JKO OT REQUIRED READING: JP 5-0

What did President Oaks say converted Latter-day Saints believe about the Family Proclamation?

Lord's reemphasis of the gospel truths we need to sustain us through current challenges to the family.

What process did the First Presidency and Quorum of Twelve use in the creation of the family proclamation?

revelatory

Elder Oaks declared that the Family Proclamation is a statement of eternal truth and the will of God for His children who seek eternal life

true

Why did Elder Oaks say some people "consider this family proclamation as just a statement of policy that should be changed

Those who do not believe in or aspire to exaltation and are most persuaded by the ways of the world consider

What doctrine defines our destiny? Why

You are a child of god, because its necessary to understand our divine destiny

What are the five witnesses that speak of our potential?

First testimony of scriptures, second, to the witness of the early Christian writers; third, to the wisdom of those poets and authors who drink from the divine well; fourth, to the power of logic; and fifth, to the voice of history.

What three things allow us to have "unlimited opportunities to progress toward [our] destiny of godhood"?

Being immersed in a world of good and evil, having the capacity to choose, and being able to draw upon the powers of the Atonement

What logical reason do we have for believing in our divine destiny?

We have divine characteristics from our parents

Rather than viewing the saving ordinances as a checklist of actions, how should we see them?

they are the keys that open the doors to heavenly powers that can lift us above our mortal limitations.

What did President Hinckley teach about our ability to add to or diminish Heavenly Mother's glory?

We pray to Heavenly Father because that's the way Jesus taught us to pray

Besides statements speaking of Heavenly Mother's procreative role, what other roles and/or responsibilities have Church leaders spoken about

Co-Creator of worldsCo-framer of the plan of salvationContinued involvement in our mortal probation

What did President Harold B. Lee teach about Heavenly Mother in comparison to our earthly mothers?

Shes more concerned than our earthly mother

Do we have evidence of General Authorities advising us not to speak about Heavenly Mother?

No

Why is it natural to assume that we can become like our Heavenly Parents?

We are like our earthly parents

When was the concept of deification first disputed by an early church father?

Fifth century

How did the teaching of creation ex nihilo impact how Christians saw men and women's relationship with God?

God had originally been completely alone. And widended perceived gulf between God and man

What two things are necessary for "receiving one's full inheritance as a child of Heavenly Father"?

through the Atonement of Christ, by obedience to the laws and ordinances of the gospel.

m How do Latter-day Saints understand the magnitude of the atonement of Jesus Christ?

the vast human potential it makes possible

What four things does Satan try to do because of the importance of family?

destroy the sanctity of the family demean the importance of the role of men and womenen courage moral uncleanlines sand to discourage parents from raising children

According to Elder Christofferson, why is marriage more than the love couples feel for each other?

love comes from you, but marriage from above, from God."

What four things did Elder Christofferson teach are "needed for the success of [God's] plan"?

Creation of the earth, condition of mortality, Redemption from the Fall (Atonement of Jesus Christ), Setting of physical birth and spiritual rebirth

m Why can no person or government alter the divine order of matrimony?

It is not a human invention

m What did President Julie B. Beck teach that the theology of the family is based on?

The Creation, The Fall, and the Atonement

Rather than a consumer approach to dating, how did President Beck describe dating and courtship?

Build lasting friendships and find eternal companions

What were Elder Bednar's two reasons for why eternal marriage is essential to our exaltation?

Man and womens spirts perfectly complement eachother and both are needed to bear a child

Which issues did Elder Bednar say constitute Satan's most direct and diabolical attack on the family?

Confuse understanding about gender, promote premature and unrighteous use of procreative power, hinder righteous marriage.

According to Elder Bednar, where must we look in order to overcome Satan's counterfeit messages regarding gender and marriage?

Jesus

What eight ways did President Oaks say that Satan would try to destroy the plan?

Discredit the Savior, nullify effects of Atonement counterfeit revelation, lead people away from truth; contradict individual accountability; confuse gender; undermine marriage - All things related to procreation

What was the first commandment given to Adam and Eve?

multiply and replenish the earth

What did Adam and Eve need to do to keep the first commandment?

Eat of fruit of tree of knowledge of good and evil

m What did Eve transgress to initiate the conditions of mortality?

Ate of the fruit

According to our readings, what is Heavenly Father's goal in parenting?

to have His children choose to do what is right and ultimately become like Him.

Why is opposition and a veil necessary for the use of agency?

so we would not remember God's plan.

What is the relationship between commandments and agency?

Though God wants us to be on the covenant path, He gives us the dignity of choosing.

m What is the relationship between commandments and God's goal for our destiny?

To further us to exaltation

If justification removes the punishment for past sin, then sanctification

Removes the stain or effects of sin ________."

Though we cannot earn the grace of Christ, what must we do to receive it?

Choose to seek and accept justification and sanctification

What is the medium through which Christ's atoning grace is applied?

The Holy Spirit

Is perfection dependent on justification and sanctification, or is justification and sanctification dependent on perfection?

Perfection is dependent on justification and sanctification

How does the grace of Christ help us see ways to do good that we otherwise would not recognize?

through faith in the atonement of Jesus Christ and repentance of their sins, receive strength and assistance

m What does the grace of Christ have to do with our good works?

Allows us eternal life after all we can do

True or false: According to the reading, the Atonement restores us to our previous innocent state.

false

What two things does grace do according to Elder Uchtdorf?

Unlocks gates of heaven, and opens the window of heaven

Why do "we seek to obey our Heavenly Father?

because our spirits will become more attuned to spiritual things.

m What doesn't "after all we can do" mean according to Elder Uchtdorf?

after" doesn't equal "because"

m According to Sister Burton, what are three principles that will increase our faith in Jesus Christ?

All that is unfair about life can be made right, there is power to overcome the natural man, The Atonement is the greatest evidence we have of the Father's love for His children

Why is it helpful to realize that we may only have partial information when we are trying to interpret prophetic teachings?

m Its not good to make decisions with partial information

What is "part of our problem in the question for truth"?

human wisdom has disappointed us so often.

How does Satan attack those who already embrace the truth? What is one of his "primary strategies"?

spread the seeds of doubt

What does the invitation to "trust the Lord" not remove from us?

does not relieve us from the responsibility to know for ourselves

What counsel was given for when we are confronted with information that conflicts with the revealed word of God?

Men cant understand full truth

m According to Carol F. McConkie, what are the three primary roles of a prophet?

Messenger of Righteousness, 2, Witness of Christ, and Hold the keys of the kingdom on earth

Why are questions different than doubts and how can they lead to good?

To doubt is to reject truth and faith.

Why can "not asking questions" be far more dangerous than asking questions?

sin makes you stupid-and so does refusing to seek after truth.

Why are spiritual wrestlers also seekers?

They are men and women of faith who want to understand more than they presently do and who are serious about increasing the light and knowledge in their lives

Where do our challenges lie in what we don't know instead of what we think we know?

WE DON'T KNOW IT SO WE CANT MAKE A DECISIOSN

Why can't we think our way to conversion?

because you cannot convince your mind of something your heart does not feel

m What habits do seekers have?

engage in the wrestle, immerse themselves regularly in the scriptures, work to be increasingly pure, then pure seekers listen

Though scholarship is valued in the church, what is required to have the right to establish doctrine?

Revelation and authority

m What lessons does Elder Christofferson draw from his two New Testament illustrations?

revelation from God. And not every statement made by a Church leader, past or present, necessarily constitutes doctrine.

OT REQUIRED READING: JP 3-0, Joint Operations

A joint force is one composed of significant elements, assigned or attached, of two or more Military Departments operating under a single joint force commander

True

Joint doctrine recognizes the nine principles of war (objective, offensive, mass, maneuver, economy of force, unity of command, security, surprise, and simplicity). Experience gained in a variety of irregular warfare situations has reinforced the value of three additional principles. Together they comprise the 12 principles of joint operations. Select from the following the three additional principles that comprise the 12 principles.

Perseverance, Restraint, Legitimacy

The military environment and the threats it presents are increasingly ______________ in nature. (JP 3-0, Chapter I, 2a)

Transregional, Multi-domain, and Multi-functional (TMM)

Unified action refers to the synchronization, coordination, and integration of what activities to achieve unity of effort? (JP 3-0, Chapter I, 5a, (1))

Governmental and nongovernmental activities

Match the appropriate level of warfare to the correct descriptor. (JP 3-0, Chapter I, 6b, 6c, 6d)

Strategic = Develops an idea or set of ideas of the ways to employ the instruments of national power
Operational = Links the tactical employment of forces to national strategic objectives
Tactical = The employment, ordered arrangement, and directed actions of forces in relation to each other.

What do mission - type orders focus on? (JP 3-0, Chapter 2, 2b)

purpose

The foundation of operational art encompasses broad vision that helps commanders and their staffs organize their thoughts and _____________ necessary to accomplish the mission and reach the desired military end state in support of national objectives. (JP 3-0, Chapter 2, 3b)

envision the conditions

Without operational art, campaigns and operations could be sets of disconnected events. (JP 3-0, Chapter 2, 3b)

true

The commander's ability to think creatively enhances the ability to employ operational art in order to answer the Ends, Ways, Means, and Risk questions. Match the Ends, Ways, Means, and Risk to the correct question. (JP 3-0, Chapter 2, 3d)

Ends = What are the objectives and desired military end state?
Ways = What sequence of actions is most likely to achieve those objectives and military end state?
Means = What resources are required to accomplish that sequence of actions?
Risk = What is the likely chance of failure or unacceptable results in performing that sequence of actions?

What extends operational art's vision with a creative process to help commanders and planners answer the ends-ways-means-risk questions. (JP 3-0, Chapter 2, 4a).

Operational Design

Joint planning consists of planning activities that help CCDRs and their subordinate commanders transform ____________ into actions that mobilize, deploy, employ, sustain, redeploy, and demobilize forces. (JP 3-0, Chapter 2, 5b)

national objectives

What assessment indicator of warfare answers the question, "Are we accomplishing tasks to standard?" (JP 3-0, Chapter 2, 6h (3))

Measures of performance

What assessment evaluates the results of weapons engagement (of both lethal and nonlethal capabilities), and thus provides data for joint fires and the joint targeting process at all levels. (JP 3-0, Chapter 2, 6h (4))

combat assessment

What is the joint force considering adding as a seventh joint function. (JP 3-0, Chapter 3, 1c)

Information

Through ____________, the joint force commander (JFC) can concentrate forces at decisive points to achieve surprise, psychological effects, and physical momentum. (JP 3-0, Chapter 3, 5c)

Maneuver

Maneuver is a means by which component commanders employ their forces in combination with fires to achieve positional advantage in respect to the enemy. At what level of war does this maneuver effort take place? (JP 3-0, 5c (3) (c))

Tactical

Sustainment is the provision of ______________ and _____________ to maintain operations through mission accomplishment and redeployment of the force. (JP 3-0, Chapter 3, 7a)

logistics and personnel services

What type of command is established to conduct broad continuing missions requiring execution by significant forces of two or more Military Departments to achieve national objectives or other criteria? (JP 3-0, Chapter 4, 3b, (1))

Unified command

What type of command is normally composed of forces from one Military Department, but may include units and staff representatives from other Military Departments? (JP 3-0, Chapter 4, 3b (1))

Specified commands

Normally, sustainment does not remain a Service component responsibility. (JP 3-0, Chapter 4, 3c (1))

False

A theater of war normally encompass geographic combatant commander's (GCC's) entire area of responsibility (AOR), but may cross the boundaries of two or more AORs. (JP 3-0, Chapter 4, 5b (2))

False

A theater of operations in an operational area defined by the ___________ for the conduct of support of specific military operations. (JP 3-0, Chapter 4, 5b (3))

Geographic Combatant Commander (GCC)

A ____________ is an area of land, sea, and airspace, defined by a GCC or subordinate unified commander, in which a JFC (normally a CJTF) conducts military operations to accomplish a specific mission. (JP 3-0, Chapter 4, c (1))

Joint Operational Area (JOA)

The general strategic objective of ______________ is to protect or further US interests at home and abroad by enabling support from Partner Nations (PNs), enhancing their capacity or capability for security and stability, and maintaining or establishing operational access. (JP 3-0, Chapter 5, 3b, (1))

military engagement, security cooperation and deterrence

A ____________ is series of tactical actions (battles, engagements, strikes) conducted by combat forces of a single or several Services, coordinated in time and place, to achieve strategic or operational objectives in an operational area. (JP 3-0, Chapter 5, 3b (3))

major operation or campaign

___________ can span from an independent, small-scale, noncombat operation, such as support of civil authorities, up to a supporting component of extended major noncombat and/or combat operations. (JP 3-0, Chapter 5, 3b, (2))

Crisis response and limited contingency operations

What military activities in the joint combat operation model help set conditions for successful theater operations. These activities include long-term persistent and preventative military engagement, security cooperation, and deterrence actions to assure friends, build partner capacity and capability, and promote regional stability? (JP 3-0, Chapter 5, 5b (1) (a))

shaping activities

What military activity in the joint combat operation model involves both defensive and offensive operations at the earliest possible time, forcing the enemy to culminate offensively and setting the conditions for decisive operations? (JP 3-0, Chapter 5, 5b (3))

Seize Initiative

What military activity in the joint combat operation model help reestablish a safe and secure environment an provide essential government services, emergency infrastructure reconstruction, and humanitarian relief? (JP 3-0, Chapter 5, 5b, (5))

Stabilize

Phases must be conducted sequentially, but some activities from a phase may begin in a previous phase and continue into subsequent phases. (JP 3-0, Chapter 5, 6b)

false

______________ is the routine contact and interaction between individuals or elements of the Armed Forces of the United States and those of another nation's armed forces, or foreign and domestic civilian authorities or agencies, to build trust and confidence, share information, coordinate mutual activities, and maintain influence. (JP 3-0, Chapter 6, 1d)

military engagement

____________ prevents adversary action through the presentation of a credible threat of unacceptable counteraction and belief that the cost of the action outweighs the perceived benefits. (JP 3-0, Chapter 6, 1f)

deterrence

JKO OT REQUIRED READING: JP 1, Doctrine for the Armed Forces of the United States

What is the purpose of joint doctrine?

To enhace the operational effectiveness of joint forces by providing fundamental principles that guide the employment of US military forces toward a common objective. (JP 1, Chapter I, Section A, 1.b.)

Joint matters relate to the integrated employment of US military forces in joint operations, including matters relating to all the following EXCEPT:

Does not include matter relating to unified action with multinational partners (JP 1, Chapter I, Section A, 1.c.)

What is defined as socially sanctioned violence to achieve a political purpose?

War is defined as socially sanctioned violence to achieve a political purpose. (JP 1, Chapter I, Section A, 2.c.)

War historically involves nine principles; they include Objective, Offensive, and _________.

Surprise. They also include: Mass; Economy of Force; Maneuver; Unity of Command; Security; and Simplicity. (JP 1, Chapter I, Section A, 2.c.)

There are tow fundamental strategies in the use of military force. What strategy is used to make the enemy helpless to resist by physically destroying his military capabilities?

The strategy of annihilation is used to make the enemy helpless to resist by physically destroying his military capabilities. (JP 1, Chapter I, Section A, 2.g.(1))

What form of warfare is characterized as violent struggle among state and non-state actors for legitimacy and influence over the relevant population?

Irregular warfare. (JP 1, Chapter I, Section A, 4.c.)

What level of warfare links strategy and tactics by establishing operational objectives needed to achieve the military end-states and strategic objectives?

Operational level. (JP 1, Chapter I, Section A, 5.c.)

What is the Nation's first priority?

Secure the homeland. (JP 1, Chapter I, Section B, 8.b.)

What is defined as the principle instrument for engaging with other states and foreign groups to advance US values, interests, and objectives?

Diplomatic. (JP 1, Chapter I, Section B, 9.a.(1))

The US uses the construct of the ______ to provide insight into the various broad usages of military power from a strategic perspective.

Range of Military Operations (ROMO). (JP 1, Chapter I, Section B, 9.e.)

What is the general term used to describe military actions conducted by joint forces and those Service forces in specified command relationships with each other?

Joint operations. (JP 1, Chapter I, Section B, 10.b.)

________ produces multiple options to employ the US military and to integrate US military actions with other instruments of US national power in time, space, and purpose to achieve global strategic end states.

Joint operation planning. (JP 1, Chapter I, Section B, 12.d.)

Who is considered the vital link between those who determine national security policy and strategy and the military forces or subordinate joint force commanders that conduct military operations within their areas of responsibility?

Geographic Combatant Commanders (GCCs). (JP 1, Chapter II, 2.c.(1))

What commander can support of be supported by geographic combatant commanders as directed by higher authority?

Functional Combatant Commander (FCC). (JP 1, Chapter II, 2.d.)

_____ perform a supply or service activity common to more than one Military Department.

Department of Defense Agencies. (JP 1, Chapter II, 2.g.)

What is defined as that action that synchronizes, coordinates, and/or integrates joint, single-service, and multinational operations with the operations of other US Government departments and agencies, nongovernmental organizations, intergovernmental organizations, and the private sector to achieve unity of effort?

Unified Action. (JP 1, Chapter II, 3.a.)

With regards to the Unified Action Plan, who may establish a joint task force?

