Annex D Prolonged Casualty Care (PCC) Practice Test

These questions are part of the practice quiz. Start practicing

• Why is splinting important for limb injuries during prolonged care?
• Too little CO2 can decrease the casualty's drive to breathe. True or false
• Give the GCS score for a patient that is speaking in random words, pulls away from pain, and only opens his eyes when spoken to.
• Oxygen changes may not be detected by the pulse oximeter until
• Why is hypothermia a major concern in prolonged casualty care?
• What are the two primary goals of burn dressing?
• Proper nursing interventions, when conducted appropriately, help to greatly reduce the possibility of all of the following complications, except:
• All deceased casualties should be placed in which container?
• When administering ketamine for analgesia and sedation in PCC, which monitoring is essential?
• What essential assessments help determine breathing adequacy in PCC?
• Which device provides a real-time display of CO2 waveform to verify ventilation and airway patency?
• Which statement best describes the purpose of the 24-hour care checklist?
• What is the starting infusion rate (mL/hr) for the 3% hypertonic saline after a bolus in the described scenario?
• The primary supply for a battalion will be from the _____ supporting
• The ______ is the amount of energy or 02 consumption needed by the resp to produce enough ventilation and respiration to meet the metabolic demands of the body.
• To prevent secondary brain injury in a casualty with a traumatic brain injury, maintain adequate _____?
• Sepsis should be suspected in febrile, hypotensive patients with all of the following injuries, except which?
• Any casualty with a TBSA greater than ___ should undergo fluid resuscitation.
• In a Role 1 PCC setting, which analgesia delivery method is preferred?
• A potentially concussive event occurs when exposure is within how many meters of a blast?
• The goals of circulation management include a return to a normal level of consciousness, stabilization of systolic blood pressure at 100-110 mmHg when appropriate, and stabilization of signs such as heart rate, respiratory rate, and ___.
• An escharotomy is indicated for burns when the 6 P's are present. They include all of the following except:
• Which ethical principle is illustrated by avoiding harm in medical decisions and actions?
• Initial fluid resuscitation for crush syndrome is a bolus of how many liters of crystalloid fluid?
• In compartment syndrome, which statement about distal pulses is true?
• In acute compartment syndrome, besides paralysis, which symptom might be present?
• Adequate fluid resuscitation and end organ perfusion is best indicated by everything, except:
• What is the recommended management for a suspected tension pneumothorax in PCC?
• Which signs indicate deterioration with head injuries during PCC?
• Which statement about end-of-life care goals is accurate?
• During airway management with a suspected cervical spine injury, which practice helps reduce risk of spinal cord damage?
• Which device provides real-time evidence of ventilation by measuring CO2 during exhalation?
• Which term completes the guidance: 'keeping a patient warm, clean, and___ as well as properly positioned' to help reduce suffering?
• Your casualty care plan is created after you implement nursing interventions. True or False.
• In conscious patients with limited mobility, encouraging deep breathing with lung expansion helps prevent pneumonia.
• What is the best option for flushing an IV according to the minimum better best paradigm?
• Which of the following is not part of the lethal diamond components?
• How should suction be used in prolonged care?
• In airway management using the DOPE framework, what action is indicated for the obstruction assessment ('O')?
• To adjust for burn resuscitation, decreasing the IV rate by 25% would be the appropriate response to which scenario?
• Signs of wound infection include heat, swelling, purulent drainage, worsening pain, and ____.
• When assessing the GCS for a casualty with a cricothyroidotomy, the 'Verbal' section should be annotated as:
• Which antiemetic and dose is appropriate to treat nausea after ketamine administration?
• What strategies help prevent hypothermia in the field?
• There are three clinical variables required to compute a NEWS2 score. True or False?
• In burn care, which action is the priority intervention for a patient with burns to multiple sites including limbs?
• Annex __ is the medical services portion of the operation plan that provides a summary of medical threats, diseases, assets, and prophylactic guidance.
• What is an example of low survivability wounds?
• Which of the following is included in the six P's used to assess burn complications?
• In prolonged care, which statement best describes how evacuation planning should be approached?
