PHTLS Exam Questions with Verified
Solutions
When the application of kinetic energy to the body from either a blunt or penetrating
mechanism displaces tissue, this is known as - ANS-CAVITATION
Which of the following is an example of the tertiary phase blast injury? - ANS-
CRUSHING INJURY DUE TO STRUCTURAL COLLAPSE.
The most common threat to life among trauma patients is? - ANS-INTERNAL
HEMORRHAGE
Your patient is an injured construction worker bleeding profusely from a large laceration
to the left thigh. He is confused and has pale, moist skin. Direct pressure applied to the
wound by a first responder has failed to control the bleeding. The next step in controlling
bleeding is to apply: - ANS-A TOURNIQUET TO THE LACERATION.
Hypotension due to spinal cord trauma occurs due to interruption of the
_______________nervous system pathway. - ANS-SYMPATHETIC
The most common fractured ribs are ribs: - ANS-4 THROUGH 8.
A hemothorax is differentiated from a tension pneumothorax by: - ANS-DULL
PERCUSSION ON THE AFFECTED SIDE.
Which of the following mechanisms is most likely to result in cardiac tamponade? -
ANS-A PATIENT IS STRUCK IN THE LEFT ANTERIOR CHEST BY A NAIL EJECTED
FROM A NAIL GUN.
Management of flail chest includes: - ANS-PAIN MANAGEMENT
VENTILATORY SUPPORT
100%O2
Which of the following types of traumatic brain injury is most likely to be associated with
hemorrhage from the middle meningeal artery? - ANS-EPIDURAL HEMATOMA
Which of the following groups of findings represents Cushing's phenomenon? - ANS-
BRADYCARDIA
ABNORMAL RESPIRATORY PATTERN
ELEVATED BLOOD PRESSURE
,Your patient is a 32 year old female who was thrown from a horse and struck her head
on the ground. She was not wearing a helmet. She does not respond verbally or open
her eyes to painful stimuli, but responds to painful stimuli with decerebrate posturing.
Her right pupil is dilated and does not react to light. Her respirations are 6 per minute
and irregular, pulse 56, blood pressure 188/98. You should ventilate the patient at a rate
of? - ANS-20 BPM.
A burn with reddened, glistening base that may have blisters is most characteristic of a -
ANS-SECOND degree burn.
A chemical solution with a pH of 4.0 is considered an ACID and causes damage to the
tissues via - ANS-COAGULATION NECROSIS.
An electrical burn caused by superheated air near the source of electricity is an - ANS-
ARC burn.
Your patient is an 82 year old female who was an unrestrained front seat passenger in a
motor vehicle collision. Which of the following is the most reliable indication of shock in
this patient? - ANS-LEVEL OF CONSCIOUSNESS.
Which of the following findings is not expected in assessment of a pregnant patient? -
ANS-A DECREASED BLOOD PRESSURE IN THE THIRD TRIMESTER.
Which of the following is contraindicated in the management of a pregnant trauma
patient in the third trimester? - ANS-SUPINE POSITION.
During the assessment of the trauma patient, auscultation of the lung sounds is first
performed during: - ANS-THE PRIMARY SURVEY.
Which of the following is indicated for the prehospital management of a circumferential
second degree burn extending from the wrist to the elbow in a 70 Kg patient? - ANS-A
DRY STERILE DRESSING
ANALGESIA
The preferred fluid for resuscitation of the patient with significant burns is: - ANS-
LACTATED RINGER'S SOLUTION.
Which of the following is the most common cause of spinal injuries? - ANS-MOTOR
VEHICLE COLLISIONS.
Hypotension in hemothorax is associated with: - ANS-THE ABILITY OF EACH SIDE OF
THE THORAX TO HOLD UP TO 3 LITERS OF BLOOD.
Cardiac tamponade is suspected with the findings of muffled heart
sounds___________, and___________ known as___________. - ANS-JUGULAR
VEIN DISTENTION, and HYPOTENSION, known as BECK'S TRIAD.
,When administering isotonic crystalloid solution, about ___________ will remain in the
vascular system after 1 hour. - ANS-ONE-THIRD
PASG is contraindicated in patients with - ANS-CHEST TRAUMA.
