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ITLS ADVANCED POST EXAM STUDY GUIDE
COMPLETE 350 QUESTIONS AND CORRECT
DETAILED SOLUTIONS JUST RELEASED THIS YEAR
QUESTION 1. 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.
QUESTION 2. 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
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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.)
QUESTION 3. 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.
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QUESTION 4. 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
Rationale: Look for signs of airway obstruction in the child, including apnea, stridor, and
"gurgling" respirations. If identified, perform a jaw-thrust maneuver without moving the neck.
QUESTION 5. 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
QUESTION 6. 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?
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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.
QUESTION 7. 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.
QUESTION 8. A pericardiocentesis is performed to:
ITLS ADVANCED POST EXAM STUDY GUIDE
COMPLETE 350 QUESTIONS AND CORRECT
DETAILED SOLUTIONS JUST RELEASED THIS YEAR
QUESTION 1. 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.
QUESTION 2. 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
, Page 2 of 84
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.)
QUESTION 3. 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.
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QUESTION 4. 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
Rationale: Look for signs of airway obstruction in the child, including apnea, stridor, and
"gurgling" respirations. If identified, perform a jaw-thrust maneuver without moving the neck.
QUESTION 5. 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
QUESTION 6. 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?
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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.
QUESTION 7. 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.
QUESTION 8. A pericardiocentesis is performed to:
