ADVANCED ITLS 8TH EDITION
QUESTIONS AND COMPLETE
SOLUTIONS GRADED A+
Your Exam Plug
,1. In a rear-impact motor vehicle crash, which area of the spine is most susceptible to injury?
A. Cervical
B. Thoracic
C. Lumbar
D. Sacral-coccygeal - Answer: A. Cervical
Rationale: The sudden increase in acceleration produces posterior displacement of the occupants and
possible hyperextension of the cervical spine if the headrest is not properly adjusted. The potential for
cervical-spine injuries is great.
2. A 36-year-old male sustains blunt force thoracic trauma and fits the criteria for a load- and-go patient.
Which of the following should be performed on the scene?
A. Obtain an EKG B.
B. Establish vascular access
C. Obtain a finger-stick serum lactate level
D. Assess for other potentially life-threatening conditions - Answer: D. Assess for other potentially life-
threatening conditions
Rationale: The purpose of the initial assessment is to prioritize the patient and to identify all
immediately life-threatening conditions. The information gathered is used to make decisions about
critical interventions and time of transport.
3. The use of external laryngeal manipulation:
A. Decreases the risk of airway trauma
B. Reduces gastric distention
C. Improves glottic visualization
D. Causes aspiration - Answer: C. Improves glottic visualization
Rationale: Manipulating the thyroid cartilage can help bring the vocal cords into view during
endotracheal intubation. This is called external laryngeal manipulation (ELM). The movement is usually
pressing the thyroid cartilage backward against the esophagus and then upward and slightly to the
patient's right side.
, 4. A pericardiocentesis is performed to:
A. To remove fluid from the lining around the lungs
B. To remove fluid from the lining around the heart
C. To inject medications directly into the heart
D. To monitor stroke volume - Answer: B. To remove fluid from the lining around the heart
Rationale: The pericardial sac is an inelastic membrane that surrounds the heart. If blood collects rapidly
between the heart and pericardium from a cardiac injury, the ventricles of the heart will be compressed,
making the heart less able to refill, and cardiac output falls.
5. A 56-year-old male sustains a gunshot wound to the abdomen. Vital signs are BP 74/32, P 136 present
only at the carotid, and R 24 and shallow. The target of fluid resuscitation is:
A. Return of peripheral pulses
B. Maintenance of central pulses
C. Systolic blood pressure of 110-120
D. Pulse rate of 100 - Answer: A. Return of peripheral pulses
Rationale: This is an example of internal, uncontrolled hemorrhage. Administer sufficient normal saline
to maintain peripheral perfusion, following local or EMS agency medical direction policies. Maintaining
peripheral perfusion is generally defined as giving enough fluid—usually in boluses—to return a
peripheral pulse, such as a radial pulse.
6. An unconscious 15-year-old male was struck on the head with a baseball bat. His arms and legs are
extended and his right pupil is dilated and fixed. You should:
A. Insert an oropharyngeal airway, administer oxygen, and restrict fluids
B. Apply a non-rebreather mask, restrict fluids, and administer Mannitol
C. Perform nasotracheal intubation, restrict fluids, and provide adequate ventilation
D. Perform bag-mask ventilation at 20 per minute Exam - Answer: D. Perform bag-mask ventilation at 20
per minute Exam
QUESTIONS AND COMPLETE
SOLUTIONS GRADED A+
Your Exam Plug
,1. In a rear-impact motor vehicle crash, which area of the spine is most susceptible to injury?
A. Cervical
B. Thoracic
C. Lumbar
D. Sacral-coccygeal - Answer: A. Cervical
Rationale: The sudden increase in acceleration produces posterior displacement of the occupants and
possible hyperextension of the cervical spine if the headrest is not properly adjusted. The potential for
cervical-spine injuries is great.
2. A 36-year-old male sustains blunt force thoracic trauma and fits the criteria for a load- and-go patient.
Which of the following should be performed on the scene?
A. Obtain an EKG B.
B. Establish vascular access
C. Obtain a finger-stick serum lactate level
D. Assess for other potentially life-threatening conditions - Answer: D. Assess for other potentially life-
threatening conditions
Rationale: The purpose of the initial assessment is to prioritize the patient and to identify all
immediately life-threatening conditions. The information gathered is used to make decisions about
critical interventions and time of transport.
3. The use of external laryngeal manipulation:
A. Decreases the risk of airway trauma
B. Reduces gastric distention
C. Improves glottic visualization
D. Causes aspiration - Answer: C. Improves glottic visualization
Rationale: Manipulating the thyroid cartilage can help bring the vocal cords into view during
endotracheal intubation. This is called external laryngeal manipulation (ELM). The movement is usually
pressing the thyroid cartilage backward against the esophagus and then upward and slightly to the
patient's right side.
, 4. A pericardiocentesis is performed to:
A. To remove fluid from the lining around the lungs
B. To remove fluid from the lining around the heart
C. To inject medications directly into the heart
D. To monitor stroke volume - Answer: B. To remove fluid from the lining around the heart
Rationale: The pericardial sac is an inelastic membrane that surrounds the heart. If blood collects rapidly
between the heart and pericardium from a cardiac injury, the ventricles of the heart will be compressed,
making the heart less able to refill, and cardiac output falls.
5. A 56-year-old male sustains a gunshot wound to the abdomen. Vital signs are BP 74/32, P 136 present
only at the carotid, and R 24 and shallow. The target of fluid resuscitation is:
A. Return of peripheral pulses
B. Maintenance of central pulses
C. Systolic blood pressure of 110-120
D. Pulse rate of 100 - Answer: A. Return of peripheral pulses
Rationale: This is an example of internal, uncontrolled hemorrhage. Administer sufficient normal saline
to maintain peripheral perfusion, following local or EMS agency medical direction policies. Maintaining
peripheral perfusion is generally defined as giving enough fluid—usually in boluses—to return a
peripheral pulse, such as a radial pulse.
6. An unconscious 15-year-old male was struck on the head with a baseball bat. His arms and legs are
extended and his right pupil is dilated and fixed. You should:
A. Insert an oropharyngeal airway, administer oxygen, and restrict fluids
B. Apply a non-rebreather mask, restrict fluids, and administer Mannitol
C. Perform nasotracheal intubation, restrict fluids, and provide adequate ventilation
D. Perform bag-mask ventilation at 20 per minute Exam - Answer: D. Perform bag-mask ventilation at 20
per minute Exam