The greatest threat to life from injury to hollow abdominal organ is - ANS-PERITONITIS.
IV fluids administered to patients in shock should be _______ in order to
______________ ______________. - ANS-WARM, PREVENT HYPOTHERMIA.
During pregnancy, signs and symptoms of shock may appear _______ due to an
_________ in maternal blood volume. - ANS-LATER, INCREASE
A fractured femur can result in___________________mL of hemorrhage. - ANS-1000
TO 2000
A male patient suffered a stab wound to his left flank. He is found to be in stage III
shock. During the 25 minute transport to the trauma center, intravenous fluids should be
administered at a rate sufficient to maintain a: - ANS-SYSTOLIC BP OF 80 TO 90.
The most common type of shock in trauma patients is - ANS-HYPOVOLEMIC.
What percentage of blood volume loss in an adult patient is associated with findings of
tachycardia (>120/beats/minute), tachypnea (30-40 Breaths/min), and hypotension
(systolic BP <90mmHg)? - ANS-30 TO 40
Minute volume of ventilation is best represented as - ANS-TIDAL VOLUME x ventilatory
rate
Which injury is most likely to be sustained by the driver in a lateral impact collision to the
left side of the vehicle with no side impact airbags (assuming the driver sits on the left)?
- ANS-FRACTURED LEFT CLAVICLE.
Give me the general ideas of trauma criteria? - ANS-Any patient that has a compromise
to Airway, Breathing, Circulation and Deficit. Any Patient that is Altered or
What three areas of a penetrating injury would be trauma criteria? - ANS-Thoracic
cavity and up. Cranial, between Thoracic and midclavicular line, neck.
For trauma criteria what must the BP be below in an adult? Child? - ANS-Adult >90 /
Child >70 (Systolic)
What is the trauma criteria for blunt head injury? - ANS-ALOC, GCS less than 14,
except pt. 1 y/o, seizures, unequal pupils, or focal neurological deficit.
, For trauma criteria what should also be present in a Cardiac arrest? - ANS-Penetrating
torso trauma.
What is the most common threat to life? - ANS-Inadequate tissue perfusion
When would a shotgun injury meet trauma criteria? - ANS-wounds to the trunk.
A fall from 15 feet is trauma criteria so what type of injuries may also be sustained that
APPLY to trauma criteria? - ANS-Blunt chest injury- flail chest, abdominal tenderness,
spinal fx w/ extremity weakness and sensory deficit.
If the driver of a vehicle is found in the passenger space can't feel his toes and has no
radial pulse in left extremity is this patient trauma criteria? How many categories does
this patient fall into? - ANS-yes/3.
Name some guidelines for trauma patients? transport is advised. - ANS-Surviving
patients in MVC where fatalities and complaint of injury occur- Pedestrian vs Auto.-
ejection from vehicle, extrication, young and old patients w/ medical history
What are indications of use of a PASG? - ANS-suspected pelvic fx- profound
hypotension (sys <50 to 60)- retroperitoneal hemorrhage.
What are CONTRAindications of use of a PASG? - ANS-Penetrating thoracic trauma-
splinting of lower extremity fx.- Eviceration of abdominal organs, impaled objects in
abdomen- Pregnancy- traumatic cardiac arrest.
When using a PASG what syndrome will occur if you decide to splint a lower extremity?
- ANS-compartment syndrome.
What is a Colles fracture? - ANS-bilateral fracture of wrist- fall w/ outstretched hands
What is Don Juan syndrome? - ANS-bilateral heel/ankles/ tib. Fib./Femur/pelvic fall on
feet.
What are early signs of increase intracranial pressure? - ANS-headache and vomiting
At what height are falls the most significant? - ANS-15 feet
In trauma what's the difference between hollow and solid organs? - ANS-hollow causes
peritonitis - solid organs bleed.
What injuries would occur at the time of impact? - ANS-crush or compression injuries.
What is the first action with a severe burn patient? - ANS-stop the burning.
