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PHTLS Post Test 9th Edition-with 100% verified solutions-2024.docx
Typology: Exams
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The displacement of tissue away from the path of a projectile, both temporarily and permanently, is known as: Cavitation The single most important factor in determining the potential for injury due to energy exchange is: Velocity of the bodies involved In the management of shock, isotonic crystalloid solutions, such as Ringer's, are preferred because: These solutions will stay in the vascular space longer than water solutions, such as D5W With respect to the distance of a fall, which of the following is a guideline for determining a critical fall? 3 times the height of the patient The phase of an explosion, or blast, in which hollow organs are squeezed and may rupture is called the __________ phase. Primary phase During the primary survey and management of a trauma patient, the E in ABCDE stands for _________? Expose/Environment The time in which surgical intervention can make a difference in patient outcome is the __________? Golden period (hour) In the absence of extenuating circumstances, the maximum amount of time it should take to identify and manage immediate threats to life, prepare the patient for transport and begin transport is _________? 10 minutes In which of the following situations is the use of a short spinal immobilization device indicated? None of the above 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? Prior to being removed from the vehicle Which of the following represents adequate spontaneous ventilation in an adult? Tidal volume 600 mL, ventilatory rate 12/minute Which of the following is 100% accurate in verifying endotracheal tube placement? None of the above When utilizing percutaneous transtracheal ventilation, the correct ration of lung inflation to lung inflation time, in seconds, is: 1: Which of the following is a possible complication of using a manually triggered oxygen powered device for ventilation? All of the above Which of the following procedures is considered an essential airway Insertion of an oropharyngeal airway Pericardial tamponade is most likely to occur in which of the following situations? Stab wound to the chest Which of the following is the preferred site for needle decompression of a tension pneumothorax? 2nd intercostal space, midclavicular line, just over top of the 3rd rib Which of the following is the mechanism by which pulmonary contusion interferes with oxygenation? Blood and fluid in the alveoli and interstitial spaces of the lung 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? Hemothorax
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 Ruptured diaphragm Which of the following is NOT a component of the Fick principle? Adequate number of platelets in the blood One of the earliest signs of hypovolemic shock Anxiety Which of the following characterizes the washout phase of shock? Systemic acidosis A trauma patient who has fallen 20 feet from an apartment balcony is alert with warm, dry, pink skin, with normal capillary refilling time to the lower extremities, and is hypotensive. The upper extremities are cool, pale and diaphoretic. Which of the following injuries should be suspected? Spinal cord injury Which of the following is a limitation of prehospital fluid resuscitation of the patient in hemorrhagic shock? All of the above Which of the following statements regarding signs of intraabdominal injury is NOT true? Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity Which of the following assessment techniques is least useful in the prehospital assessment of the patient with suspected intraabdominal trauma? Auscultation Pregnant trauma patients should be placed on the left side because: This prevents compression of the vena cava Survival of the fetus in a trauma situation is most dependent upon which of the following factors? Good resuscitation of the mother A patient struck in the back of the head with a baseball bat may sustain a cerebral contusion to which area of the brain? Occipital (probably too low velocity for Coup & Contre Coup) 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: 20
In the United State, which of the following mechanisms most frequently causes spinal cord injury in adults? Vehicle crashes Which of the following presentation indicate spinal cord injury? All of the above Of the following, which is the earliest indication of compartment syndrome? Tense swelling of the involved area A traction splint may be used for which of the following Femur fractures Which of the following descriptions meets the criteria for transport to a facility with a burn unit? A 25 year old male with an electrical burn across his chest The preferred method of dressing burns in the prehospital setting is: Dry sterile dressing In assessing the hypothermic patient in the prehospital setting, the most reliable indicator of the severity of hypothermia is: Rectal temperature In the normal child, which general statement is most accurate in comparison with the adult patient? Blood pressure is lower, heart rate is higher, and ventilatory rate is higher 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: 8T (E-3, V-T, M-4) The earliest site for intraosseous infusion is: Anterior tibia, just below the tibial tuberosity Which of the following behaviors is the most reliable indication of confusion in the elderly patient Inability to recall his/her name In the elderly trauma patient a high index of suspicion for shock should occur beginning when the systolic blood pressure is less than: C. 120 mmHg In an adult patient, blood loss into the tissue from a fractured femur may be as much as which of the following? 