Download Chemical Agents of Opportunity Final Test Answer Key and Rationale:

Chemical Agents of Opportunity Final Test Answer Key and Rationale:
1. Which of the following would best be characterized as a toxic industrial compound?
a. Ammonia
b. Anthrax
c. Sarin
d. Mustard Gas
e. Water
2. The goal of toxic terrorism is best accomplished by which of the following scenarios or releases?
a. Immediately lethal agent release in restaurant
b. Disruption of a transportation corridor
c. Creating fear leading to incapacity
d. Occult insertion of a carcinogen
e. Targeting a single factory component
3. Which characteristic is common to most TICs and TIMs?
a. Limited availability
b. Stored in small quantities
c. Inexpensive
d. Securely maintained and transported
e. Generally low toxicity
f. Only vulnerable during transport
4. Which of the following is not a component of a hazard score or ranking?
a. Toxicity of a chemical
b. Amount of a chemical on site
c. Volatility of chemical
d. Wind direction at time of release
e. History of use in prior terrorist event
5. A large scale chemical release will place substantial demands on our health care system’s ability to
respond. Efforts geared towards prevention and mitigation of such events should include:
a. Placing more information about chemicals on the Internet
b. Designing response strategies only on the basis of historical examples of major chemical events
c. Providing a framework for first responders and first receivers for the early detection and recognition of
toxic chemicals in order to optimally prepare, identify and defend against chemical threats
d. Distribute gas masks to individuals in every community
6. In order to be able to participate in a timely and appropriate manner to a large scale chemical event,
first responders and first receivers need:
a. subject matter level expertise in all chemicals
b. awareness-level and responder-level training including knowledge across a variety of toxic syndromes
likely to be encountered following exposure to chemical agents of opportunity
c. experience designing and implementing legislation addressing the transport of toxic chemicals
d. Extensive training in search and recovery
7. One of the multiple sources where terrorists and other individuals can obtain common industrial
chemicals include:
a. grocery stores
b. farm, garden and home improvement stores
c. the federal government
d. libraries
8. Chemical agents most likely to be used by terrorists include:
a. Anthrax, smallpox and plague
b. Metals, cyanide, pesticides, rodenticides, and poison gas
c. Paint thinner, candle wax, peat moss
d. Food coloring and other preservatives
9. Which of the following is a common mechanism by which coma occurs following exposure to a
toxin?
a. Enhanced inhibitory tone
b. Reduced inhibitory tone
c. Enhanced excitatory tone
d. Reduced excitatory tone
10. Which of the following was the most likely agent responsible for the poisoning event at the
Theatrical Center in Russia that resulted in over 100 fatalities?
a. Diazepam
b. Carfentanyl
c. Halothane
d. Morphine
11. What is the major direct complication of overdose with a sedative agent?
a. Bleeding
b. Cardiac arrhythmia
c. Respiratory depression
d. Seizure
12. What is the most important treatment for patients who have respiratory depression?
a. Artificial ventilation
b. Chest compressions
c. Naloxone
d. Oxygen
13. Due to the abundance of chemicals produced and the relative ease of access to industrial
chemicals there is serious concern that…
a. Prices of these chemicals will soon drop significantly
b. U.S. industry will fail to compete successfully in the global arena
c. Events will occur involving the accidental or intentional release (by terrorists) of these chemicals
d. Individuals will fail to safely store these chemicals
14. The main initial priority in a potential toxic exposure is…
a. Notification of the appropriate regulatory body
b. Initiation of cardiopulmonary resuscitation
c. Intubation and positive pressure ventilation
d. Removal of the victim from ongoing exposure
e. Extensive decontamination
15. The Acute Emergency Guideline Level-3 is the…
a. Tonal alert system for the Washington D.C. area
b. Maximum storage capacity guideline for phosgene
c. Amount of a toxic compound that triggers required notification of authorities when crossing state lines
d. Predicted airborne concentration above which people will experience life-threatening health effects or
death
16. A characteristic of a toxic gas that is predictive of the types of symptoms that victims will
experience is its…
a. Odor
b. Flavor/taste
c. Water solubility
d. Color
17. Anhydrous Ammonia (NH3) is:
a. A stable solid compound rarely used in the U.S.
