EFMB WRITTEN TEST, EFMB WRITTEN TEST 100% VERIFIED ANSWERS 2024/2025 CORRECT STUDY SET, Exams of Nursing

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EFMB WRITTEN TEST, EFMB

WRITTEN TEST 100% VERIFIED

ANSWERS 2024/

CORRECT STUDY SET

During debridement, extremity wounds should be extended _________. Longitudinally During debridement, truncal wounds should be extended _________. Along Langer's Lines Due to their heavy contamination and the diminished healing capacity, how long should the closure of blast wounds be avoided after the injury occurs? 48 Hours Assurance of ________ and removal of all nonviable skin, fat, fascia, muscle, and bone are essential to reduce the load of contamination and necrotic tissue prior to dressing application. Hemostasis All methods of wound irrigation are adjuncts and not substitutes to what? Sharp Surgical Debridement The current recommendation of irrigation volume for small wounds is: 1 - 3 Liters The current recommendation of irrigation volume for moderate wounds is: 4 - 8 Liters

The current recommendation of irrigation volume for large wounds or wounds with evidence of heavy contamination is: 9 or More Liters T/F: Normal saline, sterile water and potable tap water all have comparable efficacy and safety as irrigation solutions. True T/F: The inclusion of irrigation fluid additives such as iodine, bacitracin or antibiotics has proven benefits. False What are risk factors of invasive fungal infections assessed for during the first wound debridement? Dismounted Blast Injury, Above the Knee Amputation, Extensive Perineal/Genitourniary/Rectal Injury, Massive transfusion of >20 units in the first 24 hours T/F: All wounds must be closed prior to arrival at a definitive care location to prevent further bacterial and fungal introduction. False T/F: Placement of antibiotic impregnated polymethylmethacrylate (PMMA) can be used as an adjunct to debridement and irrigation of a wound to deliver increased local antibiotic concentrations while minimizing the associated side effects of high systemic loads of these antibiotics. True A(n) _________ event refers to an iatrogenic event in which a sponge or surgical instrument is deliberately or unintentionally left behind while the wound proceeds to definitive management. Retained Foreign Object (RFO) Explosive munitions injure through how many major mechanisms? Four

Educated and directed to self-report for evaluation and possible treatment as soon as is practicable. What is the best course of action if you find debris in the external auditory canal or in the middle ear? Treat the patient with a fluoroquinolone and steroid containing topical antibiotic. Hearing loss that persists ___ hours after acoustic trauma warrants a hearing test or audiogram 72 Hours T/F: Vestibular trauma to the inner ear may manifest in vertigo. True All patients with subjective hearing loss and tinnitus following blast exposure should: Have the exposure documented and be evaluated by hearing test as soon as possible. Patients with TTS greater than ______ losses in three consecutive frequencies should be considered candidates for high dose oral and/or transtympanic steroid injections when not otherwise contraindicated. 25 db The initial radiographic evaluation of a trauma patient begins with supine AnteriorPosterior (AP) chest and pelvis radiographs taken in the trauma bay usually with a(n) _________________. Portable X-Ray Machine T/F: Computed Tomography scanning has been largely replaced by cervical spine radiographic evaluation (CSRE) and should only be performed when CSRE is unavailable. False What is the lowest level of care equipped with a Computed Tomography scanner? Role 3 What is the lowest level of care equipped with a portable x-ray machine? Role 2

Members of the trauma team should have _____ aprons and thyroid shields available near the trauma bay for radiation safety. Lead Distance is also protective from radiation exposure. If feasible based on the patient's condition, any personnel without lead shielding should move a short distance away from the x-ray unit. The recommended minimal distance is _____. 6 Feet While the FAST scan has been validated only in hemodynamically unstable blunt trauma patients, it has become a standard tool in the trauma bay and Emergency Department (ED) in most trauma patients. FAST stands for____________________. Focused Abdominal Sonographic Assessment for Trauma FAST in combat trauma has a sensitivity of only 56% and specificity of ___. 98% T/F: The FAST exam remains the most sensitive test for hollow viscus injury and mesenteric injury. False T/F: At the Role 3, properly trained providers including radiologists, surgeons, and emergency physicians, can perform and interpret FAST scans in the emergency department on a hand held portable device. True A FAST examination is performed with a portable hand-held machine most commonly using a standard 3-7 MHz curved array _______________ probe. Ultrasound (US) The standard FAST examination is focused on evaluating for the presence of ______________ in certain areas of the body. Free Intraperitoneal Fluid

