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Question

Difficulty: HardEmergency Response and Hazardous Materials

An industrial plant explosion releases an unknown chemical vapor, prompting a local hospital to activate its mass casualty disaster plan. A licensed practical nurse (PN) is assigned to assist in the facility's external decontamination area. Which action by the PN is most appropriate?

  1. Instruct ambulatory clients to remove their own clothing and place it into designated, sealed hazardous waste receptacles.Answer
  2. B
    Apply a standard isolation gown, surgical mask, and examination gloves before physically assisting non-ambulatory clients in the shower.
  3. C
    Perform the initial clinical assessments to assign color-coded triage tags to arriving victims based on their injury severity.
  4. D
    Interview a client exhibiting audible stridor to obtain a complete list of their routine home medications and medical allergies.

Answer

The most appropriate action is to instruct ambulatory clients to remove their own clothing and place it into designated, sealed hazardous waste receptacles.
During a hazardous materials event, the safe removal of the contaminant is the primary goal of the decontamination phase. Having ambulatory clients remove their own clothing eliminates approximately 70-90% of the contaminant while minimizing secondary exposure to healthcare staff. This action is a safe, protocol-driven task that falls well within the scope of practice for the practical nurse.

Step-by-Step Solution

1
Analyze the clinical environment and the nurse's role.
The setting is an external decontamination area for unknown chemical vapor exposure, and the provider is a practical nurse (PN).
Establishing the context dictates both the necessary safety protocols and the legal scope of practice.
2
Evaluate the priority of care in a hazardous materials exposure.
The immediate priority is to stop the exposure and decontaminate the clients without creating secondary exposure for the healthcare staff.
Chemical vapors can rapidly contaminate the facility and harm responders if standard protocols are bypassed.
3
Assess each potential action against safety principles and the PN scope of practice.
Assessing disaster triage tags and managing airway stridor require RN-level intervention. Standard PPE is unsafe for chemical vapors. Directing clients to self-doff clothing is safe, effective, and within the PN role.
The PN must consistently differentiate between independent nursing actions and tasks requiring escalation or specialized training.

Key Concept

Hazardous Materials Decontamination and PN Scope of Practice
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Topics

Emergency Response and Hazardous Materials

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