PHTLS PRE AND POST TEST EXAM Questions and Answers Latest Updates 2024 GRADE A+, Exams of Nursing

Download PHTLS PRE AND POST TEST EXAM Questions and Answers Latest Updates 2024 GRADE A+ and more Exams Nursing in PDF only on Docsity! 1 / 16 1 PHTLS PRE AND POST TEST EXAM Questions and Answers Latest Updates 2024 GRADE A+ 1. The displacement of tissue away from the path of a projectile, both tem- porarily and permanently, is known as: A. Conization B. Cavitation C. Crepitation D. Contusion>>>Cavitation 2. The single most important factor in determining the potential for injury due to energy exchange is: A. Mass of the bodies involved B. Velocity of the bodies involved C. Density of the tissues involved D. Surface area of the impact involved>>>Velocity of the bodies involved 3. In the management of shock, isotonic crystalloid solutions, such as Ringer's, are preferred because: A. The protein molecules in crystalloid solutions act as volume expanders B. These fluids draw interstitial fluid into the vascular space to enhance volume C. These solutions will stay in the vascular space longer than water solutions, such as D5W D. Their pH enhance oxygen delivery to the tissues>>>These solutions will stay in the vascular space longer than water solutions, such as D5W 2 / 16 2 4. With respect to the distance of a fall, which of the following is a guideline for determining a critical fall? A. 3 times the height of the patient B. 2 times the height of the patient C. 5 times the height of the patient D. 1 ½ times the height of the patient>>>3 times the height of the patient 5. The phase of an explosion, or blast, in which hollow organs are squeezed and may rupture is called the phase. A. Tertiary phase B. Quaternary phase C. Secondary phase D. Primary phase>>>Primary phase 6. During the primary survey and management of a trauma patient, the E in ABCDE stands for ? A. Edema B. Eyes & ears C. Expose/Environment D. Electrical therapy>>>Expose/Environment 7. The time in which surgical intervention can make a difference in patient outcome is the ? A. Golden period B. Golden time C. Golden era D. Golden minutes>>>Golden period (hour) 8. 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 ? A. 5 minutes B. 10 minutes C. 15 minutes D. 30 minutes>>>10 minutes 5 / 16 5 D. Gunshot wound to the chest>>>Stab wound to the chest 17. Which of the following is the preferred site for needle decompression of a tension pneumothorax? A. 4th intercostal space, midclavicular line, just over the top of the 5th rib B. 4th intercostal space, midclavicular line, just below the 4th rib C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib D. 2nd intercostal space, midclavicular line, just below the 2nd rib>>>2nd intercostal space, midclavicular line, just over top of the 3rd rib 18. Which of the following is the mechanism by which pulmonary contusion interferes with oxygenation? A. Inability to generate negative intrapleural pressure B. Decrease in vital capacity due to collapse of the flail segment C. Increased intrathoracic pressure D. Blood and fluid in the alveoli and interstitial spaces of the lung>>>Blood and fluid in the alveoli and interstitial spaces of the lung 19. 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? A. Tension pneumothorax 6 / 16 6 B. Simple pneumothorax C. Pulmonary contusion D. Hemothorax>>>Hemothorax 20. 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 injuries? A. Abdominal aortic aneurysm B. Ruptured diaphragm C. Ruptured esophagus D. "Paper bag" syndrome of the lungs>>>Ruptured diaphragm 21. Which of the following is NOT a component of the Fick Principle? A. Adequate number of platelets in the blood B. Oxygenation of red blood cells C. Transportation of red blood cells to the tissues of the body D. Off-loading oxygen from the red blood cells to the tissues>>>Adequate number of platelets in the blood 22. One of the earliest signs of hypovolemic shock is: A. Hypotension B. Bradycardia C. Anxiety D. Reduced urine output>>>Anxiety 23. Which of the following characterizes the washout phase of shock? A. Systemic acidosis B. Localized tissue acidosis C. Edema D. Reduced capillary blood flow>>>Systemic acidosis 24. 