68W LIMITED PRIMARY CARE QUESTIONS AND ANSWERS., Exams of Nursing

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68W LIMITED PRIMARY CARE QUESTIONS

AND ANSWERS.

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Question 2 What form is known as the "Chronological Record of Medical Care"?

A. DD Form 689 B. DA Form 7652 C. SF 600 D. DD Form 2766

Correct Answer: C. SF 600

Rationale: The SF 600 (Standard Form 600) is the Chronological Record of Medical Care form used to document the chronological record of the patient's treatment. Entries should include the date and time of visit, the Medical Treatment Facility, and the signature of the person making the entry .

Question 3 What is the correct procedure for correcting an error on an SF 600?

A. Use white-out to cover the error and write over it B. Erase the error completely and rewrite C. Draw a single line through the information, write "Error," and initial D. Discard the form and start a new one

Correct Answer: C. Draw a single line through the information, write "Error," and initial

Rationale: The correct correction procedure is to draw a single line through the information, write "Error," and add your initials. If documentation is already complete and information later needs to be changed, add the correct information with the reason for change, date, and initials. Never use white-out or erase entries .

Question 4 What does HIPAA protect?

A. The hospital's right to refuse treatment B. The commander's access to all medical records C. The privacy of patient-specific healthcare information D. The pharmacy's dispensing protocols

Correct Answer: C. The privacy of patient-specific healthcare information

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Rationale: HIPAA (Health Insurance Portability and Accountability Act) is a federal law that sets standards for protecting the privacy of patient-specific healthcare information. It applies to all healthcare providers and facilities .

Question 5 Which personnel/section of the MTF handles requests for patient medical information?

A. The attending physician B. The patient's unit commander C. Patient Administration Division (PAD) D. The pharmacy section

Correct Answer: C. Patient Administration Division (PAD)

Rationale: The Patient Administration Division (PAD) handles all requests for medical information and disclosure. Personnel not involved in a patient's care or medical research will not have access to patient information unless access is required by court order, needed for hospital accreditation, or authorized by the patient via a written document .

Question 6 Access to a patient's medical information may be given to which of the following?

A. The patient only B. Patient care personnel only C. The patient, patient care personnel, medical researchers, and medical educators D. Anyone who requests it

Correct Answer: C. The patient, patient care personnel, medical researchers, and medical educators

Rationale: Access may be given to the patient, patient care personnel, medical researchers, and medical educators. This ensures continuity of care while protecting patient privacy. All other access requires authorization .

Question 7 What should an SF 600 entry contain?

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Question 10 What is the difference between "BED REST" and "QUARTERS"?

A. Bed rest allows dining facility access; quarters does not B. Bed rest restricts patient to bed; quarters allows freedom to move within living space C. Bed rest allows duty; quarters does not D. There is no difference

Correct Answer: B. Bed rest restricts patient to bed; quarters allows freedom to move within living space

Rationale: Bed rest means the patient is restricted to their bed with allowances for necessary travel to the dining facility and latrine. Quarters means restriction and rest in the patient's place of domicile, including freedom to move within their living space, to and from the dining facility, and/or medical facilities. Quarters normally will not exceed 72 hours .

Question 11 Abbreviations for medical documentation must be in accordance with which regulation?

A. IAW AR 40- B. IAW AR 600- C. IAW FM 4-25. D. IAW TC 8-

Correct Answer: A. IAW AR 40-66

Rationale: Medical documentation abbreviations must be used in accordance with IAW AR 40-66 (Army Regulation 40-66, Medical Record Administration and Healthcare Documentation). This ensures standardization and clarity in medical records .

Question 12 What form should a soldier present to the Battalion Aid Station (BAS) to initiate care?

A. SF 600 B. DA Form 4856 C. DD Form 689 D. DA Form 3349

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Correct Answer: C. DD Form 689

Rationale: DD Form 689, the Individual Sick Call Slip, is the form a soldier should present to the BAS when requesting medical evaluation or treatment. It serves as the initial documentation of the sick call visit .

SECTION 2: INFECTION CONTROL & MICROBIOLOGY (Questions 13–28)

Question 13 What is the single most useful and effective means of breaking the chain of infection?

A. Wearing gloves B. Hand washing C. Wearing a mask D. Isolation precautions

Correct Answer: B. Hand washing

Rationale: Hand washing is the single most useful and effective means of breaking the chain of infection. It removes pathogens from the hands before they can be transmitted to other surfaces or patients. Hand hygiene is the foundation of infection control .

Question 14 What are the six components of the chain of infection?

