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Difficulty: MediumEmergency Response and Hazardous Materials

A community emergency is declared following the release of an unidentified, highly contagious airborne biological agent. A practical nurse (PN) is assigned to assist in the hospital's isolation unit. Which action by the PN demonstrates a safe and appropriate emergency response?

  1. A
    Accepting an assignment to independently perform primary disaster triage on newly arriving clients
  2. Removing the N95 respirator in the hallway only after exiting the client's room and closing the doorAnswer
  3. C
    Doffing all personal protective equipment, including the N95 respirator, inside the client's room
  4. D
    Prioritizing the collection of a comprehensive exposure history before initiating oxygen for a client with stridor

Answer

The PN must remove the N95 respirator in the hallway only after exiting the client's room and closing the door.
The correct action is to remove the N95 respirator in the hallway or anteroom only after exiting the isolation room. Because the biological agent is airborne, the room air is contaminated. Removing the respirator inside the room would expose the nurse to the pathogen. The respirator must remain in place until the door is completely closed behind the nurse.

Step-by-Step Solution

1
Analyze the nature of the emergency and the assigned role.
The emergency involves a highly contagious airborne biological agent, requiring strict adherence to airborne precautions and safe delegation.
Understanding the transmission route (airborne) is critical for determining safe PPE protocols and care priorities.
2
Evaluate the clinical prioritization and scope of practice constraints.
Disaster triage is an RN-level skill. A client with stridor requires immediate airway intervention over history taking.
The PN must recognize tasks that fall outside their scope of practice (triage) and apply the ABC prioritization framework.
3
Identify the correct sequence for doffing airborne PPE.
The gown and gloves are removed inside the room, but the N95 mask must remain on until the nurse has exited the room and closed the door.
Removing the mask inside the room would expose the nurse's respiratory tract to the suspended aerosolized pathogen.

Key Concept

Airborne Precautions and PN Scope of Practice in Emergencies
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Topics

Emergency Response and Hazardous Materials

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