When there is a decrease in intravenous pressure what are common S/S? - ANS-JVD
Solutions
When the application of kinetic energy to the body from either a blunt or penetrating
mechanism displaces tissue, this is known as - ANS-CAVITATION
Which of the following is an example of the tertiary phase blast injury? - ANS-
CRUSHING INJURY DUE TO STRUCTURAL COLLAPSE.
The most common threat to life among trauma patients is? - ANS-INTERNAL
HEMORRHAGE
Your patient is an injured construction worker bleeding profusely from a large laceration
to the left thigh. He is confused and has pale, moist skin. Direct pressure applied to the
wound by a first responder has failed to control the bleeding. The next step in controlling
bleeding is to apply: - ANS-A TOURNIQUET TO THE LACERATION.
Hypotension due to spinal cord trauma occurs due to interruption of the
_______________nervous system pathway. - ANS-SYMPATHETIC
The most common fractured ribs are ribs: - ANS-4 THROUGH 8.
A hemothorax is differentiated from a tension pneumothorax by: - ANS-DULL
PERCUSSION ON THE AFFECTED SIDE.
Which of the following mechanisms is most likely to result in cardiac tamponade? -
ANS-A PATIENT IS STRUCK IN THE LEFT ANTERIOR CHEST BY A NAIL EJECTED
FROM A NAIL GUN.
Management of flail chest includes: - ANS-PAIN MANAGEMENT
VENTILATORY SUPPORT
100%O2
Which of the following types of traumatic brain injury is most likely to be associated with
hemorrhage from the middle meningeal artery? - ANS-EPIDURAL HEMATOMA
Which of the following groups of findings represents Cushing's phenomenon? - ANS-
BRADYCARDIA
ABNORMAL RESPIRATORY PATTERN
ELEVATED BLOOD PRESSURE
,Your patient is a 32 year old female who was thrown from a horse and struck her head
on the ground. She was not wearing a helmet. She does not respond verbally or open
her eyes to painful stimuli, but responds to painful stimuli with decerebrate posturing.
Her right pupil is dilated and does not react to light. Her respirations are 6 per minute
and irregular, pulse 56, blood pressure 188/98. You should ventilate the patient at a rate
of? - ANS-20 BPM.
A burn with reddened, glistening base that may have blisters is most characteristic of a -
ANS-SECOND degree burn.
A chemical solution with a pH of 4.0 is considered an ACID and causes damage to the
tissues via - ANS-COAGULATION NECROSIS.
An electrical burn caused by superheated air near the source of electricity is an - ANS-
ARC burn.
Your patient is an 82 year old female who was an unrestrained front seat passenger in a
motor vehicle collision. Which of the following is the most reliable indication of shock in
this patient? - ANS-LEVEL OF CONSCIOUSNESS.
Which of the following findings is not expected in assessment of a pregnant patient? -
ANS-A DECREASED BLOOD PRESSURE IN THE THIRD TRIMESTER.
Which of the following is contraindicated in the management of a pregnant trauma
patient in the third trimester? - ANS-SUPINE POSITION.
During the assessment of the trauma patient, auscultation of the lung sounds is first
performed during: - ANS-THE PRIMARY SURVEY.
Which of the following is indicated for the prehospital management of a circumferential
second degree burn extending from the wrist to the elbow in a 70 Kg patient? - ANS-A
DRY STERILE DRESSING
ANALGESIA
The preferred fluid for resuscitation of the patient with significant burns is: - ANS-
LACTATED RINGER'S SOLUTION.
Which of the following is the most common cause of spinal injuries? - ANS-MOTOR
VEHICLE COLLISIONS.
Hypotension in hemothorax is associated with: - ANS-THE ABILITY OF EACH SIDE OF
THE THORAX TO HOLD UP TO 3 LITERS OF BLOOD.
Cardiac tamponade is suspected with the findings of muffled heart
sounds___________, and___________ known as___________. - ANS-JUGULAR
VEIN DISTENTION, and HYPOTENSION, known as BECK'S TRIAD.
,When administering isotonic crystalloid solution, about ___________ will remain in the
vascular system after 1 hour. - ANS-ONE-THIRD
PASG is contraindicated in patients with - ANS-CHEST TRAUMA.
