Download PHTLS 9th Edition (Latest 2023/ 2024) Exam |Questions and Verified Answers| Grade A and more Exams Nursing in PDF only on Docsity!
PHTLS 9th Edition (Latest 2023/ 2024) Exam
|Questions and Verified Answers| Grade A
QUESTION
Hyperventilation of a patient with suspected traumatic brain injury should occur when? a. At time of injury b. When signs of impending brain herniation are present c. During a concussion d. Whenever the patient complains of headache Answer: b. When signs of impending brain herniation are present
QUESTION
Patients with suspected traumatic brain injuries (TBI) are susceptible 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 excess hyperventilation Answer: d. Inadvertent or excess hyperventilation
QUESTION
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 Intrathoracic pressure Answer: a. Loss of sympathetic tone causing vasodilation
QUESTION
Which of the following patients will compensate for blood loss the longest? a. 24-year-old male b. 82-year-old female c. 45-year-old female d. 6-year-old male Answer: d. 6-year-old male
QUESTION
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 injuries. Pupils reveal the R pupil is 4mm and the L pupil is 7mm and non-reactive. What is the most appropriate first step? a. Jaw-thrust maneuver b. Pharmacologically assisted intubation c. Perform nasotracheal intubation d. Perform a surgical Cricothyrotomy Answer: a. Jaw-thrust maneuver
QUESTION
In a multi-system trauma patient, what is considered the best method for confirming proper placement of an endotracheal tube? a. Auscultation of the left upper abdominal quadrant b. Waveform capnography c. Presence of bilateral breath sounds d. Pulse oximetry Answer: b. Waveform capnography
A 30-year-old male is thrown from his horse, landing on the top 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. C b. T c. T d. T Answer: b. T4
QUESTION
In a patient with a suspected traumatic brain injury, what is the most concerning physical finding? a. BP 140/ b. Heart rate of 58 c. Respiratory rate of 30 d. Altered level of consciousness Answer: d. Altered level of consciousness
QUESTION
You have a patient who is 35 weeks pregnant who was assaulted by her boyfriend. Patient is having severe abdominal pain described as "tearing" and on exam you note her abdomen is asymmetrical and believe you can feel the fetus through the abdominal wall. What condition do you suspect? a. Placenta previa b. Abruptio placenta c. Ruptured uterus d. Abdominal aortic aneurysm Answer: c. Ruptured uterus
QUESTION
EMS responds to an adult barista who spilled a cup of hot coffee and sustained partial-thickness burns to the abdomen and right leg. Initial treatment of this injury would include: a. Apply antibiotic ointment b. Run copious amounts of room temperature water over the burn c. Cover burned area with dry sterile dressings d. Cover burned area with moist sterile dressings Answer: b. Run copious amounts of room temperature water over the burn
QUESTION
Prehospital providers have treated a sucking chest wound with an occlusive dressing. During transport to the hospital the patient develops increasing respiratory distress with increased respirations and absent lung sounds are noted on repeat auscultation. What is the most appropriate next intervention? a. Release the occlusive dressing b. Perform needle decompression c. Provide positive-pressure ventilation d. Perform endotracheal intubation Answer: a. Release the occlusive dressing
QUESTION
EMS arrives on a scene and finds that emergency medical responders have attempted to immobilize a pediatric patient onto a long backboard. They note that the patient's head is in a flexed position. Which of the following actions is the most appropriate? a. Adjust the cervical collar b. Logroll patient into a left lateral recumbent position c. Place padding under the patient's head and neck d. Place padding under the patient's torso Answer: d. Place padding under the patient's torso
QUESTION
b. Pack the wound with a hemostatic dressing c. Initiate intravenous access d. Apply direct pressure Answer: d. Apply direct pressure
QUESTION
When managing a pediatric patient, pre-hospital providers should do all of the following EXCEPT: a. Use appropriately sized equipment b. Frequently reassess the patient c. Preserve body heat d. Exclude the parents from immediate care Answer: d. Exclude the parents from immediate care
QUESTION
Which of the following is a Golden Principle of trauma care? a. Ensure adequate airway and ventilation b. Complete a thorough head-to-toe survey before initiating treatment c. Rescuer safety is secondary to caring for the patient d. Use chilled intravenous fluids to promote hypothermia Answer: a. Ensure adequate airway and ventilation
QUESTION
The displacement of tissue away from the path of a projectile, both temporarily and permanently, is known as: Answer: Cavitation
QUESTION
The single most important factor in determining the potential for injury due to energy exchange is: Answer: Velocity of the bodies involved
QUESTION
In the management of shock, isotonic crystalloid solutions, such as Ringer's, are preferred because: Answer: These solutions will stay in the vascular space longer than water solutions, such as D5W
QUESTION
With respect to the distance of a fall, which of the following is a guideline for determining a critical fall? Answer: 3 times the height of the patient
QUESTION
The phase of an explosion, or blast, in which hollow organs are squeezed and may rupture is called the __________ phase. Answer: Primary phase
QUESTION
Your patient is a 32 year old man, restrained driver of a vehicle that has been involved in a frontal impact with a concrete bridge abutment. The patient is awake, but has difficulty answering questions due to shortness of breath. His ventilatory rate is 30 per minute. Of the following choices, when is the first time the patient's breath sounds should be checked? Answer: Prior to being removed from the vehicle
QUESTION
Which of the following represents adequate spontaneous ventilation in an adult? Answer: Tidal volume 600 mL, ventilatory rate 12/minute
QUESTION
Which of the following is 100% accurate in verifying endotracheal tube placement? Answer: None of the above
QUESTION
When utilizing percutaneous transtracheal ventilation, the correct ration of lung inflation to lung inflation time, in seconds, is: Answer: 1:
QUESTION
Which of the following is a possible complication of using a manually triggered oxygen powered device for ventilation? Answer: All of the above
QUESTION
Which of the following procedures is considered an essential airway Answer: Insertion of an oropharyngeal airway
QUESTION
Pericardial tamponade is most likely to occur in which of the following situations? Answer: Stab wound to the chest
QUESTION
Which of the following is the preferred site for needle decompression of a tension pneumothorax? Answer: 2nd intercostal space, midclavicular line, just over top of the 3rd rib
QUESTION
Which of the following is the mechanism by which pulmonary contusion interferes with oxygenation?