Comatose patient, symptomatic inhalation injury, deep facial burns, and burns covering more than 40% of TBSA Burn casualties with injuries greater than ___ Total Body Surface Area (TBSA) are at high risk of hypothermia. 20% T/F: When providing point of injury care to a burn patient, you must immediately debride blisters and cover burns with loose, moist gauze wraps or a wet clean sheet. False Calculate a burn patient's initial burn size using the Rule of _____. Nines Which type of burn is NOT included in the estimation of Total Body Surface Area (TBSA) used for fluid resuscitation? Superficial (First Degree) Burns Which classification of burns are moist and sensate, blister, and blanch? Partial Thickness (Second Degree) Which classification of burns appear red, do not blister, and blanch readily? Superficial (First Degree) Which classification of burns appear leathery, dry, non-blanching, are insensate, and often contain thrombosed vessels? Full Thickness (Third Degree) What is the Rule of 10s burn fluid resuscitation equation? Ensure you can apply it. (10ml fl/hr x %TBSA); if patient >80 kg, add 100 ml fluid for every 10kg over For children suffering burn injuries, ___ x Total Body Surface Area (TBSA) x body weight in kg gives the volume for the first 24 hrs of fluid resuscitation.

T/F: A hypotonic solution is the preferred resuscitation fluid for a burn patient. F T/F: Both under- and over- fluid resuscitation of burn patients can result in serious morbidity and even mortality; patients who receive over 250 mL/kg in the first 24 hours are at increased risk for severe complications including acute respiratory distress syndrome and both abdominal and extremity compartment syndromes. T At 8-12 hours post-burn, if the hourly IV fluid rate exceeds 1500 mL/hr or if the projected 24 hr total fluid volume approaches 250 mL/kg, initiate 5% ___________ infusion for an adult burn patient. Albumin What are clinical signs of inhalation injury? Progressive voice changes, soot about the mouth and nares, hypoxia, and shortness of breath. Definitive care for US service members suffering from burn injuries is provided at _____________. USAISR Burn Center, San Antonio, TX. T/F: Early ambulation and physical therapy, is critical to the long-term functional outcome in burn patients. Once post-operative dressings are removed, perform range of motion of all affected joints. True ____________ is the most common infectious complication with pediatric burn patients and usually presents within 5 days of injury. Cellulitis A patient has suffered burn injuries to the entire anterior torso (chest and abdomen), the anterior and posterior of both arms, and the anterior of his face and neck. Calculate the patient's initial burn size using the Rule of Nines.

T/F: When introducing a catheter into a Military Working Dog, it is acceptable to create a small skin nick over the intended catheter insertion site to facilitate penetration of the dog's thick skin. T The arterial pulse of a Military Working Dog is best palpated at the ____________ artery on the medial aspect of the proximal thigh in the inguinal area, or at the dorsal metatarsal artery on the dorsal aspect of the proximal hind paw. Femoral Pulse oximetry probes used for people (typically finger probes) are best placed on the ______________ for optimal reliability in unconscious, sedated, or anesthetized dogs. Tongue What are the 3 characteristic breathing patterns typically displayed in Military Working Dogs in respiratory distress? Obstructive, Restrictive, Parenchymal When performing a tracheostomy on a Military Working Dog, make a transverse incision completely through the ______________ ligament. Annular While placing an endotracheal tube in a Military Working Dog, you palpate the dog's neck and feel 2 tubes. This indicates that the endotracheal tube is in the dog's _____________. Esophagus When performing cardiopulmonary resuscitation on a Military Working Dog (MWD), begin sustained, forceful chest compressions with the MWD in lateral recumbency (on either side) at a rate of _____ compressions per minute. Sustain compression for at least 2- 3 minutes per cycle. 100 T/F: If single-person cardiopulmonary resuscitation is performed on a Military Working Dog, the responder should only perform ventilation, as this optimizes circulation. False