A. Bacteria, virus, fungi, parasite, prion, protozoa B. Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host C. Contact, droplet, airborne, vehicle, vector, fomite D. Acute, chronic, latent, subclinical, carrier, epidemic

Correct Answer: B. Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host

Rationale: The six links in the chain of infection are: (1) pathogenic microorganism (infectious agent), (2) reservoir (where the microorganism multiplies or survives), (3) portal of exit (how it leaves the reservoir), (4) vehicle of transmission (how it spreads), (5) portal of entry (how it enters a new host), and (6) susceptible host. Breaking any link prevents infection spread .

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Rationale: A nosocomial infection is a disease acquired in a hospital or clinical setting. These infections often involve microorganisms that are resistant to multiple antibiotics, and there are numerous potential reservoirs for pathogen growth in healthcare settings, including IV fluids, foods, biological materials, and equipment .

Question 18 What type of patient requires protective (reverse) isolation?

A. Patients with active tuberculosis B. Patients with C. difficile infection C. Patients who are susceptible to disease due to low immunity (e.g., chemotherapy, HIV) D. Patients with influenza

Correct Answer: C. Patients who are susceptible to disease due to low immunity (e.g., chemotherapy, HIV)

Rationale: Protective (reverse) isolation is used to protect patients with weakened immune responses from outside microorganisms. Eligible patients include burn victims, bone marrow transplant recipients, HIV patients, and those undergoing chemotherapy. Standard patients are isolated to protect others; these patients are isolated to protect themselves .

Question 19 What factors increase a pathogen's virulence? (Select all that apply)

A. Ability to produce enzymes that destroy blood cells B. Ability to produce enzymes that stop normal blood clotting C. Ability to produce enzymes that consume muscle fibers D. Ability to form protective capsules

Correct Answer: A, B, C, D (All of the above)

Rationale: All listed factors increase pathogen virulence: enzymes that destroy blood cells (hemolysins), enzymes that stop blood clotting (coagulase), enzymes that consume muscle fibers (fibrinolysin), and the ability to form protective capsules that resist phagocytosis .

Question 20 What are the four stages of the normal course of infection in correct order?

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A. Full stage, Prodromal, Incubation, Convalescent B. Incubation, Prodromal, Full stage, Convalescent C. Prodromal, Incubation, Convalescent, Full stage D. Convalescent, Full stage, Prodromal, Incubation

Correct Answer: B. Incubation, Prodromal, Full stage, Convalescent

Rationale: The normal course of infection follows this order: (1) Incubation period (pathogen enters the body), (2) Prodromal stage (initial symptoms such as fatigue or low-grade fever begin), (3) Full stage of illness (symptoms become acute and specific to the infection type), (4) Convalescent stage (acute symptoms subside and the patient recovers) .

Question 21 What are vectors in the context of disease transmission?

A. Microscopic living cells found in the environment B. Living carriers of pathogens that spread disease C. Spores that protect bacteria from extreme conditions D. Chemical disinfectants that destroy microorganisms

Correct Answer: B. Living carriers of pathogens that spread disease

Rationale: Vectors are living carriers of pathogens that spread disease onto food that people eat or when they bite a victim. Examples include mosquitoes, ticks, and other arthropods that transmit diseases like malaria, Lyme disease, and West Nile virus .

Question 22 What three types of transmission-based precautions are used for patients with highly transmissible infections?

A. Standard, universal, and body substance isolation B. Airborne precautions, droplet precautions, contact precautions C. MRSA, VRE, and C. diff precautions D. Blood, respiratory, and wound precautions

Correct Answer: B. Airborne precautions, droplet precautions, contact precautions

*Rationale: The three types of transmission-based precautions are: Airborne precautions (for diseases like TB, measles, chickenpox that spread via small evaporated droplets), Droplet

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A. Communicable disease B. Epidemic disease C. Contagious disease D. Pathogenic disease

Correct Answer: C. Contagious disease

Rationale: Contagious diseases are those that are easily and rapidly spread from one person to another. Communicable diseases can spread from person to person, but not all are equally contagious. An epidemic occurs when a large number of people in the same area are infected in a relatively short time .

Question 26 What is an arthropod in the context of infection control?

A. A type of bacteria B. A virus that infects insects C. An invertebrate animal with a segmented body and jointed appendages (e.g., mosquitoes, ticks) D. A fungal infection of the skin

Correct Answer: C. An invertebrate animal with a segmented body and jointed appendages (e.g., mosquitoes, ticks)

Rationale: Arthropods are invertebrate animals characterized by a segmented body to which jointed appendages are articulated in pairs. Examples include mosquitoes, ticks, spiders, and insects. They are important vectors for many infectious diseases .

