COMPLETE 300 QUESTIONS AND CORRECT DETAILED
ANSWERS LATEST UPDATE THIS YEAR
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ITLS 9th Edition ACTUAL EXAM
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Term 1 of 50
21. Bag-valve-mask ventilation:
A. Rarely causes gastric distention due to low airway pressures
B. Is more effective in patients whose dentures have been removed
C. Is easily accomplished by one rescuer at the head
D. May exceed 60 cm H2O pressure in the airway
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D. It can be powered by your portable O2 cylinder so it is not dependent on battery
power
Rationale: It can be hand powered or battery powered rather than oxygen driven.
, D. Multiple nose piercings
Rationale: Predictors of difficult mask ventilation can be remembered using the "BOOTS"
mnemonic:
B - Beards
O - Obesity
O - Older patients
T - Toothlessness
S - Snores or stridor
D. May exceed 60 cm H2O pressure in the airway
Rationale: Bag-valve-mask ventilation has challenges because pressures generated
by squeezing the bag may equal or exceed 60 cm H2O.
A. Direct pressure to the wound
Rationale: Pack the hemostatic agent in the wound, and hold firm pressure. Hemostatic
agent is an "adjunct" to assist in controlling hemorrhage, not a hemorrhage control by
itself.
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Term 2 of 50
20. Which finding requires interruption of the ITLS Primary Survey?
A. Complete airway obstruction
B. Gasping respirations
C. Impaled object in abdomen
D. Very weak pulse
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, B. Shock
Rationale: Clinical signs of a tension pneumothorax include dyspnea, anxiety, tachypnea,
distended neck veins, and possibly tracheal deviation away from the affected side.
Auscultation will reveal diminished breath sounds on the affected side and will be
accompanied by hyperresonance when percussed. Shock with hypotension will follow
and is not present with a simple pneumothorax.
B. It is caused by hemorrhage into the lung parenchyma
Rationale: Pulmonary contusion is a very common chest injury. It is caused by hemorrhage
into lung parenchyma secondary to blunt force trauma or penetrating injury such as a
missile. It occurs commonly with flail segment or multiple rib fractures. A pulmonary
contusion takes hours to develop and rarely develops during prehospital care.
A. Cardiac arrest
Rationale: Remember, once you begin patient assessment in the ITLS Primary Survey, only
four things should cause you to interrupt completion of the assessment. You may interrupt
the assessment sequence only if (1) the scene becomes unsafe, (2) you must treat
exsanguinating hemorrhage, (3) you must treat an airway obstruction, or (4) you must
treat cardiac arrest.
A. Complete airway obstruction
Rationale: You may interrupt the assessment sequence only if (1) the scene becomes
unsafe, (2) you must treat exsanguinating hemorrhage, (3) you must treat an airway
obstruction, or (4) you must treat cardiac arrest. (Respiratory arrest, dyspnea, or
bleeding management should be delegated to other team members while you
continue assessment of the patient.)
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Term 3 of 50
, 34. A disoriented 23-year-old male is injured in a motorcycle collision. The
patient appears to be intoxicated and does not want medical attention
despite a large laceration on his scalp, which is actively bleeding. You
should:
A. Have the patient call a friend or family member and have them drive him
home and sleep it off
B. Discuss the impact of alcohol abuse with him
C. Treat him as a head injured patient
D. Wait until the patient loses consciousness and then transport
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C. External arterial bleeding
Rationale: If your patient has major bleeding, the priority is C-A-B-C. The first C stands for
control life-threatening bleeding. (Do not confuse this with the American Heart
Association/ILCOR's "CAB" for cardiac arrest, where the C stands for compressions.) If
your patient has major external bleeding, you must immediately control it.
B. Intravenous fluid; give enough fluid to maintain peripheral pulses
Rationale: Give only enough normal saline to maintain a blood pressure high enough for
adequate peripheral perfusion. Maintaining peripheral perfusion may be defined as
producing a peripheral pulse (such as a radial pulse).
C. Fatal outcomes are more likely in the elderly than in the young
Rationale: Geriatric patients can die from less severe injuries than younger patients. In
addition, it is often difficult to separate the effects of the aging process or of a chronic
illness from the consequences of an injury.
C. Treat him as a head injured patient
Rationale: An altered mental status can be seen in every form of substance abuse.
However, remember that an altered level of consciousness is always due to a head