T/F: Conventional human tourniquets applied to the limb of a Military Working Dog are an unreliable intervention to effectively control hemorrhage. True Calculate the approximate safe but effective crystalloid bolus volume for a 55 pound Military Working Dog experiencing signs and symptoms of shock. 550 (add a zero) T/F: Gastric Dilation-Volvulus Syndrome (GDV) in Military Working Dogs occurs when the stomach rapidly dilates with fluid, food, and air and then rotates along the long axis (volvulus). When volvulus develops, the esophagus and duodenum become twisted, preventing the passage of stomach contents. T Hypothermia in Military Working Dogs caused by low body temperature due to trauma, toxicity, underlying illness, or anesthesia and surgery is classified as ______________ hypothermia. Secondary Calculate the estimated percent of total body surface area burned on a Military Working Dog suffering from burns to the head, neck, chest, and abdomen. 45% For PO supplementary analgesia of an injured Military Working Dog, administer _____________ 5- 10ml/kg PO q8-12h for up to 5 days. Tramadol How long can whole blood collected in the anticoagulant CPD be stored? 21 Days How long can whole blood collected in the anticoagulant CPDA-1 be stored? 35 Days

T/F: Fresh whole blood should routinely be collected from pre-screened donors as a way to maintain a routine inventory of Walking Blood Bank - Stored Whole Blood products. F In general, whole blood units should not be collected from donors more frequently than every ____ weeks. 8 T/F: In situations where there are a limited number of donors and a dire need for blood, no more than three units may be taken from a single donor. F Is there a known contraindication to using whole blood in pediatric casualties? No A massive transfusion in children is defined as ____ ml/kg. 40 T/F: Infection Prevention in Combat-related Injuries standard precautions apply to all patients, regardless of suspected or confirmed infectious status. True The World Health Organization's "five moments of hand hygiene" include:

1. Use of soap and water or alcohol-based sanitizer before patient contact
2. Before aseptic tasks
3. After body fluid exposure risk
4. After patient contact
5. After contact with patient surroundings, even if gloves were worn What are Infection Prevention in Combat-related Injuries standard precautions? Hand washing, gloves, gowns, masks, goggles or face shield

T/F: When implementing infection prevention measures in a combat zone, cohorting is the process of clustering host nation patients (who are not eligible to evacuate from theater) and U.S. and coalition patients (who are eligible for evacuation from theater) and separate when possible to reduce the risk of cross-contamination with multi-drug resistant organisms. T ________ and __________ should be worn with all patients suspected or known to have multi- drug resistant organism colonization or infection with C. difficile- infection (CDI). Gloves and Gowns Daily ______________of ICU patients has shown a reduction of infections with vancomycin- resistant enterococci (VRE) and methicillin-resistant staphylococcus aureus (MRSA). Bathing T/F: Antimicrobial drug usage has no impact on the development of multidrugresistant organisms. F T/F: All facilities should avoid unnecessary empiric use of broad spectrum antibiotics. T T/F: Prolonged duration of prophylaxis has been shown to decrease long term rates of infections in patients with combat-related open fractures. F Blast injuries, especially those related to_____________, present a unique bloodborne pathogen risk if an impaled body part is introduced into the trauma patient. Suicide bomber attacks T/F: The risk of transmission for human immunodeficiency virus is considered very high after blast injury and generally warrants immediate action regardless of the region of operation. F

Hydrogen Sulfide Which chemical irritant produces a "knockdown" effect, a sudden loss of consciousness, when exposed to high concentrations? Hydrogen Sulfide Which chemical irritant forms a strong base which can cause mucosal irritation, severe upper airway irritation, and alkali skin burns when reacting with water? Ammonia The triad of severe cyanide toxicity consists of: Hypotension, altered mental status, and lactic acidosis Which of the following is the most commonly available antidote for cyanide poisoning? Hydroxocobalamin T/F: High index of suspicion must be present when treating patients exposed to carbon monoxide as elevated CO may be present despite normal PaO2 and SpO2 readings. T Deglycerolized Red Blood Cells are derived from _____ ml of whole blood collected in Citrate/Phosphate/Dextrose or Citrate/Phosphate/Dextrose/Adenine collection bags. 450 - 500 Red Blood Cells are stored for up to 6 days at 1 - 6 °C before being frozen in a cryoprotectant (40% w/v glycerol), and stored in the frozen state at minus 65 °C or colder for up to ______. 10 Years T/F: Each unit of deglycerolized red blood cells (DRBCs) should be considered equivalent to a fresh unit of RBCs since they are frozen within 6 days of collection and have a 14-day shelf-life upon deglycerolization. True