An existing Joint Task Force commander, A combatant commander or subordinate unified commander, or the SecDef. (JP 1, Chapter II, 6.a.)

Who is tasked with transmitting orders given by the President or Secretary of Defense to commanders of the combatant commands and overseeing said activities?

Chairman of the Joint Chiefs of Staff (CJCS). (JP 1, Chapter II, 7.b.)

Who exercises combatant command (command authority) of assigned forces?

Combatant commander. (JP 1, Chapter II, 7.c.)

Who is responsible for the administration and support of Service forces?

Secretaries of the Military Departments. (JP 1, Chapter II, 8.b.)

What department performs certain military Service-specific functions and unique functions on matters involving non-federalized National Guard forces?

National Guard Bureau. (JP 1, Chapter II, 8.f.)

Who is the principle assistant to the President in all matters relating to the Department of Defense?

Secretary of Defense. (JP 1, Chapter III, Section A, 2.a.)

What department is tasked to maintain and employ Armed Forces to ensure, by timely and effective military action, the security of the US, its territories, and areas vital to its interests?

Department of Defense. (JP 1, Chapter III, Section A, 3.)

Who may not exercise military command over the combatant commanders, Joint Chiefs of Staff, or any of the Armed Forces?

Chairman of the Joint Chiefs of Staff. (JP 1, Chapter III, Section B, 7.c.)

What command is unique among the combatant commands in that it performs certain Service-like functions?

USSOCOM. (JP 1, Chapter III, Section C, 10.b.)

Who is assigned a geographic area of responsibility by the President with the advice of the Secretary of Defense as specified in the Unified Command Plan?

Geographic Combatant Commanders. (JP 1, Chapter III, Section C, 11.a)

Who has trans-regional responsibilities and is normally a supporting combatant commander to the geographic combatant commander's activities in his/her area of responsibility?

Functional Combatant Commander. (JP 1, Chapter III, Section C, 11.b)

What is the role of the global synchronizer?

To align and harmonize plans and recommend sequencing of actions to achieve the strategic end states and objectives of a global campaign plan. (JP 1, Chapter III, Section C, 11.d).

Whose responsibility is to synchronize planning for global missile defense in coordination with other combatant commanders, the Services, and as directed, appropriate US Government departments and agencies?

Commander, US Strategic Command. (JP 1, Chapter III, Section C, 13.b)

Whose responsibility is to synchronize planning for global distribution operations in coordination with other combatant commands, the Services, and as directed, appropriate government departments and agencies?

Commander, US Transportation Command. (JP 1, Chapter III, Section C, 13.c.)

What is the most common method to assign responsibility for continuing operations to a joint force?

By geographic area. (JP 1, Chapter IV, Section A, 1.b.(1))

What type of command is defined as a command with broad continuing missions under a single commander and composed of significant assigned components of two or more Military Departments that is established and so designated by the President through the Secretary of Defense and with the advice and assistance of the Chairman of the Joint Chiefs of Staff?

Unified Combatant Command. (JP 1, Chapter IV, Section A, 2.a.)

What type of command is defined as a command that has broad continuing missions and is established by the President, through the Secretary of Defense, with the advice and assistance of the Chairman of the Joint Chiefs of Staff?

Specified Combatant Command. (JP 1, Chapter IV, Section A, 3.)

What may be established on a geographic area or functional basis when the mission has a specified limited objective and does not required overall centralized control of logistics?

Joint Task Force. (JP 1, Chapter IV, Section A, 5.a.)

A Service Component Command consists of the _______ and the _______ assigned to that combatant commander?

Service Component Commander; Service Forces. (JP 1, Chapter IV, Section B, 8.a.)

What is the term that signifies that all forces operate under a single commander with the requisite authority to direct all forces employed in pursuit of a common purpose?

Unity of Command. (JP 1, Chapter V, Section A, 1.b.)

During multinational operations and interagency coordination, _______ may not be possible, but the requirement for _______ becomes paramount.

Unity of Command; Unity of Effort. (JP 1, Chapter V, Section A, 1,b,)

What is defined as the command authority that may be exercised by commanders at any echelon at or below the level of combatant command and may be delegated within the command?

Operational Control. (JP 1, Chapter V, Section A, 3.)

What type of support is defined as that support that units render each other against an enemy because of their assigned tasks, their position relative to each other and to the enemy, and their inherent capabilities?

Mutual Support. (JP 1, Chapter V, Section A, 5.g.)

What type of support is defined as that action of the supporting force against targets or objectives that are sufficiently near the supported force as to require detailed integration or coordination of the supporting action with the fire, movement, or other actions of the supported force?

Close support. (JP 1, Chapter V, Section A, 5.g.)

Who is responsible for organizing the joint planning and execution community for joint operation planning to carry out support relationships between the combatant commands?

Chairman of the Joint Chiefs of Staff. (JP 1, Chapter V, Section A, 6.b.)

When may a force assigned or attached to a combatant command, or Service retained by a Service Secretary, be transferred from that command to another combatant commander?

Only when directed by the SecDef and approved by the President. (JP 1, Chapter V, Section A, 8.)

What is defined as that authority granted by a commander (any level) to a subordinate to directly consult or coordinate an action with a command or agency within or outside of the granting command?

Direct Liaison Authorized (DIRLAUTH). (JP 1, Chapter V, Section A, 9.c.)

How if unity of effort over complex operations made possible?

Through decentralized execution of centralized, overarching plans or via mission command. (JP 1, Chapter V, Section B, 12.)

Effective command and control of joint operations begins by establishing unity of command through the designation of a joint force commander with authority to accomplish tasks using an uncomplicated chain of command. This is the definition for which command and control tenet?

Clearly Defined Authorities, Roles, and Relationships. (JP 1, Chapter V, Section B, 12.a.)

What are the four principles used to guide the organization of the joint force commander's command and control structure?

Simplicity, span of control, unit integrity, and interoperability. (JP 1, Chapter V, Section B, 13.)

What provides the fundamental principles that guide the employment of US military forces in coordinated action toward a common objective?

Joint Doctrine. (JP 1, Chapter VI, Section B, 4.)

What system is a four-phased methodology that aligns training strategy with assigned missions to produce trained and ready individuals, units, and staff?

Joint Training System. (JP 1, Chapter VI, Section B, 6.a.(4))

What program enhances joint force capabilities by enabling learning and collaboration from joint activities, including engagement, planning, training, exercises, operations, real-world events, and other activities involving the Armed Forces of the United States?

Joint Lessons Learned Program. (JP 1, Chapter VI, Section B, 7.b.)

What provides solutions to compelling, real-world challenges both current and envisioned for which existing doctrinal approaches and joint capabilities are deemd inadequate?

Joint Concepts. (JP 1, Chapter VI, Section B, 8.b.(1))

What is the title of JP 1 Chp 2

DOCTRINE GOVERNING UNIFIED DIRECTION OF ARMED FORCES

What is the title of JP 1?

Doctrine for the Armed Forces of the United States

President responsibilities for national strategic direction? Who is the president? Vice?

Is responsible to the American people for national strategic direction. Donald Trump. Mike Pence.

Sec Def responsibilities for national strategic direction

SecDef is the link between the President and the CCDRs. Provides direction and control of the CCDRs as they conduct military activities and operations. Jim Mattis.

CJCS responsibilities for national strategic direction

Is the principal military advisor to the President, the NSC, and SecDef and functions under the authority, direction, and control of the President and SecDef. GEN Joseph Dunford

CCDRs responsibilities for national strategic direction

CCDRs exercise combatant command (command authority) (COCOM) over assigned forces and are responsible to the President and SecDef for the preparedness of their commands and performance of assigned missions

The Chief, National Guard Bureau (CNGB), responsibilities for the national strategic direction

Principal advisor to SecDef through the CJCS on matters involving non-federalized National Guard forces and through other DOD officials as determined by SecDef.

Who is responsible for directing, coordinating, and supervising all USG elements that don't fall under the command of the CCDR in the HN?

The US chief of mission

Who are GCCs?

GCCs are the vital link between those who determine national security policy and strategy and the military forces or subordinate JFCs that conduct military operations within their AORs. GCCs are responsible for a large geographical area and for effective coordination of operations within that area.

Who are FCCs?

FCCs are responsible for a large functional area requiring single responsibility for effective coordination of the operations therein.

What is unified action?

Unified action synchronizes, coordinates, and/or integrates joint, single-Service, and multinational operations with the operations of other USG departments and agencies, NGOs, IGOs and the private sector to achieve unity of effort.

Unity of command starts with what?

National Strategic Direction.

What is the difference between a role and a function?

Roles are the broad and enduring purposes for which the Services and the CCMDs were established in law.
Functions are the appropriate assigned duties, responsibilities, missions, or tasks of an individual, office, or organization.

What is a coalition?

A coalition is an ad hoc arrangement between two or more nations for common action.

What are the three basic structures for multinational operations?

Integrated, lead nation, or parallel command

Strategic Security Environment and National Security Challenges?

Secure the Homeland
Win the Nations wars
Deter our Adversaries
Security cooperation
Support to Civil Authorities
Adapt to a changing environment

What is the purpose of JP 1?

The purpose of joint doctrine is to enhance the operational effectiveness of joint forces by providing fundamental principles that guide the employment of US military forces toward a common objective.

What joint matters relate to the integrated employment of US military forces?

(1) National military strategy (NMS).
(2) Deliberate and crisis action planning.
(3) Command and control (C2) of joint operations.
(4) Unified action with Department of Defense (DOD) and interagency partners.

The joint force is what type of organization?

It is a values based organization.

What is war?

War is socially sanctioned violence to achieve a political purpose.

Thomas Hobbes states that man's nature leads him to what?

To fight for personal gain, safety, or reputation.

Principles of war?

1. Objective
2. Offensive
3. Mass
4. Economy of Force
5. Maneuver
6. Unity of command
7. Security
8. Surprise
9. Simplicity

Who believed that war is characterized by the shifting interplay of a trinity of forces—emotion (irrational), chance (nonrational), and reason (rational)— connected by principal actors that comprise a social trinity of the people, the military forces, and the government?

Carl Von Clausewitz

What are the two fundamental strategies in war?

Strategy of annihilation and strategy of erosion.

What is the strategy of annihilation?

Making the enemy helpless by destroying their military capabilities.

What is the strategy of erosion?

To convince the enemy that accepting our terms will be less painful than continuing to aggress or resist.

What are the instruments of a national power?

diplomatic, informational, military, and economic

What is warfare?

Warfare is the mechanism, method, or modality of armed conflict against an enemy. It is "the how" of waging war.

What are the two basic forms of warfare?

Traditional and Irregualar

What is traditional warfare?

a violent struggle for domination between nation-states or coalitions and alliances of nation-states.

What is irregular warfare?

A violent struggle among state and non-state actors for legitimacy and influence over the relevant population(s).

What are the levels of warfare?

Strategic operational and tactical

What are the fundamental building blocks of concrete military activity?

Tactics, techniques, and procedures

What is an operation?

An operation is a sequence of tactical actions

What is a campaign?

A campaign is a related major operations aimed at achieving strategic and operational objectives within a given time and space

What is a task?

A clearly defined action or activity assigned to an individual or organization

What is a function?

A function is the broad, general, and enduring role for which an organization is designed, equipped, and trained.

What are the seven basic groups of joint functions?

C2, intelligence, fires, movement and maneuver, protection, sustainment, and information

What is a mission?

Mission entails the task, together with the purpose, that clearly indicates the action to be taken and the reason therefore.

What are the five parts of a mission?

The 5 W's

The US military will undertake what activities to deal with national security challenges?

Secure the Homeland, Win the nations wars, deter our adversaries, security cooperation, support to civil authorities, and adapt to the changing environment.

What are the joint functions?

C2, Intelligence, fires, movement and maneuver, sustainment, protection, and information

What is joint planning?

The way the military links and transforms national strategic objectives into tactical actions.

Planning begins with what?

The end state in mind in which providing a unifying purpose around which actions and resources are focused.

OT REQUIRED READING: Joint Operational Access Concept (JOAC)

Which of the following is a key area-denial capability?

a,b, and c

Which of these is a trend that promises to complicate the challenge of opposed access for U.S. joint forces?

a, c, and d

Which of the following is a key antiaccess capability?

all of the above

which of the following best describes the JOAC solution?

Cross-Domain Synergy

True or False? A2/AD strategies focus on preventing/disrupting the joint force from getting to the fight and disrupting freedom of action within the operational area.

True

The JOAC Operational Access Precepts must be applied:

b,c and d

True or False? Space and cyberspace are now essential to all joint force projection, both for the support they provide to operations in the other domains and as operational domains in their own right when directed.

True

True or False? The JOAC Operational Access Precepts, coupled with the central idea of Cross-Domain Synergy, provide a description of how joint forces will operate to gain access in the face of armed opposition.

True`

Which statement is true regarding the scope of the JOAC?

All of the Above

Which of the following is a factor contributing to the changing U.S. Defense posture?

All of the Above

1. Who approved the JOAC with the following description? "The Joint Operational Access Concept (JOAC) describes in broad terms my vision for how joint forces will operate in response to emerging antiaccess and area-denial security challenges...future enemies, both states and nonstates, see the adoption of antiaccess/area-denial strategies against the United States as a favorable course of action..."

The Secretary of Defense

Which of the following can be used to shape conditions prior to armed conflict? Select all that apply.

All answers are correct

Which of the following is a key area-denial capability?

All of the above

not special

JOAC Problem Statement: The essential problem for future joint forces is to be able to project military force into an operational area and sustain it in the face of armed opposition when which of these trends apply?

all of the above

The JOAC describes principles that when applied in design, planning and execution to a given set of conditions will describe how joint forces would achieve operational access. The term for these principles is:

JOAC Precepts

a) Those actions and capabilities, usually long-range, designed to prevent an opposing force from entering an operational area.
b) The ability to project military force into an operational area with sufficient freedom of action to accomplish the mission.
c) The unhindered national use of the global commons and select sovereign territory, waters, airspace and cyberspace, achieved by projecting all the elements of national power.
d) The complementary vice merely additive employment of capabilities in different domains such that each enhances the effectiveness and compensates for the vulnerabilities of the others-to establish superiority in some combination of domains that will provide the freedom of action required by the mission.
e) Those actions and capabilities, usually of shorter range, designed not to keep an opposing force out, but to limit its freedom of action within the operational area.
f) Areas of air, sea, space, and cyberspace that belong to no one state. Access to the global commons is vital to U.S. national interests, both as an end in itself and as a means to projecting military force into hostile territory.

Operational Access a b c d e f

Assured Access a b c d e f

Antiaccess (A2) a b c d e f
Area-Denial (AD) a b c d e f
Cross-Domain Synergy a b c d e f
Global Commons

The Purpose of JOAC is to describe how a future joint force will overcome opposed access challenges. Which of the following IS NOT a method for JOAC to guide force development?

Providing specific Joint Force Commander guidance regardless of the situation

(wrong) establishing

Future enemies, both states and nonstates, will see the adoption of an antiaccess/area-denial strategy against the United States as a favorable course of action. Which of the following is a common element of A2/AD strategies?

Attacking U.S. forward bases, whether by missiles, special operations units, or irregular forces to include the use of weapons of mass destruction.

Which of the following is a key antiaccess capability?

(wrong) All of the above

Which of the following is an attribute of the JOAC application of Cross-Domain Synergy?

All of the above

Which are identified as contributing to the trend of a changing U.S. overseas defense Posture?

Decreased support

severely contracting

U.S. garrisons on foreign soil

which of the following are true of the space and cyberspace domains?

gaining and maintaining
space and cyberspace operations

JKO Quality Management Two: Patient Safety

What is the most common cause of a sentinel event?

Lack of communication

Which of the following underlying causes of medical errors is described as the lack of effective "hand off" of work (e.g., transfer of medical information about a patient)?

Poor process or system design

What is the most important question you can ask when analyzing a quality or patient safety issue?

Why did the problem occur?

Which of the following is an example of lack of fail-safe methods?

Nurses not individually verifying the "five rights" of administering medications: right drug, dose, route, time and patient

What percentage of medical errors is not reported?

50-90%

patient was admitted for preterm labor, screened by RN #1 and examined by a physician. The physician gave RN #2 a verbal order for 4 gm bolus/2 gm maintenance MgSO4. RN #2 placed a large bag of MgSO4 on the IV pole and programmed the IV pump; she started the MgSO4 bolus and then was called away. Later the IV pump alarm went off and RN #1 started a second bolus. The patient complained of feeling sick but this was not addressed; the FHT alarm also was not addressed, which occurred around the time of change of shift. The physician was concerned about his order being lost during the change of shift, so he repeated the order to oncoming RN #3 but did not tell her that it was a repeat order. RN #3 gave a third bolus. Shortly after, the RNs realized that the patient had received three separate doses of 4 Gm MgSO4. All three nurses and the physician immediately went to check on the patient, and the physician ordered a stop to the MgSO4 and obtained a magnesium level. On receiving a report describing these facts, the Director of Quality Management determined that this was a sentinel event, and an interdisciplinary team was set up to look at this occurrence. In reviewing the facts of the case, what would be the major cause of the medication error?

Poor communication

Which of the following is an example of a solution to address a lack of communication?

