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PHTLS 9TH ED. SELF-TEST QUESTIONS & ANSWERS
A 30 year old male is injured in a terror bombing. [Je experiences traumatic amputation of his left leg at knee level. An improvised tourniquet was pul in place by bystanders. The yictim is conscious and in severe pain, You first action should be to do which of the following? — ANS-WW Confirm the tourniquet was properly applied. Which of the following information is assessed during the secondary survey? — ANS— VV vitals When caring for a trauma patient a principle is what is necessary for patient improvement or survival. A preference is how the principle is achieved and depends upon four factors. The factors used to accomplish the preference in treating the patient include all except: a, Condition of the patient b. Equipment available ituation that exists d, Research information —- ANS-WW When caring for a trauma paticnt a principle is what is necessary lor patient improvement or survival. A preference is haw the principle is achieved and depends upon four factors. The factars used to accomplish the preference in treating the patient include all except: a, Condition of the patient b. Equipment available ¢, Situation that exists *d, Research information* Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? a. 0 to 12 years of age b, 5 to 6 years of age c. 1 to 2 years of age d, Less than 1 year of age — ANS-Ww Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? a. 0 to 12 years of age b, 5 to 6 years of age xc, | ta 2 years of age* d, Less than 1 year of age In addition to glucose, what is required to maintain the metabolic processes of life and energy production? a, Carbon monoxide b. Krebs cells c, Lymphocytes d, Oxygen — ANS-WwW In addition to glucose, what is required to maintain the metabolic processes of life and energy praduction? a, Carbon monoxide b, Krebs cells c. Lymphocyt *d, Oxygen* The most appropriate airway mancuver in the initial management of a trauma patient is which of the following? a. Head tilt, chin lift b, Supraglottic airway ¢, Trauma jaw thrust d, Orapharyngeal airway — ANS-WwWThe most appropriate airway mancuver in the initial management of a trauma patient is which of the following? a, Head tilt, chin lift b, Supraglottic airway *c, Trauma jaw thrus d, Oropharyngeal airway When verifying ET tube placement on a perlusing patient, the "gold standard" of monitoring is considered to be? a, Colorimetric carbon dioxide detector b, Pulse oximetry c, Listening to lung sounds d, FtCO2 — ANS-¥v¥ When verifying ET tube placement on a perfusing patient, the "gold standard" of monitoring is considered to be? a, Colorimetric carbon dioxide detector b, Pulse oximetry ¢, Listening to lung sounds sd, EvCO2* A patient presents with a blunt trauma injury to the chest. On cxam, he has absent breath sounds on one side of his chest and respiratory distress. Which additional sign would indicate that the palient has a lension pneumothorax? a, Distended neck veins b, Mulfled heart sounds c, Narrowed pulse pressure d, Tracheal deviation towards the side of injury - ANS-WWA patient presents with a blunt trauma injury lo the chesl. On exam, he has absent breath sounds on one side of his chest and respiratory distress. Which additional sign would indicate that the patient has a tension pneumothorax? . Distended neck veins* b, Muffled heart sounds c. Narrowed pulse pressure d, Tracheal deviation away from the side of injury Hemostatic agents should be used for excessive blecding when dircet pressure alone does not work, The proper way to use mast hemostatic agents is which of the following? a. Placing the agent around the edges of the wound b, Placing the agent properly into the wound and holding direct pressure ¢, Only using it after a tourniquet has been applied for 10 minutes d. Hemostatic agents should never be used unless you have a fall in blood pressure — ANS-vWwvHemostatic agents should be used for excessive bleeding when direct pressure alone docs not work. The proper way to usc most hemostatic agents is which of the following? a. Placing the agent around the edges of the wound *b, Placing the agent properly into the wound and holding direct pressure c, Only using it after a tourniquet has been applicd for 10 minutes *d, Concussion* When using a selective spinal immobilization protocol, which of the following findings indicate the need for immobilization? a, Past history of spinal injury b. Being an unrestrained passenger in a motor vehicle crash c, Being ambulatory al the scene d, An associated femoral shaft fracture with severe pain — ANS-¥WW When using a selective spinal immobilization protocol, which of the fallowing findings indicate the need for immobilization? a, Past history of spinal injury b. Being an unrestrained passenger in a motor vehicle crash c, Being ambulatory at the scene *d, An associated femoral shaft