Welcome to the test answers for the Emergency Preparedness Response Course (EPRC) Clinician 8 hr test. This resource is intended as a guide to aid in understanding and preparing for the EPRC exam. The EPRC test is a critical part of training for medical professionals, designed to equip them with the necessary knowledge and skills to effectively respond to a wide variety of emergency situations.
This includes understanding and managing the impact of Chemical, Biological, Radiological, Nuclear, and high yield Explosives (CBRNE) incidents, as well as dealing with the physical and psychological effects of such events on victims and responders.
The answers listed below cover a broad range of topics addressed in the EPRC course, and can be used to supplement your study and preparation for this important exam.
| Question | Answer |
|---|---|
| A patient suffering blast effect presents with dyspnea, some hearing loss, and tinnitus following an explosion. Which of the following is NOT a likely diagnosis? | Intestinal rupture |
| Following a nuclear detonation, some of the casualties with survivable injuries are possibly contaminated with radiological material. Which of the below courses of action is most appropriate for the situation? | Treat all life-threatening injuries first |
| An explosion casualty suffering from crush injuries of the lower extremities has been admitted to your hospital with severe hyperkalemia. What emergency treatment is NOT recommended? | Limit fluids |
| A patient is suffering from painful, highly corrosive burns similar to acid, and wheals have begun to appear on the skin. Which vesicant (blister agent) is suspected? | Phosgene oxime |
| You are certain that your patient, who is now convulsing from nerve agent exposure, has already received three MARK 1/ATNAA kits and their diazepam. What else should be done? | All of the Above: Provide ventilator assistance, oxygen, and IV fluids; Administer more atropine to reduce secretions and relax the airway; Give more diazepam to prevent seizures |
| Wearing PPE can put the responder at considerable risk both physically and psychologically. Which of the following is NOT considered a risk factor? | Hyperactivity |
| What type of laboratory test(s) would NOT be conducted if you suspect a patient has contracted plague? | Gas Chromatography-Mass Spectrometry |
| Which of these are fast-acting compounds that attack oxygen-dependent tissues known to be particularly sensitive to these compounds? | Cyanide Compounds |
| In industry, cyanide compounds are widely used during: | All of the Above: Plastic production; Gold and silver extraction; Hide tanning |
| Which post disaster phase is generally characterized by optimism due to an infusion of resources? | Honeymoon phase |
| Select the three components, in correct order of administration, utilized in the treatment for cyanide exposure. | Amyl nitrite, sodium nitrite, sodium thiosulfate |
| Which of the following statements does NOT describe spores produced by Bacillus anthracis, causative agent of anthrax? | Sensitive to UV light |
| One of the contributing factors to stress reactions is the physical factor. Which of the following is associated with this factor? | Worries about others |
| ________ damage brings death very quickly so that the consequences of exposure to other systems do not have time to express themselves. | Neurovascular |
| When conducting a medical assessment, what status is checked first? | Respiratory Status |
| A group of victims has been admitted to your triage unit. All victims have recently been in an area where canisters exploded spraying them with an amber colored liquid that smells like flowers and burns intensely. You suspect Lewisite. Which of the following is not a consideration during treatment of the victims? | Unroofing of blisters |
| Disaster victims presenting for medical care should be assessed for common short-term stress reactions which fall into what categories EXCEPT? | Intellectual |
| All of the following are procedures for activating the Hospital Incident Command System (HICS) EXCEPT: | Refer to your Job Action Sheet (JAS) for response duties |
| What treatment should be given to a patient exposed to T-2 mycotoxins via ingestion? | Therapy for poison ingestion including the administration of super-activated charcoal |
| Which of the following bacterial diseases is contagious person to person? | Pneumonic plague |
| How is the victim of nerve agent exposure presenting with convulsions classified? | Immediate |
| Experts anticipate that a ________ incident is the least likely to occur but would have a great impact upon the environment and people. | Nuclear |
| What is the most available explosive agent? | Nitroglycerin |
| An all-hazards approach affects preparedness by allowing communities to: | Increase the speed, effectiveness, and efficiency of incident management |
