influenza
C)  renal failure
D)  food poisoning
A

Ans: B
Page: 2308
Type: General Knowledge

57
Q
  1. The Strategic National Stockpile’s points of distribution are:
    A) facilities that are continuously manned and can deliver medications anywhere in the country within 72 hours.
    B) locations where patients with signs and symptoms of disease exposure are quarantined and provided treatment.
    C) preestablished facilities for the mass distribution of antibiotics, antidotes, vaccines, and other medications and supplies.
    D) medical treatment facilities that are regulated and activated by local, regional, or state governments in the event of a terrorist attack.
A

Ans: C
Page: 2309
Type: General Knowledge

58
Q
  1. In contrast to alpha radiation, beta radiation:
    A) is easily stopped by a piece of paper.
    B) travels slowly and is less penetrating.
    C) can easily penetrate the human body.
    D) requires a layer of clothing to stop it.
A

Ans: D
Page: 2310
Type: General Knowledge

59
Q
59.  \_\_\_\_\_\_\_\_\_\_\_ is/are the fastest and most powerful form of radiation and can easily penetrate through lead.
A)  Alpha rays
B)  Beta rays
C)  Gamma rays
D)  Neutron energy
A

Ans: D
Page: 2310
Type: General Knowledge

60
Q
  1. Which of the following statements regarding a radiologic dispersal device (RDD) is correct?
    A) The destructive ability of an RDD, also known as a dirty bomb, is significant because it contains a chemical agent.
    B) An RDD is any container designed to disperse radioactive material and requires the use of an explosive device.
    C) An RDD is an effective weapon of mass destruction because damage is enhanced by the radioactive material contained within it.
    D) Once radioactive material is placed into the RDD, it would injure or kill 10 times as many people as the explosive alone.
A

Ans: B
Page: 2310
Type: General Knowledge

61
Q
  1. The destructive capability of a dirty bomb is:
    A) limited to the explosives that are attached to it.
    B) sufficient to injure thousands of people.
    C) directly related to the radioactive material within it.
    D) not affected by the presence of radioactive material.
A

Ans: A
Page: 2310
Type: General Knowledge

62
Q
  1. The likelihood of a nuclear attack on the United States is:
    A) remote because other nations do not have the ability to deliver a nuclear weapon via missile or bomb.
    B) probable because the whereabouts of many small nuclear devices from the former Soviet Union is unknown.
    C) high because many other nations have developed nuclear weapons and are able to deliver them via a missile.
    D) impossible because no other nations have the resources or funding to build an effective nuclear weapon.
A

Ans: A
Page: 2310
Type: General Knowledge

63
Q
63.  Radiation exposure that occurs through the body is MOST appropriately termed:
A)  infection.
B)  absorption.
C)  irradiation.
D)  internal contamination.
A

Ans: C
Page: 2310
Type: General Knowledge

64
Q
64.  Common signs of acute radiation illness include all of the following, EXCEPT:
A)  nausea.
B)  hair loss.
C)  vomiting.
D)  diarrhea.
A

Ans: B
Page: 2311
Type: General Knowledge

65
Q
  1. Which of the following statements regarding radiation is correct?
    A) Radiation is unlimited as to how far it can travel through the atmosphere.
    B) Alpha radiation can travel for several miles before losing its radioactivity.
    C) In most cases, moving 100 feet away from the radiation source is adequate.
    D) It is impossible to recognize the type of radiation emitted from a given source.
A

Ans: D
Page: 2311
Type: General Knowledge

66
Q
  1. The BEST way to protect yourself from the effects of radiation is to:
    A) wear a suit designed to completely shield yourself.
    B) use time, distance, and shielding to your advantage.
    C) wear a lead suit and self-contained breathing apparatus.
    D) limit your exposure at an incident to less than 10 minutes.
A

Ans: B
Page: 2311
Type: General Knowledge

67
Q
  1. You and your partner arrive at the scene of a building explosion. As you stage your ambulance, you can see that members of the FBI are present. You also see numerous victims lying on the ground outside the building. You should:
    A) stay where you are until you receive instructions from the staging officer.
    B) apprise the FBI of your presence and immediately begin triaging patients.
    C) park your ambulance close to the scene without blocking in other vehicles.
    D) recognize that this was a terrorist attack that likely involved a chemical agent.
A

Ans: A
Page: 2296
Type: Critical Thinking

68
Q
  1. The hazardous materials team has deemed it safe for you to enter and remove patients from an office building that exploded. As you are moving the patients, it is MOST important to:
    A) provide only immediate lifesaving care inside the building.
    B) quickly identify the patients who appear to be the most critical.
    C) remain alert to the possibility of a secondary explosive device.
    D) get them out of the building before you begin the triage process.
A

Ans: C
Page: 2296-2297
Type: Critical Thinking

69
Q
  1. While at the scene of an incident in which several patients were possibly exposed to lewisite, you are informed that an unresponsive patient with multiple blisters on his body and inadequate breathing is being brought to you for treatment. You should:
    A) prepare your intubation equipment and set up two IV lines of normal saline.
    B) have the appropriate antidote ready and notify the burn center of the situation.
    C) ensure that the patient has been decontaminated before initiating any treatment.
    D) don the appropriate personal protective equipment to avoid cross-contamination.
A

