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PHTLS Pre & Post Test correctly
answered 2023
The displacement of tissue away from the path of a projectile, both temporarily and permanently, is known as: A. Conization B. Cavitation C. Crepitation D. Contusion - correct answer B. Cavitation 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 - correct answer B. Velocity of the bodies involved 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 - correct answer C. These solutions will stay in the vascular space longer than water solutions, such as D5W 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 - correct answer A. 3 times the height of the patient 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 - correct answer D. Primary phase 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 - correct answer C. Expose/Environment 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 - correct answer A. Golden period (hour)
C. Tidal volume 300 mL, ventilatory rate 16/minute D. Tidal volume 600 mL, ventilatory rate 12/minute - correct answer D. Tidal volume 600 mL, ventilatory rate 12/minute Which of the following is 100% accurate in verifying endotracheal tube placement? A. Pulse oximetry B. End-tidal capnometry C. Syringe aspiration D. None of the above - correct answer D. None of the above When utilizing percutaneous transtracheal ventilation, the correct ration of lung inflation to lung inflation time, in seconds, is: A. 1: B. 1: C. 1: D. 2:2 - correct answer A. 1: Which of the following is a possible complication of using a manually triggered oxygen powered device for ventilation? A. Gastric distention B. Pneumothorax C. Inability to feel lung compliance D. All of the above - correct answer D. All of the above Which of the following procedures is considered an essential airway skill? A. Needle cricothyroidotomy
B. Endotracheal intubation C. Insertion of an oropharyngeal airway D. Retrograde endotracheal intubation - correct answer C. Insertion of an oropharyngeal airway Pericardial tamponade is most likely to occur in which of the following situations? A. Stab wound to the chest B. Fall from a height C. Frontal impact vehicle crash D. Gunshot wound to the chest - correct answer A. Stab wound to the chest 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 - correct answer C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib 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 - correct answer D. Blood and fluid in the alveoli and interstitial spaces of the lung 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
C. Anxiety D. Reduced urine output - correct answer C. Anxiety Which of the following characterizes the washout phase of shock? A. Systemic acidosis B. Localized tissue acidosis C. Edema D. Reduced capillary blood flow - correct answer A. Systemic acidosis 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 C. Fractured pelvis D. Spinal cord injury - correct answer D. Spinal cord injury 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 - correct answer D. All of the above 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 - correct answer C. Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity Which of the following assessment techniques is least useful in the prehospital assessment of the patient with suspected intraabdominal trauma? A. Palpation B. Auscultation C. Inspection D. Scene assessment - correct answer B. Auscultation 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 - correct answer C. This prevents compression of the vena cava Survival of the fetus in a trauma situation is most dependent upon which of the following factors? A. Gestational age of the fetus B. Prenatal care C. Immediate cesarean section D. Good resuscitation of the mother - correct answer D. Good resuscitation of the mother
C. Complete loss of function on one side of the body and loss of pain and temperature sensation on the opposite side D. All of the above - correct answer D. All of the above Of the following, which is the earliest indication of compartment syndrome? A. Paralysis of the affected muscles B. Loss of pulses C. Loss of feeling in the web space between the thumb and index finger or between the first and second toes D. Tense swelling of the involved area - correct answer D. Tense swelling of the involved area A traction splint may be used for which of the following injuries? A. Knee dislocation B. Pelvic fractures C. Femur fractures D. All of the above - correct answer C. Femur fractures Which of the following descriptions meets the criteria for transport to a facility with a burn unit? A. A 49 year old female with a partial thickness burn from her elbow to her shoulder B. A 25 year old male with an electrical burn across his chest C. A 9 year old make with superficial burns on the backs of both legs D. A 32 year old female with a partial thickness burn about twice the size of her hand on her back - correct answer B. A 25 year old male with an electrical burn across his chest The preferred method of dressing burns in the prehospital setting is: A. Dry sterile dressing
