PHTLS Pre-Test 9th Edition (Latest 2023/2024), Exams of Nursing

Download PHTLS Pre-Test 9th Edition (Latest 2023/2024) and more Exams Nursing in PDF only on Docsity! PHTLS Pre-Test 9th Edition (Latest 2023/ 2024) Questions and Verified Answers| Grade A QUESTION When approaching a trauma patient, what is the first assessment that must be made? a) Exsanguinating hemorrhage b) Scene safety c) Airway d) Breathing Answer: Scene safety QUESTION The most common type of shock resulting from trauma is? a) Neurogenic b) Septic c) Spinal d) Hemorrhagic Answer: Hemorrhagic QUESTION Which of the following best guides the decision to provide spinal immobilization? a) History and complaint b) Obvious signs of associated injury c) Patient's age and presence of pressure sores d) Mechanism alone Answer: History and complaint QUESTION 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 Answer: Hemorrhage control QUESTION 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) Ruptured abdominal aortic aneurysm d) Subdural hematoma Answer: Subdural hematoma QUESTION 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 Answer: Information provided by the dispatcher Answer: Vital signs QUESTION 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 Answer: When signs of impending brain herniation are present QUESTION Patients with suspected traumatic brain injuries (TBI) are susceptible to secondary injuries which 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 Answer: Inadvertent or excess hyperventilation QUESTION Hypotension due to a spinal cord injury is a result of what physiological mechanism? a) Loss of sympathetic tone causing vasodilation b) Increased capillary permeability c) Increased sympathetic tone causing vasoconstriction d) Increased intrathoracic pressure Answer: Loss of sympathetic tone causing vasodilation QUESTION 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 Answer: 6-year-old male QUESTION You respond to a reported assault at a local bar. On arrival, you find a 46-year-old male in 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 Answer: Jaw thrust maneuver QUESTION 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 Answer: Waveform capnography QUESTION 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 Answer: Intra-abdominal injury QUESTION Hypoperfusion will affect which of the following organs first? a) Kidney b) GI tract c) Brain d) Liver Answer: Brain QUESTION 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 Answer: 20 BPM QUESTION Falls are the most common cause of death in trauma patients over _____ years of age a) 65 b) 75 c) 55 d) 69 Answer: 75 QUESTION __________ 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 Answer: Respiratory rate increase QUESTION 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 Answer: Provide supplemental oxygen and transport to a trauma center QUESTION 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 Answer: Apply direct pressure QUESTION 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) Waveform capnography Answer: Waveform capnography QUESTION 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) Inspiratory wheezing c) narrowed pulse pressure d) Tracheal deviation towards the side of injury Answer: Distended neck veins QUESTION 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 Answer: Placing the agent properly into the wound and holding direct pressure QUESTION Of the following, which is a preventable cause of secondary brain injury addressable during the transport phase? a) Intraparenchymal hemorrhage b) Systemic hypoxia c) Intracranial hematomas d) Herniation syndromes Answer: Systemic hypoxia QUESTION 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) Intraabdominal hemorrhage c) Diffuse axonal injury d) Concussion Answer: Concussion QUESTION 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 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 establish the preference in treating the patient include all except: a) Condition of the patient b) Equipment available c) Situation that exists d) Research information Answer: Research information QUESTION Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? a) 10 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 Answer: 1 to 2 years of age QUESTION 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 Answer: Oxygen QUESTION 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 spinal motion restriction c) Scoop stretcher d) Short immobilization device Answer: Scoop stretcher QUESTION 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 Answer: Weather conditions QUESTION 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 Answer: Trauma jaw thrust