FACRRM Practice and Application 3

Question 1

A 45-year-old Indigenous woman presents with a deep facial laceration sustained in a remote community. She refuses suturing for cultural reasons. What is the most appropriate response?

Accepted Answer

Respect her decision, document it, and offer wound closure alternatives such as steri-strips

Answer

Informed refusal must be respected in a competent adult; offering culturally acceptable alternatives demonstrates patient-centered care.

Question 2

A child is brought to a remote clinic with burns covering approximately 15% BSA. Using the Parkland formula, what IV fluid should be given in the first 8 hours?

Accepted Answer

Half of the total 24-hour Ringer's lactate calculated as 4 mL × kg × %BSA

Answer

The Parkland formula gives 4 mL × kg × %TBSA of Ringer's lactate over 24 hours, with 50% in the first 8 hours post-burn.

Question 3

A patient in a rural community presents with a snakebite and progressive coagulopathy. The nearest antivenom is 2 hours away. Which immediate action is most important?

Accepted Answer

Immobilize the limb with a pressure immobilization bandage and arrange urgent transfer

Answer

Pressure immobilization bandaging slows lymphatic spread of venom; tourniquet and incision are contraindicated in Australian snakebite management.

Question 4

A rural GP reviews a patient with poorly controlled type 2 diabetes (HbA1c 10.5%) who is reluctant to start insulin. What is the most appropriate approach?

Accepted Answer

Explore barriers to insulin use, optimize oral agents, and set a shared glycemic goal with a clear review plan

Answer

Shared decision-making that addresses patient concerns while optimizing available therapy is the cornerstone of chronic disease management in rural practice.

Question 5

You are the only clinician when a patient in a remote location goes into cardiac arrest. Your automated external defibrillator (AED) indicates a shockable rhythm. What is the correct sequence?

Accepted Answer

Deliver shock immediately, then resume CPR for 2 minutes before re-analyzing

Answer

Current ALS guidelines recommend immediate defibrillation for shockable rhythms followed by 2 minutes of CPR before rhythm re-analysis.

(FACRRM) Fellowship of the Australian College of Rural and Remote Medicine Practice Test

(FACRRM) Fellowship of the Australian College of Rural and Remote Medicine Practice Test

FACRRM Practice and Application 3