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? A. Aortic dissection B. Liver laceration 7 / 16 7 C. Fractured pelvis D. Spinal cord injury>>>Spinal cord injury 25. Which of the following is a limitation of prehospital fluid resuscitation of the patient in hemorrhagic shock? A. Inability of fluids to carry oxygen B. Pulmonary edema C. Increased hemorrhage D. All of the above>>>All of the above 26. Which of the following statements regarding signs of intraabdominal injury is NOT true? A. Fresh blood in the abdominal cavity does not cause signs of peritonitis B. A significant amount of blood loss occurs before abdominal distention can be noticed C. Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity D. Signs and symptoms of shock greater than can be explained by other injuries is a reliable indicator of intraabdominal injury>>>Substantial intraab- dominal hemorrhage always causes tenderness and abdominal rigidity 27. Which of the following assessment techniques is least useful in the pre- hospital assessment of the patient with suspected intraabdominal trauma? A. Palpation B. Auscultation C. Inspection D. Scene assessment>>>Auscultation 28. Pregnant trauma patients should be placed on the left side because: A. This prevents seizures due to eclampsia B. This prevents abruption of the placenta C. This prevents compression of the vena cava D. This is the best way to auscultate fetal heart tones>>>This prevents com- pression of the vena cava 29. Survival of the fetus in a trauma situation is most dependent upon which of the following factors? A. Gestational age of the fetus 10 / 16 10 C. Blood pressure is lower, heart rate is higher, and ventilatory rate is higher D. Blood pressure is lower, heart rate is higher, and ventilatory rate is lowe>>>Blood pressure is lower, heart rate is higher, and ventilatory rate is higher 40. 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: A. 8 B. 8T C. 7 D. 7T>>>8T (E-3, V-T, M-4) 41. The earliest site for intraosseous infusion is: A. Anterior tibia, just above the tibial tuberosity B. Anterior fibula C. Anterior tibia, just below the tibial tuberosity D. Posterior fibula>>>Anterior tibia, just below the tibial tuberosity 42. Which of the following behaviors is the most reliable indication of confu- sion in the elderly trauma patient? A. Inability to recall his/her name B. Inability to recall the day of the week C. Inability to identify his/her present location when out of his/her normal residence D. Focus on repeated retelling of events that occurred years ago>>>Inability to recall his/her name 43. In the elderly trauma patient a high index of suspicion for shock should occur beginning when the systolic blood pressure is less than: A. 90 mmHg B. 150 mmHg C. 120 mmHg D. 100 mmHg>>>120 mmHg 44. In an adult patient, blood loss into the tissue from a fractured femur may be as much as which of the following? 11 / 16 11 A. 150 to 500 mL B. 500 to 1000 mL C. 1000 2000 mL D. 2500 to 5000 mL>>>1000 2000 mL 45. Delayed death due to trauma is usually a result of: A. Biochemical and pathophysiological effects of inadequate initial resusci- tation B. Acute circulatory failure C. Brain injury D. Acute hypoxia>>>Biochemical and pathophysiological effects of inadequate initial resuscitation 46. 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 a: A. Level IV trauma center B. Level III trauma center C. Level II trauma center D. Level I trauma center>>>Level I trauma center 47. Which of the following patients is not indicated for spinal immobiliza- tion? A. Intoxicated patient in a MVC B. Patient who fell 8 feet and lost consciousness C. Patient complaining of pain on palpation of the neck D. Patient with a knife wound to the chest and a GCS of 15>>>Patient with a knife wound to the chest and a GCS of 15 48. The premise of PHTLS is that: A. EMTs must treat all trauma patient based on protocols B. EMTs are capable of sound patient care judgment, given an adequate knowledge base C. EMTs must work only under on-line medical direction when caring for trauma patients D. EMTs are capable of working independently of medical direction>>>EMTs are capable of sound patient care judgment, given an adequate knowledge base 49. Which of the