b. Used mainly as a fertilizer and is the third most produced chemical in the U.S.
c. Common window cleaner that poses little threat to human health
d. Causes damage resulting from acidic burns when exposed
18. Exposure to toxic gases will create serious health consequences for victims and will be determined
primarily by:
a. Age of the victim
b. Prevailing weather conditions during the time of the exposure
c. Length of time until responders arrive
d. Dose (concentration and duration of exposure)
19. Which of the following is not a fumigant?
a. Methylene chloride
b. Sulfuryl fluoride
c. Methyl Bromide
d. Phosphine
20. Which of the following agents is most likely to cause gasping and death after being inhaled?
a. Cyanide
b. Sulfuryl fluoride (Vikane)
c. Methyl Bromide
d. Phosphine
e. Chloropicrin
21. Which of the following agents is added to fumigant gases in order to make it more easily detectable
when inhaled?
a. Chloropicrin
b. Mercaptans
c. Hydrogen sulfide
d. Organophosphates
e. Yellow dye number 20
22. Which of the following agents is a potent lachrymator?
a. Chloropicrin
b. Sulfuryl fluoride (Vikane)
c. Methyl bromide
d. Phosphine
e. Cyanide
23. Antidotes are available for which of the following agents?
a. Cyanide
b. Sulfuryl fluoride
c. Methyl bromide
d. Phosphine
e. Chloropicrin
24. Management of which of the following exposures may involve the administration of a vitamin
precursor?
a. Cyanide
b. Sulfuryl fluoride
c. Methyl bromide
d. Phosphine
e. Chloropicrin
25. In 2003, the Department of Homeland Security issued a bulletin warning of which of the following
threats:
a. Introduction of cyanide gas into ventilation systems
b. Increased use of chloropicrin in agriculture
c. Increased purchase of Vikane by uncertified users
d. Increased imports of aluminum phosphide from China
e. Theft of Vikane from delivery trucks in Texas.
26. Which of the following agents was purchased on the Internet in order to commit a murder?
a. Potassium cyanide
b. Sulfuryl fluoride (Vikane)
c. Methyl bromide
d. Phosphine
e. Chloropicrin
27. Which of the following statements regarding drinking water standards is correct?
a. FDA enforces standards set by EPA
b. EPA sets and enforces the standards either directly or through state-run programs
c. USDA enforce standards set by EPA
d. EPA specifies the methods used to achieve required regulatory standards for water quality
28. Which of the following statements regarding drinking water disinfection in the US is correct?
a. Chlorine is added at the beginning of the process to help with coagulation
b. Ozone is often used because of its excellent residual effects on contaminating organisms
c. Chlorine has poor residual antimicrobial effects against viruses
d. Chlorine may not inactivate bacterial spores and some protozoans and its effect on chemical hazards is
variable
29. Which of the following statements regarding food safety in the US is correct?
a. FDA is responsible for the majority of food safety issues in the USA
b. USDA is not involved in food safety
c. The current food -safety system in the USA was designed to help prevent acts of food terrorism
d. FDA is the agency responsible for regulation of all aspects of milk production and safety
30. Which of the following statements regarding food terrorism is true?
a. Food terrorism would be difficult to detect quickly because it would likely appear similar to common
food-borne outbreaks
b. Current strategies in place are adequate to prevent food-borne terrorism in the USA
c. Limited geographic distribution of processed foods makes food terrorism unlikely
d. The methods most commonly used in the USA to pasteurize milk makes it unlikely that milk would be
used in a terror attack
31. Which of the following statements regarding the prevention of poisoning of medications is correct?
a. The FDA routinely inspects drugs for contamination
b. The “Tylenol Act” was passed by the US Congress to help prevent intentional drug contamination after
a series of deaths due to cyanide-contaminated Tylenol
c. Terror attacks on the medication supply would only include the primary ingredient and not any other
additives since they are all present in amounts too small to be significant
d. The FDA has a mandatory reporting system in place for medical providers who recognize adverse
events associated with medications
32. Which one of the following describes a reason that a toxin with a delayed-onset would be desirable
as a terrorist weapon?
