Download PHTLS Pre & Post Test 2024-2025. Questions & Correct Answers. Graded A and more Exams Health sciences in PDF only on Docsity!
PHTLS Pre & Post Test 2024-2025.
Questions & Correct Answers. Graded A
A 20-year-old female was ejected from her vehicle during a high-speed roll-over motor vehicle collision. She has significant bleeding from a large laceration. Your initial assessment reveals a GCS score of 7, systolic blood pressure of 70 mm Hg and pupils that are equal but respond sluggishly to light. After establishing two large bore IV lines, you should titrate the infusion rate to achieve a target blood pressure of at least A) 60 mm Hg. B) 70 mm Hg. C) 80 mm Hg. D) 90 mm Hg. – ANS D) 90 mm Hg. A patient struck in the back of the head with a baseball bat may sustain a cerebral contusion to which area of the brain? A. Frontal and occipital B. Occipital C. Parietal D. Frontal - ANSB. Occipital (probably too low velocity for Coup & Contre Coup)
A patient who withdraws from painful stimuli, opens eyes on verbal command, and cannot speak because of intubation has a Glasgow Coma Scale of which of the following: A. 8 B. 8T C. 7 D. 7T - ANSB. 8T (E-3, V-T, M-4) A regional resource center with a full spectrum of trauma services from prevention to rehabilitation which serves as the leader in trauma care for a geographical region is a: A. Level IV trauma center B. Level III trauma center C. Level II trauma center D. Level I trauma center - ANSD. Level I trauma center A traction splint may be used for which of the following injuries? A. Knee dislocation B. Pelvic fractures C. Femur fractures
An adult male sustained a deep laceration to his distal thigh. Bright red blood is spurting from the wound. Direct pressure is not controlling the bleeding. What is the most appropriate next step? A) Apply a topical hemostatic agent and transport B) Apply a tourniquet and tighten it until bleeding stops C) Elevate the leg and apply pressure to the femoral artery D) Maintain direct pressure and transport immediately - ANSB) Apply a tourniquet and tighten it until bleeding stops Bilateral femur fractures are most often associated with which type of motorcycle crash? A) Angular impact B) Bike-road impact C) Head-on impact D) Rear impact - ANSC) Head-on impact Delayed death due to trauma is usually a result of:
A. Biochemical and pathophysiological effects of inadequate initial resuscitation B. Acute circulatory failure C. Brain injury D. Acute hypoxia - ANSA. Biochemical and pathophysiological effects of inadequate initial resuscitation Deterioration of ventilation and oxygenation after inflation of a PASG in a patient who has sustained a high-pressure compression injury of the abdomen, such as a sudden deceleration with the lap belt placed across the abdomen, most likely represents which of the following injuries? A. Abdominal aortic aneurysm B. Ruptured diaphragm C. Ruptured esophagus D. "Paper bag" syndrome of the lungs - ANSB. Ruptured diaphragm During the primary survey and management of a trauma patient, the E in ABCDE stands for _________? A. Edema B. Eyes & ears
In an adult patient, blood loss into the tissue from a fractured femur may be as much as which of the following? A. 150 to 500 mL B. 500 to 1000 mL C. 1000 2000 mL D. 2500 to 5000 mL - ANSC. 1000 2000 mL In assessing the hypothermic patient in the prehospital setting, the most reliable indicator of the severity of hypothermia is: A. Rectal temperature B. Oral temperature C. Heart rate < 60 D. Presence or absence of shivering - ANSA. Rectal temperature In the absence of extenuating circumstances, the maximum amount of time it should take to identify and manage immediate threats to life, prepare the patient for transport and begin transport is _________? A. 5 minutes B. 10 minutes C. 15 minutes D. 30 minutes - ANSB. 10 minutes In the context of the caring for an adult patient with traumatic brain injury who is deteriorating and exhibiting signs of herniation, hyperventilation means ventilating with a BVM and 100% oxygen at a rate of: A. 12 to 16 per minute B. 32 to 40 per minute C. 8 to 12 per minute D. 20 per minute - ANSD. 20
