Trauma Care and Management, Exams of Nursing

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PHTLS EXAM 2024/2025 WITH 100%

ACCURATE SOLUTIONS

PHTLS EXAM 2024/2025 WITH 100%

ACCURATE SOLUTIONS

The pre-hospital assessment of the trauma patient begins with which of the following? Select one: a. Assessment of scene safety and situation b. Information provided by the dispatcher c. The initial assessment d. The primary survey Feedback - Precise Answer ✔✔Information Provided by the dispatcher 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? Select one: a. Hypothermia b. Cerebral vasodilation c. Increased cardiac output d. Inadvertent or excess hyperventilation - Precise Answer ✔✔Inadvertent or excess hyperventilation Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? Select one: 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 - Precise Answer ✔✔The correct answer is: 1 to 2 years of age Falls are the most common cause of death in trauma patients over _____ years of age Select one: a. 65 b. 75 c. 55

d. 69 - Precise Answer ✔✔ 75 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? Select one: a. Apply a tourniquet b. Pack the wound with a hemostatic dressing c. Initiate intravenous access d. Apply direct pressure - Precise Answer ✔✔Apply Direct Pressure 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:

Select one: a. Condition of the patient b. Equipment available c. Situation that exists d. Research information - Precise Answer ✔✔The correct answer is: Research information When verifying ET tube placement on a perfusing patient, the "gold standard" of monitoring is considered to be? Select one: a. Colorimetric carbon dioxide detector b. Pulse oximetry

c. Listening to lung sounds d. Waveform capnography - Precise Answer ✔✔Waveform Capnography The most common type of shock resulting from trauma is? Select one: a. Neurogenic b. Septic c. Spinal d. Hemorrhagic - Precise Answer ✔✔Hemorrhagic

While caring for a patient who was involved in an altercation, the patient vomits, causing his airway to become totally obstructed with vomitus and blood. What is the most important action? Select one: a. Performing an RSI b. Performing a head-tilt chin lift c. Intubating d. Suctioning the airway - Precise Answer ✔✔Suctioning the Airway 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? Select one: a. C

b. T c. T d. T12 - Precise Answer ✔✔The correct answer is: T Of the following, which is a preventable cause of secondary brain injury addressable during the transport phase? Select one: a. Intraparenchymal hemorrhage b. Systemic hypoxia c. Intracranial hematomas

d. Herniation syndromes - Precise Answer ✔✔Systemic Hypoxia 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? Select one: a. Placenta previa b. Abruptio placenta c. Ruptured uterus d. Abdominal aortic aneurysm - Precise Answer ✔✔The correct answer is: Ruptured uterus Hypoperfusion will affect which of the following organs first? Select one:

a. Kidney b. GI tract c. Brain d. Liver - Precise Answer ✔✔Brain EMS responds to an adult barista with partial-thickness burns to the abdomen and right leg, sustained from a cooking accident. Initial treatment of this injury would include: Select one: 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 - Precise Answer ✔✔Cover burned area with a dry sterile dressing Which best describes the goal of airway management in a trauma patient? Select one: a. Perform complex airway maneuvers b. Perform a surgical cricothyrotomy c. Provide for adequate exchange of oxygen and CO d. Perform RSI - Precise Answer ✔✔Provide for adequate exchange of oxygen and CO

When using a selective spinal immobilization protocol, which of the following findings indicate the need for immobilization? Select one: 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 - Precise Answer ✔✔An associated femoral shaft fracture with severe pain What is the most common cause of airway obstruction in the unresponsive trauma patient? Select one: a. Blood

b. Teeth c. Tongue d. Vomitus - Precise Answer ✔✔Tongue 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? Select one: a. Distended neck veins b. Inspiratory wheezing c. narrowed pulses pressure

d. Tracheal deviation towards the side of injury - Precise Answer ✔✔Distended Neck veins Which of the following is the best indicator of shock in a trauma patient? Select one: a. Depressed level of cognition b. Heart rate of 80 c. Respirations of 18 d. GCS of 15 - Precise Answer ✔✔Depressed level of cognition When managing a pediatric patient, pre-hospital providers should do all of the following EXCEPT: Select one: a.

Use appropriately sized equipment b. Frequently reassess the patient c. Preserve body heat d. Use half the adult dose or medication administration - Precise Answer ✔✔Use half the adult dose or medication administration 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? Select one: 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 - Precise Answer ✔✔Placing the agent properly into the wound and holding direct pressure In a patient with a suspected traumatic brain injury, what is the most concerning physical finding? Select one: a. BP 140/ b. Heart rate of 58 c. Respiratory rate of 30 d. Altered level of consciousness - Precise Answer ✔✔Altered Level of consciousness

EMS responds for a patient involved in a motorcycle vs. motor vehicle collision. The patient is poorly responsive with no movement of lower extremities and loss of temperature sensation (hot vs cold) below the T10. Which of the following types of shock is the patient most likely experiencing? Select one: a. Cardiogenic b. Hypovolemic c. Neurogenic d. Obstructive - Precise Answer ✔✔Neurogenic In a blast-related multiple patient situation, which of the following patients should be treated first? Select one: 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 Feedback The correct answer is: A 33-year-old female with altered level of consciousness and decreased capillary refill - Precise Answer ✔✔A 33- year-old female with altered level of consciousness and decreased capillary refill Hypotension due to a spinal cord injury is a result of what physiologic mechanism? Select one: a. Loss of sympathetic tone causing vasodilation

b. Increased capillary permeability c. Increased sympathetic tone causing vasoconstriction d. Increased intrathoracic pressure - Precise Answer ✔✔Loss of sympathetic tone causing vasodilation 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. Your first action should be to do which of the following? Select one: a. Provide IV analgesia b. Put on pressure dressing c.

Confirm the tourniquet was properly applied d. Check the airway - Precise Answer ✔✔Confirm the tourniquet was properly placed The secondary survey should be accomplished: Select one: a. Never on a critical patient b. Before transport c. When time and situation allow d. Before moving the patient - Precise Answer ✔✔When time and situation allow Which of the following best guides the decision to provide spinal immobilization?

Select one: a. History and complaint b. Obvious signs of associated injury c. Patient's age and presence of pressure sores d. Mechanism alone - Precise Answer ✔✔History and complaint 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? Select one: a. Release and reapply the occlusive dressing

b. Perform needle decompression c. Provide positive-pressure ventilation d. Perform endotracheal intubation - Precise Answer ✔✔The correct answer is: Release and reapply the occlusive dressing __________ is the earliest sign of deterioration in a patient with a flail chest. Select one: a. Respiratory rate increase b. Oxygen saturation decrease c. Pulse rate increase d.

Blood pressure decrease - Precise Answer ✔✔Respiratory rate increase In a multi-system trauma patient what is considered the best method for confirming proper placement of an endotracheal tube? Select one: a. Auscultation of the left upper abdominal quadrant b. Waveform capnography c. Presence of bilateral breath sounds d. Pulse oximetry - Precise Answer ✔✔Waveform capnography 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? Select one:

a. Jaw thrust maneuver b. Pharmacologically assisted intubation c. Perform nasotracheal intubation d. Perform a surgical crocothyrotomy - Precise Answer ✔✔Jaw Thrust Maneuver 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? Select one: a. Brain herniation b. Intracranial hemorrhage