Team building

A patient was admitted for preterm labor, screened by RN #1 and examined by a physician. The physician gave RN #2 a verbal order for 4 gm bolus/2 gm maintenance MgSO4. RN #2 placed a large bag of MgSO4 on the IV pole and programmed the IV pump; she started the MgSO4 bolus and then was called away. Later the IV pump alarm went off and RN #1 started a second bolus. The patient complained of feeling sick but this was not addressed; the FHT alarm also was not addressed, which occurred around the time of change of shift. The physician was concerned about his order being lost during the change of shift, so he repeated the order to oncoming RN #3 but did not tell her that it was a repeat order. RN #3 gave a third bolus. Shortly after, the RNs realized that the patient had received three separate doses of 4 Gm MgSO4. All three nurses and the physician immediately went to check on the patient, and the physician ordered a stop to the MgSO4 and obtained a magnesium level. On receiving a report describing these facts, the Director of Quality Management determined that this was a sentinel event, and an interdisciplinary team was set up to look at this occurrence. As a leader, what would you advise the team to do as a first step in conducting their RCA for the medication error?

Map out what happened

A patient was admitted for preterm labor, screened by RN #1 and examined by a physician. The physician gave RN #2 a verbal order for 4 gm bolus/2 gm maintenance MgSO4. RN #2 placed a large bag of MgSO4 on the IV pole and programmed the IV pump; she started the MgSO4 bolus and then was called away. Later the IV pump alarm went off and RN #1 started a second bolus. The patient complained of feeling sick but this was not addressed; the FHT alarm also was not addressed, which occurred around the time of change of shift. The physician was concerned about his order being lost during the change of shift, so he repeated the order to oncoming RN #3 but did not tell her that it was a repeat order. RN #3 gave a third bolus. Shortly after, the RNs realized that the patient had received three separate doses of 4 Gm MgSO4. All three nurses and the physician immediately went to check on the patient, and the physician ordered a stop to the MgSO4 and obtained a magnesium level. On receiving a report describing these facts, the Director of Quality Management determined that this was a sentinel event, and an interdisciplinary team was set up to look at this occurrence. After the RCA has been completed, what would contribute the most to organizational effectiveness?

Documentation and distribution of lessons learned

A patient was admitted for preterm labor, screened by RN #1 and examined by a physician. The physician gave RN #2 a verbal order for 4 gm bolus/2 gm maintenance MgSO4. RN #2 placed a large bag of MgSO4 on the IV pole and programmed the IV pump; she started the MgSO4 bolus and then was called away. Later the IV pump alarm went off and RN #1 started a second bolus. The patient complained of feeling sick but this was not addressed; the FHT alarm also was not addressed, which occurred around the time of change of shift. The physician was concerned about his order being lost during the change of shift, so he repeated the order to oncoming RN #3 but did not tell her that it was a repeat order. RN #3 gave a third bolus. Shortly after, the RNs realized that the patient had received three separate doses of 4 Gm MgSO4. All three nurses and the physician immediately went to check on the patient, and the physician ordered a stop to the MgSO4 and obtained a magnesium level. On receiving a report describing these facts, the Director of Quality Management determined that this was a sentinel event, and an interdisciplinary team was set up to look at this occurrence. In reviewing the facts of this case, what is the major implication for leadership?

Building a team to ensure the coordination of care

A patient is having shoulder arthroscopy under general anesthesia. The patient has been prepped, placed on the operating table, and Valium has already been given to the patient to relax him prior to surgery. Right before general anesthesia is to be administered, what should the operating team consider doing?

Calling a 'time out' to verify the surgical site and that this is the right patient

A patient was admitted for preterm labor, screened by RN #1 and examined by a physician. The physician gave RN #2 a verbal order for 4 gm bolus/2 gm maintenance MgSO4. RN #2 placed a large bag of MgSO4 on the IV pole and programmed the IV pump; she started the MgSO4 bolus and then was called away. Later the IV pump alarm went off and RN #1 started a second bolus. The patient complained of feeling sick but this was not addressed; the FHT alarm also was not addressed, which occurred around the time of change of shift. The physician was concerned about his order being lost during the change of shift, so he repeated the order to oncoming RN #3 but did not tell her that it was a repeat order. RN #3 gave a third bolus. Shortly after, the RNs realized that the patient had received three separate doses of 4 Gm MgSO4. All three nurses and the physician immediately went to check on the patient, and the physician ordered a stop to the MgSO4 and obtained a magnesium level. On receiving a report describing these facts, the Director of Quality Management determined that this was a sentinel event, and an interdisciplinary team was set up to look at this occurrence. What mechanism or approach would you advise the team to take?

Root-cause analysis (RCA)

JKO JFC 100 Module 02: Joint Intelligence

Which of the following are true when forming priority intelligence requirements (PIR)? (Select all that apply)

- The JFC's PIRs should be prioritized to the most urgent intelligent requirements
-Staff must be aware of intelligence requirements of higher, adjacent, subordinate and supporting elements
-PIRs will drive collection and production requirements

During this activity in the joint intelligence process raw data is converted into forms that can be readily used by commanders, decision makers at all levels, intelligence analysts, and other consumers.

Processing and exploitation

Identify the National Intelligence member that has overall responsibility for intelligence support to the President and the day-to-day management of the intelligence community.

Director of National Intelligence

A key function of the J-2 is to integrate outside stakeholders into intelligence planning and operations. The J-2 can support the Joint Force Commander by integrating:

Partner nation intelligence capabilities and assessments

Which one of the following non-DoD intelligence communities supports HUMINT collection, all source analysis, and political, economic, and biographic intelligence?

Central Intelligence Agency (CIA)

Collection activities acquire and extract data from the operational environment such that Processing and Exploitation can convert that data into information to be used during Analysis and Production to refine into __________ to satisfy Requests for Information (RFI) or the commander's Priority Intelligence Requirements (PIR).

intelligence

Technology is often applied against what common analyst challenge?

Information overload

Which of the following are tasks that the J-2 performs? (Select all that apply)

- Produces threat assessments on a continuing basis to help the commander create or exploit opportunities to accomplish friendly force objectives
- Assesses the characteristics of the adversary's decision-making process and identifies weaknesses that may be exploited
- Ensures that critical intelligence is disseminated appropriately in a timely manner to the joint force commanders (JFCs), staff, and components
- Analyzes the adversary and other relevant aspects of the operational environment

Which of the following intelligence communities is responsible for providing timely, relevant, and accurate geospatial intelligence (GEOINT) support to imagery intelligence (IMINT), geospatial information, national imagery collection management, commercial imagery, imagery-derived MASINT, and some meteorological and oceanographic data?

National Geospatial-Intelligence Agency (NGA)

When considering the principle of synchronization, the most common error that impacts the J-2, J-3, and J-5 is the failure to build sufficient lead time for intelligence production.

True

Which of the following levels of intelligence focuses on adversary military capabilities and intentions and helps the JFCs and component commanders keep abreast of events within their area of interest?

Operational Intelligence

As it relates to management of priority intelligence requirements (PIRs), what is the responsibility of the J-2 once the commander has approved the PIRs?

Continuously review the PIRs with respect to the adversary and the changing situation to determine whether they remain relevant to the commander's intent

This intelligence product category involves the integration of time-sensitive, all-source intelligence and information into concise, objective reporting on the current situation in a particular area.

Current Intelligence

Which one of the following intelligence principles is described as the process of collecting and examining information from all available sources and intelligence disciplines to derive as complete an assessment as possible?

Fusion

Automation technology can be used to reduce the burden of sorting through large amounts of __________ to enable an analyst to correlate various sets of __________ to make an assessment.

data, information

The joint intelligence preparation of the operational environment (JIPOE) consists of four steps. Match each of the steps of the JIPOE to its correct process.

Step 1 -- Analyze the adversary and other relevant aspects of the operational environment (OE)
Step 4 -- Determine/describe potential adversary COAs and civilian activities that might impact military ops
Step 2 -- Describe the impact of the OE on the adversary and friendly courses of action (COAs)
Step 3 -- Evaluate the capabilities of adversary forces operating in the operational environment

What level of intelligence is produced for the President, Congress, Secretary of Defense, senior military leaders and Combatant Commanders?

National strategic

This intelligence product category results from the fusion of identity attributes and other information and intelligence associated with those attributes collected across all intelligence disciplines.

Identity Intelligence

Joint intelligence planning supports joint operation planning and may result in the production of what products? (Select all that apply)

- Dynamic Threat Assessment
- National Intelligence Support Plan
- Annex B: Intelligence

The JTF J-2 should have personnel knowledgeable in foreign disclosure policy and procedures and should obtain necessary foreign disclosure authorization from DIA as soon as possible.

True

Intelligence analysts must communicate a degree of analytical confidence to help intelligence consumers decide how much weight to place on an intelligence assessment when making a decision.

True

The __________ validates or produces a baseline Dynamic Threat Assessment for each Joint Strategic Capabilities Plan (JSCP) directed plan.

Defense Intelligence Agency

The Commander's Critical Information Requirements represent both Friendly Force Information requirements and ______ which are derived from the intelligence organization and vetted across staff.

priority intelligence requirements (PIR)

What level of intelligence is produced for the President, Congress, Secretary of Defense, senior military leaders and Combatant Commanders?

National strategic

Who is/are responsible for providing maps, charts, digitized products, and precise geodetic coordinates?

The Geospatial Information and Services Officer

Match each intelligence product category to its brief description.

General Military Intelligence: H
Target Intelligence: F
Estimative Intelligence: E
Counterintelligence: D
Current Intelligence: A
Scientific and Technology Intelligence: B
Warning Intelligence: G
Identity Intelligence: C

JKO North Atlantic Treaty Organization (NATO) Introduction for U.S. European Command (USEUCOM)

Transatlantic Link

The nickname that was given to NATO because it included countries on both sides of the Atlantic working together for a common goal: Peace

Warsaw Pact

Alliance of communist nations in response to the information of NATO

Cold War

Major event that was occurring when NATO was formed

Partnership for Peace

1994
A North Atlantic Treaty Organization program aimed at creating trust between NATO and other states in Europe and the former Soviet Union

The North Atlantic Treaty

Was signed in April 4, 1949 in Washington, D.C. and the North Atlantic Treaty Organization was created.

NATO members stated that an attack on one NATO member is an attack on all

Collective Defense - Article 5

Brussels, Begium

Location of NATO headquarters

12 Founding Nations of NATO - 1949

BELGIUM
CANADA
DENMARK
FRANCE
ICELAND
ITALY
LUXEMBOURG
NETHERLANDS
NORWAY
PORTUGAL
THE UNITED KINGDOM
THE UNITED STATES

Initial NATO expansion - the 1950's

GREECE (1952)
TURKEY (1952)
GERMANY (1955)

NATO expansion in the 1980's and 90's

SPAIN (1982)
CZECH REPUBLIC (1999)
HUNGARY (1999)
POLAND (1999)

NATO additions in the 21st Century (with some former Communist countries joining)

BULGARIA (2004)
ESTONIA (2004)
LATVIA (2004)
LITHUANIA (2004)
ROMANIA (2004)
SLOVAKIA (2004)
SLOVENIA (2004)
ALBANIA (2009)
CROATIA (2009)
MONTENEGRO (2017)

Which nation funds the majority of NATO?

The United States

JKO Advanced Trauma Life Support Instructor Course

what do ABCDE stand for

A - airway and cervical spine protection

B- breathing

C - circulation and haemorrhage control

D - disability

E- exposure and environmental control

what are some signs of tension pneumothorax

engorged neck veins
decreased lung expansion
tracheal deviation
hyperresonance
decreased breath sounds on affected sign

how do you treat tension pneumothorax

needle decompression in the 2nd intercostal space (midclavicular line)

how does an open pneumothorax present

sucking chest wound

how do you manage an open pneumothorax

three sided dressing

definitive chest drain

what are two haemorrhagic conditions you should look out for

pelvis fracture

massive haemothorax

how do you manage a massive haemothorax

needs chest drain
may require surgery

what is a massive haemothorax

>1500mls blood in pleural cavity

large volue loss
respiratory compromise

what is the triad seen in cardiac tamponade

hypotension
decreased heart sounds
elevated JVP

what percentage blood loss is seen in type i haemorrhagic shock

<15

what percentage blood loss is seen in type ii haemorrhagic shock

15-30

what percentage blood loss is seen in type iii haemorrhagic shock

30-40

what percentage blood loss is seen in type iv haemorrhagic shock

>40

how much blood loss is seen in type i haemorrhagic shock

<750mls

how much blood loss is seen in type ii haemorrhagic shock

750-1500

how much blood loss is seen in type iii haemorrhagic shock

1500-2000

how much blood loss is seen in type iv haemorrhagic shock

>2000

what are the marks for eye opening in the GCS

1) no eye opening
2) to stimulus
3) to voice
4) spontaneous

what are the marks for verbal in GCS

1) no sounds
2) sounds
3) incoherent sounds
4) confused
5) orientated

what are the marks for motor in GCS

1) no movements
2) extension to stimuli
3) abnormal flexion to stimuli
4) withdrawal to stimuli
5) localised
6) obeys command

what is the AVPU scale

alert
verbal
pain
unresponsive

Patients with GSC of less than _____ usually require intubation

8

The "A" in ABCD stands for ______.

Airway maintenance with Cervical SPINE protection

You should assume that any patient in a multisystem trauma with an altered level of consciousness or blunt injury above the clavice has what type of injury

Cervical Spine Injury

Flail chest is invariably accompanied by _______ which can interfere with blood oxygenation

pulmonary contusion - do NOT over fluid resuscitate these patients.

Hypotension is caused by ______ until proven otherwise.

hypovolemia

When you dont have a BP what are three things to look for when evaluating perfusion?

1. level of consciousness (brain perfusion
2. Skin color (ashen face/grey extremities)
3. Pulse (bilateral femoral - thready/tachy)

Elderly patients have a limited ability to ___________ to compensate for blood loss

increase heart rate

Resuscitation fluids should be warmed to 39 Celsius

Only for Cyrstalloids, NOT for blood

Urinary catheters are good for assessing renal perfusion and volume status. List 5 signs of urethral injury that might precent you from inserting one

Blood at urethral meatus, perineal ecchymosis, blood in scrotum, high-riding/non-palpable prostate, pelvic fracture

Which arm should you NOT put a pulse-ox on?

The arm with the BP cuff

2 anatomical things that can interfere

Obesity and intraluminal bowel gas

When should radiographs be obtained?

During the Secondary survey!

How do get an ample patient history?

Allergies
Medications
PMH/Pregnancy
Last meal
Events/Environment

Why might you want a Bair Hugger for a patient who smells of Alcohol?

Vasodilation can lead to hypothermia

What things are you looking for when you do a DRE in trauma

Blood, high riding prostate, sphincter tone,

What should be done for every female patient

Pregnancy test

Adult patients should maintain UOP of at least _____mL/kg/hr. Kids should have at least ______ mL/kg/hr

Adults 0.5 mL/kg.hr
Kids 1.0 mL/kg/hr

Preventing hypercarbia (hypercapnia) is critical in patients who have sustained a _______ injury

head

What two places would you LOOK at a patient if you suspect hypoxemia?

Lips and fingernail beds

Patients may be abusive and belligerent because of ______-, so don't just assume its due to drugs, alcohol, or the fact they they are just inherently a jerk

hypoxia

Can a patient breath on their own after complete cervical cord transection

Yes if the phrenic nerves (C3-C5 are spared. This will result in 'abdominal' breathing. The intercostal muscles will be paralyzed though

Can you use an OPA (Guedel) in a conscious patient

No, it could make them vomit. An NPA (trumpet) would be okay.

Bougies are typically inserted blindly, how do you know you are in the trachea and not the esophagus?

You can feel the clicks as the distal tip rubs against the cartilaginous tracheal rings, or it will deviate right or left when entering either bronchus (at 50 cm)

What do yo NOT want to hear if you auscultate a patient after placement of an ET tube?

Borborygmi - rumbling or gurgling noices suggest esophageal insertion.

What is the RSI dose for etomidate

0.3 mg/kg (usually 20 mg)

What is the RSI dose for succinylcholine

1-2 mg/kg (usually 100 mg)

How does etomidate affect blood pressure

it doesnt -it shouldnt have any effect on BP. Ketamine will increase BP, and propofol and thiopental will both drop BP.

A RSI dose of succinylcholine usually lasts about ___ minutes

5

What hypnotic/sedative/induction agent do you NOT want to use for a severely burned patient?

Sux - patients with severe burns, crush injuries, hyperkalemia, or chronic paralytic/neuromuscular disease should NOT get Sux because of hyperkalemia risk

O2 should flow at 15L for needle cricothyroidotomy, and have a Y connector for insufflation if possible. What size needle do you use for adults? Kids?

Adults: 12-14 gauge
kids: 16-18 gauge

Cricoid cartilage is the only circumferential support for the upper trachea in kids, therefore surgical cricothyroidotomy is not recommeded for kids under the age of ________.

12

In a 'normal' patient without significant chest wall injury or lung disease, needle cricothyroidotomy can provide adequate oxygenation for approximately ______ minutes

30-45

For a patient with difficulty breathing, what things might you try before you provide a surgical aurway

Chin Lift, jaw-thrust (NOT head-tilt while maintaining c-spine precautions), OPA (guedel), NPA (trumpet), LMA, Combitube, ET tube +- bougie

How do you know if an OPA/Guedel is the correct size for the patient?

