PHTLS Pre & Post Test Exam Questions and Answers A+ Graded

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PHTLS Pre & Post Test Exam Questions and
Answers A+ Graded

1. Which is the most common cause of upper airway obstruction in the trauma
patient? - ANSWER Tongue

2. Which is the preferred adjunct device for verifying placement of an
endotracheal tube in a patient with a perfusing rhythm? - ANSWER End-
tidal CO2 monitoring (capnography)

3. Which is the most important reason to maintain an open airway in the
trauma - ANSWER Prevents hypoxemia and hypercarbia

4. Essential airway skills include manual clearing of the airway, manual
maneuvers, suctioning and which of the following? - ANSWER
Oropharyngeal airway

5. 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? - ANSWER Begin ventilation with a BVM

6. Which best describes shock? - ANSWER Generalized inadequate tissue
perfusion

7. Your patient has a deep laceration to his antecubital fossa with significant
bleeding. What is the most appropriate initial action? - ANSWER Apply
direct pressure

8. Hypotension of unknown etiology in a trauma patient should be assumed to
result from which of the following? - ANSWER Blood loss

9. Which assessment is most beneficial in differentiating hemorrhagic shock
from neurogenic shock in the prehospital setting? - ANSWER Skin

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10.The body initially compensates for blood loss through activation of which of
the following? - ANSWER Sympathetic nervous system

11.Medication used by trauma patients for pre-existing conditions may cause
which of the following? - ANSWER Beta blockers may prevent tachycardia
with blood loss

12.The target blood pressure for a trauma patient with suspected intraabdominal
hemorrhage is which of the following? - ANSWER 80 - 90 mm Hg

13.Which best explains the mechanism by which gas exchange is impaired in
pulmonary contusion? - ANSWER Blood in the alveoli

14.The displacement of tissue away from the path of a projectile, both
temporarily and permanently, is known as: - ANSWER Cavitation

15.The single most important factor in determining the potential for injury due
to energy exchange is: - ANSWER Velocity of the bodies involved

16.In the management of shock, isotonic crystalloid solutions, such as Ringer's,
are preferred because: - ANSWER These solutions will stay in the vascular
space longer than water solutions, such as D5W

17.With respect to the distance of a fall, which of the following is a guideline
for determining a critical fall? - ANSWER 3 times the height of the patient

18.The phase of an explosion, or blast, in which hollow organs are squeezed
and may rupture is called the __________ phase. - ANSWER Primary phase

19.During the primary survey and management of a trauma patient, the E in
ABCDE stands for _________? - ANSWER Expose/Environment

20.The time in which surgical intervention can make a difference in patient
outcome is the __________? - ANSWER Golden period (hour)

21.In the absence of extenuating circumstances, the maximum amount of time it
should take to identify and manage immediate threats to life, prepare the
patient for transport and begin transport is _________? - ANSWER 10
minutes

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22.In which of the following situations is the use of a short spinal
immobilization device indicated? - ANSWER None of the above

23.Your patient is a 32 year old man, restrained driver of a vehicle that has been
involved in a frontal impact with a concrete bridge abutment. The patient is
awake, but has difficulty answering questions due to shortness of breath. His
ventilatory rate is 30 per minute. Of the following choices, when is the first
time the patient's breath sounds should be checked? - ANSWER Prior to
being removed from the vehicle

24.Which of the following represents adequate spontaneous ventilation in an
adult? - ANSWER Tidal volume 600 mL, ventilatory rate 12/minute

25.Which of the following is 100% accurate in verifying endotracheal tube
placement? - ANSWER None of the above

26.When utilizing percutaneous transtracheal ventilation, the correct ration of
lung inflation to lung inflation time, in seconds, is: - ANSWER 1:4

27.Which of the following is a possible complication of using a manually
triggered oxygen powered device for ventilation? - ANSWER All of the
above

28.Which of the following procedures is considered an essential airway -
ANSWER Insertion of an oropharyngeal airway

29.Pericardial tamponade is most likely to occur in which of the following
situations? - ANSWER Stab wound to the chest

30.Which of the following is the preferred site for needle decompression of a
tension pneumothorax? - ANSWER 2nd intercostal space, midclavicular
line, just over top of the 3rd rib

31.Which of the following is the mechanism by which pulmonary contusion
interferes with oxygenation? - ANSWER Blood and fluid in the alveoli and
interstitial spaces of the lung

32.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

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of 112, and breath sounds are decreased on the right side. The trachea is
midline and jugular veins are flat while the patient is supine. There is
isolated crepitus over the 4th and 5th ribs in the midaxillary line on the
patient's right side. Based on the mechanism of injury and the assessment
findings, which of the following is the most likely cause of the patient's
signs and symptoms? - ANSWER Hemothorax

33.Deterioration of ventilation and oxygenation after inflation of a PASG in a
patient who has sustained a high-pressure compression injury of the
abdomen, such as a sudden deceleration with the lap belt placed across the
abdomen, most likely represents which of the following - ANSWER
Ruptured diaphragm

34.Which of the following is NOT a component of the Fick principle? -
ANSWER Adequate number of platelets in the blood

35.One of the earliest signs of hypovolemic shock - ANSWER Anxiety

36.Which of the following characterizes the washout phase of shock? -
ANSWER Systemic acidosis

37.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? -
ANSWER Spinal cord injury

38.Which of the following is a limitation of prehospital fluid resuscitation of
the patient in hemorrhagic shock? - ANSWER All of the above

39.Which of the following statements regarding signs of intraabdominal injury
is NOT true? - ANSWER Substantial intraabdominal hemorrhage always
causes tenderness and abdominal rigidity

40.Which of the following assessment techniques is least useful in the
prehospital assessment of the patient with suspected intraabdominal trauma?
- ANSWER Auscultation

41.Pregnant trauma patients should be placed on the left side because: -
ANSWER This prevents compression of the vena cava