PHTLS 9th Edition (Latest 2023/ 2024) Exam |Questions and Verified Answers| Grade A, Exams of Nursing

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* 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 Falls are the most common cause of death in trauma patients over ____ years of age. a. 65 b. 75 c. 55 d. 69 Answer: *b. 75* QUESTION 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 Answer: *a. Respiratory rate increase* QUESTION 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 Answer: *b. Provide supplemental oxygen and transport to a trauma center* QUESTION 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 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 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: 1:4 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? Answer: Blood and fluid in the alveoli and interstitial spaces of the lung QUESTION 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 Answer: *a. A 33-year-old female with altered level of consciousness and decreased capillary refill* QUESTION 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 Answer: *a. Increased blood loss* QUESTION 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 Answer: 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 Answer: *c. Neurogenic* QUESTION 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 Answer: *a. Depressed level of cognition* QUESTION 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 Answer: *c. Provide for adequate exchange of oxygen and C02* QUESTION What is the most common cause of airway obstruction in the unresponsive trauma patient? a. Blood b. Teeth c. Tongue 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: 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? Answer: All of the above QUESTION Of the following, which is the earliest indication of compartment syndrome? Answer: Tense swelling of the involved area QUESTION A traction splint may be used for which of the following Answer: Femur fractures QUESTION Which of the following descriptions meets the criteria for transport to a facility with a burn unit? Answer: A 25 year old male with an electrical burn across his chest QUESTION The preferred method of dressing burns in the prehospital setting is: Answer: Dry sterile dressing QUESTION In assessing the hypothermic patient in the prehospital setting, the most reliable indicator of the severity of hypothermia is: Answer: Rectal temperature QUESTION In the normal child, which general statement is most accurate in comparison with the adult patient? Answer: Blood pressure is lower, heart rate is higher, and ventilatory rate is higher QUESTION 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: Answer: 8T (E-3, V-T, M-4) QUESTION The earliest site for intraosseous infusion is: Answer: Anterior tibia, just below the tibial tuberosity QUESTION You arrive at the scene of a motor vehicle collision in which a vehicle struck a tree. Which is the best indicator of potential injury? Answer: Speed of the vehicle QUESTION The potential for death or serious injury is greatest in which of the following motor vehicle collisions? Answer: Ejection from vehicle QUESTION Bilateral femur fractures are most often associated with which type of motorcycle crash? Answer: Head-on impact QUESTION Which is the preferred fluid for resuscitation of hemorrhagic shock in the prehospital setting? Answer: Lactated Ringer's QUESTION Which is the most common cause of upper airway obstruction in the trauma patient? Answer: Tongue QUESTION Which is the preferred adjunct device for verifying placement of an endotracheal tube in a patient with a perfusing rhythm? Answer: End-tidal CO2 monitoring (capnography) QUESTION Which is the most important reason to maintain an open airway in the trauma Answer: Prevents hypoxemia and hypercarbia QUESTION Essential airway skills include manual clearing of the airway, manual maneuvers, suctioning and which of the following? Answer: Oropharyngeal airway QUESTION Your patient is a middle aged male who crashed his motorcycle. He is unresponsive. After opening the airway using a modified jaw thrust, you note the patient has respirations at a rate of 6. Auscultation reveals breath sounds are absent on the left side. Which of the following is the most appropriate next intervention? Answer: Begin ventilation with a BVM QUESTION Which best describes shock? Answer: Generalized inadequate tissue perfusion QUESTION Your patient has a deep laceration to his antecubital fossa with significant bleeding. What is the most appropriate initial action? Answer: Apply direct pressure QUESTION Hypotension of unknown etiology in a trauma patient should be assumed to result from which of the following? Answer: Blood loss QUESTION Which assessment is most beneficial in differentiating hemorrhagic shock from neurogenic shock in the prehospital setting? Which of the following is the preferred prehospital wound management for a patient with a 36% body surface area flame burn? Answer: Dry sterile dressings QUESTION The most immediate life threatening condition resulting from injury to solid abdominal organs is which of the following? Answer: Hemorrhage. QUESTION 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? Answer: Apply a tourniquet and tighten it until bleeding stops QUESTION An 18-year-old female was struck by a car and has sustained an apparent left femur fracture. Communication with her is hampered because she only speaks a foreign language. Which finding, by itself, does not mandate immobilization of the cervical spine? Answer: Mechanism of injury QUESTION During the primary survey of a trauma patient, you note that the patient is agitated and confused, and has multiple injuries from an altercation. Which of the following choices is the most appropriate first treatment ? Answer: Correction of possible hypoxia QUESTION 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? Answer: Confirm the tourniquet was properly applied. QUESTION Which of the following information is assessed during the secondary survey? Answer: vitals QUESTION 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 Answer: *d. Research information* QUESTION 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 Answer: *c. 1 to 2 years of age* QUESTION 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 Answer: *d. Oxygen* QUESTION 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 Answer: *c. Scoop stretcher* QUESTION