B. Moist sterile dressing C. Wet dressings D. Petroleum gauze - correct answer A. Dry sterile dressing In assessing the hypothermic patient in the prehospital setting, the most reliable indicator of the severity of hypothermia is: A. Rectal temperature B. Oral temperature C. Heart rate < 60 D. Presence or absence of shivering - correct answer A. Rectal temperature In the normal child, which general statement is most accurate in comparison with the adult patient? A. Blood pressure is higher, hear rate is higher, and ventilatory rate is higher B. Blood pressure is lower, heart rate is lower, and ventilatory rate is higher 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 - correct answer C. Blood pressure is lower, heart rate is higher, and ventilatory rate is higher 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 - correct answer B. 8T (E-3, V-T, M-4) The earliest site for intraosseous infusion is:
Delayed death due to trauma is usually a result of: A. Biochemical and pathophysiological effects of inadequate initial resuscitation B. Acute circulatory failure C. Brain injury D. Acute hypoxia - correct answer A. Biochemical and pathophysiological effects of inadequate initial resuscitation 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 - correct answer D. Level I trauma center Which of the following patients is not indicated for spinal immobilization? 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 - correct answer D. Patient with a knife wound to the chest and a GCS of 15 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 - correct answer B. EMTs are capable of sound patient care judgment, given an adequate knowledge base Which of the following warrants classification of a patient as a critical 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 - correct answer B. Preexisting major medical problem 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 - correct answer C. The ability to quickly locate and manage life- threatening and potentially life-threatening injuries 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 - correct answer D. Speed of the vehicle 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) Pulse oximeter D) Stethoscope - correct answer A) End-tidal CO2 monitoring (capnography) Which is the most important reason to maintain an open airway in the trauma patient? A) Prevents aspiration and pneumonia B) Prevents hypoxemia and hypercarbia C) Prevents snoring respirations D) Prevents the tongue from blocking the pharynx - correct answer B) Prevents hypoxemia and hypercarbia Essential airway skills include manual clearing of the airway, manual maneuvers, suctioning and which of the following? A) Dual lumen airway B) Endotracheal intubation C) Laryngeal mask airway D) Oropharyngeal airway - correct answer D) Oropharyngeal airway Your patient is a middle aged male who crashed his motorcycle. He is unresponsive. After opening the airway using a modified jaw thrust, you note the patient has respirations at a rate of 6. Auscultation reveals breath sounds are absent on the left side. Which of the following is the most appropriate next intervention? A) Apply a non-rebreather mask B) Begin ventilation with a BVM C) Insert an endotracheal tube D) Perform a needle decompression - correct answer B) Begin ventilation with a BVM Which best describes shock?
A) Decreased Glasgow Coma Scale (GCS) B) Flushed, dry, hot skin combined with bradycardia C) Generalized inadequate tissue perfusion D) Low blood pressure combined with tachycardia - correct answer C) Generalized inadequate tissue perfusion Your patient has a deep laceration to his antecubital fossa with significant bleeding. What is the most appropriate initial action? A) Apply a tourniquet B) Apply direct pressure C) Initiate rapid transport D) Restore blood volume - correct answer B) Apply direct pressure Hypotension of unknown etiology in a trauma patient should be assumed to result from which of the following? A) Blood loss B) Cardiac tamponade C) Spinal injury D) Tension pneumothorax - correct answer A) Blood loss Which assessment is most beneficial in differentiating hemorrhagic shock from neurogenic shock in the prehospital setting? A) Abdomen B) Blood pressure C) Neurologic status D) Skin - correct answer D) Skin
D) Partial occlusion of the bronchi - correct answer A) Blood in the alveoli Which of the following is a key finding that differentiates cardiac tamponade from tension pneumothorax? A) Distended jugular veins B) Equal breath sounds C) Hypotension D) Tachycardia - correct answer B) Equal breath sounds 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. B) 20 breaths per minute. C) 30 breaths per minute. D) 35 breaths per minute. - correct answer B) 20 breaths per minute 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. - correct answer D) 90 mm Hg.
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 - correct answer B) Dry sterile dressings 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 - correct answer B) Hemorrhage. 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 - correct answer B) Apply a tourniquet and tighten it until bleeding stops 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 immobilization of the cervical spine? A) Fracture of the femur B) Inability to communicate