In the elderly trauma patient a high index of suspicion for shock should occur beginning when the systolic blood pressure is less than: A. 90 mmHg B. 150 mmHg C. 120 mmHg D. 100 mmHg - ANSC. 120 mmHg In the management of shock, isotonic crystalloid solutions, such as Ringer's, are preferred because: A. The protein molecules in crystalloid solutions act as volume expanders B. These fluids draw interstitial fluid into the vascular space to enhance volume C. These solutions will stay in the vascular space longer than water solutions, such as D5W D. Their pH enhance oxygen delivery to the tissues - ANSC. These solutions will stay in the vascular space longer than water solutions, such as D5W In the normal child, which general statement is most accurate in comparison with the adult patient? A. Blood pressure is higher, hear rate is higher, and ventilatory rate is higher B. Blood pressure is lower, heart rate is lower, and ventilatory rate is higher C. Blood pressure is lower, heart rate is higher, and ventilatory rate is higher D. Blood pressure is lower, heart rate is higher, and ventilatory rate is lowe - ANSC. Blood pressure is lower, heart rate is higher, and ventilatory rate is higher In the United State, which of the following mechanisms most frequently
Of the following, which is the earliest indication of compartment syndrome? A. Paralysis of the affected muscles B. Loss of pulses C. Loss of feeling in the web space between the thumb and index finger or between the first and second toes D. Tense swelling of the involved area
- ANSD. Tense swelling of the involved area One of the earliest signs of hypovolemic shock is: A. Hypotension B. Bradycardia C. Anxiety D. Reduced urine output - ANSC. Anxiety Pericardial tamponade is most likely to occur in which of the following situations? A. Stab wound to the chest B. Fall from a height C. Frontal impact vehicle crash D. Gunshot wound to the chest - ANSA. Stab wound to the chest Pregnant trauma patients should be placed on the left side because: A. This prevents seizures due to eclampsia B. This prevents abruption of the placenta C. This prevents compression of the vena cava D. This is the best way to auscultate fetal heart tones - ANSC. This prevents compression of the vena cava Survival of the fetus in a trauma situation is most dependent upon which of the following factors? A. Gestational age of the fetus B. Prenatal care
C. Immediate cesarean section D. Good resuscitation of the mother - ANSD. Good resuscitation of the mother The body initially compensates for blood loss through activation of which of the following? A) Parasympathetic nervous system B) Reticular activating system C) Spinal reflex arcs D) Sympathetic nervous system - ANSD) Sympathetic nervous system The displacement of tissue away from the path of a projectile, both temporarily and permanently, is known as: A. Conization B. Cavitation C. Crepitation D. Contusion - ANSB. Cavitation The earliest site for intraosseous infusion is: A. Anterior tibia, just above the tibial tuberosity B. Anterior fibula C. Anterior tibia, just below the tibial tuberosity D. Posterior fibula - ANSC. Anterior tibia, just below the tibial tuberosity The most immediate life-threatening condition resulting from injury to solid abdominal organs is which of the following? A) Acute respiratory failure B) Hemorrhage. C) Multiple organ failure. D) Peritonitis - ANSB) Hemorrhage. The phase of an explosion, or blast, in which hollow organs are squeezed and may rupture is called the __________ phase. A.
The single most important factor in determining the potential for injury due to energy exchange is: A. Mass of the bodies involved B. Velocity of the bodies involved C. Density of the tissues involved D. Surface area of the impact involved - ANSB. Velocity of the bodies involved The target blood pressure for a trauma patient with suspected intraabdominal hemorrhage is which of the following? A) 60 - 70mm Hg B) 80 - 90 mm Hg C) 100 - 110 mm Hg D) 120 - 130 mm Hg - ANSB) 80 - 90 mm Hg The time in which surgical intervention can make a difference in patient outcome is the __________? A. Golden period B. Golden time C. Golden era D. Golden minutes - ANSA. Golden period (hour) When utilizing percutaneous transtracheal ventilation, the correct ration of lung inflation to lung inflation time, in seconds, is: A. 1:4 B. 1:5 C. 1:2 D. 2:2 - ANSA. 1: Which assessment is most beneficial in differentiating hemorrhagic shock from neurogenic shock in the prehospital setting? A) Abdomen B) Blood pressure C) Neurologic status D) Skin - ANSD) Skin
Which best describes shock? A) Decreased Glasgow Coma Scale (GCS) B) Flushed, dry, hot skin combined with bradycardia C) Generalized inadequate tissue perfusion D) Low blood pressure combined with tachycardia - ANSC) Generalized inadequate tissue perfusion Which best explains the mechanism by which gas exchange is impaired in pulmonary contusion? A) Blood in the alveoli B) Collapse of the alveoli C) Compression of the lung tissue D) Partial occlusion of the bronchi - ANSA) Blood in the alveoli Which is the most common cause of upper airway obstruction in the trauma patient? A) Blood B) Teeth C) Tongue D) Vomitus - ANSC) Tongue Which is the most important reason to maintain an open airway in the trauma patient? A) Prevents aspiration and pneumonia B) Prevents hypoxemia and hypercarbia C) Prevents snoring respirations D) Prevents the tongue from blocking the pharynx - ANSB) Prevents hypoxemia and hypercarbia
