Trauma Patient Management: Principles and Practices, Exams of Nursing

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PHTLS 9TH ED EXAM 2024 WITH 100%

ACCURATE SOLUTIONS

PHTLS 9TH ED EXAM 2024 WITH 100%

ACCURATE SOLUTIONS

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? - Precise Answer ✔✔ Confirm the tourniquet was properly applied. Which of the following information is assessed during the secondary survey? - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 b. Weather conditions c. The need for immediate transport d. Post-exposure prophylaxis - Precise Answer ✔✔ 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 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 - Precise Answer ✔✔ 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

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. EtCO2 - Precise Answer ✔✔ 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. EtCO2 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. Muffled heart sounds c. Narrowed pulse pressure d. Tracheal deviation towards the side of injury - Precise Answer ✔✔ 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. Muffled heart sounds c. Narrowed pulse pressure d. Tracheal deviation away from the side of injury 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 - Precise Answer ✔✔ 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 Of the following, which is a preventable cause of secondary brain injury? a. Cerebral edema

b. Systemic hypoxia c. Intracranial hematomas d. Herniation syndromes - Precise Answer ✔✔ Of the following, which is a preventable cause of secondary brain injury? a. Cerebral edema b. Systemic hypoxia c. Intracranial hematomas 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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. Rapid transport - Precise Answer ✔✔ 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 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. Epidural hematoma d. Subdural hematoma - Precise Answer ✔✔ 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. Epidural hematoma d. Subdural hematoma 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 - Precise Answer ✔✔ 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 EMS responds for a patient involved in a motorcycle vs. car collision. The patient is unresponsive with no movement of lower extremities and loss of temperature control below the T10. Which type of shock is the patient experiencing? a. Cardiogenic b. Hypovolemic c. Neurogenic

d. Obstructive - Precise Answer ✔✔ EMS responds for a patient involved in a motorcycle vs. car collision. The patient is unresponsive with no movement of lower extremities and loss of temperature control below the T10. Which type of shock is the patient experiencing? a. Cardiogenic b. Hypovolemic c. Neurogenic d. Obstructive Which of the following is the best indicator of shock? a. Depressed level of cognition b. Heart rate of 80 c. Respirations of 18 d. GCS of 15 - Precise Answer ✔✔ Which of the following is the best indicator of shock? a. Depressed level of cognition b. Heart rate of 80 c. Respirations of 18 d. GCS of 15 Which best describes the goal of airway management in a trauma patient? a. Perform complex airway maneuvers b. Perform a surgical Cricothyrotomy

c. Provide for adequate exchange of oxygen and C d. Perform RSI - Precise Answer ✔✔ Which best describes the goal of airway management in a trauma patient? a. Perform complex airway maneuvers b. Perform a surgical Cricothyrotomy c. Provide for adequate exchange of oxygen and C02 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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 - Precise 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. 45-year-old female d. 6-year-old male - Precise Answer ✔✔ 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 You respond to a reported assault at a local bar. On arrival, you find a 46-year-old male on 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 - Precise Answer ✔✔ You respond to a reported assault at a local bar. On arrival, you find a 46-year-old male on 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 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 - Precise Answer ✔✔ 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 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 - Precise Answer ✔✔ 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 Hypoperfusion will affect which of the following organs first? a. Kidney b. Gl tract c. Brain d. Liver - Precise Answer ✔✔ Hypoperfusion will affect which of the following organs first? a. Kidney b. Gl tract c. Brain d. Liver 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 - Precise Answer ✔✔ 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 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 - Precise 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 - Precise 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 - Precise 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