PHTLS 9th Edition Self-Test Questions with Correct Answers, Exams of Nursing

Download PHTLS 9th Edition Self-Test Questions with Correct Answers and more Exams Nursing in PDF only on Docsity!

PHTLS 9TH ED. SELF-TEST QUESTIONS WITH CORRECT

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? Correct Answer Confirm the tourniquet was properly applied. Which of the following information is assessed during the secondary survey? Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 present 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 Correct Answer A patient present 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 Correct Answer 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 Correct Answer 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 b. Intracranial hemorrhage c. Diffuse axonal injury d. Concussion Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer The most common type of shock resulting from trauma is?

a. Neurogenic b. Septic c. Spinal d. Hemorrhagic

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 Correct Answer 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 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 Correct Answer 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 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 Correct Answer 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 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 Correct Answer 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 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 Correct 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 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Hypo perfusion will affect which of the following organs first? a. Kidney b. Gl tract c. Brain d. Liver Correct Answer Hypo perfusion 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 Correct Answer 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 Correct Answer 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 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 Correct Answer 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 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 Correct Answer 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 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 Correct Answer 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 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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 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 Correct Answer 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