• Trending vital signs can help identify:
• During prolonged casualty care, how should spinal immobilization be handled when a spinal injury is suspected?
• What is the gtt/min rate for a maintenance infusion running at 52 mL/hr with a 15 gtt/mL set?
• Do not leave an IO needle in place more than 24 hours. True or False.
• Ketamine is dosed for procedural anesthesia at which IV/IO dose?
• _____ is used to confirm airway device placement and monitor ventilation.
• Ear burns are particularly prone to which condition?
• Which condition warrants cautious use of analgesia in head injury?
• The amount of air that moves in or out of the lungs with each respiratory cycle is called what?
• When using the VC3 guide, everything should be included to the physician, except:
• Which information allows the corpsmen and care team to assess a casualty's status over time?
• What term describes the lethal cycle of four physiological derangements prolonging blood loss?
• What infection prevention practices are essential during prolonged care?
• As the PCC team lead on deployment, which two requirements are critical to ensure that nursing care is scheduled appropriately and divided amongst the care team?
• Your burn patient’s urine output over the last 4 hours is 230 mL. What adjustment should be made to the IV fluid rate?
• When should spinal immobilization be reassessed after initial placement?
• When should you change a dressing over a contaminated wound in PCC?
• What is the most common form of distributive shock?
• Which statement best describes a common element of burn casualty management?
• True or False, When appropriate, a minimum better best format should be utilized
• Which term describes the action of incising burned tissue to relieve pressure?
• In the burn resuscitation context, Bradycardia of 50-60 bpm is not expected after 24 hours of resuscitation. Which option correctly reflects this statement?
• Which burn pattern is most associated with the greatest risk of burn-induced hypovolemic shock?
• Which statement best describes the guideline about dressings in burn care?
• In a crush injury context, what is the target urine output to indicate adequate renal perfusion?
• How should you monitor a casualty with chest injuries during prolonged care?
• What is the recommended approach to oxygen therapy in PCC?
• The lethal diamond includes hypocalcemia as one of its components.
• What vital signs indicate deterioration due to bleeding in PCC?
• Which burn condition is used as an example of low survivability?
• How should you manage a suspected cervical spine injury during airway management?
• Which statement is true regarding benzodiazepines in PCC?
• You suspect your patient has a severe TBI with impending herniation. You should begin bagging the patient at a rate of 1 breath every 3 seconds for 5 minutes before reassessing.
• Which annex contains the PACE communication plan details?
• Your patient requires a maintenance dose of 3% hypertonic saline following a 250mL bolus. You have tubing with a drip factor of 15 gtt/mL. What is the gtt/min of the maintenance dose?
• What is the normal value associated with EtCO2?
• Annex Q is the medical services portion of the operation plan that provides a summary of medical threats, diseases, assets, and prophylactic guidance.
• In a patient with acute compartment syndrome you may find paralysis etc and ___?
• What should be assessed in the field to monitor potential brain injury progression?
• Which consideration is key when selecting analgesia for prolonged casualty care?
• In Role 1, which route is used for analgesia delivery?
• What is the recommended approach for spinal injury with poor perfusion during PCC?
• A casualty care plan should be created before implementing nursing interventions.
• Bradypnea can be caused by which of the following?
• A vasovagal episode is self-limited and blood pressure quickly normalizes when the patient is placed in a horizontal position.
• What term describes a fainting spell caused by vagal nerve stimulation?
• A burn patient weighs 220 pounds and has a TBSA of 30%. What is the initial IV resuscitation rate?
• You received a patient from point of injury with burns to anterior/posterior of both legs and anterior portion of the right arm. What is the priority intervention for this patient?
• You are preparing to administer a 3% hypertonic saline continuous infusion to a patient with severe TBI following a bolus of 250 mL. The IV tubing has a drip chamber of 10 gtt/mL. You plan to start the infusion at 100 mL/hr. What is the gtt/min rate?
• If facial trauma or basal skull fracture is suspected, which airway adjunct should be avoided?
• Which of the following statements correctly identifies TLAMM in a theater logistics context?
• _____ is the pressure in the airway at the end of expiratory phase the alveoli of the lung from completely collapsing and helps to recruit more alveoli for gas
• Which measurement is critical to calculate fluid resuscitation needs in burns?
