Natural Disasters and Their Injury and Illness Patterns Practice Questions

25 multiple-choice questions on Natural disasters and their injury and illness patterns for paramedic and EMT students, from Chapter 52 (Disaster Response). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. Most deaths and injuries in a major earthquake are caused by:

   1. A. Ground cracks that swallow people whole
   2. B. Collapsing buildings and falling objects
   3. C. Fires that start after the shaking stops
   4. D. Tsunami waves that later reach the shore
   Show answer

   Answer: B. Collapsing buildings and falling objects

   Structural collapse and falling objects cause most earthquake deaths and injuries, including head trauma, fractures, and crush injuries. Ground cracks swallowing people is a popular myth; post-quake fires can be deadly but cause fewer casualties overall.

2. You are inside a station when a strong earthquake begins. The recommended action is to:

   1. A. Run outside while it shakes
   2. B. Stand in an inside doorway
   3. C. Get into a bathtub at once
   4. D. Drop, cover, and hold on
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   Answer: D. Drop, cover, and hold on

   Dropping, taking cover under sturdy furniture, and holding on protects against falling objects, the main hazard. Doorways in modern buildings are no stronger than other areas, and running during shaking leads to falls and injuries from falling debris.

3. In the hours after a major urban earthquake, EMS should expect a rise in calls for:

   1. A. Pediatric asthma attacks
   2. B. Severe allergic reactions
   3. C. Sudden cardiac death and acute MI
   4. D. Hypoglycemia in insulin-using diabetics
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   Answer: C. Sudden cardiac death and acute MI

   Studies after major earthquakes show a sharp rise in sudden cardiac deaths and MIs in the hours after the shock, triggered by intense emotional and physical stress. Responders should not assume every collapse after a quake is traumatic.

4. You are treating a patient beside a cracked building 2 hours after a strong earthquake. The greatest ongoing threat to you and your patient is:

   1. A. An aftershock causing further collapse
   2. B. A tsunami reaching this inland area
   3. C. A second, larger quake within a few minutes
   4. D. Toxic gas from the cracked foundation
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   Answer: A. An aftershock causing further collapse

   Aftershocks are common for hours to weeks and can bring down structures already weakened by the main shock, so patients should be moved away from damaged buildings. A tsunami threatens coastal areas, not an inland site.

5. Strong shaking stops while you are at the beach, and you see the sea suddenly pull far back from the shore. You should:

   1. A. Wait for an official tsunami alert
   2. B. Move to high ground right away
   3. C. Go to the shoreline to check on people
   4. D. Shelter in a car parked near the beach
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   Answer: B. Move to high ground right away

   Strong shaking near the coast or a sudden drop in the sea are natural warnings that a tsunami may arrive within minutes. Waiting for an official alert wastes time that may not exist for a nearby quake.

6. Historically, the greatest number of US hurricane deaths has been caused by:

   1. A. Wind-blown flying debris
   2. B. Collapse of tall buildings
   3. C. Storm surge and flooding
   4. D. Lightning and electric shock
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   Answer: C. Storm surge and flooding

   Water, from storm surge on the coast and freshwater flooding inland, has caused most hurricane deaths. Wind damage is dramatic, but drowning has been the main killer, which is why surge zones are evacuated.

7. A hurricane warning means that hurricane conditions are:

   1. A. Expected within about 36 hours
   2. B. Possible within about 48 hours
   3. C. Occurring now far out over water
   4. D. Over, and it is safe to go outside
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   Answer: A. Expected within about 36 hours

   A hurricane warning means hurricane conditions are expected, usually within 36 hours; a watch means they are possible within 48 hours. Mixing up the two can delay evacuation until it is too late.

8. To prevent carbon monoxide poisoning, residents using portable generators after a storm should place them:

   1. A. In an attached garage with the big door left open
   2. B. Under an open window to keep them dry
   3. C. In a basement far from the living areas
   4. D. Outdoors, at least 6 m (20 ft) from openings
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   Answer: D. Outdoors, at least 6 m (20 ft) from openings

   CDC advises running generators outdoors at least 20 ft (6 m) from doors, windows, and vents. An open garage door does not clear enough exhaust, and CO poisoning after hurricanes and ice storms is a leading cause of preventable death.