following warrants classification of a patient as a critical 12 / 16 12 trauma patient? A. An extremity fracture B. Preexisting major medical problem C. Bleeding from the nose D. Deployment of air bags in a motor vehicle crash>>>Preexisting major medical problem 50. Which of the following is the foundation of effective trauma care? A. Protocols permitting invasive airway procedures B. The ability to administer large amounts of crystalloid fluids C. The ability to quickly locate and manage life-threatening and potentially life-threatening injuries D. Effective spinal immobilization skills>>>The ability to quickly locate and manage life-threatening and potentially life-threatening injuries 51. 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? A. Circumference of the vehicle B. Diameter of the tree C. Mass of the vehicle D. Speed of the vehicle>>>Speed of the vehicle 52. The potential for death or serious injury is greatest in which of the following motor vehicle collisions? A) Down and under B) Ejection from vehicle C) Lateral compression D) Up and over (answer)) Ejection from vehicle 53. Bilateral femur fractures are most often associated with which type of motorcycle crash? A) Angular impact B) Bike-road impact C) Head-on impact D) Rear impact (answer)) Head-on impact 54. Which is the preferred fluid for resuscitation of hemorrhagic shock in the prehospital setting? 15 / 16 15 C) Spinal reflex arcs D) Sympathetic nervous system (answer)) Sympathetic nervous system 65. Medication used by trauma patients for pre-existing conditions may cause which of the following? A) Herbal preparations may enhance blood clotting B) Anti-inflammatory agents may enhance blood clotting C) Beta blockers may prevent tachycardia with blood loss D) Calcium channel blockers may slow the onset of shock (answer)) Beta blockers may prevent tachycardia with blood loss 66. The target blood pressure for a trauma patient with suspected intraab- dominal hemorrhage is which of the following? A) 60 - 70mm Hg B) 80 - 90 mm Hg C) 100 - 110 mm Hg D) 120 - 130 mm Hg (answer)) 80 - 90 mm Hg 67. Which best explains the mechanism by which gas exchange is impaired in pulmonary contusion? A) Blood in the alveoli B) Collapse of the alveoli C) Compression of the lung tissue D) Partial occlusion of the bronchi (answer)) Blood in the alveoli 68. Which of the following is a key finding that differentiates cardiac tampon- ade from tension pneumothorax? A) Distended jugular veins B) Equal breath sounds C) Hypotension D) Tachycardia (answer)) Equal breath sounds 69. 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? A) 10 breaths per minute. 16 / 16 16 B) 20 breaths per minute. C) 30 breaths per minute. D) 35 breaths per minute. (answer)) 20 breaths per minute 70. 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 A) 60 mm Hg. B) 70 mm Hg. C) 80 mm Hg. D) 90 mm Hg. (answer)) 90 mm Hg. 71. Which of the following is the preferred prehospital wound management for a patient with a 36% body surface area flame burn? A) Cool moist dressings B) Dry sterile dressings C) Elastic bandages D) Topical ointments (answer)) Dry sterile dressings 72. The most immediate life threatening condition resulting from injury to solid abdominal organs is which of the following? A) Acute respiratory failure B) Hemorrhage. C) Multiple organ failure. D) Peritonitis (answer)) Hemorrhage. 73. 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? A) Apply a topical hemostatic agent and transport B) Apply a tourniquet and tighten it until bleeding stops C) Elevate the leg and apply pressure to the femoral artery D) Maintain direct pressure and transport immediately (answer)) Apply a tourniquet and tighten it until bleeding stops 17 / 16 17 74. 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 immo- bilization of the cervical spine? A) Fracture of the femur B) Inability to communicate C) Mechanism of injury D) Tenderness over the cervical spine (answer)) Mechanism of injury 75. 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 priority? A) Blood glucose determination B) Correction of possible hypoxia C) Full immobilization to a backboard D) Obtain intravenous access (answer)) Correction of possible hypoxia