PHTLS Post Test 9th 2023 with complete solution

PHTLS Post Test 9th The displacement of tissue away from the path of a projectile, both temporarily and permanently, is known as: - Cavitation The single most important factor in determining the potential for injury due to energy exchange is: - Velocity of the bodies involved In the management of shock, isotonic crystalloid solutions, such as Ringer's, are preferred because: - 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? - 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. - Primary phase During the primary survey and management of a trauma patient, the E in ABCDE stands for _________? - Expose/Environment The time in which surgical intervention can make a difference in patient outcome is the __________? - Golden period (hour) 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 _________? - 10 minutes In which of the following situations is the use of a short spinal immobilization device indicated? - None of the above 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? - Prior to being removed from the vehicle Which of the following represents adequate spontaneous ventilation in an adult? - Tidal volume 600 mL, ventilatory rate 12/minute Which of the following is 100% accurate in verifying endotracheal tube placement? - None of the above When utilizing percutaneous transtracheal ventilation, the correct ration of lung inflation to lung inflation time, in seconds, is: - 1:4 Which of the following is a possible complication of using a manually triggered oxygen powered device for ventilation? - All of the above Which of the following procedures is considered an essential airway - Insertion of an oropharyngeal airway Pericardial tamponade is most likely to occur in which of the following situations? - Stab wound to the chest Which of the following is the preferred site for needle decompression of a tension pneumothorax? - 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? - 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 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? - Hemothorax 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 - Ruptured diaphragm Which of the following is NOT a component of the Fick principle? - Adequate number of platelets in the blood One of the earliest signs of hypovolemic shock - Anxiety Which of the following characterizes the washout phase of shock? - 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? - Spinal cord injury Which of the following is a limitation of prehospital fluid resuscitation of the patient in hemorrhagic shock? - All of the above Which of the following statements regarding signs of intraabdominal injury is NOT true? - 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? - Auscultation Pregnant trauma patients should be placed on the left side because: - This prevents compression of the vena cava Survival of the fetus in a trauma situation is most dependent upon which of the following factors? - Good resuscitation of the mother A patient struck in the back of the head with a baseball bat may sustain a cerebral contusion to which area of the brain? - Occipital (probably too low velocity for Coup & Contre Coup) In the context of the caring for an adult patient with traumatic brain injury who is deteriorating and exhibiting signs of herniation, hyperventilation means ventilating with a BVM and 100% oxygen at a rate of: - 20 In the United State, which of the following mechanisms most frequently causes spinal cord injury in adults? - Vehicle crashes Which of the following presentation indicate spinal cord injury? - All of the above Of the following, which is the earliest indication of compartment syndrome? - Tense swelling of the involved area A traction splint may be used for which of the following - Femur fractures Which of the following descriptions meets the criteria for transport to a facility with a burn unit? - A 25 year old male with an electrical burn across his chest The preferred method of dressing burns in the prehospital setting is: - Dry sterile dressing In assessing the hypothermic patient in the prehospital setting, the most reliable indicator of the severity of hypothermia is: - Rectal temperature In the normal child, which general statement is most accurate in comparison with the adult patient? - 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: - 8T (E-3, V-T, M-4) The earliest site for intraosseous infusion is: - Anterior tibia, just below the tibial tuberosity Which of the following behaviors is the most reliable indication of confusion in the elderly patient - Inability to recall his/her name In the elderly trauma patient a high index of suspicion for shock should occur beginning when the systolic blood pressure is less than: - C. 120 mmHg In an adult patient, blood loss into the tissue from a fractured femur may be as much as which of the following? - mL Delayed death due to trauma is usually a result of: - 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 - Level I trauma center Which of the following patients is not indicated for spinal immobilization? - Patient with a knife wound to the chest and a GCS of 15 The premise of PHTLS is that: - 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? - Preexisting major medical problem Which of the following is the foundation of effective trauma care? - 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? - Speed of the vehicle The potential for death or serious injury is greatest in which of the following motor vehicle collisions? - Ejection from vehicle Bilateral femur fractures are most often associated with which type of motorcycle crash? - Head-on impact Which is the preferred fluid for resuscitation of hemorrhagic shock in the prehospital setting? - Lactated Ringer's Which is the most common cause of upper airway obstruction in the trauma patient? - Tongue Which is the preferred adjunct device for verifying placement of an endotracheal tube in a patient with a perfusing rhythm? - End-tidal CO2 monitoring (capnography) Which is the most important reason to maintain an open airway in the trauma - Prevents hypoxemia and hypercarbia