• In mass casualty scenarios, which item is used to transport the deceased?
• Which statement by a member of the care team indicates they may need additional instructions?
• Which nursing intervention is recommended for preventing deep vein thrombosis?
• The four points of lethal diamond are coagulopathy, acidosis, hypothermia, and hypocalcemia.
• Which practice most effectively helps prevent hypothermia in prolonged field care?
• What are the indications for a supraglottic airway device in PCC?
• What is the normal range for EtCO2 in a healthy individual?
• Which statement best summarizes the overarching goal of PCC in transport scenarios?
• Which option correctly identifies the monitoring method that uses exhaled CO2 measurement to assess ventilation?
• Underestimating burn size by more than what percentage is critical for fluid resuscitation decisions?
• What is the role of balanced blood products in PCC when available?
• Following ketamine administration, the patient is nauseated. Which medication and dose would be appropriate?
• When is TXA indicated in prolonged casualty care?
• The foundation of good PCC is mastery of ____
• What is the primary purpose of rigid or vacuum splints?
• You are caring for a Marine that is considered expectant based off of his injuries. You administer IV morphine to assist with pain control. Upon reassessment, the patient is anxious, breathing at 22 bpm, and crying. What is the next most appropriate action?
• Which class of medication is used to reduce anxiety and ease suffering in the expectant patient?
• When evacuating a patient with a burn wound, what is a prudent antibiotic consideration?
• What information is essential to communicate during handoff in extended care?
• If a patient appears well-oxygenated by pulse oximetry but ventilation is compromised, which monitoring method provides direct information about ventilation?
• In PCC, what is the recommended approach to using ketamine for analgesia and sedation?
• Which route is used for initial fluid resuscitation in burn casualties?
• When treating a patient with a crush injury, which fluids can be used?
• Rising CO2 stimulates breathing.
• How many principles exist in Prolonged Casualty Care (PCC)?
• Which option best describes the recommended approach to fluids in burn resuscitation?
• How does environmental exposure influence decisions in PCC?
• The empiric probability of death increases as time passes due to which condition?
• Analgesia in head injury patients should be used cautiously under which condition?
• Fractures in prolonged care should be managed how?
• A burn patient with anterior torso and anterior leg burns weighing 200 pounds should have which initial fluid rate in mL per hour?
• On the PCC flow sheet, SpO2 is represented by a triangle.
• When ventilating an adult casualty, how often should you provide ventilations?
• In the care team, the team lead ensures that ____ happens during each change.
• What is considered the best format to use when providing information via telemedicine?
• What is the role of PCC in evacuation planning?
• Which frontline steps help prevent ventilation problems in prolonged casualty care?
• Your senior line corpsman ordered 150 mL/hr of NS. You have tubing with a drip factor of 15 gtt/mL. What is the rate in drips per minute (gtt/min)?
• A patient is brought to Role 2 after falling from a 30-foot cliff. She is A&O x3, respirations are non-labored, and she reports upper back pain with bilateral arm numbness and inability to move her legs. The first set of vital signs shows significant hypotension. Which condition do you suspect?
• This kind of event occurs when a strong stimulus of the vagus nerve produces Bradycardia?
• Which statement best describes the non-maleficence principle in medical ethics?
• What is the primary source of resupply in theater?
• Which sign indicates ongoing bleeding during PCC?
• Which is NOT a goal of end-of-life care?
• What is the basic airway management approach in prolonged casualty care (PCC)?
• Which factor should guide a decision about performing an escharotomy in austere environments?
• Monitoring the measurement of the pressure of carbon dioxide being exhaled through the describes ___
• The ___ develops a PACE communication plan which is detailed in ANNEX Q.
• What is the primary objective of the basic airway management approach in PCC?
• Trending vital signs refer to which practice?
• What is a key tactic to minimize infection during prolonged care?
• How should a sucking chest wound be treated in PCC?
• What type of shock is the only shock where in the absence of TBI is primary?
• What is the GCS score for a casualty described as speaking in random words, withdrawing from pain, and opening eyes to speech?
• Ear burns are prone to which complication?
• In the described patient, what does A&O x3 indicate?