c. When time and Situation allow
QUESTION
When approaching a trauma patient, what is the first assessment that must be made? a. Circulation b. Scene safety c. Airway d. Breathing Answer: b. Scene safety
QUESTION
The most common type of shock resulting from trauma is? a. Neurogenic b. Septic c. Spinal d. Hemorrhagic Answer: d. Hemorrhagic
QUESTION
- Which of the following best guides the decision to provide spinal immobilization? a. History and complaint b. Obvious signs of associated injury c. Avoid due to possible pressure sores d. Mechanism alone Answer: d. Mechanism alone
QUESTION
A 38-year-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 IV access and infuse crystalloid b. Administer supplemental oxygen c. Hemorrhage control d. Rapid transport Answer: c. Hemorrhage control
QUESTION
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 following: 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 Answer: d. Subdural hematoma
QUESTION
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 Answer: b. Information provided by the dispatcher
QUESTION
d. Vomitus Answer: c. Tongue
QUESTION
While caring for a patient who was involved 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 Answer: d. Suctioning the airway
QUESTION
When energy produced by the cells occurs during a state of adequate oxygenation, it is referred to as which of the following conditions? a. Aerobic metabolism b. Anaerobic metabolism c. Lactic acidosis d. Lactic alkalosis Answer: a. Aerobic metabolism
QUESTION
Which of the following signs of shock is found during the secondary survey? a. Absent radial pulse b. Decreased LOC c. Increased respiratory rate d. Low blood pressure measurement Answer:
d. Low blood pressure measurement
QUESTION
EMS responds for a patient who has sustained a blunt injury to the head. She had a period of unconsciousness followed by a brief period of consciousness and then became unresponsive just as EMS arrived. Based solely on this information, when did the injury occur? a. Primary blast injury b. Secondary blast injury c. Tertiary blast injury d. Quaternary blast injury Answer: d. Quaternary blast injury
QUESTION
Your patient is a 55 year old male who was struck in the right side of the chest with a piece of steel pipe. He presents with uncooperative behavior, his skin is pale and moist, the ventilatory rate is 32, there is a weak radial pulse of 112, and breath sounds are decreased on the right side. The trachea is midline and jugular veins are flat while the patient is supine. There is isolated crepitus over the 4th and 5th ribs in the midaxillary line on the patient's right side. Based on the mechanism of injury and the assessment findings, which of the following is the most likely cause of the patient's signs and symptoms? Answer: Hemothorax
QUESTION
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 Answer: Ruptured diaphragm
Answer: All of the above
QUESTION
Which of the following statements regarding signs of intraabdominal injury is NOT true? Answer: Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity
QUESTION
Which of the following assessment techniques is least useful in the prehospital assessment of the patient with suspected intraabdominal trauma? Answer: Auscultation
QUESTION
Pregnant trauma patients should be placed on the left side because: Answer: This prevents compression of the vena cava
QUESTION
Survival of the fetus in a trauma situation is most dependent upon which of the following factors?
Answer: Good resuscitation of the mother
QUESTION
A patient struck in the back of the head with a baseball bat may sustain a cerebral contusion to which area of the brain? Answer: Occipital (probably too low velocity for Coup & Contre Coup)
QUESTION
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: Answer: 20
QUESTION
In the United State, which of the following mechanisms most frequently causes spinal cord injury in adults? Answer: Vehicle crashes
QUESTION
Which of the following presentation indicate spinal cord injury?