on repeated retelling of events that occurred years ago - ANSA. Inability to recall his/her name Which of the following characterizes the washout phase of shock? A. Systemic acidosis B. Localized tissue acidosis C. Edema D. Reduced capillary blood flow - ANSA. Systemic acidosis Which of the following descriptions meets the criteria for transport to a facility with a burn unit? A. A 49 year old female with a partial thickness burn from her elbow to her shoulder B. A 25 year old male with an electrical burn across his chest C. A 9 year old make with superficial burns on the backs of both legs D. A 32 year old female with a partial thickness burn about twice the size of her hand on her back - ANSB. A 25 year old male with an electrical burn across his chest Which of the following is 100% accurate in verifying endotracheal tube placement? A. Pulse oximetry B. End-tidal capnometry C. Syringe aspiration D. None of the above - ANSD. None of the above
Which of the following is a key finding that differentiates cardiac tamponade from tension pneumothorax? A) Distended jugular veins B) Equal breath sounds C) Hypotension D) Tachycardia - ANSB) Equal breath sounds Which of the following is a limitation of prehospital fluid resuscitation of the patient in hemorrhagic shock? A. Inability of fluids to carry oxygen B. Pulmonary edema C. Increased hemorrhage D. All of the above - ANSD. All of the above Which of the following is a possible complication of using a manually triggered oxygen powered device for ventilation? A. Gastric distention B. Pneumothorax C. Inability to feel lung compliance D. All of the above - ANSD. All of the above Which of the following is NOT a component of the Fick Principle? A. Adequate number of platelets in the blood B. Oxygenation of red blood cells C. Transportation of red blood cells to the tissues of the body D. Off-loading oxygen from the red blood cells to the tissues - ANSA. Adequate number of platelets in the blood
Which of the following is the preferred site for needle decompression of a tension pneumothorax? A. 4th intercostal space, midclavicular line, just over the top of the 5th rib B. 4th intercostal space, midclavicular line, just below the 4th rib C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib D. 2nd intercostal space, midclavicular line, just below the 2nd rib - ANSC. 2nd intercostal space, midclavicular line, just over top of the 3rd rib Which of the following patients is not indicated for spinal immobilization? A. Intoxicated patient in a MVC B. Patient who fell 8 feet and lost consciousness C. Patient complaining of pain on palpation of the neck D. Patient with a knife wound to the chest and a GCS of 15 - ANSD. Patient with a knife wound to the chest and a GCS of 15 Which of the following presentation indicate spinal cord injury? A. Complete loss of sensory and motor function below the site of injury B. Weakness and parethesia in the upper extremities, but normal function in the lower extremities C. Complete loss of function on one side of the body and loss of pain and temperature sensation on the opposite side D. All of the above - ANSD. All of the above
Which of the following procedures is considered an essential airway skill? A. Needle cricothyroidotomy B. Endotracheal intubation C. Insertion of an oropharyngeal airway D. Retrograde endotracheal intubation - ANSC. Insertion of an oropharyngeal airway Which of the following represents adequate spontaneous ventilation in an adult? A. Tidal volume 100 mL, ventilatory rate 40/minute B. Tidal volume 500 mL, ventilatory rate 8/minute C. Tidal volume 300 mL, ventilatory rate 16/minute D. Tidal volume 600 mL, ventilatory rate 12/minute - ANSD. Tidal volume 600 mL, ventilatory rate 12/minute Which of the following statements regarding signs of intraabdominal injury is NOT true? A. Fresh blood in the abdominal cavity does not cause signs of peritonitis B. A significant amount of blood loss occurs before abdominal distention can be noticed C. Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity D. Signs and symptoms of shock greater than can be explained by other injuries is a reliable indicator of intraabdominal injury - ANSC. Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity
