PHTLS - Post Test, 8th Edition 2023, Exams of Nursing

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Care of the trauma patient in the field is an evolving science and should be evidence-based. As lifelong learners, we must be prepared to adapt our practices based on research. This is because research may

lead to, what? - correct answer changes in our current practices (p.11)

In trauma care, a 'principle' is defined as, what? - correct answer what needs to be done (p.34)

In addition to oxygen, what is required to maintain the metabolic processes of life and energy

production? - correct answer glucose

You respond for a patient who has sustained a GSW to the right upper thorax. He is barely responsive,

pale, and diaphoretic. What device is most appropriate for transport? - correct answer scoop

stretcher Units responding to a motor vehicle accident on the highway should consider what, as part of their pre-

arrival assessment? - correct answer weather conditions

The most appropriate airway maneuver for trauma patients is what technique? - correct answer jaw

thrust maneuver

Endo-tracheal in-tubation is a technique that requires, what? - correct answer substantial training,

to maintain proficiency

What indicates that a trauma patient is having trouble breathing? - correct answer the patient's

breathing is noticeable 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 pneumo-thorax? - correct answer hemo-dynamic compromise (proper blood flow is being

prevented)

In addition to direct pressure, tourniquets, and immobilizing fractures, what is considered most effective

when controlling hemorrhage? - correct answer hemo-static agents

What is a preventable cause of secondary brain injury? - correct answer systemic hypoxia

You're 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 and he is awake but confused, does not recall the incident,

and is vomiting with a headache. What injury is he most likely to have suffered? - correct answer

concussion What findings would indicate the need for immobilization when using a selective spinal immobilization

protocol? - correct answer pain or tenderness along the spine

What patient should be treated first in a blast-related situation involving multiple patients? - correct

answer a 30-year-old female with altered level of consciousness and decreased capillary refill

Excessive fluid resuscitation of the trauma patient can result in, what? - correct answer increased

blood loss

When should the secondary survey be accomplished? - correct answer when the time and situation

allow (p.146)

When approaching a trauma patient, what is the first assessment that must be made? - correct

answer scene safety

What is the most common type of shock resulting from trauma? - correct answer hemorrhagic

What information gathered can best guide the decision to provide spinal immobilization? - correct

answer the (patient's) history and complaints

A 38 year old male sustained a large wound to his right thigh while at work. What action is the most

important initial step? - correct answer hemorrhage control

A patient who sustained extensive blunt trauma to his trunk; has absent lung sounds on the right, marked respiratory distress, tachy-cardia and hyper-tension. What is the most appropriate intervention?

• correct answer needle decompression (DART)

The pre-hospital assessment of the trauma patient begins when? - correct answer when information

is provided by the dispatcher E.M.S. responds to a patient involved in a motor vehicle versus car collision. The patient is unresponsive with vital signs of: BP 82, palpitation; respirations, 24; pulse, 128. What is the most likely type of shock? -

correct answer hypo-volemic

What definition best describes shock? - correct answer a state of inadequate energy production

What is the most common cause of airway obstruction in the unconscious trauma patient? - correct

answer tongue

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 maximum amount of time that you can suction his

airway? - correct answer suction until his airway is clear

When energy produced by cells occurs during the state of inadequate oxygenation, it is referred to as

what condition? - correct answer anaerobic metabolism

What sign of shock is not found during the primary survey? - correct answer low blood pressure

measurement E.M.S. responds to 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

E.M.S. arrived. Based solely on this information, what is most likely her injury? - correct answer

epidural hema-toma Inadvertent hyper-ventilation of a patient with suspected traumatic brain injury (TBI) may lead to which

complication? - correct answer cerebral vasoconstriction

Spinal cord injuries can lead to hypo-tension due to what type of physiologic changes? - correct

answer vasodilation below the level of injury

Which subset of patients compensate for blood loss the longest? - correct answer pediatrics

A 55-year-old male is found unconscious after being assaulted. Assessment reveals: snoring respirations,

brady-pnea, facial swelling, and unequal pupils. What is the most appropriate first step? - correct

answer jaw thrust maneuver

What is the best method for confirming proper placement of an endo-tracheal tube in a trauma patient

that has a palpable pulse? - correct answer capnography

What best describes the goal of airway management? - correct answer provide for adequate

exchange of oxygen and carbon dioxide (CO2)

What is most likely the source of hemorrhage in a patient with unexplainable signs of shock? - correct

answer intra-abdominal injury

What organ is most sensitive to hypo-tension? - correct answer brain

After falling from the third story at a construction site, a 27-year-old male is found unconscious with

unequal pupils and irregular respirations. What is the most appropriate rate of ventilations? - correct

answer 20 beats per minute (bpm)

After falling from the high bar, a gymnast has a loss of sensation from the nipples down. What area of

the spine is most likely damaged? - correct answer thoracic four (T4)

What is the most important physical finding in a patient with a suspected traumatic brain injury (TBI)? -

correct answer abnormal levels of consciousness

Pre-hospital providers respond to a male patient lying on the ground after being struck by a high-speed

motor vehicle. The patient is ap-neic and pulseless. What is the most appropriate action? - correct

answer declare the patient dead

E.M.S. responds to an adult barista who spilled a cup of hot coffee and sustained partial thickness burns to the abdomen and right leg. The patient ran cool water over the area. What intervention is most

appropriate next? - correct answer cover the affected area with dry sterile dressings

Pre-hospital providers have treated a sucking chest wound with an occlusive dressing. During transport, the patient develops increasing respiratory distress with increased respirations and absent lung sounds

[noted on repeat auscultation]. What is the most appropriate next intervention? - correct answer

remove the occlusive dressing ("burping" the dressing) E.M.S. arrived on scene and finds an emergency medical responder immobilizing a pediatric patient onto a long backboard. They know that the patient's head is in a flexed position. What action is most

appropriate? - correct answer place padding under the patient's torso

What is the most common cause of death from trauma in patients over 75 years of age? - correct

answer falls

What is an early sign of deterioration in a patient with a flail chest? - correct answer respiratory rate

increase E.M.S. is treating an unrestrained driver of an automobile involved in a high-speed crash who struck his chest against the steering column. Patient has: paradoxical movement of a portion of chest wall;

respiratory rate, 16; oxygen saturation, 94%. What is the most appropriate action? - correct answer

provide supplemental oxygen and observe Pre-hospital providers respond to a 16-year-old male who punched a glass window and sustained a large laceration to his arm that is bleeding heavily. He is restless, diaphoretic and has a weak pulse of 30. What

is the most appropriate action? - correct answer apply direct pressure

In addition to using appropriately sized equipment, frequently re-assessing the patient, employing age- appropriate immobilization techniques; pre-hospital providers should do what, when managing pediatric

patients? - correct answer preserve body heat

What is a golden principle of trauma care? - correct answer provide adequate pain relief