Disaster Triage and Chemical/Biologic Hazards Practice Questions
20 free Disaster Triage and Chemical/Biologic Hazards practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
During triage of a chemical exposure mass-casualty event, which step is crucial before entering the treatment zone?
- A Enter and begin treatment without any safety checks
- B Don appropriate PPE and route casualties through decontamination
- C Wait until all patients are decontaminated at the hospital
- D Skip decontamination when the chemical odor seems faint
Correct answer: Don appropriate PPE and route casualties through decontamination
In chemical incidents, responders must don appropriate PPE and decontaminate casualties before treatment to prevent further harm and secondary contamination. Odor is not a reliable gauge of hazard.
What is the most important principle of triage in large-scale disasters?
- A First come, first served regardless of severity
- B The greatest good for the greatest number
- C Treat the most severely injured first in every case
- D Treat only those with minor, walking-wounded injuries
Correct answer: The greatest good for the greatest number
Disaster triage aims to do the greatest good for the greatest number, directing limited resources to casualties most likely to survive with treatment, rather than by arrival order or treating only the minor cases.
In a mass casualty scenario with limited resources, a patient with massive full-thickness burns covering 70% of body surface area may be triaged as:
- A Green – walking wounded
- B Yellow – delayed
- C Red – immediate
- D Black – expectant
Correct answer: Black – expectant
In resource-limited disasters, extremely severe injuries with low survival probability may be classified expectant to conserve resources for salvageable patients.
In a suspected chemical incident, decontamination should occur:
- A Only when individual patients request it
- B Before patients enter definitive care areas
- C After all diagnostic imaging is completed
- D For staff exposure but not for casualties
Correct answer: Before patients enter definitive care areas
Decontamination must occur before casualties enter definitive care areas to prevent secondary contamination of the facility, equipment, and staff and to limit further patient injury.
During decontamination of multiple casualties, which practice is correct?
- A Skip rinsing individual casualties to save time
- B Remove contaminated clothing and rinse the skin thoroughly
- C Lightly wipe exposed skin with a dry cloth only
- D Move contaminated patients into clean care areas directly
Correct answer: Remove contaminated clothing and rinse the skin thoroughly
Removing contaminated clothing and thoroughly rinsing the skin removes the bulk of the agent and prevents contamination of clean zones; dry wiping or skipping rinsing is inadequate.
A biologic hazard such as aerosolised anthrax may initially present with flu-like symptoms. Which feature should raise immediate concern for inhalational anthrax?
- A Mild cough without fever and normal imaging
- B Chest pain with mediastinal widening and rapid decline
- C An isolated localized skin rash without systemic signs
- D Mild joint aches that resolve with rest
Correct answer: Chest pain with mediastinal widening and rapid decline
Inhalational anthrax classically progresses from flu-like symptoms to chest discomfort, mediastinal widening on chest X-ray, and rapid deterioration with high mortality, warranting urgent recognition and treatment.
During hospital surge capacity in a disaster, “reverse triage” means:
- A Discharging or relocating stable patients to free space for incoming critical patients
- B Deliberately treating the worst injuries last
- C Reserving intensive care units for minor cases
- D Abandoning triage criteria during the surge
Correct answer: Discharging or relocating stable patients to free space for incoming critical patients
Reverse triage frees in-hospital capacity by safely discharging or relocating stable patients so that resources are available for incoming critical casualties during a disaster surge.
Which of the following decontamination materials is most appropriate for removing chemical agent from skin?
- A Water and mild soap after removing clothing
- B Wiping the skin with alcohol pads only
- C Brushing off visible residue with a dry cloth
- D Applying a topical antiseptic ointment alone
Correct answer: Water and mild soap after removing clothing
Skin decontamination of a chemical agent is best achieved by removing contaminated clothing and rinsing with copious water and mild soap, which physically removes the agent and reduces absorbed dose.
A mass casualty incident involving a biological agent release requires which key public health nursing action?
- A Forgo contact tracing of exposed individuals
- B Set up prophylaxis clinics, monitor exposed groups, coordinate with public health
- C Delay action until hundreds of cases appear
- D Treat only symptomatic patients and observe the rest
Correct answer: Set up prophylaxis clinics, monitor exposed groups, coordinate with public health
After a biological release, public health nursing prioritizes rapid prophylaxis or vaccination clinics, surveillance and monitoring of exposed populations, and coordination with public health authorities to limit spread.
Which of the following statements best describes “secondary contamination” in a chemical/biologic event?
- A Contamination confined to the original victim alone
- B Spread of the agent from a contaminated patient or environment to others
- C Contamination that affects only outdoor scene areas
- D Contamination occurring only within hospital laboratories
Correct answer: Spread of the agent from a contaminated patient or environment to others
Secondary contamination is the transfer of a hazardous agent from a contaminated patient or environment to other people (including responders) or clean zones, which is why decontamination and containment protocols are essential.
