ITLS 8th Edition Additional Q&As With Complete Solution

Upon arrival at a trauma scene, you should complete a(n) - Answer Scene Size-up Prolonged scene times may reflect: - Answer Ineffective team collaboration Which of the following indicates a state of hyperventilation? - Answer An end tidal CO2 level less than 30 mmHG A 23 year old female fell from a 2nd floor balcony. Upon arrival, you find her lying in the grass. She responds to verbal commands and your assessment reveals flat neck veins, & normal chest/abdomen/pelvic examinations. Vital signs are: BP 74/40, P 54 & Weak, and R 16. You should suspect: - Answer Relative hypovolemic (high-space) shock Rationale: The condition causing the vascular space to be too large for a normal amount of blood has been called "shock", or relative hypovolemia. Neurogenic shock, commonly called spinal shock, is a form of relative hypovolemia. The clinical presentation of neurogenic shock differs from hemorrhagic shock in that there is no catecholamine release and this no pallor (vasoconstriction), tachycardia, or sweating. The patient will have a decreased BP but the HR will be normal or slow, and the skin is usually warm, dry and pink An unresponsive 34 y/o female was struck by a vehicle. You observe Asymmetrical chest wall movement with a flail segment on the right. Following delegation of c-spine control and opening the airway, you should? - Answer Stabilize the chest wall Which of the following regarding PT positioning for external jugular cannulation is Incorrect? - Answer Elevate the head to distend the vein and prevent air embolism. Rationale: The PT must be in the supine position, preferably head down, to distend the vein and prevent air embolism. Which of the following set of vital signs is most compatible with a diagnosis of isolated traumatic brain injury with increasing ICP? - Answer BP 170/100, P 50 Rationale: When the ICP increases, the systemic BP increases to try to preserve blood flow to the brain. The body senses the rise in systemic BP, and this triggers a drop in the pulse rate as the body tries to lower the systemic BP Which of the following statements is incorrect regarding spinal motion restriction? - Answer Neck traction should be applied to extend the neck upward during cervical collar application A 15 y/o male was stabbed and has an abdominal evisceration. The PT is A/O, BP 112/68, P 94, R18. You should? - Answer Prepare PT for transport & establish vascular access during transport. A 33yo female's leg was trapped in a piece of industrial equipment and has been extricated. She is now complaining of secure lower leg pain. PT is A/O with no signs of external hemorrhage. Vital signs are: BP 132/78, P 96, R 20. Which of the following is indicated? - Answer Administer pain medication Establishing vascular access on scene is indicated: - Answer To administer medication Which of the following changes is most useful to monitor in the child with head injury? - Answer Level of consciousness Rationale: changing of LOC is the best indicator of traumatic brain injury In the geriatric PT, which of the following findings is most likely caused by an acute injury? - Answer Hypotension A 31yo female was the restrained driver of a vehicle that hit a utility pole at moderate speed. The drivers side airbag deployed. She is A/O & anxious. She reports that she is 8mo pregnant and complain of abdominal, chest and lower extremity pain. Her vital signs are BP 100/60, P 90, R 20. Your impression and interventions are: - Answer Early signs of shock. Treat with O2, fluid administration, at "keep open" rate. Rationale: Do not mistake normal vital signs in pregnant PTs. The pregnant PT has a normal resting pulse that is 10-15 beats faster than usual, and the BP is 10-15mmHG lower than usual. However, it is also important to realize that a BP loss of 30% can occur in these PTs before there is a significant change in BP A disoriented 23yo male is injured in a motorcycle collision. The PT appears to be intoxicated and does not want medical attention despite a large laceration on his scalp, which is actively bleeding. You should: - Answer Treat him as a head injury PT What is the most common cause of cardiopulmonary arrest in the trauma PT? - Answer Hypoxemia Rationale: Hypoxemia is the most common cause of traumatic cardiopulmonary arrest. Acute airway obstruction or ineffective breathing will be clinically manifested in hypoxemia