Ans: C
Page: 2299
Type: Critical Thinking

70
Q
70.  A young man presents with severe respiratory distress. He is conscious, but confused, and smells of freshly cut grass. Auscultation of his breath sounds reveals coarse crackles in all lung fields, and he is coughing up copious secretions. This patient's clinical presentation is MOST consistent with exposure to:
A)  chlorine.
B)  phosgene.
C)  V agent.
D)  soman or tabun.
A

Ans: B
Page: 2300, 2304
Type: Critical Thinking

71
Q
  1. You are caring for a 40-year-old man who was exposed to an unknown chemical and has been appropriately decontaminated by the hazardous materials team. The patient responds to pain only, is incontinent of urine and feces, and has a heart rate of 40 beats/min and weak. Further assessment reveals that his breathing effort is poor and his blood pressure is low. After taking standard precautions, the MOST appropriate treatment for this patient involves:
    A) protecting his airway with an ET tube, monitoring his cardiac rhythm, establishing vascular access, initiating an epinephrine infusion at 2 µg/min, and considering 0.5 mg of atropine.
    B) assisting his ventilations with a bag-mask device and 100% oxygen, performing intubation if necessary, establishing vascular access, applying the cardiac monitor, and administering atropine and pralidoxime.
    C) applying high-flow oxygen via nonrebreathing mask, establishing vascular access, applying the cardiac monitor, attempting immediate transcutaneous cardiac pacing, and administering several 20-mL/kg boluses of normal saline.
    D) immediately administering 2-PAM chloride, applying supplemental oxygen via nonrebreathing mask, establishing vascular access, administering crystalloid fluid boluses to increase his blood pressure, and monitoring his cardiac rhythm.
A

Ans: B
Page: 2301-2302
Type: Critical Thinking

72
Q
72.  A 21-year-old woman presents with a severe headache, body aches, and a fever of 102.8°F. She tells you that she returned from a humanitarian aid mission overseas a week and a half ago and began feeling ill yesterday morning. Given this patient's travel history and clinical presentation, you should expect her to develop:
A)  spontaneous hemorrhaging.
B)  cutaneous lesions on her arms.
C)  bradycardia and hypersalivation.
D)  a rash and blisters on her face.
A

Ans: D
Page: 2304-2305
Type: Critical Thinking

73
Q
73.  You are dispatched to a residence for a 50-year-old woman with respiratory distress. While you are assessing the patient, she tells you that she began experiencing flulike symptoms 4 days ago, shortly after delivering mail on the rural mail route for which she is responsible. Due to her illness, she has been unable to return to work. Her blood pressure is 90/50 mm Hg, pulse rate is 120 beats/min, and respirations are 26 breaths/min and labored. Auscultation of her breath sounds reveals the presence of coarse crackles. This patient has MOST likely been exposed to:
A)  anthrax.
B)  smallpox.
C)  a neurotoxin.
D)  botulinum toxin.
A

Ans: A
Page: 2306, 2309
Type: Critical Thinking

74
Q
  1. A 39-year-old man presents with severe abdominal cramping accompanied by nausea, vomiting, and bloody diarrhea. During your assessment, the patient tells you that in an attempt to kill himself, he intentionally ingested some castor beans because he heard they were poisonous. The patient’s blood pressure is 96/58 mm Hg, heart rate is 112 beats/min, and respirations are 24 breaths/min. Which of the following statements regarding this scenario is correct?
    A) You should quickly don a mask and gown because this patient’s condition is highly communicable.
    B) Castor beans commonly cause the symptoms your patient is experiencing but rarely result in death.
    C) Your patient has ingested the key ingredient for ricin and is at high risk for vascular collapse and death.
    D) This patient has exposed himself to botulinum toxin and will soon experience diaphragmatic paralysis.
A

Ans: C
Page: 2307-2308
Type: Critical Thinking

75
Q
  1. Over the course of your 24-hour shift, you and your partner responded to seven calls involving patients with signs and symptoms of the flu. To the best of your knowledge, your area is not in the midst of a flu outbreak. You should:
    A) seek medical attention at once and receive a flu vaccination.
    B) report these calls to your supervisor or local health department.
    C) immediately check to see what the current terrorist threat level is.
    D) advise area hospitals that you suspect a biologic terrorist event.
A

Ans: B
Page: 2308
Type: Critical Thinking

76
Q
  1. You are at the scene of an explosion at an office complex. There are a total of 15 casualties, including 2 deaths. In addition to injuries experienced by the explosion, most of the victims are complaining of nausea, vomiting, and diarrhea. When caring for any of these victims, you must:
    A) ensure that they have been properly decontaminated first.
    B) wear a lead shield or apron to protect yourself adequately.
    C) immediately treat those with injuries that are life threatening.
    D) recall that a dirty bomb does not cause radiation contamination.
A

Ans: A
Page: 2311
Type: Critical Thinking