9. In the cleanup days after a hurricane, EMS should expect more:

   1. A. Penetrating wounds from flying window glass
   2. B. Falls from roofs and chainsaw injuries
   3. C. Drowning in coastal storm surge
   4. D. Lightning strikes on open ground
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   Answer: B. Falls from roofs and chainsaw injuries

   Cleanup brings falls from roofs and ladders, chainsaw cuts, electrocution from downed lines, heat illness, and CO poisoning. Flying glass and storm-surge drowning happen during the storm itself, not during cleanup.

10. A 58-year-old man with cirrhosis waded through coastal floodwater after a hurricane with a cut on his leg. Two days later he has fever, rapidly spreading redness with blisters, and a BP of 84/50 mmHg. You should suspect:

    1. A. Tetanus from a dirty wound
    2. B. Vibrio vulnificus wound infection
    3. C. Leptospirosis from rat urine
    4. D. Contact dermatitis from spilled fuel oil
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    Answer: B. Vibrio vulnificus wound infection

    Vibrio vulnificus lives in warm brackish water and can cause rapidly spreading wound infection with bullae and septic shock, especially in people with liver disease. Tetanus causes muscle rigidity, not spreading skin infection and shock.

11. During a tornado warning, the safest place in a sturdy building is:

    1. A. The top floor, above the risk of flooding
    2. B. Near an outside wall on the second floor
    3. C. An interior room on the lowest floor
    4. D. A large open room such as the gymnasium
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    Answer: C. An interior room on the lowest floor

    A small interior room or hallway on the lowest floor, away from windows, puts the most walls between people and debris. Large open rooms such as gyms have wide-span roofs that tend to collapse.

12. Most deaths from tornadoes are caused by:

    1. A. Head and chest trauma from debris
    2. B. Drowning in flash floods
    3. C. Burns from fires and downed power lines
    4. D. Hypothermia from rain
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    Answer: A. Head and chest trauma from debris

    Tornado winds turn debris into missiles and throw people, so head injuries and chest trauma are leading causes of death. Burns and drowning occur but are uncommon.

13. Survivors of a tornado have many deep wounds packed with soil and debris. In the field, these wounds are best managed by:

    1. A. Closing them tightly with adhesive skin strips
    2. B. Sealing them with tissue adhesive glue
    3. C. Scrubbing them clean with soap on scene
    4. D. Covering them and planning hospital cleaning
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    Answer: D. Covering them and planning hospital cleaning

    Debris-filled tornado wounds carry high infection risk, including rare invasive fungal infections, so they need cleaning and often delayed closure at the hospital. Closing a dirty wound in the field traps contamination inside.

14. Most deaths in US floods occur when people:

    1. A. Are trapped in basements
    2. B. Touch downed power lines
    3. C. Drink contaminated water
    4. D. Drive into flooded roads
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    Answer: D. Drive into flooded roads

    More than half of flood deaths involve vehicles driven into moving water, which can float and sweep away a car. Public education ('turn around, don't drown') targets this, the leading cause.

15. A 34-year-old man with asthma returns to his flooded home a week after the water recedes and develops wheezing and chest tightness. The most likely trigger is:

    1. A. Carbon monoxide from the furnace
    2. B. Lead in the floodwater residue
    3. C. Mold growing in wet materials
    4. D. Smoke from nearby wildfires
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    Answer: C. Mold growing in wet materials

    Mold grows on wet drywall, carpet, and furniture within 24 to 48 hours and is a strong asthma trigger after floods. Cleanup workers with lung disease should avoid the work or wear an N95 respirator.

16. During a wildfire, the part of smoke that poses the greatest health threat to the public is:

    1. A. Fine particles (PM2.5)
    2. B. Large, visible flakes of ash
    3. C. Carbon dioxide gas
    4. D. Water vapor in steam
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    Answer: A. Fine particles (PM2.5)

    Fine particles 2.5 micrometers or smaller reach deep into the lungs and bloodstream, worsening asthma, COPD, and heart disease. Large ash flakes are visible but are trapped mostly in the nose and upper airway.

17. A man with COPD asks whether a mask will protect him from wildfire smoke. You should tell him that:

    1. A. A cloth mask blocks most smoke particles
    2. B. A fitted N95 filters particles, not gases
    3. C. A surgical mask filters out carbon monoxide
    4. D. A dust mask also filters out toxic gases
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    Answer: B. A fitted N95 filters particles, not gases

    A well-fitted N95 traps most fine particles but does nothing against gases such as carbon monoxide. Cloth and surgical masks fit loosely and let fine particles leak around the edges.