fracture with severe pain* In a blast-related multiple patient situation, which of the following patients should be treated first? a, A 33-year-old female with altered level of consciousness and decreased capillary refill b, A 28-year-old male with an arm ampulalion who has bleeding controlled with a tourniquet c. A 14-ycar—old pulseless female with grey matter visible from a head wound d, A 78-ycar-old male awake and unable to hear — ANS-WwW In a blast-rclated multiple patient situation, which of the following patients should be treated first? xa, A 33-year-old female with altered level of consciousness and decreased capillary refills b, A 28-year-old male with an arm amputation who has bleeding controlled with a tourniquet c. A 14-year-old pulseless female with grey matter visible from a head wound d. A 78-year-old male awake and unable to hear Excessive fluid resuscitation of the trauma patient can result in which of the following? a, Increased blood lass b, Decreased mortality c¢. Earlier discharge from the hospital d, A higher incidence of sepsis in the ICL — ANS-WW Excessive fluid resuscitation of the trauma patient can result in which of the following? xa, Increased blood loss* b, Decreased mortality c, Earlier discharge from the hospital d, A higher incidence of sepsis in the ICU The secondary survey should be accomplished: a, Never on a critical patient b, Before transport c, When time and Situation allow d. Before moving the patient - ANS-WWThe secondary survey should be accomplished: a, Never on a critical patient b, Before transport xe, When time and Situation allow* a, History and complaint b, Obvious signs of associated injury c, Ayoid duc to possible pressure sores d, Mechanism alone — ANS-WeW Which of the following best guides the decision to provide spinal immobilization? a. [listory and complaint b, Obvious signs of associated injury ¢, Avoid due to possible pressure sores *d, Mechanism alone A 38-ycar—old male sustains a large wound to his right thigh while at work, Which of the following actions is the most important initial step? a, Obtain IY access and infuse crystalloid b, Administer supplemental oxygen c. Hemorrhage control d, Rapid transport - ANS-WWA 38—-ycar—old male sustains a large wound to his right thigh while at work, Which of the following actions is the most important initial step? a, Obtain TY access and inluse crystalloid b, Administer supplemental oxygen xc, lemorrhage contral* d. Rapid transport You respond to a Jocal bar for an uncons us person, On arrival, you are met by a police officer who reports that ane of their "regular alcoholics" was found in the alley behind the bar, On exam, you note the smell of an aleoholic beverage as well as the follawing: Patient flexes his arms to painful stimuli, has bilateral fixed and dilated pupils, irregular respirations at 12 breaths per minute and a BP of 210/100. What condition do you suspect? a, Subarachnoid hemorrhage b, Alcohol poisoning c, Epidural hematoma d, Subdural hematoma — ANS-WW/You respond to a local bar for an unconscious person, On arrival, you are met by a police officer who reports that one of their “regular alcoholics" was found in the alley behind the bar, On exam, you note the smell of an alcoholic beverage as well as the follawing: Patient flex s his arms to painful stimuli, has bilateral fixed and dilated pupils, irregular respirations at 12 breaths per minute and a BP of 210/100. Whal condition do you suspect? a, Subarachnoid hemorrhage b, Aleohal poisoning ¢, Epidural hematoma sd, Subdural hematoma* The pre-hospital assessment ol the trauma patient begins with which of the follawing? a, Assessment of scene safety and situation b, Information provided by the dispatcher c, The initial assessment d. The primary survey — ANS-WwW The pre-hospital assessment of the trauma patient begins with which of the following? a, Assessment of scene safety and situation *b, Information provided by the dispatcher c, The initial assessment d. The primary survey Which best describes the goal of airway management in a trauma patient? a, Perform complex airway mancuyers b, Perform a surgical Cricothyrotomy c, Provide for adequate exchange of oxygen and C02 d, Perform RSI - ANS-Wv Which best describes the goal of airway management in a trauma patient? a, Perlarm complex airway maneuvers b, Perform a surgical Cricothyrotomy *c, Provide for adequate exchange of oxygen and CO2# d, Perform RSI What is the most common cause of airway obstruction in the unresponsive trauma patient? a, Blood b. Teeth c, Tongue d. Yomitus - ANS-Wev What is the most common cause of airway obstruction in the unresponsive trauma patient? a, Blood b. Teeth xc, Tanguc* d, Vomitus While caring for a patient who was involyed in an altercation, he yomits and his airway is totally obstructed with vomitus and blood, What is the most important action? a, Performing an RSI b, Performing