Download PHTLS 9th Edition Self-test Questions and Answers (GRADED A) (Verified Answers) and more Exercises Nursing in PDF only on Docsity! PHTLS 9th Edition Self-test Questions and Answers (GRADED A) (Verified Answers) 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 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 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 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 d. EtCO2 A patient presents with a blunt trauma injury to the chest. 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? a. 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 bleeding when direct pressure alone does not work. The proper way to use 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 applied for 10 minutes d. Hemostatic agents should never be used unless you have a fall in blood pressure Of the following, which is a preventable cause of secondary brain injury? a. Cerebral edema b. Systemic hypoxia c. Intracranial hematomas d. Herniation syndromes 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 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 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 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 b. Secondary blast injury c. Tertiary blast injury d. Quaternary blast injury 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 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 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 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 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 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 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. 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 d. Altered level of consciousness 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