A correctly sized OPA will extend from the corner of the patients mouth to the external auditory canal.

What should you do with the balloon on an ET tube/LMA/foley before you insert it?

Inflate it to make sure it doesnt leak- then deflate and insert

What size LMA do you use for Kid, woman/small man, large woman/man

Kid: 3
Woman/Small Man: 4
Large woman/Man 5
C3,4,5 keep them all alive

The proper size ET tube for an infant is

The same size as the infants nostril or little finger (3 for neonates, 3.5 for infants

What size cuffed endotracheal tube do you use for an emergency cricothyroidotomy?

5 or 6

Use a size 3 ET tube for neonates
3.5 for infants for 0-6 months
4 fo infants 6-12 months
How do you calculate what size ET tube to use or toddlers and kids?

Age/4 +4mm = internal diameter

Shock is defined as an abnormality of the circulatory system that results in inadequate organ perfusion and tissue oxygenation. what are the 4 different types

Neurogenic, cardiogenic, hypovolemic, septic

The most common cause of shock in the injured trauma patient is _________.

hemorrhage

Approximately ___% of the body's total blood volume is located in the venous circuit/

70

Why does shock actually reduce the total volume of circulating blood?

Anaerobic metabolism --> cant make more ATP --> endoplasmic then mitochondrial damage --> lysosomes rupture --> sodium and water enter the cell, which SWELLS and dies

Which vasopressors should you use to treat hemorrhagic shock? What are the drug doses

Never use pressors hypovolemic shock - use VOLUME replacement. Pressors will worsen tissue perfusion in hemorrhagic shock

Compensatory mechanisms may preclude a measurable fall in systolic blood pressure until up to ____% of the patient's blood volume is lost.

30

Any patient who is cool and is tachycardic is considered to be _______until proven otherwise.

in shock

The definition of tachycardia depends on patients age. What heart rate is considered tachycardic for infants, toddlers/PS, schoolage/prepubescent, and adults

Infants >160
toddlers/PS > 140
schoolage/prepubescent >120
Adults > 100

Elderly patients may not exhibit tachycardia in response to hypovolemia because of limited cardiac response to catecholamines. Why else might they not get tachy?

On a Beta-Blocker or have a pacemaker

A FAST scan in an excellent way to diagnose cardiac tamponade. What signs sugget tamponade

Beck's Triad: JVD, muffled heard sounds and hypotension (will be resistant to fluid therapy). Will also likely be tachycardic

Patients with a tension pneumo and patient with cardiac tamponade may present with many of the same signs. What findings will you see with a tension will you NOT see with tamponade?

Absent breath sounds and hyperresonance to percussion over the affected hemithorax.

Immediate thoracic decompresion is warrented for anyone with absent breath sounds, hyperressonance to percussion, tracheal deviation, _________ and _________

Acute respiratory distress & subcutaneous emphysema

Can isolated intracranial injuries cause neurogenic shock?

NO

How do you calculate total blood volume in an adult?

70 mL per kg. A 70 kg person has about 5 L of circulating blood. (70*70) = 4900 mL

How do you calculate TBV in child

BW (kg) X 80-90 mL

The blood volume of an obese person is calculated based upon their _________ weight

ideal

Fluid replacement should be guided by __________, not simply by the initial classification (Class I-IV)

The patient's response to initial replacement

How much blood volume is lost with Class I hemorrhage?

Up to 15% Donating 1 pint, or ~500 mL of blood is about 10% volume lose and would classify as Class I Hemorrhage.
Transcapillary refill and other compensatory mechanisms restore blood volume within 24 hours

How much blood volume is lost with Class II hemorrhage>

15-30% (750-1500 mL in a 70 kg adult)

How do you treat a Class II hemorrhage

Usually just crystalloid resuscitation

Subtle CNS changes such as anxiety, fright, and hostility would be expected in patient with a Class ____ hemorrhage

II

How much blood volume is lost with Class III hemorrhage?

30-40% (2000 mL in a 70 kg adult)

A patient with inadequate perfusion, marked tachycardia and tachypnea, significant mental status change, and a measurable fall in systolic blood pressure likely has a Class _____ Hemorrhage

III or IV - these patients requre a blood transfusion, which depends on their response to initial fluid resuscitation. The first priority is stopping the hemorrhage.

Loss of more than 50% of blood volume results in loss of consciousness.

50

How much blood volume is lost with Class IV hemorrhage?

More than 40%. Unless very aggressive measures are taken the patients will die within minutes

A Class _____ Hemorrhage represents the smallest volume of blood lost that is consistently associated with a drop in systolic blood pressure

III

Up to __________ mL of blood loss is commonly associated with femur fractures

1500

Unexplained hypotension or cardiac dsyrhythmias (usually bradycardia from excessive vagal stimulation) are often caused by ______ especially in children

gastric distention

How much crystalloid should you give an adult for an initial fluid resuscitation bolus? for kids

Adults: 2 L
Kids: 20 mL/kg (may repeat and give as much as 60 mL/Kg but wit high reserve in kids, if they're in shock they should get blood sooner rather than later

Each mL of blood loss would be replaced with ____ mL of crystalloid, thus allowing for replacement of plasma volume lot into interstitial and intracellular saces

3

Blood on the floor x four more is mneumonic for occult blood loss where?

Chest, pelvis, retroperitoneum, and thigh

For children UNDER 1 year of age, UOP should be ______ mL/Kg/Hr

2

Would patients in EARLY hypovolemic shock be acidodic or alkalotic?

Alkalotic - respiratory alkalosis from tachypnea .... followed later by mild metabolic acidosis in the early phase of shock

"Rapid Responders" whose vital signs return to normal (and stay there) after fluid

I or II

"Transient responders" are associated with Class ______ hemorrhage

II or III

What differential diagnosis shoudl you always consider for "non-responders" following fluid resuscitation?

Non-hemorrhagic causes e.g. tension pneumothorax, tamponade, blunt cardiac injury, MI, acute gastric distention, neurogenic shock

Most Patients receiving blood transfusions ___________ need calcium replacement

dont

How should you position the patient before placing a subclavian or IJ line?

Supine, head down 15 degrees to distend neck neck veins and prevent embolism, only turn head away is C-spine has been cleared first.

How long can you keep and IO line in

Intraosseous infusions should be limited to emergency resuscitation and should be discontinued as soon as other venous access is obtained

Where do you want to make an incision for a saphenous vein cutdown and how long should your incisions be?

1 cm superior, 1 cm anterior to medial malleolus. 2.5 cm transverse incusion through the skin and SQ, careful to not to inure the vessel.

A patient arrives to the trauma bay intubated and there are absent breath sounds over the left hemithorax, where should you place your decompression needle?

This may NOT be a pneumothorax, for intubated patients always suspect a right main-stem before attempting needle decompression.

Where would you insert a large caliber needle to decompress a tension pneumo

2nd IC space in the midclavicular line of affected hemithorax

For an open pneumothorax, (sucking chest wound) air passes preferentially through the chest wall defect (least resistance) if the diameter of the defect is at least ___ the diameter of the trachea.

2/3

Flail chest results from multiple rib fractures - by definition this would be ___ or more ribs, fractured in ___ or more places.

2 or more ribs fractured in 2 or more places

Both tension pneumothorax and massive hemothorax are associated with decreased breath sounds on auscultation, so you can tell which it is by _______.

Percussion - hyperresonant with pnuemo, dull with hemothorax.

If a patient doesn't have JVD, does this mean they don't have a tension pneumo or tamponade?

No, they might have a massive internal hemorrhage and be hypovolemic.

By definition, how much blood is in the chest cavity to call it a "massive hemothorax"?

1500 mL or 1/3 or more of the patient's total blood volume. (Some also define it as continued blood loss of 200 mL/hr for 2-4 hours- but ATLS does NOT use this rate for any mandatory treatment decisions).

What size chest tube might you use to evacuate a massive hemothorax?

#38 French - inserted at the 4th or 5th intercostal space, just anterior to the midaxillary line.

What is Kussmaul's sign?

A rise in venous pressure with inspiration while breathing spontaneously, and is a true paradoxical venous pressure abnormality associated with cardiac tamponade.

How well do CPR compressions work on someone with a penetrating chest injury and hypovolemia?

"Closed heart massage for cardiac arrest or PEA is INEFFECTIVE in patients with hypovolemia." Patients with PENETRATING thoracic injuries who arrive pulseless, but with myocardial electrial activity, may be candidates for an ED thoacotomy.

Are patients with PEA who have sustained blunt thoracic injuries candidates for an ED thoracotomy?

NO - Only PEA with PENETRATING thoracic injuries should get an ED thoracotomy.

An ED thoracotomy can allow you to do what?

Evacuate pericardial blood, directly control hemorrhage, cardiac massage, cross-clamp the descending aorta to slow blood loss below the diaphragm and increase perfusion to the heart and brain.

For a patient with a traumatic simple pneumothorax, what should you do BEFORE you start positive pressure ventilation or take them to surgery for a GA?

Chest tube - positive pressure ventilation can turn a sumple pneumo into a tension pneumo, so put in a chest tube first.

Should you evacuate a simple hemothorax if it is not causing any respiratory problems?

YES - A simple hemothorax, if not fully evacuated, may result in a retained, clotted hemothroax with lung entrapment or, if infected, develop into an empyema.

A pneumothorax associated with a persistent large air leak after tube thoracostomy suggests a _______ injury.

tracheobronchial - Use bronchoscopy to confirm, you may need more than one chest tube before definitive operative management.

What radiographic findings are suggestive of traumatic aortic disruption?

Widened mediastinum, obliteration of aortic knob, deviation of trachea to the right, depression of left mainstem bronchus, deviation of esophagus (NG tube) to right, widened paratracheal stripe, fx'd 1st/2nd ribs or scapula.

A deceleration injury victim with a left pnuemothorax or hemothorax without rib fractures, is in pain or shock out of proportion to the apparent injury, and has particulate matter in their chest tube may have _________.

an ESOPHAGEAL RUPTURE - a forceful blow causes expulsion of gastric contents into the esophagus, producing a linear tear in the lower esophagus allowing leakage into the mediastinum.

Fractures for the lower ribs (10-12) should increase suspicion for _____ injury.

hepatosplenic

Why are upper torso, facial, and arm plethora with petechiae associated with crush injuries to the chest?

Temporary compression of the superior vena cava.

How does ATLS suggest you should review a chest radiograph?

Trachea & bronchi, pleural spaces and parenchyma, mediastinum, diaphragm, bones, soft tissues, tubes & lines.

You should use a size 16 or 18 gauge 6" needle for pericardiocentesis. How do you insert it?

Puncture the skin 1-2 cm inferior to the left xiphohondral junction at a 45 degree angle to the skin towards the heart, aiming toward the top of the left scapula.

What's a good way to know if you've advanced your needle too far during pericardiocentesis and have entered ventricular muscle?

ECG Changes - extreme ST-changes, widened QRS, PVCs, etc... Withdrawl needle until ECG returns to baseline.

What should you do with your needle after you successfully evacuate blood during pericardiocentesis?

Lock the stopcock and leave the catheter in place in case it needs to be reevacuated. If possible, use the Seldinger technique to pass a 14 gauge flexible catheter over the guidewire. This is NOT a definitive treatment.

For patients with facial fractures or basillar skull fractures, gastric tubes should be inserted ____ before doing a DPL.

through the mouth

You need to do retrograde urethrography PRIOR to foley placement if _____.

inability to void, unstable pelvic fracture, blood at urethral meatus, scrotal hematoma, perineal ecchymoses, or high-riding prostate.

DPL is considered to be __% sensitive for detecting intraperitoneal bleeding.

98

What are the four places you should look first when doing a FAST scan?

Mediastinum, hepatorenal fossa, splenorenal fossa, pouch of Douglas.

DPL is indicated when a patient with multiple blunt injuries is hemodynamically unstable, especially when they have _____.

Change in sensorium (brain injury/EtOH or drug intoxication), change in sensation (spinal cord injury), injury to adjacent structures (pelvis, lumbar spine), lap-belt sign (from seatbelt), or if patient is going for long studies (CT, ortho surgery...).

What is the only ABSOLUTE contraindication to DPL?

An existing indication for laparotomy.

What are some RELATIVE contraindications to DPL?

Morbid obesity, advanced cirrhosis, preexisting coagulopathy, and previous abdominal operations (adhesions).

When should you use an open SUPRAUMBILICAL approach for a DPL?

PELVIC FRACTURES (don't want to enter pelvic hematoma) and ADVANCED PREGNANCY (don't want to damage enlarged uterus).

When doing a DPL, what INITIAL findings (not from lab) would mandate a laparotomy?

Free blood (>10 mL) or GI contents (vegetable fiber, bile).

If you don't get gross blood upon initial DPL aspiration, what do you do next for an adult? For a child?

Adult - 1,000 mL warm isotonic crystalloid. Kid - 10 mL/kg

You've just put a bunch of fluid in the belly and aspirated more fluid for your DPL. No gross GI contents or anything alarming are present, what QUANTATIVE things would make the DPL positive?

>100,000 red cells/mm^3, 500 white cells/mm^3, or BACTERIA (on gram stain).

Your trauma patient needs an urgent laparotomy, can you take them to the CT scanner first to evaluate injuries?

No, if they need an emergent laparotomy they are unstable - unstable patients should NOT go to the CT scanner!

What are some indications for laparotomy in patients with penetrating abdominal wounds?

Unstable, GSW, peritoneal irritation, fascial penetration

What percentage of stab wounds to the anterior abdomen do NOT penetrate the peritoneum?

25-33%

Does an early normal serum amylase level exclude major pancreatic trauma?

NO

Do you need to operate on anyone with an isolated solid organ injury?

No - not if they remain hemodynamically stable (Of all patients who are initially thought to havea ISOLATED solid organ injury, <5% will have hollow viscus injury as well).

Which is LESS likely to have a life-threating hemorrhage - an open book or closed book pelvic fracture?

Closed book - the pelvic volume is compressed, so not as much room for blood.

Anterior/posterior forces causes _____ book pelvic fractures, and lateral forces cause _____ book fractures.

AP = Open Book, LATERAL = Closed Book

Which are more common, open or closed book pelvic fracturs?

CLOSED BOOK - 60-70% (Open book 15-20%, vertical shear 5-15%)

If a patient with a pelvic fracture is positive for intraperitoneal gross blood, a ex-lap is warranted. What is your next move if that same patient is NEGATIVE for gross intraperitoneal blood?

Angiography

What do you need to do BEFORE you do a DPL? (Other than getting stuff together and surgically prepping, etc...)

DECOMPRESS BLADDER, DECOMPRESS STOMACH

What is "adequate" fluid return when getting DPL fluid back?

30%

A blown pupil in a patient with a traumatic injury is caused by compression of which nerve?

Superficial parasympathetic fibers of the CN III (occulomotor).

What is a "normal" ICP in the resting state?

10mm Hg (Pressures >20, particularly if sustained, are associated with poor outcomes).

The Monro-Kellie Doctrine describes compensatory mechanisms inside the calvarium to stabilize pressure - what are the 2 main/first ones?

Venous Blood & CSF (decreased in equal volumes, when this is exhausted, herniation can occur and brain perfusion will likely be inadequate).

Patients with a GCS of 3-8 meet the accepted definition of "coma" or "severe brain injury." What are the GCS scores for "minor" and "moderate" brain injury?

Minor = 13-15, Moderate = 8-12

When calculating GCS and there is right/left assymetry in the motor response - which one do you use?

The "BEST" response. (Better predictor than worst response)

What signs might you see if a patient has a basillar skull fracture?

PERIORBITAL ECCHYMOSIS (raccoon eyes), RETROAURICULAR ECCHYMOSIS (Battle sign), and otorrhea/rhinorrhea.

What do you need to know about the GCS

What things might require a person with MINOR brain injury get admitted?

Abnormal CT (or no scan available), penetrating head injury, prolonged LOC, worsening LOC, moderate to severe HA, significant drug/alcohol intoxication, skull fx, oto/rhinorrhea, nobody at home to watch, GCS stays <15, focal neuro deficits.

What would you want to do if a patient with a minor brain injury fails to reach a GCS of 15 within 2 hour post injury, had LOC >5 min, are older than 65, emesis x 2, or had retrograde amnesia >30 minutes

CT scan - Everything but the 30 min amnesia makes them HIGH risk for neurosurgical intervention (as would a basillar skull fx).

What 2 things do you need to do first for everyone with a MODERATE brain injury (according to ATLS algorithm)?

CT scan, admit to faciolity capable of definitive neurosurgical care (Moderate = GCS 9-12)

High levels of CO2 will cause cerebral vasculature to _____.

Dilate (to increase blood flow) - so you might want to HYPERventilate people with brain injuries.

Ideally, you want to wait to perform a GCS on a person with SEVERE brain injury until what?

BP is normalized

A FAST scan, DPL, or ex-lap should take priority over a CT scan if you can't get the brain injured patient's BP up to ____ mm Hg.

100 If a patient has a systolic over 100 with evidence of intracranial mass (blown pupil, unequal motor exam) THEN a CT would take first priority.

A midline shift of greater than ___ often indicates the need for neurosurgical evacuation of the mass/blood.