Question 27 What is envenomation?

A. The ingestion of bacterial toxins from food B. The injection of venom (toxins) into the body through bites or stings C. The inhalation of toxic fumes D. The absorption of toxins through skin contact

Correct Answer: B. The injection of venom (toxins) into the body through bites or stings

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Rationale: Envenomation is the injection of venom (toxins) into the body through bites or stings. This can occur from snakes, spiders, scorpions, and other venomous arthropods. Envenomation requires prompt medical assessment and specific treatment protocols .

Question 28 Which of the following is NOT an environmental factor that affects the growth of microorganisms?

A. Oxygen B. Nutrients C. Light D. Sound frequency

Correct Answer: D. Sound frequency

Rationale: Environmental factors that affect the growth of microorganisms include oxygen, nutrients, temperature (most grow at normal body temperature; cold slows growth; high temperatures usually kill organisms), moisture, pH, and light. Sound frequency is not a significant factor in microbial growth .

SECTION 3: PHARMACOLOGY & MEDICATION ADMINISTRATION (Questions 29–44)

Question 29 What are the "Six Rights" of medication administration?

A. Right Prescriber, Right Dispenser, Right Administrator, Right Receiver, Right Time, Right Place B. Right Patient, Right Medication, Right Dose, Right Route, Right Time, Right Documentation C. Right Patient, Right Drug, Right Dose, Right Indication, Right Cost, Right Outcome D. Right Prescriber, Right Dispenser, Right Receiver, Right Time, Right Dose, Right Indication

Correct Answer: B. Right Patient, Right Medication, Right Dose, Right Route, Right Time, Right Documentation

Rationale: The six rights are: Right Patient, Right Medication, Right Dose, Right Route, Right Time, and Right Documentation. These rights help prevent medication errors and ensure patient safety .

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Correct Answer: B. 45 degree angle

Rationale: Subcutaneous (SQ) injections should be administered at a 45-degree angle to the skin surface. The needle is injected into the fatty tissue below the skin. For intramuscular (IM) injections, the needle is positioned at a 90-degree angle .

Question 33 What is the gauge range for subcutaneous (SQ) injections?

A. 18- B. 23- C. 26- D. 30-

Correct Answer: B. 23-25

Rationale: The gauge range for subcutaneous (SQ) injections is 23-25. For intramuscular (IM) injections, the gauge range is 20-22. The gauge refers to the diameter of the needle; the larger the gauge number, the smaller the diameter of the needle .

Question 34 What is the purpose of intramuscular (IM) injections?

A. To test for exposure to diseases or sensitivity to allergens B. To provide rapid absorption (10-20 minutes) and long duration (hours to weeks) C. To administer medication into the dermal layer for slow absorption D. To inject medication directly into a vein for immediate effect

Correct Answer: B. To provide rapid absorption (10-20 minutes) and long duration (hours to weeks)

Rationale: IM injections are utilized when rapid absorption (10-20 minutes) and long duration (hours to weeks) are desired. They are also used when administering viscous or irritating medications or when a large volume of medication is needed for a stronger effect. IM absorption is faster than SQ but slower than IV .

Question 35 Which muscle is the primary injection site for IM injections due to its faster absorption rate?

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A. Gluteus maximus B. Vastus lateralis C. Deltoid muscle D. Ventrogluteal

Correct Answer: C. Deltoid muscle

Rationale: The deltoid muscle is the primary injection site for IM injections because of its faster absorption rate compared to other IM sites. The maximum volume for deltoid injection is up to 2 mL. The vastus lateralis is also a safe IM site (up to 5 mL), and the gluteus maximus can be used for larger volumes (up to 5 mL) with careful quadrant division to avoid the sciatic nerve .

Question 36 How long should a patient be monitored after an injection for potential adverse reactions?

A. 5-10 minutes B. 10-15 minutes C. 15-20 minutes D. 20-30 minutes

Correct Answer: C. 15-20 minutes

Rationale: Patients should remain in the treatment area for monitoring for at least 15- minutes following injections because of the possibility of a severe reaction (anaphylaxis). This allows for immediate intervention if an allergic reaction occurs .

Question 37 What is the medication volume limit for a deltoid IM injection?

A. Not to exceed 0.5 mL B. Not to exceed 1 mL C. Not to exceed 2 mL D. Not to exceed 5 mL

Correct Answer: C. Not to exceed 2 mL

Rationale: The medication volume for a deltoid IM injection should not exceed 2 mL. The vastus lateralis can accept up to 5 mL, and the gluteus maximus (using the upper outer quadrant to avoid the sciatic nerve) can also accept up to 5 mL .