The greatest threat to life from injury to hollow abdominal organ is - ANS-PERITONITIS.
IV fluids administered to patients in shock should be _______ in order to
______________ ______________. - ANS-WARM, PREVENT HYPOTHERMIA.
During pregnancy, signs and symptoms of shock may appear _______ due to an
_________ in maternal blood volume. - ANS-LATER, INCREASE
A fractured femur can result in___________________mL of hemorrhage. - ANS-1000
TO 2000
A male patient suffered a stab wound to his left flank. He is found to be in stage III
shock. During the 25 minute transport to the trauma center, intravenous fluids should be
administered at a rate sufficient to maintain a: - ANS-SYSTOLIC BP OF 80 TO 90.
The most common type of shock in trauma patients is - ANS-HYPOVOLEMIC.
What percentage of blood volume loss in an adult patient is associated with findings of
tachycardia (>120/beats/minute), tachypnea (30-40 Breaths/min), and hypotension
(systolic BP <90mmHg)? - ANS-30 TO 40
Minute volume of ventilation is best represented as - ANS-TIDAL VOLUME x ventilatory
rate
Which injury is most likely to be sustained by the driver in a lateral impact collision to the
left side of the vehicle with no side impact airbags (assuming the driver sits on the left)?
- ANS-FRACTURED LEFT CLAVICLE.
Give me the general ideas of trauma criteria? - ANS-Any patient that has a compromise
to Airway, Breathing, Circulation and Deficit. Any Patient that is Altered or
What three areas of a penetrating injury would be trauma criteria? - ANS-Thoracic
cavity and up. Cranial, between Thoracic and midclavicular line, neck.
For trauma criteria what must the BP be below in an adult? Child? - ANS-Adult >90 /
Child >70 (Systolic)
What is the trauma criteria for blunt head injury? - ANS-ALOC, GCS less than 14,
except pt. 1 y/o, seizures, unequal pupils, or focal neurological deficit.
, For trauma criteria what should also be present in a Cardiac arrest? - ANS-Penetrating
torso trauma.
What is the most common threat to life? - ANS-Inadequate tissue perfusion
When would a shotgun injury meet trauma criteria? - ANS-wounds to the trunk.
A fall from 15 feet is trauma criteria so what type of injuries may also be sustained that
APPLY to trauma criteria? - ANS-Blunt chest injury- flail chest, abdominal tenderness,
spinal fx w/ extremity weakness and sensory deficit.
If the driver of a vehicle is found in the passenger space can't feel his toes and has no
radial pulse in left extremity is this patient trauma criteria? How many categories does
this patient fall into? - ANS-yes/3.
Name some guidelines for trauma patients? transport is advised. - ANS-Surviving
patients in MVC where fatalities and complaint of injury occur- Pedestrian vs Auto.-
ejection from vehicle, extrication, young and old patients w/ medical history
What are indications of use of a PASG? - ANS-suspected pelvic fx- profound
hypotension (sys <50 to 60)- retroperitoneal hemorrhage.
What are CONTRAindications of use of a PASG? - ANS-Penetrating thoracic trauma-
splinting of lower extremity fx.- Eviceration of abdominal organs, impaled objects in
abdomen- Pregnancy- traumatic cardiac arrest.
When using a PASG what syndrome will occur if you decide to splint a lower extremity?
- ANS-compartment syndrome.
What is a Colles fracture? - ANS-bilateral fracture of wrist- fall w/ outstretched hands
What is Don Juan syndrome? - ANS-bilateral heel/ankles/ tib. Fib./Femur/pelvic fall on
feet.
What are early signs of increase intracranial pressure? - ANS-headache and vomiting
At what height are falls the most significant? - ANS-15 feet
In trauma what's the difference between hollow and solid organs? - ANS-hollow causes
peritonitis - solid organs bleed.
What injuries would occur at the time of impact? - ANS-crush or compression injuries.
What is the first action with a severe burn patient? - ANS-stop the burning.
When there is a decrease in intravenous pressure what are common S/S? - ANS-JVD