5mm

Your patient has a dilated pupil and you want to give mannitol on the way to the CT scanner or OR. What is the correct dose?

0.25-1.0 g/kg via rapid bolus

A cast cutter should be removed to remove a trauma victim's helmet if there is evidence of a c-spine injury or if _____.

the patient experiences pain or paresthesias during an initial attempt to remove the helmet.

What are the signs of neurogenic shock?

Vasodilation of lower extremity blood vessels - resulting in pooling of blood and hypotension. This loss of sympathetic tone may cause bradycardia or inhibit the tachycardic response to hypovolemia.

How do you treat neurogenic shock?

Judicious use of pressors and MODERATE fluid resuscitation. Too much fluid may result in overload and pulmonary edema.

What's the difference between types I, II, and III odontoid process fractures?

I=tip of odontoid, II=fx at base, III=base of odontoid and extends obliquely into body of axis. (Odontoid process = dens).

What are the indications for c-spine radiographs in a trauma patient? Which x-ray views should be obtained?

Midline neck pain, tenderness on palpation, neurological deficits related to c-spine injuries, altered LOC or intoxication. 1) Lateral, 2) AP, 3) Open mouth odontoid view

With the proper views of the c-spine, and a qualified radiologist - what is the sensitivity for finding unstable cervical spine injuries?

>97% (CT with 3mm slices >99%).

Ten percent of all patients with a c-spine fracture have what?

A second, noncontiguous vertebral column fracture. (So scan the rest of their spine).

Attempts to align the spine for the purpose of immobilization on the backboard are not recommended if they _______.

cause pain

Can you clear a c-spine without films?

Yes, if they are awake, alert, sober, neurological normal, have NO pain, and can flex, extend, and move their head to both sides without pain - you don't need films.

Should a quadriplegic or paraplegic patient be put on a hard board?

Not for more than 2 hours - get them off ASAP.

What's a big difference in a physical finding between hypovolemic and neurogenic shock?

Hypovolemic = usually TACHY, Neurogenic = usually BRADY

Partial or total loss of respiratory function may be seen in a patient with a cervical spine injury above ___.

C6

Why might someone not be able to breathe if they have a long bone fracture

Fat embolism - uncommon though

Abnormal arterial blood flow is indicated by an ABI of ____.

<0.9

By LOOKING at the patient, what findings might suggest pelvic injury?

Leg-length discrepancy, rotation (usually external)

Crush injuries may result in rhabdomyolysis - casts block flow, also iron is released which forms ROS which then damage cells and impair ability to regulate K+ etc... What can you do to prevent this?

Volume expansion, and alkalization of urine with bicarb will reduce intratubular precipitation of myoglobin. UOP should be 100 mL/hr until myoglobinuria is cleared.

Muscle does not tolerate lack of arterial flow (tourniquet) for more than ___ hours before necrosis begins.

6

What things increase the risk for tetanus?

Wounds >6 hours old, wounds contused or abraded, >1 cm deep, from high velocity missiles, due to burns or cold, and significantly contaminated wounds.

Should legs be completely straight when splinting?

No, flexion of 10 degrees recommended to take pressure off neurovascular structures.

Any patient with burns covering more than ___% of BSA require fluid resuscitation.

20

The palmer surface of a patient's hand represents approximately ___% of their BSA.

1%

A high index of suspicion for inhalation injury must be maintained, because patients may not display clinical evidence for up to ___ hours, by this time edema may prevent non-surgical intubation.

24

Carbon monoxide has ____ times the affinity for oxygen as hemoglobin.

240

Patients with CO levels less than ___% usually don't have any physical symptoms

20%

Adult head BSA = ___%.

9 (ENTIRE head front and back = 9)

Baby head BSA = __%

18 (9 front, 9 back)

What is the main difference between adult and baby BSA determination for burns?

Entire head on baby is 18, whereas it's 9 for adults. This difference of 9 is made up by the fact that each side (front/back) on adult = 9, but only 7 for kids. (36 vs 28).

Chest BSA = ___%.

18

Back BSA = ____%

18

Arm BSA = ___%.

9 TOTAL (front AND back).

Leg BSA for adult = ___%.

18 TOTAL (9 front, 9 back).

Baby front or back of leg BSA =___%.

7 (TOTAL leg = 14%)

If you add up BSA head, chest, back, arms, and legs you get 99% of BSA. What is the remaining 1%?

Perineum

Partial/2nd degree burns extend into the _____ whereas full thickness/3rd degree burns

Partial - go into dermis, FULL go all the way through dermis and into/beyond SQ tissue

For patients with CO poisoning, the ½ life is ___ when breathing room air and ___ breathing 100% oxygen

4 hours on RA, 40 min on 100% O2

How do you calculate the Parkland formula? (BURNS)

4 * weight (kg) * percent BSA burned = volume in 24 hours (1st half in 8 hrs, 2nd half over 16 hrs).4*70kg*25 percent = 7 liters in 24 hours. ***Use 25, NOT 0.25)***

Partial or full thickness burns of ___% in patients less than 10 or older than 50 warrants transfer to a burn center.

10%

What percent partial/full thickness burns would qualify a 25 year old for a burn center transfer?

20%

What anatomical positions with partial/full thickness burns warrant burn center transfer?

Face, eyes, ears, hands, genitalia, perineum, feet, skin overlying joints.

Does an inhalation injury warrant transfer to a burn center?

Yes

Should you treat frostbite by soaking body part in water or not?

YES, 40 degree (104F) for 20-30 min should suffice. Don't warm if there is risk of REFREEZING.

Insofar as hypothermia is concerned, patients are not pronounced dead until they are _____ and dead.

warm

What are you thinking if a child has broken ribs?

MASSIVE force and highly likely organ damage (since their ribs are very pliable, a huge amount of force is required to break them, there is often underlying organ damage WITHOUT broken ribs).

How should you insert a Guedel in a kid?

Use tongue blade depressor and insert gently without turning - otherwise there is great risk for trauma and resultant hemorrhage. NOT the 180 degree spin trick.

The normal systolic BP in kids can be estimated by what?

90 mm Hg + (age x 2)

How do you estimate a child's total circulating volume?

80 mL/kg

When shock in a child is suspected, how much fluid do you give them?

20 mL/kg warm crystalloid May need to repeat up to 3 times (60 mL/kg) then consider blood products.

Optimal UOP for infants is ___ mL/kg/hr.

2 (1.5 for younger kids, and 1.0 for older kids)

How much warmed crystalloid should be used for a DPL in kids?

10 mL/kg (up to 1000 mL)

What would you see in an infant that would make you suspect very severe brain injury despite normal LOC?

Bulging fontanelles - these allow tolerance for expanding masses/swelling...

What is a possible mistake about a blood pressure of 120/80 in a 87 year old man?

Assuming that normal blood pressure = normovolemia. Many geriatric patients have uncontrolled hypertension, and if their normal systolic is 180, then 120/80 is relative HYPOtension for them.

How well do geriatric patients do with non-operative management of abdominal injuries compared to younger people?

Not as well - the risks of non-operative management are often worse than the risks of surgery.

Why would geriatric patients be MORE susceptible to head bleeds when there is increased space around a shrinking brain to protect them from contusion?

Atrophic brains = stretching of the parasagittal bridging veins, making them more prone to rupture upon impact.

Plasma volume increases during pregnancy, what happens to hematocrit?

Decreases - dilution by plasma (31-35% is normal in pregnancy)

What would you think of a WBC of 15,000 in a pregnant woman?

Normal, it can go up to 25,000 during labor!

What should you always assume about a pregnant patient's stomach?

That it is always full. (Gastric emptying time increases during pregnancy). Early NG tube placement recommended.

A PaCO2 of 35 to 40 in a pregnant patient may indicate what?

Impending respiratory failure. It is usually around 30 due to hyperventilation due to increased levels of progesterone.

True or False: All Rh negative pregnant trauma patients should get Rhogam?

True, unless the injury is remote from the uterus (distal extremity injury only). This therapy should be initiated within 72 hours of injury.

When worn correctly, seatbelts reduce fatalities by ___%.

65-70%, with a 10-fold reduction in serious injury.

A midline shift of greater than ___ often indicates the need for neurosurgical evacuation of the mass/blood.

JKO Medical Ethics and Detainee Operations Basic Course

f you are given an unlawful order, what is the process to follow?

Challenge the order. If the order is not revoked, report through the Chain of Command

The following are reasons for complying with the Law of War EXCEPT:

It can cause people to question our motives

The Principles of Medical Ethics require healthcare personnel to avoid which of the following acts?

Participate actively or passively in acts in an attempt to commit torture or other cruel, inhumane or degrading treatment or punishment

Which of the following guidelines are applicable to body cavity searches and exams?

Body cavity exams may be performed for valid medical reasons with the verbal consent of the patient

Body cavity searches are to be conducted only when there is reasonable belief that the detainee is concealing an item that presents a security risk

Both of these anwers are correct**

Unconscious or psychotic individuals can be examined without verbal consent as long as one person verifies that the detainee is "impaired" and documents this clearly on the examination report

False

Which of the following behaviors WOULD be considered rude or socially unacceptable in Middle Eastern cultures?

Public displays of affection between a man and woman

Which of the following is NOT true concerning the Qur'an?

It is not the ultimate law in Muslim society

One of the detainees is an insulin-dependent diabetic, who has been moved from level one security to level four for misbehaving. Now he is refusing his insulin and has been admitted to the ward for monitoring. The medic needs to draw the detainee's blood for baseline results but the patient refuses citing cultural and religious conflicts. What should the medic do? Select all that apply.

Explain to the patient the reason for drawing his blood and for administering insulin to him

You do not have informed consent, notify the MTF Commander of the situation

Prolong handshakes, kissing of the face, grasping elbows, and even prolonged hand holding by two men in public is a sign of friendship and respect.

True

Key points about dealing with the language barriers include which of the following?

Use translators with some medical expertise

Make sure detainees understand what care you are providing them

Ensure that detainees don't agree to care they don't understand

All of the answers are correct**

Which of the following is NOT true about the International Committee of the Red Cross?

They carry out their mission under the direction of the host country

Members of the ICRC arrive to perform an inspection of the medical treatment ares of the detainee facility and ask to visit patients and view medical data. What should you do?

You forward the request for access to the facilities through your Chain of Command

Military Police may make the initial decision to classify a detainee as being on suicide watch. Is this statement correct?

Yes, Military Police may make the initial decision before a detainee is given a mental health assessment

MPs provide valuable input regarding the medical care and concerns of detainees. Which statement below is TRUE?

Military police know which detainees repeatedly do not come up for head count and can point them out for medical evaluation

Which of the following statements is/are TRUE about the role healthcare personnel would play in interrogations? Select all that apply.

Healthcare personnel are prohibited from assisting detainee interrogation teams

Medical personnel who help interrogation team should not be a part of the healthcare team

Which of the following statements is/are TRUE about the Behavioral Science Support (BSS) personnel? Select all that apply.

They will not provide training in first aid, sanitation, or other health matters

They are exclusively assigned as operational support to detainee operations and intelligence interrogations in the DoD

They will not be used as a medical monitor or safety officer, or to supervise, conduct, or direct detainee operations or intelligence interrogations

Which of the following are responsibilites of the healthcare providers? Select all that apply.

Administer care

Restrain detainee patients for medical purposes

The detaining forces have an obligation to provide certain groups with either medical care or to ensure that they have access to medical care. Which group should be ensured access to care?

Civilian Population

When recommending treatment to a detainee, they have the right to refuse treatment. If they do decline treatment, which documents does NOT need to be completed?

DD Form 93 (Record of Emergency Data)

A detainee is in critical need of care. The MPs have not given him an ISN. You rush to the MP to obtain an ISN, so that you can begin processing. Is this correct?

No

In accordance with Army Regulation 190-8, all detainees must receive an initial screening chest x-ray and be given any necessary immunizations. This is crucial to stopping the spread of tuberculosis and other communicable diseases.

False

During the initial screening exam, it's important that you take pictures of a detainee's existing and pre-existing injuries and wounds.

True

Detainee medical records do not need to be at the same standard as those for U.S. and coalition service members.

False

One of the detainees in your treatment facility is about to be release from detention and has requested a copy of his medical records. What should you do?

Give him a copy which has had the unit and healthcare provider personal information edited

Who makes the determination whether an autopsy will be conducted after the death of a detainee?

Armed Forces Medical Examiner

Which records should be traceably mailed to the Washington National Record Center in Suitland, MD?

Outpatient records upon release or final disposition of the detainee from detention

Only Geneva Convetions III has an Article 3 that states that the following acts are, and shall remain, prohibited at any time and in any place whatsoever: violence to life and person, in particular cruel treatment and torture, and outrages upon personal dignity, in particular humiliating and degrading treatment.

False

Non-consensual sexual activity can include exhibitionism, inappropriate touching, or sexual intercourse

True

While examining a young female detainee, you discover bruising to her genital area. You ask her if she has been sexually assaulted and she says no, but it is obvious she is scared. What should you do?

Report the incident immediately

Which of the 4 Ps of Abuse Prevention states that a system should be in place to reduce the potential for abuse.

Priorites

Per AR 190-8 Paragraph 1-5a (4), inhumane treatment of EPW, CI or RP is a serious and punishable violation under the international law and the Uniform Code of Military Jutice (UCMJ).

True

Which of the following makes up the general legal obligations for military operations worldwide?

Law of War

There are 4 Geneva Conventions which cover the protections and treatment of people caught up in armed conflict. Which of these Conventions lists the rights and protections of Prisoners of War?

Geneva Convention III

Which of the duties listed below are owed to Enemy Prisoner of War in accordance with the Geneva Conventions?

Duty to protect

Duty to respect

Duty regarding abandonment

All of the answers are correct**

Which of the persons below does NOT qualify as a protected person under the Geneva Conventions?

Paratroopers exiting aircraft

How long can medical personnel be retained?

Only while needed to treat wounded and sick

Before a detainee can be transferred from a Role 2 to a Role 3 medical unit, what conditions must be met? Select all that apply.

Detainee must be medically stable

Each medical treatment facility commander certifies that the transfer documentation for the detainee is complete

Transfer must be authorized by accepting physician

When detainees are transferred between roles of care, all these individuals are required to accompany the detainee except?

A chaperone

You challenge an unlawful order, but your Supervisor refuses to rescind the order. What do you do?

Follow the Chain of Command, proceed to Senior Leadership with the request to rescind the order (correct)

When the Laws of War are broken (breached), there are simple and grave breaches, depending on the severity of the violation. Which of the following is a grave breach?

Torture (correct)

The Principles of Medical Ethics require healthcare personnel to avoid which of the following acts?

Participate actively or passively in acts in an attempt to commit torture or other cruel, inhumane or degrading treatment or punishment (correct)

Which of the following guidelines are applicable to body cavity searches and exams?

Both of these answers are correct (correct)

Which of the following stipulations is TRUE regarding the verification of a detainee as being impaired?

Two members of the medical staff must agree to the determination (correct)

Which of the following behaviors WOULD be considered rude or socially unacceptable in Middle Eastern cultures? [Remediation Accessed :N]

Public displays of affection between a man and woman (correct)

The Qur'an is the holy book of Islam and it guides Muslims in the following areas:

All of the answers are correct (correct)

One of the detainees is an insulin-dependent diabetic, who has been moved from level one security to level four for misbehaving. Now he is refusing his insulin and has been admitted to the ward for monitoring. The medic needs to draw the detainee's blood for baseline results but the patient refuses citing cultural and religious conflicts. What should the medic do? Select all that apply.

You do not have informed consent, notify the MTF Commander of the situation (correct)
Explain to the patient the reason for drawing his blood and for administering insulin to him (correct)

Prolong handshakes, kissing of the face, grasping elbows, and even prolonged hand holding by two men in public is a sign of friendship and respect.

True (correct)

Key points about dealing with the language barriers include which of the following?

All of the answers are correct (correct)

Which of the following statements are TRUE regarding ICRC visits to detainee compounds. Select all that apply. [Remediation Accessed :N]

All ICRC findings are given to the authorities in charge of the detainee compound (correct)
You forward the request for access to the facilities through your Chain of Command (correct)

Members of the ICRC arrive to perform an inspection of the medical treatment areas of the detainee facility and ask to visit patients and view medical data. What should you do?

You forward the request for access to the facilities through your Chain of Command (correct)

13) Which of the following responsibilities are roles for security personnel? Select all that apply. [Remediation Accessed :N]

Report detainee discipline problems (correct)
Control detainees (correct)
Discipline detainees (correct)

MPs provide valuable input regarding the medical care and concerns of detainees. Which statement below is TRUE?

Military police know which detainees repeatedly do not come up for head count and can point them out for medical evaluation (correct)

Which of the following statements is/are TRUE about the role healthcare personnel would play in interrogations? Select all that apply.

Healthcare personnel are prohibited from assisting detainee interrogation teams (correct)
Medical personnel who help interrogation team should not be a part of the healthcare team (correct)

Which of the following statements is/are TRUE about the Behavioral Science Support (BSS) personnel? Select all that apply.

They will not provide training in first aid, sanitation, or other health matters (correct)
They will not be used as a medical monitor or safety officer, or to supervise, conduct, or direct detainee operations or intelligence interrogations (correct)
They are exclusively assigned as operational support to detainee operations and intelligence interrogations in the DoD (correct)

Which of the following statements is NOT true regarding separation of medical care and security responsibilities? [Remediation Accessed :N]

Detainee security will be provided by designated medical personnel (correct)

Which of the following groups of people are NOT entitled to both medical and dental care?

