Answer to Question 1
ANS: B
With smallpox vaccination, the scab falls off in the third week, leaving a small scar; the nurse should expect to see a scar. A necrotic vesicle would be a symptom of progressive vaccinia (vaccinia necrosum), which develops almost exclusively in those who are immunodeficient. There is progressive necrosis at the inoculation site. During the first week after inoculation, the bump becomes a blister, which begins to dry and develop a scab. Within 3 to 4 days of administration of the vaccine, a red, itchy bump appears.
Answer to Question 2
ANS: D
The primary danger from a dirty bomb is the blast itself, and not the radiation, since dispersal of the radiation is limited to a relatively small area. Persons exposed should remove clothing as soon as possible and then decontaminate the skin by showering or bathing. Since dirty bombs do not release iodine-131, taking potassium iodide is of no benefit. Prussian blue is used to hasten excretion of radioactive cesium and radioactive and non-radioactive thallium. Patients treated with Prussian blue should have close monitoring of stools and urine.