18. A family with a wheelchair-using member lives in a wildfire area. The best time for them to evacuate is:

    1. A. Once flames can be seen from the home
    2. B. Early, before an order is issued
    3. C. When a mandatory order comes
    4. D. After the fire front has passed
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    Answer: B. Early, before an order is issued

    People who need more time or help to move should leave early, as soon as a warning or 'get ready' notice is given. Waiting for a mandatory order can leave them on roads jammed with traffic as the fire approaches.

19. Which weather hazard causes the most deaths in the United States in a typical year?

    1. A. Extreme heat
    2. B. Tornadoes
    3. C. Hurricanes
    4. D. Lightning
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    Answer: A. Extreme heat

    Extreme heat kills more people in most years than any other weather hazard, though its toll is less visible than that of storms. Climate change is making heat waves longer, hotter, and more frequent.

20. A hurricane knocks out power for a week during 35 °C (95 °F) heat. Which community step best reduces heat-related deaths?

    1. A. Advise residents to rely on electric fans
    2. B. Tell people to stay inside until the power returns
    3. C. Open cooling centers and check on isolated people
    4. D. Send heat-illness patients to general shelters
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    Answer: C. Open cooling centers and check on isolated people

    Heat deaths after storms cluster among isolated, older, and chronically ill people without cooling, so cooling centers and wellness checks save lives. Staying inside a hot home without power is what puts them at risk.

21. During a blizzard, a car is stuck in a snowdrift with its engine idling and the occupants inside. The greatest immediate danger is:

    1. A. Hypothermia once fuel runs out
    2. B. Dehydration from dry heater air
    3. C. Fumes from the car battery acid
    4. D. CO from a snow-blocked tailpipe
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    Answer: D. CO from a snow-blocked tailpipe

    Snow blocking the exhaust pipe lets carbon monoxide build up in the cabin. Occupants should clear the tailpipe and run the engine only briefly; hypothermia is a risk later, but CO can kill first.

22. Volcanic ashfall in a populated area mainly causes:

    1. A. Eye and airway irritation
    2. B. Severe burns far from the vent
    3. C. Carbon monoxide poisoning indoors
    4. D. Silicosis within the first few days
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    Answer: A. Eye and airway irritation

    Ash is fine, abrasive rock and glass that irritates the eyes and airway, worsens asthma and COPD, and makes roads slick. Burns occur only close to the volcano from lava flows or hot gas flows. Silicosis needs years of heavy exposure to crystalline silica, and settled ash does not produce carbon monoxide indoors.

23. On the Saffir-Simpson scale, a 'major' hurricane is one that is:

    1. A. Category 1 or higher
    2. B. Category 2 or higher
    3. C. Category 4 or higher
    4. D. Category 3 or higher
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    Answer: D. Category 3 or higher

    Category 3 and above, with winds of at least 178 km/h (111 mph), are major hurricanes with devastating damage. The scale rates wind only, so lower-category storms can still kill through surge and flooding.

24. Months after a large wildfire, heavy rain falls over the burned hillsides above a town. The main hazard now is:

    1. A. The wildfire flaring up again
    2. B. Ash inhalation from the wet slopes
    3. C. Debris flows and flash flooding
    4. D. Smoke from smoldering roots
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    Answer: C. Debris flows and flash flooding

    Burned soil absorbs little water, so heavy rain on a burn scar can cause sudden, fast mudslides and flash floods that destroy homes downhill. Planners must extend wildfire hazard plans well past the fire itself. Months after the fire and during heavy rain, ash is wet and smoldering has ended, so airborne ash and smoke are not the main threat.

25. You arrive at a flooded basement where a man lies motionless in standing water. The lights are still on in the house. You should:

    1. A. Wade in quickly with rubber boots on
    2. B. Stay out until the power is shut off
    3. C. Pull him out with a dry wooden pole
    4. D. Turn off the lights at the wall switch
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    Answer: B. Stay out until the power is shut off

    Water in a powered building can be energized, so rescuers must not enter until the utility or a qualified person cuts the power at the main. Rubber boots do not reliably protect against electrocution in standing water.