| A patient presents to the hospital. He has been feeling ill since his return from safari in Africa a few days ago. He exhibits symptoms of fever, mild hypotension, flushing, conjunctival injection, and now a bad rash has appeared that is bleeding in spots. What type of viral infection do you suspect? | Viral Hemorrhagic Fever |
| ________ occurs outside of the incident area when people come in contact with a contaminated person or object. | Secondary Contamination |
| What type of care is a stress management component that fosters a mourning process and helps treat psychological stress reactions? | Pastoral care |
| What agent blocks enzymes resulting in a cholinergic crisis? | Nerve agent |
| One of the five intervention principles in the management of the stress response is promoting the sense of safety. How can this be accomplished? | Leadership provide an accurate, organized voice to help circumvent threat |
| Used in life-threatening situations, the goal is to remove contaminant as quickly as possible. | Immediate decontamination |
| What type of biological toxin is predominantly derived from the bean of the castor plant? | Ricin |
| What form of ionizing radiation can penetrate deeply into body tissue? | Photon |
| What is the comprehensive preparedness required to manage the casualties resulting from the host of possible hazards? | All-hazard preparedness |
| A metallic taste in the mouth, epigastric distress, and possible nausea and vomiting are ingestion symptoms for which chemical agent? | Cyanide |
| The primary toxicity of pulmonary agents is to the ________ and follows __________ of smoke, particles, vapors, or gases. | Airways, inhalation |
| A patient is exhibiting the following symptoms: fever, cough, dyspnea, prominent gastrointestinal symptoms, absence of buboes. Which form of plague is responsible? | Pneumonic |
| Penetrating trauma caused by shrapnel is usually attributed to which of the following? | Secondary blast effect |
| Which nerve agent is the most persistent, is very oily, and will stay active in an area for several days? | VX |
| What blood test is available that will give an accurate estimate of radiation dose? | Lymphocytes count |
| Secretary of Defense has the responsibility to provide defense support to civil authorities when the actions: | Are legal |
| Which of the following is considered a pulmonary (choking) agent? | Chlorine |
| For which virus is the mosquito not known as a possible vector? | Smallpox |
| What Mission Oriented Protective Posture (MOPP) level provides the greatest level of protection? | IV |
| Which of the following compounds can be administered to reduce the absorption of radiation that targets the thyroid? | Potassium Iodide |
| What directive establishes policies to strengthen the preparedness of the US to prevent and respond to threatened or actual domestic terrorist attack, major disasters and other emergencies by requiring a national domestic all-hazards preparedness goal? | Presidential Policy Directive-8 |
| Decontamination will be conducted in the __________ hazard zone. | Warm |
| What types of CBRNE agents are man-made and act rapidly, burn and blister skin, mucous membranes, airways and gastrointestinal systems? | Vesicants |
| Personal Protective Equipment (PPE) is generally divided into two categories. They are: | Respiratory Protection & Chemical Protective Garments |
| A secondary explosive device has been spotted. Which of the following options describes how to proceed? | Withdraw at least 50 yards from the scene and tell the Incident Commander (IC) immediately |
| How is the victim of a pulmonary agent exposure presenting with respiratory distress less than 4 hours after exposure classified? | Expectant |
| Over 20 people who worked together developed cough, excess fluid in their lungs, and difficulty breathing. Chest x-rays show bilateral infiltrates with bronchial aspirates rich in protein. Several died. What was the likely agent? | Ricin |
| Which of the following agents is considered to be a fast effect agent? | Nerve agent |
| Which of the following cell types are most sensitive to radiation damage? | Cells that are actively dividing |
| A patient was admitted to the hospital suffering from the following symptoms for the past week: fever, chills and weakness, very swollen tender lymph nodes of bubo, and skin ulcerations. He states the ulcerations are exactly where very small insects bit him. Which type of plague is responsible for the patient’s symptoms? | Bubonic |
| A patient presents to the emergency room all exhibiting the following symptoms: nausea, vomiting, problems with eye movement, dry mouth, sore throat, difficulty swallowing, no gag reflex, and extreme weakness. Patient is alert and oriented during the exam. What toxin do you suspect and how do you treat it? | Botulinum toxin, supportive care and antitoxin. |