Civilian Population (correct)

When specialty care is available to coalition forces, specialty care should also be available to detainees in theater.

True (correct)

When recommending treatment to a detainee, they have the right to refuse treatment. If they do decline treatment, which documents does NOT need to be completed?

DD Form 93 (Record of Emergency Data) (correct)

Which of the following is TRUE regarding detainee identification numbers?

All of the answers are correct (correct)

In accordance with Army Regulation 190-8, all detainees must receive an initial screening chest x-ray and be given any necessary immunizations. This is crucial to stopping the spread of tuberculosis and other communicable diseases.

True (correct)

How often, at a minimum, should a detainee's weight be checked while in the detention facility?

Monthly (correct)

Detainee medical records do not need to be at the same standard as those for U.S. and coalition service members.

False (correct)

Upon release, detainees are entitled to copies of their medical record. The medical documentation provided must be de-identified of the following: Select all that apply. [Remediation Accessed :N]

All U.S. military unit designation (correct)

When a detainee dies, the attending medical officer is responsible for which of the following? Select all that apply.

Furnishing a statement detailing whether or not the detainee's death was caused by his own misconduct (correct)
Completing DA Form 2669 (Certificate of Death) (correct)

Being thorough with detainee records helps provide the best care and it helps us to comply with our legal and ethical obligations.

True (correct)

Only Geneva Conventions III has an Article 3 that states that the following acts are, and shall remain, prohibited at any time and in any place whatsoever: violence to life and person, in particular cruel treatment and torture, and outrages upon personal dignity, in particular humiliating and degrading treatment.

False (correct)

Non-consensual sexual activity can include exhibitionism, inappropriate touching, or sexual intercourse.

True (correct)

While examining a young female detainee, you discover bruising to her genital area. You ask her if she has been sexually assaulted and she says no, but it is obvious she is scared. What should you do?

Report the incident immediately (correct)

When it comes to the 4 Ps of Abuse Prevention, which of the following is NOT a correct statement? [Remediation Accessed :N]

Policies - Telling people to do the right thing is more important than putting the policy in writing (correct)

Which of the following is NOT prohibited under the Geneva Conventions?

Transplant procedures for blood and skin grafts with informed consent (correct)

Which of the following makes up the general legal obligations for military operations worldwide?

The Law of War (correct)

According to Geneva Conventions III, detainees who meet which of the following criteria can be considered an Enemy Prisoner of War?

Soldiers who were engaged in combat under order of their government prior to capture (correct)

Which of the duties listed below are owed to Enemy Prisoner of War in accordance with the Geneva Conventions?

All of the answers are correct (correct)

Which of the following statements is FALSE regarding the duties owed civilian detainees under the Geneva Conventions?

They must be used as shields, if necessary (correct)

Which of the following individuals is considered a civilian?

Small boy around the age of 5 (correct)

Which transfers require the following minimum documentation: Operative Note (SF 516), Transfer Narrative Summary of Care (SF 502), and radiographs?

Detainees' transfers from Role 2 b to Role 3 treatment units (correct)

When detainees are transferred between roles of care, all these individuals are required to accompany the detainee except?

A chaperone (correct)

If you are given an unlawful order, what is the process to follow? [Remediation Accessed :N]

Challenge the order. If the order is not revoked, report through the Chain of Command (correct)

When the Laws of War are broken (breached), there are simple and grave breaches, depending on the severity of the violation. Which of the following is a simple breach? [Remediation Accessed :N]

Abuse of a flag of truce (correct)

Which of the following stipulations is TRUE regarding the verification of a detainee as being impaired?

Two members of the medical staff must agree to the determination (correct)

Non-Muslim male physicians are not allowed to treat women in many Islamic societies. Please note that for many Muslims treating the illness takes precedence, and seeking permission from the patient and male guardian, will likely result in allowing treatment for illness.

True (correct)

_____ is a holy month in which fasting from dawn until sunset for 29/30 days is required of all able-bodied Muslims.

Ramadan (correct)

One of the detainees is an insulin-dependent diabetic, who has been moved from level one security to level four for misbehaving. Now he is refusing his insulin and has been admitted to the ward for monitoring. The medic needs to draw the detainee's blood for baseline results but the patient refuses citing cultural and religious conflicts. What should the medic do? Select all that apply.

You do not have informed consent, notify the MTF Commander of the situation (correct)
Explain to the patient the reason for drawing his blood and for administering insulin to him (correct)

In Middle Eastern culture, the _____ is considered the most unclean part of the body.

Sole of the foot (correct)

In Middle Eastern cultures, largely Muslim, there are no rules regarding eye contact between the sexes.

False (correct)

Which of the following is NOT true about the International Committee of the Red Cross?

They carry out their mission under the direction of the host country (correct)

Members of the ICRC arrive to perform an inspection of the medical treatment areas of the detainee facility and ask to visit patients and view medical data. What should you do?

You forward the request for access to the facilities through your Chain of Command (correct)

Military Police may make the initial decision to classify a detainee as being on suicide watch. Is this statement correct?

Yes, Military Police may make the initial decision before a detainee is given a mental health assessment (correct)

MPs provide valuable input regarding the medical care and concerns of detainees. Which statement below is TRUE?

Military police know which detainees repeatedly do not come up for head count and can point them out for medical evaluation (correct)

Which of the following statements is/are TRUE about the role healthcare personnel would play in interrogations? Select all that apply.

Healthcare personnel are prohibited from assisting detainee interrogation teams (correct)
Medical personnel who help interrogation team should not be a part of the healthcare team (correct)

Which of the following statements is/are TRUE about the Behavioral Science Support (BSS) personnel? Select all that apply.

They will not provide training in first aid, sanitation, or other health matters (correct)
They will not be used as a medical monitor or safety officer, or to supervise, conduct, or direct detainee operations or intelligence interrogations (correct)
They are exclusively assigned as operational support to detainee operations and intelligence interrogations in the DoD (correct)

Which of the following are the responsibilities of the healthcare providers? Select all that apply.

Restrain detainee patients for medical purposes (correct)
Administer care (correct)

The detaining forces have an obligation to provide certain groups with either medical care or to ensure that they have access to medical care. Which group should be ensured access to care?

Civilian Population (correct)

When specialty care is available to coalition forces, specialty care should also be available to detainees in theater.

True (correct)

Treat enemy casualties and detainees with the same ethics and medical standards of care as for multinational forces. Triage by medical condition only.

True (correct)

A detainee is in critical need of care. The MPs have not given him an ISN. You rush to the MP to obtain an ISN, so that you can begin processing. Is this correct?

No (correct)

A group of detainees has just been escorted in for screening. A few were coughing and one is on a stretcher and had to be wheeled in. You've been asked to screen them all and that the two obviously uninjured detainees need to be interrogated. Do you complete and process the two uninjured detainees first?

No (correct)

During the initial screening exam, it's important that you take pictures of a detainee's existing and pre-existing injuries and wounds.

True (correct)

Detainee medical records do not need to be at the same standard as those for U.S. and coalition service members.

False (correct)

Who is entitled to see a detainee's medical records? [Remediation Accessed :N]

Anyone in the detention center Chain of Command (correct)

Who makes the determination whether an autopsy will be conducted after the death of a detainee?

Armed Forces Medical Examiner (correct)

Which records should be traceably mailed to the Washington National Record Center in Suitland, MD?

Outpatient records upon release or final disposition of the detainee from detention (correct)

ATP 4-02.46, Army Health System Support to Detainee Operations give specific guidelines for identifying signs of abuse and procedures to follow should you suspect a detainee has been abused.

True (correct)

Which of the following are considered physical abuse? Select all that apply. [Remediation Accessed :N]

Slapping a detainee intentionally to cause physical abuse (correct)
Using restraints to punish a detainee (correct)

Healthcare personnel and Military Police/CID both have specific roles after a sexual abuse report. Which of the following actions is the responsibility of medical personnel?

Collect physical evidence from the victim (correct)

When it comes to the 4 Ps of Abuse Prevention, which of the following is NOT a correct statement?

Policies - Telling people to do the right thing is more important than putting the policy in writing (correct)

Per AR 190-8 Paragraph 1-5a (4), inhumane treatment of EPW, CI or RP is a serious and punishable violation under the international law and the Uniform Code of Military Justice (UCMJ).

True (correct)

Which of the following makes up the general legal obligations for military operations worldwide?

The Law of War (correct)

According to the Hague and Geneva Conventions, American Soldiers are required to:

Treat Enemy Prisoners of War humanely (correct)

Which of the duties listed below are owed to Enemy Prisoner of War in accordance with the Geneva Conventions?

All of the answers are correct (correct)

Which of the persons below does NOT qualify as a protected person under the Geneva Conventions?

Paratroopers existing aircraft (correct)

Which of the following individuals is considered a civilian?

Small boy around the age of 5 (correct)

Before a detainee can be transferred from a Role 2 to a Role 3 medical unit, what conditions must be met? Select all that apply. [Remediation Accessed :N]

Each medical treatment facility commander certifies that the transfer documentation for the detainee is complete (correct)
Detainee must be medically stable (correct)
Transfer must be authorized by accepting physician (correct)

During a detainee ground transfer, healthcare personnel are in charge of a detainee's restraints.

False (correct)

Although your shift has just ended, before you may leave you are tasked to screen the detainees so that they can be transferred to another location. They have just knelt for mid-day prayer. The MPs tell you that this procession usually requires about half an hour. What do you do? Select all that apply.

Wait for the prayer to be over to do the screening
Leave a note for the next shift to do the screening after the prayer

Members of the ICRC arrive to perform an inspection of the medical treatment areas of the detainee facility and ask to visit patients and view medical data. What should you do?

You forward the request for access to the facilities through your Chain of Command

If you are given an unlawful order, what is the process to follow?

Challenge the order. If the order is not revoked, report through the Chain of Command (correct)

The following are reasons for complying with the Law of War EXCEPT:

It can cause people to question our motives (correct)

The Principles of Medical Ethics require healthcare personnel to avoid which of the following acts?

Participate actively or passively in acts in an attempt to commit torture or other cruel, inhumane or degrading treatment or punishment (correct)

What should you do during medical examinations to ensure the respect for dignity of the detainee?

All of the answers are correct (correct)

Unconscious or psychotic individuals can be examined without verbal consent as long as one person verifies that the detainee is "impaired" and documents this clearly on the examination report. [Remediation Accessed :N]

False (correct)

Which of the following behaviors WOULD be considered rude or socially unacceptable in Middle Eastern cultures?

Public displays of affection between a man and woman (correct)

Which of the following is NOT true concerning the Qur'an? [Remediation Accessed :N]

It is not the ultimate law in Muslim society (correct)

Although your shift has just ended, before you may leave you are tasked to screen the detainees so that they can be transferred to another location. They have just knelt for mid-day prayer. The MPs tell you that this procession usually requires about half an hour. What do you do? Select all that apply.

Leave a note for the next shift to do the screening after the prayer (correct)
Wait for the prayer to be over to do the screening (correct)

Which of the below postures are considered rude in Middle Eastern culture? Select all that apply.

Showing the sole of your shoes (correct)
Leaning against a wall (correct)
Crossing your legs if in the presence of an elder (correct)
Slouching with legs open (correct)
Having your hands in your pockets (correct)

A detainee comes to the clinic with severe abdominal pain. The physician orders a catheter urine specimen and an IV insertion. The female medic attempts to communicate these orders to the patient, but the patient doesn't understand and refuses the procedures. He becomes angry with the medic. She calls for the interpreter to translate, but he is busy. What should she do?

She waits for the interpreter and finds out that the patient didn't understand what she was going to do with the tube and why she was attempting to lift his gown (correct)

Which of the following statements are TRUE regarding ICRC visits to detainee compounds. Select all that apply. [Remediation Accessed :N]

The ICRC inspects the treatment of detainees and the material conditions of the detention facility (correct)
All ICRC findings are given to the authorities in charge of the detainee compound (correct)

Members of the ICRC arrive to perform an inspection of the medical treatment areas of the detainee facility and ask to visit patients and view medical data. What should you do?

You forward the request for access to the facilities through your Chain of Command (correct)

Which of the following responsibilities are roles for security personnel? Select all that apply.

Discipline detainees (correct)
Control detainees (correct)
Report detainee discipline problems (correct)

MPs provide valuable input regarding the medical care and concerns of detainees. Which statement below is TRUE?

Military police know which detainees repeatedly do not come up for head count and can point them out for medical evaluation (correct)

Which of the following statements is/are TRUE about the role healthcare personnel would play in interrogations? Select all that apply.

Healthcare personnel are prohibited from assisting detainee interrogation teams (correct)
Medical personnel who help interrogation team should not be a part of the healthcare team (correct)

Which of the following statements is/are TRUE about the roles between healthcare personnel and military intelligence? Select all that apply.

BSS Teams personnel assigned to military intelligence are not a part of the healthcare team and will not provide care to detainees (correct)
Healthcare personnel are prohibited from assisting detainee interrogation teams (correct)

Which of the following are the responsibilities of the healthcare providers? Select all that apply.

Restrain detainee patients for medical purposes (correct)
Administer care (correct)

The detaining forces have an obligation to provide certain groups with either medical care or to ensure that they have access to medical care. Which group should be ensured access to care?

Civilian Population (correct)

When specialty care is available to coalition forces, specialty care should also be available to detainees in theater.

True (correct)

Treat enemy casualties and detainees with the same ethics and medical standards of care as for multinational forces. Triage by medical condition only.

True (correct)

Screening Requirements include all of the following EXCEPT?

Body cavity exam (correct)

Which of the following procedures is NOT part of the detainee in-processing medical examination?

Rectal cavity search (correct)

How often, at a minimum, should a detainee's weight be checked while in the detention facility?

Monthly (correct)

When you are in a deployed environment, which of the following issues can hinder patient identification?

All of the answers are correct (correct)

Which of the following statements regarding the Health Insurance Portability and Accountability Act (HIPAA) is TRUE? [Remediation Accessed :N]

Detainees are not covered under HIPAA, but they are guaranteed the same standards of care, so this should apply to medical records as well (correct)

When a detainee dies, the attending medical officer is responsible for which of the following? Select all that apply.

Furnishing a statement detailing whether or not the detainee's death was caused by his own misconduct (correct)
Completing DA Form 2669 (Certificate of Death) (correct)

Which records should be traceably mailed to the Washington National Record Center in Suitland, MD?

Outpatient records upon release or final disposition of the detainee from detention (correct)

Only Geneva Conventions III has an Article 3 that states that the following acts are, and shall remain, prohibited at any time and in any place whatsoever: violence to life and person, in particular cruel treatment and torture, and outrages upon personal dignity, in particular humiliating and degrading treatment.

False (correct)

Which of the following are considered physical abuse? Select all that apply.

Using restraints to punish a detainee (correct)
Slapping a detainee intentionally to cause physical abuse (correct)

While examining a young female detainee, you discover bruising to her genital area. You ask her if she has been sexually assaulted and she says no, but it is obvious she is scared. What should you do?

Report the incident immediately (correct)

Which of the 4 Ps of Abuse Prevention states that a system should be in place to reduce the potential for abuse.

Priorities (correct)

Per AR 190-8 Paragraph 1-5a (4), inhumane treatment of EPW, CI or RP is a serious and punishable violation under the international law and the Uniform Code of Military Justice (UCMJ).

True (correct)

Which of the following makes up the general legal obligations for military operations worldwide?

The Law of War (correct)

In order to be classified as an EPW, a guerilla fighter must do which of the following? Select all that apply.

Wear fixed, distinctive insignia (correct)
Operate under a responsible command (correct)
Carry arms openly (correct)

Which of the duties listed below are owed to Enemy Prisoner of War in accordance with the Geneva Conventions?

All of the answers are correct (correct)

Which of the following statements is FALSE regarding the duties owed civilian detainees under the Geneva Conventions?

They must be used as shields, if necessary (correct)

Which of the following are TRUE regarding the rights afforded to civilians? Select all that apply. [Remediation Accessed :N]

Right not to be forced into labor by the enemy force (correct)
Right to have customs and religion respected(correct)

When detainees are transferred between roles of care, all these individuals are required to accompany the detainee except?

A chaperone (correct)

If you are given an unlawful order, what is the process to follow?

Challenge the order. If the order is not revoked, report through the Chain of Command (correct)

Reprisals or acts which are usually violations of war may NEVER be taken to: [Remediation Accessed :N]

Take revenge on the opponent (correct)

The Principles of Medical Ethics require healthcare personnel to avoid which of the following acts?

Participate actively or passively in acts in an attempt to commit torture or other cruel, inhumane or degrading treatment or punishment (correct)

What should you do during medical examinations to ensure the respect for dignity of the detainee?

All of the answers are correct (correct)

Unconscious or psychotic individuals can be examined without verbal consent as long as one person verifies that the detainee is "impaired" and documents this clearly on the examination report. [Remediation Accessed :N]

False (correct)

Which of the following behaviors WOULD be considered rude or socially unacceptable in Middle Eastern cultures?

Public displays of affection between a man and woman (correct)

Which of the following is NOT true concerning the Qur'an?

