Download PHTLS 9th Edition Self-test Questions with Answers Latest Update and more Exams Nursing in PDF only on Docsity! PHTLS 9th Edition Self-test Questions with Answers Latest Update 1. 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? - ☑☑️C️onfirm the tourniquet was properly applied. 2. Which of the following information is assessed during the secondary survey? - ☑☑️v️itals 3. 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 - ☑☑️W️hen 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: 4. Condition of the patient 5. Equipment available 6. Situation that exists 7. *d. Research information* 8. 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 - ☑☑️A️pproximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? 9. 0 to 12 years of age 10. 5 to 6 years of age 11. *c. 1 to 2 years of age* 12. Less than 1 year of age 13. 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 - ☑☑️I️n addition to glucose, what is required to maintain the metabolic processes of life and energy production? 14. Carbon monoxide 15. Krebs cells 16. Lymphocytes 17. *d. Oxygen* 38. 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 towards the side of injury - ☑☑️A️ 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? 39. *a. Distended neck veins* 40. b. Muffled heart sounds 41. Narrowed pulse pressure 42. Tracheal deviation away from the side of injury 43. 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 - ☑☑️H️emostatic 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? 44. Placing the agent around the edges of the wound 45. *b. Placing the agent properly into the wound and holding direct pressure* 46. Only using it after a tourniquet has been applied for 10 minutes 47. Hemostatic agents should never be used unless you have a fall in blood pressure 48. Of the following, which is a preventable cause of secondary brain injury? a. Cerebral edema b. Systemic hypoxia c. Intracranial hematomas d. Herniation syndromes - ☑☑️O️f the following, which is a preventable cause of secondary brain injury? 49. Cerebral edema 50. *b. Systemic hypoxia* 51. Intracranial hematomas 52. Herniation syndromes 53. 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 - ☑☑️Y️ou 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? 54. Brain herniation 55. Intracranial hemorrhage 56. Diffuse axonal injury 57. *d. Concussion* 58. 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 - ☑☑️W️hen using a selective spinal immobilization protocol, which of the following findings indicate the need for immobilization? 59. Past history of spinal injury 60. Being an unrestrained passenger in a motor vehicle crash 61. Being ambulatory at the scene 62. *d. An associated femoral shaft fracture with severe pain* 63. 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 85. Septic 86. Spinal 87. *d. Hemorrhagic* 88. 18. 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 - ☑☑️W️hich of the following best guides the decision to provide spinal immobilization? 89. History and complaint 90. Obvious signs of associated injury 91. Avoid due to possible pressure sores 92. *d. Mechanism alone* 93. 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 - ☑☑️A️ 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? 94. Obtain IV access and infuse crystalloid 95. Administer supplemental oxygen 96. *c. Hemorrhage control* 97. Rapid transport 98. 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 - ☑☑️Y️ou 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? 99. Subarachnoid hemorrhage 100. Alcohol poisoning 101. Epidural hematoma 102. *d. Subdural hematoma* 103. 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 - ☑☑️T️he pre-hospital assessment of the trauma patient begins with which of the following? 104. Assessment of scene safety and situation 105. *b. Information provided by the dispatcher* 106. The initial assessment 107. The primary survey 108. 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 - ☑☑️E️MS 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? 109. Cardiogenic 110. Hypovolemic 111. *c. Neurogenic* 112. Obstructive 113. Which of the following is the best indicator of shock? a. Depressed level of cognition b. Heart rate of 80 c. Respirations of 18 137. Lactic alkalosis 138. 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 - ☑☑️W️hich of the following signs of shock is found during the secondary survey? 139. Absent radial pulse 140. Decreased LOC 141. Increased respiratory rate 142. *d. Low blood pressure measurement* 143. 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 - ☑☑️E️MS 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? 144. Primary blast injury 145. Secondary blast injury 146. Tertiary blast injury 147. *d. Quaternary blast injury* 148. 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 - ☑☑️H️yperventilation of a patient with suspected traumatic brain injury should occur when? 149. At time of injury 150. *b. When signs of impending brain herniation are present* 151. During a concussion 152. Whenever the patient complains of headache 153. 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 - ☑☑️P️atients 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? 154. Hypothermia 155. Cerebral vasodilation 156. Increased cardiac output 157. *d. Inadvertent or excess hyperventilation* 158. 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 - ☑☑️H️ypotension due to a spinal cord injury is a result of what physiologic mechanism? 159. *a. Loss of sympathetic tone causing vasodilation* 160. b. Increased capillary permeability 161. Increased sympathetic tone causing vasoconstriction 162. Increased Intrathoracic pressure 163. 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 - ☑☑️W️hich of the following patients will compensate for blood loss the longest? 164. 24-year-old male 165. 82-year-old female 166. 45-year-old female 186. *c. Brain* 187. Liver 188. 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 - ☑☑️A️ 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? 189. 30 BPM 190. 25 BPM 191. *c. 20 BPM* 192. 12 BPM 193. 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 - ☑☑️A️ 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? 194. C3 195. *b. T4* 196. T10 197. T12 198. 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 - ☑☑️I️n a patient with a suspected traumatic brain injury, what is the most concerning physical finding? 199. BP 140/90 200. Heart rate of 58 201. Respiratory rate of 30 202. *d. Altered level of consciousness* 203. 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 - ☑☑️Y️ou 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? 204. Placenta previa 205. Abruptio placenta 206. *c. Ruptured uterus* 207. Abdominal aortic aneurysm 208. 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 - ☑☑️E️MS 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: 209. Apply antibiotic ointment 210. *b. Run copious amounts of room temperature water over the burn* 211. Cover burned area with dry sterile dressings 212. Cover burned area with moist sterile dressings d. Blood pressure decrease - ☑☑️W️hat is the earliest sign of deterioration in a patient with a flail chest? 229. *a. Respiratory rate increase* 230. b. Oxygen saturation decrease 231. Pulse rate increase 232. Blood pressure decrease 233. 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 - ☑☑️E️MS 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? 234. Endotracheal intubation 235. *b. Provide supplemental oxygen and transport to a trauma center* 236. Place bulky dressing over the wound and tightly wrap the chest 237. Stabilize the segment with sandbags on the chest 238. 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 - ☑☑️P️rehospital 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? 239. Apply a tourniquet 240. Pack the wound with a hemostatic dressing 241. Initiate intravenous access 242. *d. Apply direct pressure* 243. 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 - ☑☑️W️hen managing a pediatric patient, pre-hospital providers should do all of the following EXCEPT: 244. Use appropriately sized equipment 245. Frequently reassess the patient 246. Preserve body heat 247. *d. Exclude the parents from immediate care* 248. 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 - ☑☑️W️hich of the following is a Golden Principle of trauma care? 249. *a. Ensure adequate airway and ventilation* 250. b. Complete a thorough head-to-toe survey before initiating treatment 251. Rescuer safety is secondary to caring for the patient 252. Use chilled intravenous fluids to promote hypothermia