Trauma Care: Principles and Practices, Exams of Advanced Education

Download Trauma Care: Principles and Practices and more Exams Advanced Education in PDF only on Docsity! PHTLS 9TH ED. SELF-TEST VERIFIED EXAM QUESTIONS AND ANSWERS 2023 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. You first action should be to do which of the following? - Answer Confirm the tourniquet was properly applied. Which of the following information is assessed during the secondary survey? - Answer vitals 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 accomplish 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 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 accomplish the preference in treating the patient include all except: a. Condition of the patient b. Equipment available c. Situation that exists *d. Research information* Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? a. 0 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 Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? a. 0 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 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 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* 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 full spine immobilization c. Scoop stretcher d. Short immobilization device - Answer 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 full spine immobilization *c. Scoop stretcher* d. Short immobilization device 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 d. Herniation syndromes 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. Intracranial hemorrhage c. Diffuse axonal injury d. Concussion - Answer 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. Intracranial hemorrhage c. Diffuse axonal injury *d. Concussion* 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 - Answer 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* In a blast-related multiple patient situation, which of the following patients should be treated first? 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 - Answer In a blast-related multiple patient situation, which of the following patients should be treated first? *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 Excessive fluid resuscitation of the trauma patient can result in which of the following? a. Increased blood loss b. Decreased mortality c. Earlier discharge from the hospital d. A higher incidence of sepsis in the ICU - Answer Excessive fluid resuscitation of the trauma patient can result in which of the following? *a. Increased blood loss* b. Decreased mortality c. Earlier discharge from the hospital d. A higher incidence of sepsis in the ICU The secondary survey should be accomplished: a. Never on a critical patient b. Before transport c. When time and Situation allow d. Before moving the patient - Answer The secondary survey should be accomplished: a. Never on a critical patient b. Before transport *c. When time and Situation allow* d. Before moving the patient When approaching a trauma patient, what is the first assessment that must be made? a. Circulation b. Scene safety c. Airway d. Breathing - Answer When approaching a trauma patient, what is the first assessment that must be made? a. Circulation *b. Scene safety* c. Airway d. Breathing The most common type of shock resulting from trauma is? a. Neurogenic b. Septic c. Spinal d. Hemorrhagic - Answer The most common type of shock resulting from trauma is? a. Neurogenic b. Septic c. Spinal *d. Hemorrhagic* 18. Which of the following best guides the decision to provide spinal immobilization? a. History and complaint b. Obvious signs of associated injury c. Avoid due to possible pressure sores d. Mechanism alone - Answer Which of the following best guides the decision to provide spinal immobilization? a. History and complaint b. Obvious signs of associated injury c. Avoid due to possible pressure sores *d. Mechanism alone* 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. Perform RSI What is the most common cause of airway obstruction in the unresponsive trauma patient? a. Blood b. Teeth c. Tongue d. Vomitus - Answer What is the most common cause of airway obstruction in the unresponsive trauma patient? a. Blood b. Teeth *c. Tongue* d. Vomitus 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 most important action? a. Performing an RSI b. Performing a head-tilt chin lift c. Intubating d. Suctioning the airway - Answer 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 most important action? a. Performing an RSI b. Performing a head-tilt chin lift c. Intubating *d. Suctioning the airway* When energy produced by the cells occurs during a state of adequate oxygenation, it is referred to as which of the following conditions? a. Aerobic metabolism b. Anaerobic metabolism c. Lactic acidosis d. Lactic alkalosis - Answer When energy produced by the cells occurs during a state of adequate oxygenation, it is referred to as which of the following conditions? *a. Aerobic metabolism* b. Anaerobic metabolism c. Lactic acidosis d. Lactic alkalosis Which of the following signs of shock is found during the secondary survey? a. Absent radial pulse b. Decreased LOC c. Increased respiratory rate d. Low blood pressure measurement - Answer Which of the following signs of shock is found during the secondary survey? a. Absent radial pulse b. Decreased LOC c. Increased respiratory rate *d. Low blood pressure measurement* EMS responds for 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 EMS arrived. Based solely on this information, when did the injury occur? a. Primary blast injury b. Secondary blast injury c. Tertiary blast injury d. Quaternary blast injury - Answer EMS responds for 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 EMS arrived. Based solely on this information, when did the injury occur? a. Primary blast injury b. Secondary blast injury c. Tertiary blast injury *d. Quaternary blast injury* 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 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 Patients with suspected traumatic brain injuries (TBI) are susceptible to secondary injuries that 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 Patients with suspected traumatic brain injuries (TBI) are susceptible to secondary injuries that 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* Hypotension due to a spinal cord injury is a result of what physiologic mechanism? a. Loss of sympathetic tone causing vasodilation b. Increased capillary permeability c. Increased sympathetic tone causing vasoconstriction d. Increased Intrathoracic pressure - Answer Hypotension due to a spinal cord injury is a result of what physiologic mechanism? *a. Loss of sympathetic tone causing vasodilation* b. Increased capillary permeability c. Increased sympathetic tone causing vasoconstriction d. Increased Intrathoracic pressure Which of the following patients will compensate for blood loss the longest? a. 24-year-old male b. 82-year-old female *c. 20 BPM* d. 12 BPM 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? a. C3 b. T4 c. T10 d. T12 - Answer 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? a. C3 *b. T4* c. T10 d. T12 In a patient with a suspected traumatic brain injury, what is the most concerning physical finding? a. BP 140/90 b. Heart rate of 58 c. Respiratory rate of 30 d. Altered level of consciousness - Answer In a patient with a suspected traumatic brain injury, what is the most concerning physical finding? a. BP 140/90 b. Heart rate of 58 c. Respiratory rate of 30 *d. Altered level of consciousness* 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? a. Placenta previa b. Abruptio placenta c. Ruptured uterus d. Abdominal aortic aneurysm - Answer 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? a. Placenta previa b. Abruptio placenta *c. Ruptured uterus* d. Abdominal aortic aneurysm EMS responds to an adult barista who spilled a cup of hot coffee and sustained partial-thickness burns to the abdomen and right leg. Initial treatment of this injury would include: 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 - Answer EMS responds to an adult barista who spilled a cup of hot coffee and sustained partial-thickness burns to the abdomen and right leg. Initial treatment of this injury would include: 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 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? a. Release the occlusive dressing b. Perform needle decompression c. Provide positive-pressure ventilation d. Perform endotracheal intubation - Answer 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? *a. Release the occlusive dressing* b. Perform needle decompression c. Provide positive-pressure ventilation d. Perform endotracheal intubation EMS arrives on a scene and finds that emergency medical responders have attempted to immobilize a pediatric patient onto a long backboard. They note that the patient's head is in a flexed position. Which of the following actions is the most appropriate? a. Adjust the cervical collar b. Logroll patient into a left lateral recumbent position c. Place padding under the patient's head and neck d. Place padding under the patient's torso - Answer EMS arrives on a scene and finds that emergency medical responders have attempted to immobilize a pediatric patient onto a long backboard. They note that the patient's head is in a flexed position. Which of the following actions is the most appropriate? a. Adjust the cervical collar b. Logroll patient into a left lateral recumbent position c. Place padding under the patient's head and neck *d. Place padding under the patient's torso* Falls are the most common cause of death in trauma patients over ____ years of age. a. 65 b. 75 c. 55 d. 69 - Answer Falls are the most common cause of death in trauma patients over ____ years of age. a. 65 *b. 75* c. 55 d. 69 What 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