What are the clinical indications for use of each unit of deglycerolized red blood cells (DRBCs)? Should be considered equivalent to a fresh unit of RBCs; contain more than 80% of the RBCs present in the original unit of blood; provides the same physiological benefits as liquid RBCs; carries the same expectation for post-tranfusion survival as liquid-stored RBCs; contains significantly lower concentrations of proteins associated with non-hemolytic transfusion reactions; is a supplement to liquid RBCs during periods of increased transfusion requirements in order to decrease hemorrhagic morbidity and mortality. How long does it take to thaw frozen red blood cells in a plasma thawer? 35 minutes How long does it take to thaw frozen red blood cells in a 42°C water bath? 45 minutes Optimal but not necessarily definitive patient stabilization before transport is critical and encompasses four connected elements. What are these elements? Injury control, optimized/ongoing resuscitation, other treatments, besides resuscitative measures, should be provided at a steady-state, not requiring dynamic, complex, or life-saving measures en route; deterioration en route must be anticipated and prevented with risk mitigation procedures prior to departure. T/F: Medical capability is the quality or state of being able to provide the expected and required medical services and support to the casualty. True ____________ transport is required when "the patient has a critical illness or injury that acutely impairs one or more vital organ systems such that there is a high probability of imminent or life- threatening deterioration in the patient's condition during transport." Critical Care The gold standard for unstable patient transport is movement with critical care capability led by a ____________ who is qualified, experienced, and proficient at critical care transport. physician

capability, promulgate medical policy, and the authority to enforce the standard of care through quality assurance with local privileging actions of individual en route care providers. True _______________ medical direction includes protocol development and review, continuing education of prehospital providers, and quality improvement activities. Offline The commander of the unit assigned to perform medical evacuation should appoint the unit's ________________ as the medical director. physician T/F: Medical direction at the regional level (Patient Evacuation Control Center) is centered on online medical direction activities. False What are the responsibilities of a regional medical director?

1. Advise theater commander on MEDCOP and allocation of resources for intra-theater transportation.
2. Ensure requirements for documentation of intra-theater transport care are done.
3. Assist medical directors operating in the theater and ensure they have the knowledge and skills to perform their job
4. Provide technical supervision to medical directors in theater
5. Ensure relevant out-of-hospital research is supported and accomplished
6. Ensure information from intra-theater transport is supplied to the DoD Trauma Registry What are the approved Joint Trauma System patient care records (PCR) for interfacility patient transports? DD 1380 (TCCC Card) DA 4700 (TacEvac PCR) AF IMT 3899 (Patient Movement Record) Medical Rescue Report SAR Form 3-50.1A

Which approved Joint Trauma System patient care record (PCR) is primarily used for rotary wing transports from point of injury or inter-facility transfer? DA 4700 TacEvac PCR Which approved Joint Trauma System patient care record (PCR) is primarily used for Critical Care Air Transport Team movements? AF IMT 3899, Patient Movement Record Which approved Joint Trauma System patient care record (PCR) is required whenever a search or rescue is attempted or accomplished that involves Navy personnel or assets? Medical Rescue Report SAR Form 3-50.1A T/F: While the patient is delivered to the receiving medical treatment facility, the patient care record should be maintained with the evacuation unit. False T/F: The Acute pain service (APS) should be established and be an integral part of casualty care starting at the Role I. False T/F: Sedation should be optimized as a priority over pain control. False Adjuncts can greatly increase patient safety and the effectiveness of narcotics to treat pain while reducing side effects. What are examples of adjuncts? Acetaminophen, ketamine, non-steroidal anti-inflammatory drugs, continuous peripheral nerve infusions, and continuous epidural infusions If is it not feasible to incorporate the acute pain service (APS) team into trauma rounds, then the APS is responsible for _________ pain rounds, pain management consults, and reports to the trauma team leader. Daily