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PHTLS 9th Ed. Self-test 2022 with complete solution
A 30 year old male is injured in a terror bombing. He experiences traumatic amputation of his left leg at knee level. An improvised tourniquet was put in place by bystanders. The victim is conscious and in severe pain. You first action should be to do which of the following? - Confirm the tourniquet was properly applied. Which of the following information is assessed during the secondary survey? - 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 c. Situation that exists d. Research information - 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 c. 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 - 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 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 - 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 You respond to a patient who has sustained a stab wound to the left upper thorax. She is barely responsive, pale and diaphoretic. Which of the following is the most appropriate for transport? a. Stair chair b. Long board with full spine immobilization c. Scoop stretcher d. Short immobilization device - You respond to a patient who has sustained a stab wound to the left upper thorax. She is barely responsive, pale and diaphoretic. Which of the following is the most appropriate for transport? a. Stair chair b. Long board with full spine immobilization c. Scoop stretcher d. Short immobilization device Units responding to a motor vehicle accident on the highway should consider which of the following as part of their pre-arrival assessment? a. Calling for more units to respond b. Weather conditions c. The need for immediate transport d. Post-exposure prophylaxis - Units responding to a motor vehicle accident on the highway should consider which of the following as part of their pre-arrival assessment? a. Calling for more units to respond b. Weather conditions c. The need for immediate transport d. Post-exposure prophylaxis The most appropriate airway maneuver in the initial management of a trauma patient is which of the following? a. Head tilt, chin lift b. Supraglottic airway c. Trauma jaw thrust d. Oropharyngeal airway - The most appropriate airway maneuver in the initial management of a trauma patient is which of the following? a. Head tilt, chin lift b. Supraglottic airway c. Trauma jaw thrust d. Oropharyngeal airway 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 c. Listening to lung sounds
You are called to treat a patient who was knocked unconscious when he slipped and fell on a wet floor, striking his head. It is now several hours later. He is awake but confused, does not recall the incident and is vomiting with a headache. Which of the following injuries is most likely? a. Brain herniation b. Intracranial hemorrhage c. Diffuse axonal injury d. Concussion - You are called to treat a patient who was knocked unconscious when he slipped and fell on a wet floor, striking his head. It is now several hours later. He is awake but confused, does not recall the incident and is vomiting with a headache. Which of the following injuries is most likely? a. Brain herniation b. Intracranial hemorrhage c. Diffuse axonal injury 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 at the scene d. An associated femoral shaft fracture with severe pain - 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 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 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 - 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 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 loss b. Decreased mortality c. Earlier discharge from the hospital d. A higher incidence of sepsis in the ICU - Excessive fluid resuscitation of the trauma patient can result in which of the following? a. 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 - 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 When approaching a trauma patient, what is the first assessment that must be made? a. Circulation b. Scene safety c. Airway d. Breathing - When approaching a trauma patient, what is the first assessment that must be made? a. Circulation b. Scene safety c. Airway d. Breathing The most common type of shock resulting from trauma is? a. Neurogenic b. Septic c. Spinal d. Hemorrhagic - The most common type of shock resulting from trauma is? a. Neurogenic b. Septic c. Spinal d. Hemorrhagic
- 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
b. Information provided by the dispatcher c. The initial assessment d. The primary survey EMS responds for a patient involved in a motorcycle vs. car collision. The patient is unresponsive with no movement of lower extremities and loss of temperature control below the T10. Which type of shock is the patient experiencing? a. Cardiogenic b. Hypovolemic c. Neurogenic d. Obstructive - EMS responds for a patient involved in a motorcycle vs. car collision. The patient is unresponsive with no movement of lower extremities and loss of temperature control below the T10. Which type of shock is the patient experiencing? a. Cardiogenic b. Hypovolemic c. Neurogenic d. Obstructive Which of the following is the best indicator of shock? a. Depressed level of cognition b. Heart rate of 80 c. Respirations of 18 d. GCS of 15 - Which of the following is the best indicator of shock? a. Depressed level of cognition b. Heart rate of 80 c. Respirations of 18 d. GCS of 15 Which best describes the goal of airway management in a trauma patient? a. Perform complex airway maneuvers b. Perform a surgical Cricothyrotomy c. Provide for adequate exchange of oxygen and C d. Perform RSI - Which best describes the goal of airway management in a trauma patient? a. Perform complex airway maneuvers b. Perform a surgical Cricothyrotomy c. Provide for adequate exchange of oxygen and C02 d. Perform RSI What is the most common cause of airway obstruction in the unresponsive trauma patient? a. Blood b. Teeth c. Tongue d. Vomitus - What is the most common cause of airway obstruction in the unresponsive trauma patient?
a. Blood b. Teeth c. Tongue d. Vomitus 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 - 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 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 - 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 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 - 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 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
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 female c. 45-year-old female d. 6-year-old male - 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 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 - 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 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 - 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 What is the most likely source of bleeding 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 - What is the most likely source of bleeding 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 Hypoperfusion will affect which of the following organs first? a. Kidney b. Gl tract c. Brain d. Liver - Hypoperfusion will affect which of the following organs first? a. Kidney b. Gl tract c. Brain d. Liver A 23-year-old male construction worker fell approximately 30 feet from a roof. The patient is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his l 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 c. 20 BPM d. 12 BPM - A 23-year-old male construction worker fell approximately 30 feet from a roof. The patient is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his l 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 c. 20 BPM d. 12 BPM 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. T12 - 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. T4 c. T d. T
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 - 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 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 - 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 Falls are the most common cause of death in trauma patients over ____ years of age. a. 65 b. 75 c. 55 d. 69 - Falls are the most common cause of death in trauma patients over ____ years of age. a. 65 b. 75 c. 55 d. 69 What is the earliest sign of deterioration in a patient with a flail chest? a. Respiratory rate increase b. Oxygen saturation decrease c. Pulse rate increase d. Blood pressure decrease - What is the earliest sign of deterioration in a patient with a flail chest?
a. Respiratory rate increase b. Oxygen saturation decrease c. Pulse rate increase d. Blood pressure decrease EMS is treating a 24-year-old soccer player who was kicked in the chest. Prehospital providers note paradoxical movement of a portion of the patient's chest wall. The patient's respiratory rate is 16 and oxygen saturation is 94%. What is the most appropriate action? a. Endotracheal intubation b. Provide supplemental oxygen and transport to a trauma center c. Place bulky dressing over the wound and tightly wrap the chest d. Stabilize the segment with sandbags on the chest - EMS is treating a 24-year-old soccer player who was kicked in the chest. Prehospital providers note paradoxical movement of a portion of the patient's chest wall. The patient's respiratory rate is 16 and oxygen saturation is 94%. What is the most appropriate action? a. Endotracheal intubation b. Provide supplemental oxygen and transport to a trauma center c. Place bulky dressing over the wound and tightly wrap the chest d. Stabilize the segment with sandbags on the chest Prehospital providers respond to a 17-year-old male who fell through a sliding glass door and sustained a large laceration to his arm that is bleeding heavily. He is restless and diaphoretic, with a weak, thready pulse. What is the most appropriate first action? a. Apply a tourniquet b. Pack the wound with a hemostatic dressing c. Initiate intravenous access d. Apply direct pressure - Prehospital providers respond to a 17-year-old male who fell through a sliding glass door and sustained a large laceration to his arm that is bleeding heavily. He is restless and diaphoretic, with a weak, thready pulse. What is the most appropriate first action? a. Apply a tourniquet b. Pack the wound with a hemostatic dressing c. Initiate intravenous access d. Apply direct pressure 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 - 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