It is not the ultimate law in Muslim society (correct)

One of the detainees is an insulin-dependent diabetic, who has been moved from level one security to level four for misbehaving. Now he is refusing his insulin and has been admitted to the ward for monitoring. The medic needs to draw the detainee's blood for baseline results but the patient refuses citing cultural and religious conflicts. What should the medic do? Select all that apply. [Remediation Accessed :N]

You do not have informed consent, notify the MTF Commander of the situation (correct)
Explain to the patient the reason for drawing his blood and for administering insulin to him (correct)

Which of the below postures are considered rude in Middle Eastern culture? Select all that apply.

Having your hands in your pockets (correct)
Leaning against a wall (correct)
Slouching with legs open (correct)
Showing the sole of your shoes (correct)
Crossing your legs if in the presence of an elder (correct)

In Middle Eastern cultures, largely Muslim, there are no rules regarding eye contact between the sexes.

False (correct)

Which of the following statements are TRUE regarding ICRC visits to detainee compounds. Select all that apply.

The ICRC inspects the treatment of detainees and the material conditions of the detention facility (correct)
All ICRC findings are given to the authorities in charge of the detainee compound (correct)

Members of the ICRC arrive to perform an inspection of the medical treatment areas of the detainee facility and ask to visit patients and view medical data. What should you do?

You forward the request for access to the facilities through your Chain of Command (correct)

Military Police may make the initial decision to classify a detainee as being on suicide watch. Is this statement correct?

Yes, Military Police may make the initial decision before a detainee is given a mental health assessment (correct)

Which medications are detainees allowed to have in their possession? Select all that apply.

Moisturizing creams (correct)
Albuterol inhalers (correct)

Which of the following statements is/are TRUE about the role healthcare personnel would play in interrogations? Select all that apply.

Healthcare personnel are prohibited from assisting detainee interrogation teams (correct)
Medical personnel who help interrogation team should not be a part of the healthcare team (correct)

Which of the following statements is/are TRUE about the Behavioral Science Support (BSS) personnel? Select all that apply.

They are exclusively assigned as operational support to detainee operations and intelligence interrogations in the DoD (correct)
They will not provide training in first aid, sanitation, or other health matters (correct)
They will not be used as a medical monitor or safety officer, or to supervise, conduct, or direct detainee operations or intelligence interrogations (correct)

Which of the following are the responsibilities of the healthcare providers? Select all that apply.

Administer care (correct)
Restrain detainee patients for medical purposes (correct)

Which of the following groups of people are NOT entitled to both medical and dental care?

Civilian Population (correct)

When specialty care is available to coalition forces, specialty care should also be available to detainees in theater.

True (correct)

When recommending treatment to a detainee, they have the right to refuse treatment. If they do decline treatment, which documents does NOT need to be completed?

DD Form 93 (Record of Emergency Data) (correct)

Screening Requirements include all of the following EXCEPT?

Body cavity exam (correct)

In accordance with Army Regulation 190-8, all detainees must receive an initial screening chest x-ray and be given any necessary immunizations. This is crucial to stopping the spread of tuberculosis and other communicable diseases.

True (correct)

How often, at a minimum, should a detainee's weight be checked while in the detention facility?

Monthly (correct)

Detainee medical records do not need to be at the same standard as those for U.S. and coalition service members.

False (correct)

One of the detainees in your treatment facility is about to be released from detention and has requested a copy of his medical records. What should you do?

Give him a copy which has had the unit and healthcare provider personal information edited (correct)

When a detainee dies, the attending medical officer is responsible for which of the following? Select all that apply.

Furnishing a statement detailing whether or not the detainee's death was caused by his own misconduct (correct)
Completing DA Form 2669 (Certificate of Death) (correct)

Being thorough with detainee records helps provide the best care and it helps us to comply with our legal and ethical obligations.

True (correct)

Only Geneva Conventions III has an Article 3 that states that the following acts are, and shall remain, prohibited at any time and in any place whatsoever: violence to life and person, in particular cruel treatment and torture, and outrages upon personal dignity, in particular humiliating and degrading treatment.

False (correct)

Non-consensual sexual activity can include exhibitionism, inappropriate touching, or sexual intercourse.

True (correct)

While screening a detainee during in-processing, he mentions through the interpreter that he was beaten up by the Iraq National Guard last year. You may ignore his statement since he is a detainee.

False (correct)

When it comes to the 4 Ps of Abuse Prevention, which of the following is NOT a correct statement?

Policies - Telling people to do the right thing is more important than putting the policy in writing (correct)

Per AR 190-8 Paragraph 1-5a (4), inhumane treatment of EPW, CI or RP is a serious and punishable violation under the international law and the Uniform Code of Military Justice (UCMJ).

True (correct)

Which of the following makes up the general legal obligations for military operations worldwide?

The Law of War (correct)

According to the Hague and Geneva Conventions, American Soldiers are required to:

Treat Enemy Prisoners of War humanely (correct)

Which of the duties listed below are owed to Enemy Prisoner of War in accordance with the Geneva Conventions?

All of the answers are correct (correct)

Article 3 of the Geneva Conventions protects prisoners of war and wounded combatants from all of the following EXCEPT:

Execution after receiving a fair trial (correct)

Which of the following are TRUE regarding the rights afforded to civilians? Select all that apply. [Remediation Accessed :N]

Right to have customs and religion respected (correct)
Right not to be forced into labor by the enemy force (correct)

Which transfers require the following minimum documentation: Operative Note (SF 516), Transfer Narrative Summary of Care (SF 502), and radiographs?

Detainees' transfers from Role 2 b to Role 3 treatment units (correct)

During a detainee ground transfer, healthcare personnel are in charge of a detainee's restraints.

False (correct)

JKO Navy Health Promotion Basics

To enhance the acceptance and potential success of the Health Promotion (HP) Program by encouraging command, crew members, and staff ownership of the program is the primary job description of?

(T)- Health Promotion Committee.

What is the name of the survey that is funded by DoD (Health Affairs) and is conducted every three years?

(T)- The Department of Defense (DoD) Survey of Health Related Behaviors Among Military Personnel.

Student manuals, course fees, and Health Promotion Program participation incentives are all examples of what type of expense?

(T)- Variable Costs.

At what point in the ten step planning process does the Health Promotion Coordinator implement Health Promotion Program activities?

(T)- After developing a budget.

What is the Navy website that has a Health & Wellness page targeted with information for DAPAs, CFLs, HP Coordinators and the individual Sailors?

(T)- NKO website.

Which is the first step in developing a successful Health Promotion Program?

(T)- Form a HP Committee

What is the last step in developing an effective Marketing Plan for your command Health Promotion Program?

(T)- Evaluate marketing efforts

What is a prerequisite of a Health Promotions Committee Coordinator?

(T)- Has been at the command at least six months or is familiar with the command and the command culture and has good "people" skills

Which award is designed to enhance battle readiness by promoting health, fitness, and mental well being of active duty Sailors assigned to Commander Naval Surface Force (COMSURFOR)?

(T)- Green H Health Promotion Award

What needs to be established prior to evaluating a Health Promotion Program?

(T)- Program goals and objectives

Which of the following is a method that can be used at your command to determine the interests of your crew or staff?

(T)- Conduct key leader interviews

Looking at the pros and cons of making a behavior change is one of the key issues involved in what?

(T)- Contemplation

Which of the following is a type of Health Promotion Program evaluation?

(T)- Outcome

What is an example of an uncontrollable risk factor that can influence the level of risk for developing particular diseases or that can contribute to early death and disability?

(T)- Family history

What is the fifth stage in the Stages of Behavior Change model?

(T)- Maintenance

Using a short article in the command newsletter or a flyer to report Needs Assessment results would be most appropriate and effective for which group?

(T)- Command personnel

Which of the following is an example of a measurable process objective?

(T)- By September 30, 2008, the command will decrease tobacco use by at least 10%, as evidenced by results on the Fleet & Marine Corps HRA.

What serves as the construction phase of a program evaluation?

(T)- Data analysis

Which of the following is a data source for an Outcome Evaluation?

(T)- Pre/post Tests, Measurement of health risk factors, and Monitor use of healthcare system.

Which of the following is essential in conducting an Outcome Evaluation?

(T)- Customer satisfaction surveys

What is the first step in developing an effective Marketing Plan for your command Health Promotion Program?

(T)- Identify the audience

What step in the HP Program planning process can help ensure that command personnel know about the Health Promotion Program, the activities and events offered, the benefits of participation, and the long term outcomes of adopting a healthy lifestyle?

(T)- HP Program Marketing Plan

How many steps are there to designing a successful Health Promotion Program?

(T)- Ten

What element of the Health Promotion Program Evaluation Report highlights the purpose of the program evaluation?

(T)- Summary of results

What should the Health Promotion Coordinator consult when scheduling a Health Promotion Program activity?

(T)- The results of the Command Assessment

Encouraging enrollment in an Intervention level program, such as ShipShape or a Tobacco Cessation Program, is most effective for individuals who are in at least what stage of behavior change?

(T)- Contemplation

What is an indicator of the success of a Health Promotion Program activity?

(T)- Participation rate

What is an advantage to using Health Promotion Program participation incentives?

(T)- Encourages participation in Health Promotion Programs.

How much of the annual Health Promotion Program budget should be dedicated to Intervention level programs?

(T)- 5-50%

What is focused on the necessary actions to achieve one or more marketing objectives?

(T)- Marketing Plan

The long-term components should be reviewed and possibly updated every two years.

= Vision Statement, Mission Statement, Goal Statements

The short-term components should be updated annually.

= Develop measurable objectives, Develop strategies and action steps, Develop a budget, Develop an evaluation plan

A Marketing Plan is developed on an annual basis, consisting of these 5 steps.

1. Identify audience
2. Research methods to reach target audiences
3. Develop and pretest materials
4. Distribute marketing message
5. Evaluate marketing efforts

According to the national Healthy People 2010 report over 70% of all premature deaths in this country are directly related to behaviors and environmental factors.

True.

What is the level of prevention that should be the major focus of your command's Health Promotion Program?

(T)- Primary

Videotapes, DVDs, reference books, and computer software programs are all examples of what type of expense?

(T)- Fixed

Which type of question used on a written questionnaire typically asks for a Yes or No answer?

(T)- Closed, form questions

What is the name of the annual Health Promotion Program award that is given for excellence in the delivery of Health Promotion programming and divided into two categories, medical and fleet?

(T)- Health Promotion and Wellness Award

What stage of behavior change is an individual in when they have no intention of making any behavior changes even though their family and friends may recognize the need for that person to change?

(T)- Pre-contemplation

What instruction provides guidance to the Navy's comprehensive Health Promotion Program?

(T)- OPNAVINST 6100.2A

What is a key element of a command Health Promotion Program Evaluation Report?

(T)- Cost of the program activity

Who appoints members to the Health Promotion Committee?

(T)- Commanding Officer

What characteristic of a successful Health Promotion Program is being addressed when the staff and crews preference for content is taken into account?

(T)- High satisfaction rate

What tool can be used by Navy and Marine Corps commands to quickly assess the lifestyle of its members?

(T)- Fleet and Marine Corps Health Risk Appraisal (HRA)

Which group would an abbreviated, executive summary with charts or graphs be most appropriate and effective to report the results of the Command Assessment?

(T)- Chain of command

What provides general statements about the expectations for the program?

(T)- Goal Statements

Which of the following is an example of a long term component of a Health Promotion Plan?

(T)- Vision Statement

The Navy Health Promotion Coordinator should use Health Promotion Program resources that are primarily focused on what?

(T)- Navy Health Promotion Program priority areas

What determines the type of Health Promotion Program participation incentives?

(T)- Target audience

How much of the annual Health Promotion Program budget should be dedicated to Education/Motivational level programs?

(T)- 20-40%

What is the first stage in the Stages of Behavior Change model?

(T)- Pre-contemplation

What is the participation rate for Awareness level program activities?

(T)- 100%

What is the next step after "Developing Measurable Program Objectives" in the Health Promotion Program planning process?

(T)- Develop strategies and action steps

JKO US480 Supervisor Safety Training

PL 91-596, OSHAct

Also known as the Occupational Safety and Health Act, or OSH Act, requires employers to provide safe and healthful working conditions and requires all mishaps to be investigated

E.O.12196

Makes OSHA requirements applicable for federal agencies

29 CFR 1960, OSHA Basic Elements

Establishes the basic program elements for federal agencies

DoDI 6055.01 SOH Program

Establishes the DoD Safety and occupational health program

DHA AI 6055.01, DHA Safety Program

Establishes how the federal and DoD regulations apply specifically to the DHA

Employees can speak to:

Supervisors, employee safety, representatives (ESRs), and local safety offices

Risk Management Process

1) Identify Hazard
2)Assess Hazards
3)Implement Controls
4)Risk mitigation
5)Supervision&Evaluation

Employee Rights Training

1)Rules and regulations
2)Training
3)Non retaliation
4)Data access
5)Promote safety
6)Inspections

Your team has been incredibly busy at the hospitals loading dock. Which of these employee rights might affect what you do?

Right to non retaliation
Right to promote safety

A new piece of equipment has arrived. You understand the urgency but are nervous about using the new equipment. Which one might affect what you do?

Right to training

Your supervisor is proud there have been few mishaps while he has been in charge. Which might affect what you do?

Right to data access

Action 1: Your work station is located under a high window.

Supported by OSH Acts rights

Action 2: Subsequently, an industrial hygienist sampled the air quality....etc

Supported by OSH Acts Rights

Employee Responsibilities

Comply
Follow
Protect
Report
Cooperate

You are scheduled to attend required OSHA safety training today, but need to meet the deadline, which you will miss if you attend the meeting. What should you do?

Attend the training

You have been assigned a new workstation. What should you do?

Report the hazard to the appropriate person or office

Far too long since you cleaned out the gutters. What should you do?

Discard the damaged ladder

Action 1: During the first day on the job, you attend required safety training.

Comply

Action 2: Before you start work etc

Follow

Supervisor mishap report

DHA Form 172

Inspections

Quarterly with written form

After Keith submitted the hazard report. Etc

B) Form 176

Supervisor Responsibilities

Hold employees accountable
Ensure all mishaps investigated
Develop analysis
Quarterly inspections

Shared responsibilities

Report hazards
Cooperate with inspectors

JKO DMHRSi - Annual Refresher: Policy Updates and Reminders

Knowledge Check #1

When is your DMHRSi Timecard due?

The first business day after the end of the pay period

Test Question #1

DMHRSi tracks the time staff spend supporting all the MTF's missions. This includes clinical missions, administrative missions, training missions, and Army readiness missions. DMHRSi does not affect an individual's pay.

True

Test Question #2

The best strategy for accurately capturing labor hours is to:

Capture your hours every day by either entering them into DMHRSi or noting them on a calendar spreadsheet, or notepad and then entering them into DMHRSi

Test Question #3

I am a soldier and I just finished an hour of Physical Training (PT), what code would I use in DMHRSi to capture my PT time?

GFAA or GFAD (depending on assignment to MEDDAC or DENTAC)

Test Question #4

Time spent providing non-face-to-face patient care is Virtual Health (telephone calls, returning emails, TCONs). Virtual Healthcare to include telephone calls, returning emails via secure messaging, and TCONs not for Periodic Health Assessments is capture using the individual's normal clinic Task Code with a sub identification code added.

Which Task Codes would be correct?

B***__DMIS ID.99
B***__DMIS ID.06 for skill type 3 (nursing)

JKO Why is DMHRSi Important

Knowledge Check #1

When staff accurately report their time in DMHRSi, this communicates resourcing requirements.

True

Knowledge Check #2

Which of the following are benefits of accurate time reporting? Select all of the correct answers.

Adequate Budget & Resources
Adequate Staffing
Patient Satisfaction

Knowledge Check #3

It is a good practice to use your patient or administrative schedule to help input your time into DMHRSi each day to increase accuracy.

True

Test Question #1

The most important mission to capture as we input our labor hours in DMHRSi is...

All missions are equally important

Test Question #2

Labor data from DMHRSi is used by...

All the Above

Test Question #3

Capturing all your available time as patient care time...

Overinflates the cost of delivering patient care

Test Question #4

ATAAPS tells leadership how you support all of the Army medical missions.

False

Test Question #5

Who is responsible for accurately capturing your labor hours against the missions you support?

You are responsible to ensure the hours in DMHRSi accurately reflect the missions you supported

JKO DHA Virtual Health Provider Training

Which of the following video teleconferencing technologies include a built in system with an integrated CODEC and audio/video components, to include medical peripherals and typically handled by a tele-presenter?

Dedicated VTC systems

Which of the following is NOT a common technical troubleshooting issue during a VTC session?

Language barriers

Which of the following is true about virtual health care?

- It provides and supports healthcare when distance separates the patient and provider.

- It may also be known as telehealth, video teleconferencing, eHealth, telecare, etc

- It uses electronic, information, imaging and communication technologies

VH providers may encounter a wide variety of virtual health care equipment. Which of the following are common options for virtual health care settings?

- A dedicated VH cart with or without peripheral devices such as vital sign tools and held hand cameras

- A video conferencing setup with a desktop screen and speaker phone

- Mobile phones and tablet capabilities

All of the following are examples of differences between in-person care and virtual health care EXCEPT:

Patient education to alter behavior or improve their health status

The provider can often rely on a presenter (technician or nurse) who serves as the face of VHC at the patient site and acts as the hands of virtual health for the provider.