During a chemical exposure mass casualty incident, which step is crucial before entering the treatment zone?
- A Enter and begin treatment without any safety checks
- B Don appropriate PPE and route casualties through decontamination
- C Wait until all patients are decontaminated at the hospital
- D Skip decontamination when the chemical odor seems faint
Correct answer: Don appropriate PPE and route casualties through decontamination
Before entering the treatment zone of a chemical mass-casualty incident, responders must don appropriate PPE and decontaminate casualties to prevent secondary contamination and protect themselves and the care area.
In a mass casualty chemical incident, the triage category “expectant” (often black) means:
- A The patient can safely wait several hours for treatment
- B The patient needs immediate life-saving surgery now
- C Survival is unlikely with the resources available
- D The patient is ambulatory with only minor wounds
Correct answer: Survival is unlikely with the resources available
In disaster triage the “expectant” category is used when the resource investment is unlikely to benefit the patient and may divert resources from others who could survive.
A biologic hazard scenario involves exposure to an aerosolised agent. Which nurse action is most immediate?
- A Continue with standard precautions only and observe
- B Start airborne plus contact precautions and notify infection control
- C Wait for laboratory confirmation before taking any action
- D Evacuate all patients from the area before triaging anyone
Correct answer: Start airborne plus contact precautions and notify infection control
In biologic events aerosol exposure requires airborne/contact isolation, rapid notification, and monitoring of exposed staff to prevent further spread and morbidity.
In a mass casualty incident, the triage tag colour and category typically assigned to a patient who can walk and has minor injuries is:
- A Red tag - immediate priority
- B Yellow tag - delayed priority
- C Green tag - minor/walking wounded
- D Black tag - expectant/deceased
Correct answer: Green tag - minor/walking wounded
The “walking wounded” category are those ambulatory casualties with minor injuries who can wait; they are often tagged green in systems like START.
During triage of a chemical exposure mass-casualty event, which sign in a casualty would shift their triage category from delayed (yellow) to immediate (red)?
- A Stable vital signs and able to ambulate without help
- B Respiratory distress with accessory muscle use and hypoxia
- C A superficial cut on the hand with stable vital signs
- D Mild chest pain with a normal oxygen saturation reading
Correct answer: Respiratory distress with accessory muscle use and hypoxia
Respiratory distress and hypoxia indicate severe injury needing immediate intervention, therefore they shift to immediate priority for treatment.
In the field triage system for disasters, the algorithm known as START stands for:
- A Simple Triage And Rapid Treatment
- B Standard Triage And Rescue Team
- C Simple Trauma Assessment Rapid Transport
- D Serious Trauma Acute Response Triage
Correct answer: Simple Triage And Rapid Treatment
START is a commonly used triage algorithm for mass casualty incidents to quickly categorise patients by breathing, perfusion and mental status.
A nurse performing mass casualty triage notes a patient is not breathing. She opens the airway and still no breathing. According to START, the patient is:
- A Pulse 90, respirations 16, oxygen saturation 98%
- B Respirations over 30/min with inability to follow commands
- C Patient is walking, talking, and oriented at the scene
- D Pulse 60, respirations 12, and stable vital signs
Correct answer: Respirations over 30/min with inability to follow commands
In START, if after airway repositioning the patient remains apneic, they are tagged black as expectant or deceased in overwhelmed‐resource setting.
Which chemical hazard presents with cherry-red skin and rapid onset of unconsciousness in a fire-related exposure?
- A Wait until all patients have arrived before setting up triage
- B Maintain personal safety with PPE and oversee decontamination
- C Bypass the decontamination zone and admit patients directly
- D Provide care only to unexposed staff and ignore casualties
Correct answer: Maintain personal safety with PPE and oversee decontamination
Cyanide poisoning from smoke inhalation leads to cellular hypoxia, rapid unconsciousness and often cherry-red skin; emergency nurses must recognise this as toxic hazard.
In a mass chemical exposure zone, which vital sign threshold might prompt movement from delayed (yellow) to immediate (red)?
- A Pulse 90, respiration 16, saturations 98%
- B Respirations >30/min, inability to follow commands
- C Walking and talking
- D Pulse 60, respirations 12, stable
Correct answer: Respirations >30/min, inability to follow commands
Tachypnea (>30) and inability to follow commands signal severe compromise and need urgent intervention, thus marking immediate triage category.
Which of the following is a key nursing role during hospital “first receiver” operations in a chemical/biologic mass casualty?
- A Waiting until all patients have arrived before setting up triage
- B Maintaining personal safety via PPE, decontamination oversight, and rapid sorting of patients
- C Ignoring the decon zone and admitting patients directly
- D Only caring for unexposed staff
Correct answer: Maintaining personal safety via PPE, decontamination oversight, and rapid sorting of patients
Nurses responding to hazardous materials events must ensure their own safety (PPE), supervise decon, and assist in rapid patient triage and sorting to protect patients and staff.