| The amount of radiation that an individual absorbs depends on ____? | All of the Above: Time exposed to a radioactive source, Distance a person is from a radioactive source, Type and amount of shielding between a person and a radioactive source |
| What command system is a widely used and accepted tool for command, control and coordination of a response to a disaster? | Incident Command System |
| Definitive diagnosis of Viral Hemorrhagic Fever rests on _______________. | Specific virologic diagnosis |
| Which of the following is a way to organize chemical agents that manifest most of their symptoms within seconds or minutes? | Fast effect |
| What is the role of the liaison officer within the Hospital Incident Command System (HICS)? | Function as the incident contact person for representatives from other agencies |
| What is the purpose of a secondary device? | Injure or kill first responders |
| Which of the following decontamination method is NOT recommended for removing vesicants from casualties? | Wash patient with their clothing still on. |
| Type of decontamination that is carried out by a unit to reduce contamination equal to natural background or to the lowest level possible. | Thorough |
| Which of the following is NOT relevant to a laboratory diagnosis of smallpox (variola)? | A positive Tzank smear |
| Which of the bacterial diseases produces a non-specific illness that may produce a prolonged disability but is rarely fatal? | Q Fever |
| What phase is characterized by improvement of symptoms but becomes shorter with increasing doses. | Latent |
| ICS has been used to manage incidents such as fires, earthquakes, hurricanes, and acts of terrorism. Which of the following situations represents another viable application for the use of ICS? | The planning and operation of the Central City annual Labor Day celebration, including a parade and fair. |
| Acute Radiation Syndrome results from high-level external exposure to ionizing radiation. Which sub-syndrome is normally seen at the lower range of exposure? | Hematopoietic Syndrome |
| Victims caught in a fire have inhaled toxic smoke from furnishings and plastics that have released cyanide in the burning process. What precaution/side effects should you be aware of when administering cyanide antidotes? | Sodium nitrite can increase methemoglobin levels, which will decrease blood oxygenation |
| Your patient is recovering from injuries sustained in a terrorist incident and is exhibiting stress symptoms. Which of the following is a common behavior reaction associated with severe short-term stress reactions? | Substance abuse |
| Experts anticipate that biological incidents are ________________. | The most likely to occur, and will have the greatest impact on the greatest number of people. |
| How does cyanide cause cell death in the body? | Interferes with anaerobic metabolism of the cell |
| All-hazards are often categorized as: | Man-made: technological |
| Radiation burns, which cause delayed, irreversible changes of the skin, can be caused by high doses of what form of ionizing radiation? | Beta |
| A bomb blast victim presents with nausea and abdominal pain. A Computed Tomography (CT) scan shows no hemorrhage. What treatment should be recommended? | Admit patient for observation for 12 to 24 hours in case a hematoma develops. |
| You are certain that your patient, who is now convulsing from nerve agent exposure, has already received three MARK 1/ATNAA kits and their diazepam. What else should be done? | All of the Above |
| Vesicant (blister) agents include all of the following, EXCEPT: | Sarin (GB) |
| Which phase of CBRN response synchronizes planning and execution efforts with the efforts of the supported civil authorities? | Phase III – Operate |
| What form of ionizing radiation is the least penetrating? | Alpha |
| The Disaster Mental Health Response Team can be called upon to assist victims and disaster responders. Which of the following is NOT a service that they may provide: | Provide professional psychological treatment |
| The majority of the injuries to gas-containing organs is usually attributed to which of the following? | Primary blast effect |
| What type of explosive is widely used by the military, and is one of the least sensitive explosives. | TNT |
| Which of the following statements does NOT describe Brucellosis? | The brucellae are highly infectious via the aerosol route and brucellosis is associated with a high mortality rate. |
| An explosion victim was admitted to your facility approximately 4 hours ago with chest pain, normal oxygenation and radial pulse. His condition continues to worsen with symptoms that include labored, rapid breathing, low blood pressure, and semi-consciousness. What emergency treatment would be appropriate? | Intubate and provide assisted ventilation with Positive End Expiratory Pressure (PEEP). |
| Treatment of patients suffering from pulmonary agent exposure should focus on? | Recognizing which compartment(s) are damaged and minimizing that damage. |