1000 2000 mL Delayed death due to trauma is usually a result of:
Biochemical and pathophysiological effects of inadequate initial resuscitation A regional resource center with a full spectrum of trauma services from prevention to rehabilitation which serves as the leader in trauma care for a geographical region is Level I trauma center Which of the following patients is not indicated for spinal immobilization? Patient with a knife wound to the chest and a GCS of 15 The premise of PHTLS is that: EMTs are capable of sound patient care judgment, given an adequate knowledge base Which of the following warrants classification of a patient as a critical trauma patient? Preexisting major medical problem Which of the following is the foundation of effective trauma care? The ability to quickly locate and manage life-threatening and potentially life- threatening injuries 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? Speed of the vehicle The potential for death or serious injury is greatest in which of the following motor vehicle collisions? Ejection from vehicle Bilateral femur fractures are most often associated with which type of motorcycle crash? Head-on impact Which is the preferred fluid for resuscitation of hemorrhagic shock in the prehospital setting? Lactated Ringer's Which is the most common cause of upper airway obstruction in the trauma patient? Tongue Which is the preferred adjunct device for verifying placement of an endotracheal tube in a patient with a perfusing rhythm? End-tidal CO2 monitoring (capnography) Which is the most important reason to maintain an open airway in the trauma Prevents hypoxemia and hypercarbia Essential airway skills include manual clearing of the airway, manual maneuvers, suctioning and which of the following? Oropharyngeal airway 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? Begin ventilation with a BVM Which best describes shock? Generalized inadequate tissue perfusion Your patient has a deep laceration to his antecubital fossa with significant bleeding. What is the most appropriate initial action? Apply direct pressure Hypotension of unknown etiology in a trauma patient should be assumed to result from which of the following? Blood loss Which assessment is most beneficial in differentiating hemorrhagic shock from neurogenic shock in the prehospital setting? Skin The body initially compensates for blood loss through activation of which of the following? Sympathetic nervous system Medication used by trauma patients for pre-existing conditions may cause which of the following? Beta blockers may prevent tachycardia with blood loss The target blood pressure for a trauma patient with suspected intraabdominal hemorrhage is which of the following? 80 - 90 mm Hg Which best explains the mechanism by which gas exchange is impaired in pulmonary contusion? Blood in the alveoli Which of the following is a key finding that differentiates cardiac tamponade from tension pneumothorax? Equal breath sounds Your patient is a 20 year old male who struck his head on a teammate's knee while diving to catch a football. He was not wearing a helmet. He demonstrates decerebrate posturing and has a GCS score of 4. His heart rate is 58, blood pressure 180/102 and his left pupil is dilated. What is the best ventilation rate to use when managing this patient? 20 breaths per minute A 20 year old female was ejected from her vehicle during a high speed roll-over motor vehicle collision. She has significant bleeding from a large laceration. Your initial assessment reveals a GCS score of 7, systolic blood pressure of 70 mm Hg and pupils that are equal but respond sluggishly to light. After establishing two large
bore IV lines, you should titrate the infusion rate to achieve a target blood pressure of at least 90 mm Hg. Which of the following is the preferred prehospital wound management for a patient with a 36% body surface area flame burn? Dry sterile dressings The most immediate life threatening condition resulting from injury to solid abdominal organs is which of the following? Hemorrhage. 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? Apply a tourniquet and tighten it until bleeding stops 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? Mechanism of injury 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? Correction of possible hypoxia