ITLS Advanced 8th Edition | Exam Revision Questions and Correct Answers
With 100% Correct Answers | Latest 2025 Update.
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
Rationale: The classic findings of this life-threatening situation are a decreasing level of
consciousness (LOC) that rapidly progresses to coma, dilation of the pupil and an outward-
downward deviation of the eye on the side of the injury, paralysis of the arm and leg on the side
opposite the injury, or decerebrate posturing (arms and legs extended). The danger of immediate
herniation outweighs the risk of cerebral ischemia that can follow hyperventilation. The cerebral
herniation syndrome is the only situation in which hyperventilation is still indicated. (You must
ventilate every three seconds [20/minute] for adults.)
7. Which of the following mechanisms of injury does not commonly cause damage to the spinal
cord?
A. Hyperextension
B. Hyperflexion
C. Lateral stress
D. Compression - ANSWER- C. Lateral stress
Rationale: Certain mechanisms of trauma can overcome the protective properties, injuring the
spinal column and cord. The most common mechanisms are hyperextension, hyperflexion,
compression, and rotation. Less commonly, lateral stress or distraction will injure the cord.
8. A 4-year-old female is unconscious after falling off a bicycle. Which of the following is the best
method to open the airway?
A. Modified jaw-thrust
B. Head tilt
C. Neck flexion
D. Neck lift - ANSWER- A. Modified jaw-thrust
With 100% Correct Answers | Latest 2025 Update.
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
Rationale: The classic findings of this life-threatening situation are a decreasing level of
consciousness (LOC) that rapidly progresses to coma, dilation of the pupil and an outward-
downward deviation of the eye on the side of the injury, paralysis of the arm and leg on the side
opposite the injury, or decerebrate posturing (arms and legs extended). The danger of immediate
herniation outweighs the risk of cerebral ischemia that can follow hyperventilation. The cerebral
herniation syndrome is the only situation in which hyperventilation is still indicated. (You must
ventilate every three seconds [20/minute] for adults.)
7. Which of the following mechanisms of injury does not commonly cause damage to the spinal
cord?
A. Hyperextension
B. Hyperflexion
C. Lateral stress
D. Compression - ANSWER- C. Lateral stress
Rationale: Certain mechanisms of trauma can overcome the protective properties, injuring the
spinal column and cord. The most common mechanisms are hyperextension, hyperflexion,
compression, and rotation. Less commonly, lateral stress or distraction will injure the cord.
8. A 4-year-old female is unconscious after falling off a bicycle. Which of the following is the best
method to open the airway?
A. Modified jaw-thrust
B. Head tilt
C. Neck flexion
D. Neck lift - ANSWER- A. Modified jaw-thrust