| The decontamination site should NOT be located: | Near waterways and drainage systems |
| What technique may be used to test for T-2 Mycotoxins in environmental and clinical samples? | Gas Chromatography-Mass Spectrometry |
| MOPP Level __ has flexibility built into the system to allow relief during hot weather. | IV |
| Which of these are fast-acting compounds that attack oxygen-dependent tissues known to be particularly sensitive to these compounds? | Cyanide Compounds |
| A patient presents to the hospital. He exhibits symptoms of high fever, mild hypotension, flushing, conjunctiva injection, and now a bad rash has appeared that is bleeding in spots. He has been feeling ill since his return from safari in Africa a few days ago. What type of viral infection do you suspect? | Viral Hemorrhagic Fever |
| A patient is suffering from painful, highly corrosive bums similar to acid, and wheals have begun to appear on the skin. Which vesicant (blister agent) is suspected? | Phosgene oxime |
| This form of detection provides warning in sufficient time to implement protective and/or treatment measures before exposure to agent. | Detection to protect or treat |
| Which of the following bacterial agents is contagious person to person? | Pneumonic plague |
| Disaster victims presenting for medical care should be assessed for common short-term stress reactions which fall into all categories EXCEPT? | Intellectual |
| Select the two categories Personal Protective Equipment (PPE) is generally divided into. | Respiratory Protection & Chemical Protective Garments |
| ___ may be thought of as a form of identification. | Detection to protect or treat |
| What color triage tag would be used for a patient that requires immediate treatment? | Red |
| What type of CBRNE agent acts by inhibiting a crucial enzyme called acetylcholinesterase (AChE)? | Nerve |
| START stands for: | Simple Triage and Rapid Treatment |
| When washing with water, what procedures should be used when decontaminating a patient that has been exposed to a CBRNE agent? | Use high-flow, low-pressure water for 2-3 min. Gently scrub with soap and water using a soft bristle brush. |
| Which post disaster phase is generally characterized by optimism due to an infusion of resources? | Honeymoon phase |
| What directive establishes a single comprehensive national incident management system that allows all levels of government to work efficiently and effectively together? | Homeland Security Presidential Directive-5 |
| A male, non-smoking chemical worker is accidentally exposed to phosgene. The chest radiograph taken 2 hours post-exposure is normal. Should you discharge him? | No, because pulmonary edema normally takes longer to develop, he should be closely watched |
| Which of the following would NOT be used for the detection or collection of radiological material? | Nucleic acid amplification |
| Following a nuclear detonation, some of the casualties with survivable injuries are possibly contaminated with radiological material. Which of the below courses of action is most appropriate for the situation? | Treat all life-threatening injuries first |
| The majority of the injuries to gas-containing organs is usually attributed to which of the following? | Primary blast effect |
| In a stress management briefing, a clinician attendee says this is the first disaster to which she has been called. She states her biggest frustration is that no one has really defined her role. What category of stressor is this responder experiencing? | Occupational factors |
| When should the self-protection measures of time, distance, and shielding be implemented? | Immediately upon arrival at the incident scene |
| Which of the following bacterial diseases produce ulcers on the skin? | Tularemia |
| How is the victim of a vesicant agent presenting with pulmonary distress more than 4 hours after exposure classified? | Immediate |
| Which of the following is NOT a service that the Disaster Mental Health Response Team may provide? | Provide professional psychological treatment |
| Which nerve agent is the most persistent, is very oily, and will stay active in an area for several days? | VX |
| What is the preferred treatment for a patient splashed with insecticide showing symptoms of vomiting, diarrhea, difficulty breathing, body twitching and general weakness? | Administer additional 2-PAM Cl |
| Occurs when people comes in direct contact with a harmful agent at or near an incident. | Contamination |
| Eyes are the most vulnerable to this agent due to their thin, moist, warm mucosa. | Sulfur mustard |
| Chlorine casualties that require immediate treatment would most likely be suffering from: | Larynospasm |
| During which post disaster phase do survivors realize that they will need to solve their problems of rebuilding their homes, businesses, and lives and have gradually assumed the responsibility to do so? | Reconstruction/Recovery Phase |