• Which statement best describes the effect of proper spinal immobilization during transport?
• A definitive airway is defined as any intervention that is below the level of the ____.
• In PCC, how should you time suctioning relative to evacuation?
• In PCC, the designation S6 refers to which plan?
• Which type of burns may be associated with inhalation injury?
• You are caring for an unconscious patient in PCC. Part of your care plan is to perform foot pumps, ankle circles, and leg raises. These exercises are performed at what interval to prevent which condition?
• During a MACE 2 exam on a suspected traumatic brain injury patient who reports a severe headache and vomiting, which action is inappropriate?
• The risk of initiating this procedure in an austere environment must be weighed in regard to the benefit.
• When is wound irrigation appropriate in PCC?
• A patient has burns to the anterior torso and anterior of both legs, and an estimated weight of 200 pounds. What is the initial fluid rate?
• In writing the care plan for a patient with bilateral lower-extremity amputations, which intervention would not be necessary?
• What is the role of antibiotics for burn wounds in PCC?
• What is the approach to fluid resuscitation in PCC for suspected hemorrhagic shock?
• Which of the following describes the lethal cycle of four physiological derangements that can prolong blood loss and increase the risk of death?
• After 24 hours of burn resuscitation, which finding would not be expected in a well-resuscitated patient?
• In the scenario where a wounded enemy soldier is being treated and a team member suggests lethal dosing of morphine, the team lead's action reflects which ethical principle?
• What is the best treatment protocol for fluid resuscitation for a burn casualty?
• While performing nursing care for a patient with a crush injury to the left leg, you note tea colored urine. What is an appropriate urine output for this patient?
• To monitor brain injury progression in PCC, what is essential?
• How should you monitor for clinical improvement after needle decompression in tension pneumothorax?
• Which GCS component is annotated with a 'T' in the notation used for intubated patients?
• How should head injuries be monitored in PCC?
• In the analgesia scenario, which action is most appropriate after a patient remains in pain following the initial morphine dose?
• The _____ regulates natural ventilation by detecting the increase of CO2 level.
• Which guide is identified as the best format to use for telemedicine information exchange?
• How do you manage poor perfusion with suspected spinal injury during PCC?
• Procedural analgesia should be initiated prior to fracture or dislocation reduction if no vitals or level of consciousness.
• Which rate is correct for 150 mL/hr with a 15 gtt/mL drop factor?
• While monitoring a patient, you assess the heart is 136 bpm. All are potential causes, except:
• When are nasopharyngeal airways contraindicated in PCC?
• In field settings, which statement best describes the role of AMAL in battalion support?
• During prolonged care, what is the rationale for reassessing immobilization during transport?
• Which burn pattern most strongly predisposes to hypovolemia due to fluid loss?
• How should open wounds be dressed during prolonged care?
• Prophylactic antibiotics should be considered in PCC under what circumstances?
• Which statement best describes the use of the 'minimum, better, best' decision format in PCC?
• Cushing's Triad presents with all of the following, except:
• Because it is self-limited, a ______ is unlikely to result in abnormal blood pressure and quickly restores when the patient is placed in a horizontal position.
• For IV lines not being used, flush saline locks with 10mL of NS at least every 24 hours.
• The statement 'Do not leave blister intact and use DRY dressings' is true.
• Which of the following is NOT a potential complication from using a bag-valve mask?
• Which item is NOT part of Cushing's Triad?
• How do you detect ongoing bleeding during prolonged care?
• The medical term for a vagal-induced bradycardic syncopal event is VASOVAGAL SYNCOPE.
• How should chest injuries be stabilized during prolonged evacuation?
• With vitals showing BP 100/50, HR 110, Temp 101.6F, RR mid 20s, frequent dressing changes and constant pain at 8/10, what is the status of the patient and the frequency of head-to-toe assessment?
• What is the ketamine dose for procedural anesthesia when given IV or IO as a slow push?
• In a PCC scenario, which situation would most likely require a higher-frequency head-to-toe assessment (every 4 hours)?
• What is the role of blood products in PCC?
• Under what circumstances should a cricothyrotomy be considered in PCC?
• Which statement best describes splinting during prolonged care?