a. The exposed victim can leave the immediate area of release, making diagnosis difficult
b. It is likely to produce a large number of victims in a small geographic area
c. Always produce unrecognizable syndromes
d. Easier to produce than acute onset toxins
33. Which of the following describes the toxicity of organochlorines such as dioxin?
a. They rapidly cause cardiovascular toxicity upon inhalation
b. They are highly carcinogenic to humans
c. They produce a classic syndrome of skin toxicity
d. They are associated with neurologic toxicity following long term exposure
34. Which of the following explains the differences among the various toxic metals?
a. All metals produce a similar toxicological syndrome
b. The toxicologic syndrome produced by a specific metal varies by its chemical form
c. Metal-containing toxins cannot be absorbed through the skin
d. The expense of metal-containing toxins makes them unlikely to be used by terrorists
35. In addition to having a delayed onset of symptoms, which of the following describes a desirable
feature of some organochlorines, such as dioxin, as a terrorist weapon?
a. Biopersistence
b. Explosive
c. Difficult to diagnose toxic syndrome
d. Transmissible between people
36. The majority of most health care workers’ annual exposure to radiation is due to:
a. Proximity to diagnostic tests, such as x-rays and fluoroscopy, performed on patients
b. Caring for contaminated patients
c. Background radiation found in our environment
d. Consumer products
37. When caring for patients exposed to high levels of radiation, it is important to understand that:
a. They are radioactive and pose a significant risk to providers
b. Seriously injured patients must be decontaminated before being stabilized
c. Providers must be decontaminated before emergency care is given
d. Patients are not necessarily radioactive and pose little health risk to others
38. A patient presents to the ED with a severe burn to the skin with evidence of charring. This patient
has most likely sustained a:
a. Lethal radiation injury
b. Serious radiation injury but will benefit from medical intervention
c. Thermal injury
d. Radiation injury with active “hot” (radioactive) particles still present on the skin
39. Almost immediately after a radiation exposure of 10,000 rem or more, symptoms including nausea,
vomiting, disorientation, and seizures develop. This form of radiation sickness is called:
a. Prodromal syndrome.
b. Hematopoietic syndrome
c. Gastrointestinal syndrome
d. Cerebrovascular syndrome
40. A drop in which lab value gives the earliest indication of a serious whole body radiation:
a. Red blood cell count
b. Platelet count
c. O2 saturation
d. Absolute lymphocyte count
41. If a person gets radioactive material on his/her clothes, the person is said to be:
a. Radioactive
b. Externally contaminated
c. Radiation exposed only
d. Extremely dangerous
42. An immediate concern regarding a person who has been exposed to radiation and has an open
wound is:
a. Stroke
b. Tissue necrosis
c. Internal contamination
d. Development of a local radiation injury
43. The largest group of patients that typically present to an ED after a potential mass chemical
exposure is/are:
a. Requesting evaluation for non-specific symptoms or “just to get checked out”.
b. Mildly Poisoned
c. Critically ill and poisoned
d. Grossly contaminated with toxic chemicals on their clothing
44. “Mass Hysteria” during a large-scale chemical exposure is:
a. Common with at least a 5:1 ratio of hysterical to ill
b. A common, but pejorative term for victims with perceived poisoning and anxiety-induced autonomic
arousal
c. Is a term used for panic commonly,observed during a disaster
d. Is the most widely accepted term for a group of victims complaining of symptoms without objective
findings or without symptoms that are just coming to get checked out
45. Fear, anxiety and emotional reactions following a mass chemical exposure are:
a. A normal reaction to extraordinary circumstances
b. Easy to distinguish from toxic chemical effects
c. Is a form of panic often observed during disasters
d. Is not contagious