| Patient presents with 5-day-old blisters/rash mostly on the arm, face, and hands. No scabs are present. Patient reports fever started several days before blisters appeared. Based on the information would you suspect chickenpox or smallpox? | Smallpox, because the rash is centrifugal on the patient |
| Which of the following is NOT critical in the treatment of a nerve agent casualty? | Administering pyridostigmine bromide (PB) |
| Which of the following is a cyanide antidote? | Nitrite |
| What directive establishes a single comprehensive national incident management system? | Homeland Security Presidential Directive-5 |
| Which of the following is NOT considered a risk factor when wearing PPE? | Hyperactivity |
| What level of civilian chemical equipment would healthcare providers don when providing initial medical treatment after an incident but not involved with decontamination? | Level C |
| Type of decontamination that occurs on scene and is accomplished by first responders. | Mass Decontamination |
| What is the value of verification or confirmation of biological agents? | Determination of genetic differences in pathogens may allow determination of source laboratories |
| What is the majority of injuries to gas-containing organs usually attributed to? | Primary blast effect |
| For which virus is the mosquito not known as a possible vector? | Smallpox |
| Your unit has responded within minutes to a suspected CBRNE incident. Select the important steps that you should take. | Practice protective measures of time, distance, and shielding |
| What emergency treatment would be appropriate for an explosion victim with worsening symptoms including labored, rapid breathing, low blood pressure, and semi-consciousness? | Intubate and sedate |
| Which of the following decontamination method is NOT recommended for removing vesicants from casualties? | Wash patient with their clothing still on |
| Radiodermatitis can be caused by high doses of what form of ionizing radiation? | Beta |
| Which of the following is a way to organize chemical agents that manifest most of their symptoms for several hours to days? | Slow effect |
| Advantages of adopting a comprehensive all-hazards approach include the following EXCEPT: | Attention is directed towards a single hazard |
| What type of viral infection might a patient returning from Africa with symptoms of fever, mild hypotension, flushing, conjunctival injection, and a bleeding rash have? | Viral Hemorrhagic Fever |
| What type of decontamination neutralizes the contaminant? | Chemical decontamination |
| Processed foods and temperature-abused foods are most commonly associated with ___ poisoning. | Staphylococcal Enterotoxin B (SEB) |
| A metallic taste in the mouth, epigastric distress, and possible nausea and vomiting are ingestion symptoms for which chemical agent? | Cyanide |
| Which of the following bacterial disease is contagious person to person? | Pneumonic plague |
| What is the correct order for the phases of Acute Radiation Syndrome (ARS)? | Prodromal, latent, and manifest |
| What type of ionizing radiation is the least penetrating? | Alpha |
| Which of the following CBRNE Consequence Task Pillars coordinates activities that include exercise; warning and reporting; and command and control? | Coordinate operations |
| START stands for ___ ? | Simple Triage and Rapid Treatment |
| What type of explosive is widely used by the military, and is one of the least sensitive explosives? | C-4 |
| Which of the following equipment is NOT used for collection and/or detection of biological agents? | Surface Acoustic Wave (SAW) detectors |
| Definitive diagnosis of Viral Hemorrhagic Fever rests on ___ | Specific virologic diagnosis |
| Pulmonary (choking) agents primarily enter the victim by what means? | Inhalation |
| What is secondary contamination? | It occurs outside of the incident area when people come in contact with a contaminated person or object |
| Which of the following is NOT a likely diagnosis for a patient suffering blast effect with dyspnea, some hearing loss, and tinnitus? | Intestinal rupture |
| What precaution/side effects should you be aware of when administering cyanide antidotes to victims of fire? | Sodium nitrite can increase methemoglobin levels, which will decrease blood oxygenation |
| What types of objects might a terrorist use to disguise a secondary explosive device? | Knapsack, backpack, or parcel; Trash can or dumpster; Automobile or truck |
| Which CBRNE agent would most likely produce a strange smell, headaches, and vomiting in an arena? | Chemical |
| What is responsible for the symptoms of a patient who was hunting rabbits about a week ago and presents with fever, headache, sore throat, diarrhea, conjunctivitis, and inflammation of lymph nodes? | Tularemia |