True

Which of the following terms matches this definition: "Real time video or telephone appointments which involves dialog, interactions, electronic communication exchange in at least two directions in the same time period."?

Synchronous Virtual Health

DOD uniformed providers have traditionally been exempt from state licensure, then in 2012 the waiver was implemented. "The Wavier" refers to?

The exemption of state licensure was expanded to facilitate telemedicine in the Military Health System

The three I's referees to an acronym related to privacy and security which may be jealously for the provider to use during the "meet and greet" portion of VH session. what do the three I's stand for?

Identify, Introduce, Inquire

XXXXXMatch the terms to the correct definition
A) Privileging by Proxy
B) Licensure
C) Virtual Health to the Patient's location
D) Privileging

A) Allows Commanders at originating/patient end site to accept the decision of the distant/provider site.

B) Uniformed providers are traditionally exempt from originating site in-state requirements

C) Uses a secure, DOD-approved, HIPAA-compliant health information technology platform.

D) A provider must be explicitly given this by the facility in which he or she is providing services

Select the statement that best explains the he presenter's role in supporting virtual health care. The presenter....

- Facilitates the communication when the provider and patient are in separate locations

- Coordinates the patient care at the originating site

- Uses technology to connect the patient with the provider

Federal law requires that virtual health providers must personally complete an in-person assessment of a patient before he/ she can prescribe, renew it refill controlled substances

False

In virtual health care the originating site of care refers to...

The physical location of the patient.

Match the terms and to the correct patient experience terms with the examples given.

A) Framing
B) Staging
C) Netiquette

A) Sit a comfortable distance from the camera.

B) Avoid patterns, white coats and bold colors, while using bright natural light if possible.

C) Speak slowly, confirm understanding, and allow time for the patient to respond.

Match the terms:
A) Staging
B) Netiquette
C) Framing

A) Remove visual clutter and extraneous background noise.

B) Make eye simulated contact by looking at the camera rather than the patient's eye on the screen.

C)Position camera at top center of the monitor if possible for better eye to eye display.

Which of the following benefits applies to virtual health?

- Increases access to care

- Reduces travel and other costs

- Leverages specialty providers

- Links scattered medical resources

Match the terms:

A) Synchronous
B) Asynchronous
C) Distant site
D) Originating site

A) Immediate form of interaction-think "dialogue", like video chat.

B) A delayed form of interaction-think "series of monologues" like emails or texting.

C) The treatment facility where the provider is

D) The treatment facility where the patient is

JKO Mental Health Assessment Health Care Personnel Training Course

In accordance with Title 10, United States Code, 1074m, Mental Health Assessments for Members of the Armed Forces Deployed in Connection with a Contingency Operation, deployment mental health assessments are required for the following Service members deployed in connection with a contingency operation:

All of the above

Follow-up questions assessing functional impairment help providers identify which of the following items?

All of the above

How many questions on the Primary Care PTSD Screen (PC-PTSD) must be answered "yes" to require administration of the PTSD Checklist - Civilian version (PCL-C)?

Two or more

At or above what PCL-C score is a referral for a mental health evaluation required (assuming the deplorer self-reported level of functioning is "very difficult" to "extremely difficult")?

50

MHA provider will complete only Part C, Section II of the PHA and must certify the Mental Health Assessment process by signing and dating the Mental Assessment portion of the PHA.

True

What is the time period covered by the questions in the PTSD Screening checklist PCL-C?

One month

Providers can use the Alcohol Feedback Cards to show Service Members how their drinking compares to the drinking of deployed Service members. In what ways are the feedback cards broken down?

A and B

During provider feedback, you should offer an impression of the Service member's symptoms and referral options.

True

After completing the Self-Report Survey, Service members must:

Can proceed directly to the person-to-person interview if screening for PTSD and depression is negative

During the person-to-person interview, the provider performs which of the following functions?

All of the above

The brief intervention for managing risky drinking includes which of the following activities?

All of the above

How many questions on the Patient Health Questionnaire-2 (PHQ-2) for depression must be endorsed as "2" or "3" ("more than half of the days" or "nearly every day") to require administration of the Patient Health Questionnaire-8 (PHQ-8)?

At least two

What type qualifies as a person-to-person deployment mental health assessment?

All of the above

By law, a deployment mental health assessment is NOT required at which of the time periods listed below?

Within 30 days after return from deployment

When should the provider consider a mental health referral for the Service member?

All of the above

Why is the Civilian rather than the Military version of the PTSD Checklist (PCL) is used in the deployment mental health assessment?

All of the above

Which Service members are eligible for the Military Health System's inTransition Program, which is designed to assist Service members receiving mental health treatment by ensuring a smooth transition to their next provider in case of transfer or separation from the Service?

All of the above

Which type of provider is NOT eligible to be trained and certified to perform the person-to-person interview portion of the Mental Health Assessment?

Licensed practical nurse

In making a decision to refer Service members to mental health care for depression or PTSD, which of the following things should providers consider?

Both of these choices

The brief intervention for managing risky drinking includes which of the following activities?

All of the above

At or above what AUDIT-C score should a referral for alcohol treatment be considered?

8

What determines if the Service member must answer the entire 10 questions on the Alcohol Use Disorders Identification Test?

If the AUDIT-C is contains 3 questions marked positive

SCRA (Servicemembers Civil Relief Act) and MLA (Military Leave Act)

What is the major requirement of the MLA in terms of interest rate cap?

Imposes a 36% interest rate cap on consumer purpose credit transactions

What is the scope of SCRA?

Covers loan obligations, lease agreements, lawsuits & insurance contracts for active duty in the federal military service

What is excluded under the 36% interest rate cap?

Residential mortgages and purchase money transactions for personal property (i.e. auto loans for purchase) and business purpose loans

What is a dependent under SCRA?

Spouse, child and any individual dependent for which the servicemember provided at least 1/2 of their support during 180 days preceding the request for relief (e.g. parent of servicemember)

What is the upfront disclosure required under the MLA?

Military Annual Percentage Rate (MAPR) that is calculated using an expanded list of fees and charges

What is the limit on interest rates (including fees and charges) on obligations entered into BEFORE active duty during the entire period of military service?

6%

What is included in the MAPR?

a complete list of fees and charges included in the special MAPR calculation

Protections under SCRA

a court order is required for mortgage foreclosures, evictions and repossession, termination of certain contracts or leases for purchase of real or personal property including vehicles for a breach of terms w/out a court order, entitled to terminate certain motor vehicle leases for personal or business use as well as residential, professional, business, agriculture or similar purposes to certain conditions

Is the description of the payment obligation required under MLA?

Yes

What is the coverage for MLA?

covered members already on active duty in the federal military service

What is a covered borrower check under the MLA?

A lender is required to perform a covered borrower check at the time of application to determine if the consumer is a covered member entitled to MLA protections

Is there safe harbor if a covered borrower check is performed against the Dept of Defense or nationwide consumer reporting agency?

Yes, if they can provide evidence

Which of the following is NOT a required disclosure for an income tax refund anticipation loan to a servicemember?
MAPR
APR
A description of each of the events of default
A list of all the fees included in the MAPR

A description of each of the events of default

Which of the following is not considered consumer credit under MLA?
Residential mortgage
Credit card loan
Payday loan
Unsecured consumer loan

Residential Mortgage

Whose responsibility is it to notify the lender under SCRA and what is required?

Servicemember must self identify and provide in writing a request to receive rate reduction including a copy of his orders.

Whose responsibility is it to notify the lender for MLA coverage and what is required

Lender must have in place a method to determine if a customer is a servicemember or not and deliver special MLA disclosures and the MAPR calculation

Under SCRA are spouses and dependents provided interest rate relief?

No, unless they are joint on the obligation

How long is foreclosure protection?

Extended for 12 months after the END of active duty

JKO DMLSS: Defense Medical Logistics Standard Support (DMLSS) Basics

Once you are logged into Customer Support, which button would you clock to view a work order?

A) Catalog Search
B) Order Supply
C) WR Status
D) Search Equipment Work Order
E) Customer

D) Search Equipment Work Order

The acronym DMLSS stands for:

A) Defense Medical logistics Standard Support
B) Defense Medial Life Support System
C) Deployed Medical Logistics Standard System
D) Defense Maintenance Logistics Standard System

A) Defense Medical logistics Standard Support

True or False? Once the DMLSS SA has created the New Smart Card-enabled user, he/she will notify the new user(s).

A) True
B) False

A) True

Catalog Searches may also be accessed from the _____ menu.

A) Utilities
B) Window
C) Navigate
D) File

C) Navigate

Click the area of the window you would select first when changing you Default Printer to Xerox Phaser 8560.

B)

You are looking for Nursing in the Department type-ahead field. You type the Letter N, and the list is advanced to the first items in the list beginning with N. When you add the letter U, the list advances to the first items in the list beginning with NU. Is this an editable or non-editable type-ahead field?

A) Editable
B) Non-Editable

A) Editable

Match the items to the correct position.

Field Help
Menu
Horizontal Tool Bar
Vertical Tool Bar
Server/Build Release
Title Bar

E) Field Help
B) Menu
C) Horizontal Tool Bar
D) Vertical Tool Bar
F) Server/Build Release
A) Title Bar

Which of the following statements are true? Select all that apply. In reference to your current application:

A) The Navigate menu lists all options for the current application
B) The horizontal toolbar contains only the most commonly used modules
C) The vertical toolbar varies depending on the current module and the tasks you are performing

A) The Navigate menu lists all options for the current application
B) The horizontal toolbar contains only the most commonly used modules
C) The vertical toolbar varies depending on the current module and the tasks you are performing

Which area of the window provides you with online help specific to the New Work Order window?

E)

What is the meaning of the "red dot" next to some fields on this window?

A) These fields are "locked" and cannot be edited
B) These field have been populated from various data entered elsewhere in DMLSS
C) It is mandatory that these fields be completed before saving

C) It is mandatory that these fields be completed before saving

Notice the tabs on this window. Which of the following statements are true? Select all that apply.

A) You must proceed in order from left to right when selecting tabs
B) The Search Summary Result tab is "grayed out," meaning the table is incomplete
C) Clicking a tab name moves the tab to the front
D) Tabs indicate multiple window layer available in a window

C) Clicking a tab name moves the tab to the front
D) Tabs indicate multiple window layer available in a window

Notice the tabs on this window. Which of the following statements are true? Select all that apply.

A) !
B) %
C) @
D) #

B) %

What is the meaning of the "grayed out" areas in this window? Select all that apply.

A) They cannot be edited from this window
B) They contained erroneous data
C) They are mandatory, or required fields

A) They cannot be edited from this window

Match the items to the correct positions.

Sourced Items
Contracted Items
Unsourced Items
The Customer Catalog
The MTF Catalog
The LOG Catalog

E) Sourced Items
D) Contracted Items
C) Unsourced Items
A) The Customer Catalog
B) The MTF Catalog
F) The LOG Catalog

Select the area of the window that would alphabetically sort the Search Summary Result rows by their SOS

C)

True or False? You can adjust the width of a catalog search result column, and you can change where it is displayed by dragging it to another location.

A) True
B) False

A) True

Which button is used to advance to the last retrieved catalog record?

C)

On the window, if you want to highlight the first, third and fifth rows (all purchased by the case), which key would you hold down while making your selections?

A) Shift
B) Control

B) Control

Click the area of the window that you would click to exit DMLSS.

E)

JKO DMLSS: Catalog Search and Record Management

MTF catalog records are pulled together from various possible sources. Where might the catalog records come from? Select all that apply

A) Site Personnel
B) Master Catalog
C) Manufacturers

A) Site Personnel
B) Master Catalog

Which button provides information on catalog items?

A) Cat Search
B) Gain/Loss
C) LOG Order
D) Cust Req
E) Issues
F) Trans History

A) Cat Search

Match the Catalog Search tabs with their descriptions

Basic Search
Advanced Search
Categorical Search

B) Basic Search
C) Advanced Search
A) Categorical Search

When using the Catalog Search, which of the following statements are true? Select all that apply.

A) Search results are limited to the first 500 records.
B) You can adjust the Search Limit to fewer, but not greater, than 500 records.
C) The Search Limit can be set as high as 999.

A) Search results are limited to the first 500 records.
B) You can adjust the Search Limit to fewer, but not greater, than 500 records.

Match the Catalog Search with tis definition below:

Sourced items
Unsourced Items
Contracted Items
MTF

D) Sourced items
A) Unsourced Items
C) Contracted Items
B) MTF

With the exception of customer catalog searches, how many characters must be typed in a search field for a generic search? Please type a number

3

Which button takes you to the ECAT vendor Website?

A) Cat Search
B) Gain/Loss
C) LOG Order
D) Search
E) ECAT
F) Help Topics

E) ECAT

Where would you click to expand the Dental Supplies sub-category?

C)

Select the ways that items can be added to your MTF catalog. Select all that apply.

A) From the IM Navigate menu, select New Catalog Item.
B) Copy another site's MTF Catalog yo your site.
C) Use the Add like button when viewing an existing MTF Catalog Record
D) Phone the manufacturer and ask that they add an item to your MTF catlog
E) Use catalog search to locate an item in the Sourced and Contracted Items Scopes, and click the add MTF button.

A) From the IM Navigate menu, select New Catalog Item.
C) Use the Add like button when viewing an existing MTF Catalog Record
E) Use catalog search to locate an item in the Sourced and Contracted Items Scopes, and click the add MTD button.

Special characters in Item IDs, such as #$@"%, make database searches difficult.
A) True
B) False

B) False

Using a Basic Search, the Number field will search and return results from which of the following fields: (Check all that apply)

A) Item ID
B) NDC
C) NSN
D) GTIN
E) PVON
F) Manufacturer Catalog Number
G) Vendor Item Number
H) ECAT Supplier Part
I) ECAT Catalog ID

A) Item ID
B) NDC
C) NSN
D) GTIN
E) PVON
F) Manufacturer Catalog Number
G) Vendor Item Number
H) ECAT Supplier Part
I) ECAT Catalog ID

Which button would you click to mark this as a Controlled Substance in the MTF Restrictions?

A)

True or False?
Your primary source of supply for LOF is selected on the SOS Cat tab.

A) True
B) False

B) False

Which area of the window opens the Business Common Name Look-Up window?

D)

In the SOS Lookup window, what area of the window allows the results to be filtered by the SOS code?

B)

JKO Narcotics Order Review and Approval (NORA) Basics

NORA stand for?

B. Narcotics Order Review and Approval

What information is required to check and order status?

B. contract number
C. call number
D.DEA tracking number

only registered users of NORA can check on the status of orders.

B. False

in order to retransmit an order, what conditions must be met?

A. it has been more than two hours since the original EDI 850 purchase order was sent to the prime vender

C. NORA has not received an EDI 855 acknowledgement that the prime vendor has received the original EDI 850 purchase order

D. direct coordination has been made with the prime vendor and the prime vendor is aware that the purchase order is being retransmitted

what roles is (are) allowed to approve or reject pending controlled substance purchase orders?

B. registrant/POA

NORA allows a properly privileged user to digitally sign narcotics orders made in SMLSS and TEWLS

A. true

who issues the digital certs that are uploaded into NORA?

C. Drug enforcement agency (DEA)

after the access manger approves a NORA account, what does the new account holder do next?

B. Active the account following the instruction on approval email.

what users can an access manager see when they access the view users menu?

A. all approved , rejected and pending account for the access managers services

once registered and approved, a DEA employee can unregister a user's account?

B. False

JKO Medical Readiness Administrative Portal Training

Which of the culture mandates relates to applying standards in a systematic and uniformed manner?

consistency

Which term takes into account the mental and physical fitness of the soldier?

Deployable

Which of the following is true of the new DOD PHA?

1. It is completed online
2. It is available across all service branches
3. It includes mental health assessments

What has changed about MRC categories?

They have been streamlined

Which MRC category meets all individual medical readiness (IMR) requirements and has a dental readiness class (DRC) 1 OR 2?

MRC1

Which MRC category means that a soldier's status is unknown, the soldier is missing the periodic health assessment (PHA), or the soldier has a dental readiness (DRC) 4?

MRC4

Which portal allows personnel to update profile condition codes and view assigned task force items?

Administrative Portal

Which of the following statements about the Medical Readiness Assessment Tool (MRAT) are true?

It is an effective tool to help identify trends affecting a unit's health

Which form provides visibility into a soldier's current functional and assignment limitations?

DA form 3349

Which of the following are considered responsibilities shared by everyone?

1. Emphasize preventive measures
2. Maintain data integrity
3. Use designated tools
4. Follow established IMR elements

What is the best way to initiate the PMRT process?

Self directed

Why is the healthcare support staff important to the assessment decision?

They are information gate keepers

Which of the following should a commander do before deciding deployability?

1. Communicate with provider, if needed
2. Review profile

What are the two categories of roles in the Administrative Portal?

Reporting staff and post board staff

Which tab would you select to get a Profile Condition Roster?

Reports

When creating a new profile condition, which tool allows you to pre-populate most of the profile condition details with commonly used information

profile condition template

Which of the below is not a portion of the DOD PHA?

MAR2 capture