a head-tilt chin lift c, Intubating d, Suctioning the airway — ANS-We While caring for a paticnt who was involyed in an altercation, he vomits and his airway is totally obstructed with vomitus and blood. What is the most important action? a, Performing an RSI b, Performing a head—-tilt chin lift c, Intubating *d. Suctioning the airway* When energy praduced by the cells occurs during a stale of adequate oxygenation, it is referred ta as which of the following conditions? a, Acrobic metabolism b, Anacrobic metabolism c, Lactic acidosis d, Lactic alkalosis - ANS-WW When cnergy produced by the cells occurs during a state of adequate oxygenation, it is referred to as which of the following conditions? xa, Aerobic metabalism* b, Anaerabic metabolism c, Lactic acidosis d, Lactic alkalosis Which of the fallowing signs of shock is found during the secondary survey? a, Absent radial pulse b, Decreased LOC c, Increased respiratory rate d, Whenever the patient complains of headache — ANS-WWHyperventilation of a patient with suspected traumatic brain injury should occur when? a, At time of injury xb, When signs of impending brain herniation are present* c. During a concussion d, Whenever the palient complains af headache Patients with suspected traumatic brain injuries (TBI) are susceptible to secondary injuries that are typically preventable. In addition to hypoxia and hypatension, which of the following can also decrease cerebral perfusion? a, Hypothermia b, Cerebral vasodilation c, Increased cardiac output d, Inadvertent or excess hyperventilation —- ANS-WwW Patients with suspected traumatic brain injurics (TBI) are susecptible to secondary injuries that are typically preventable. In addition to hypoxia and hypotension, which of the following can also decrease cerebral perfusion? a, Hypothermia b, Cerebral vasodilation c, Increased cardiac output *d, Inadvertent or exeess hyperventilatia Hypotension due to a spinal cord injury is a result of what physiologic mechanism? a, Loss of sympathetic tone causing vasodilation b, Increased capillary permeability c, Increased sympathetic tone causing vasoconstriction d, Increased Intrathoracie pressure — ANS-WW Hypotension duc to a spinal cord injury is a result of what physiologic mechanism? «a, Loss of sympathetic tone causing vasodilation b, Increased capillary permeability c, Increased sympathetic tone causing vasoconstriction d. Increased Intrathoracic pressure Which of the following patients will compensate for blood loss the longest? a, 24-year-old male b, 82-year-old lemale c, 45-year-old female d. G-year—-old male — ANS-Wv Which of the Jallowing palients will compensate for bload loss the longest? a, 24-year-old male b, 82-year-old female c, 45-year-old female *d, G-ycar—old male* You respond to a reported assault at a local bar. On arrival, you find a 46-year-old male on the bathroom floor with snoring respirations at 4 times per minute and obvious facial injurics. Pupils reyeal the R pupil is 4mm and the L pupil is 7mm and non-reactive, What is the most appropriate first step? a, Jaw—thrust mancuver b, Pharmacologically assisted intubation c, Perform nasotracheal intubation d, Pelvic fracture — ANS-WW What is the most likely source of blecding in a patient with signs of shock and no obvious injury? a, Femur fracture *b. Intra—abdominal injury* c. Severe traumatic brain injury d, Pelvic fracture Ilypoperfusion will affect which of the following organs first? a, Kidney b, Gl tract . Brain d, Liver — ANS-WWHypopcerfusion will affeet which of the following organs first? a, Kidney b, Gl tract xe, Brain* d, Liver year-old male construction worker fell approximately 30 fect from a roof. The paticnt is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his | pupil is 3mm. He has irregular respirations at 8 breaths per min, You do not have waveform capnography, so what is the mast appropriale rate of ventilalions? a, 30 BPM b, 25 BPM c, 20 BPM d. 12 BPM — ANS-WWA 23-year-old male canstruclion worker [ell approximately 30 feet from a roof, The patient is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his | pupil is 3mm, He has irregular respirations at 8 breaths per min. You do not have waveform capnography, so what is the most appropriate rate of ventilations? a, 30 BPM b, 25 BPM sc, 20 BPM* d, 12 BPM A 30-year-old male is thrown [rom his horse, landing an the tap rail of a pipe fence and now has a loss of sensation from the nipples down. What level of the spine do you suspect he injured? a C3 b. T4 c, T10 d. T12 — ANS-WWA 30-year-old male is thrown from his horse, landing on the top rail of a pipe fenee and now has a loss of sensation from the nipples down. What level of the spine do you suspcet he injured? a C3 *b, T4# c, T10 d. T12 In a patient with a suspected traumatic brain injury, what is the most concerning physical finding? a. BP 140/90 b. Heart rate of 58 c, Respiratory rate of 30 