| What bacterial infection requires confirmation through serological testing, because it is difficult to culture the organism (causative agent)? | Q Fever |
| Which of the following is a common behavior reaction associated with severe short-term stress reactions in a patient recovering from injuries sustained in a terrorist incident? | Substance abuse |
| Burned skin, shrapnel wounds, blunt trauma injuries, and ruptured organs may be symptoms of what type of CBRNE exposure? | Explosives |
| Who is responsible for directing the command and control of all operations? | Incident Commander |
| What CBRNE agent inhibits the enzyme AChE allowing Ach to accumulate affecting the way cells transmit signals to the body? | Nerve agents |
| Select the important steps that you should take after responding within minutes to a suspected CBRNE incident. | Practice protective measures of time, distance, and shielding |
| Which type of plague is responsible for symptoms including fever, chills and weakness, very swollen tender lymph nodes of bubo, and skin ulcerations following insect bites? | Bubonic |
| Where should the decontamination site NOT be located? | Near waterways and drainage systems |
| What command system is a widely used and accepted tool for command, control, and coordination of a response to a disaster? | Incident Command System |
| What is a disadvantage of adopting a comprehensive all-hazards approach? | Attention is directed towards a single hazard |
| Which of the following is NOT a physical requirement of those expected to wear PPE? | Ability to handle emergency condition |
| Which of the following cell types are least sensitive to ionizing radiation damage? | Cells that divide slowly |
| What is the likely culprit for a group of people presenting with a delayed onset of blisters and a dry productive cough that later turns productive? | Mustard |
| What is contamination? | It occurs when people come in direct contact with a harmful agent at or near an incident |
| Based on symptoms including a 5-day-old rash mostly on the arm, face, and hands and a fever starting several days before the rash, is the patient more likely to have chickenpox or smallpox? | Smallpox, because the rash is centrifugal on the patient |
| Nerve agents are organophosphorus agents that cause all the following EXCEPT? | Slow heart rate |
| How do nerve agents produce effects in the body? | They inhibit the enzyme Acetylcholinesterase (AChE) allowing Acetylcholine (ACh) to accumulate |
| What personal situation stressor is a veteran responder exhibiting if he freezes up after responding to a second nerve gas attack? | Prior disaster experience |
| Which form of plague is responsible for symptoms including fever, cough, dyspnea, prominent gastrointestinal symptoms, and absence of buboes? | Pneumonic |
| Which of the following bacterial diseases typically produce ulcers on the skin? | Tularemia |
| What should be done for patients with concurrent surgical injuries and radiation exposure? | They should either be operated on expeditiously or delayed until past the time of bone marrow suppression and delayed wound healing |
| How is the victim of vesicant (blister agent) exposure with skin burn over less than 5 percent of Body Surface Area (BSA) and minor eye irritation classified? | Minimal |
| Which type of anthrax is responsible for symptoms including fever, malaise, fatigue, nonproductive cough, widened mediastinum in chest x-rays, and elevated white blood cell count? | Inhalational |
| Which of the following agents is considered to be a slow effect agent? | Chlorine |
| A patient presents with the following symptoms: nausea, vomiting, problems with eye movement, dry mouth, sore throat, difficulty swallowing, no gag reflex, and extreme weakness. Patient is alert and oriented during the exam. What toxin do you suspect and how do you treat it? | Botulinum toxin, supportive care and antitoxin. |
| Which of the following is NOT a challenge in gaining access and acceptance? | Similar cultural values |
| How can smallpox spread from one person to another? | All of the Above |
| Which phase of CBRN response focuses on the prioritization of forces to deploy for mission task? | Phase II – Response |
This concludes the answer guide for the Emergency Preparedness Response Course (EPRC) Clinician 8 hr test. Remember, these answers are meant to supplement your own studying and comprehension of the material covered in the EPRC course, and may not exactly match the format or content of your specific test.
Be sure to thoroughly review all course materials and understand the concepts behind these answers before taking your test. Emergency preparedness and response is a critical skill for healthcare providers, and your careful study will help to ensure you are equipped to provide the best possible care in the event of a disaster. Good luck on your test, and in all your future emergency response efforts!
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