Advanced ITLS 8th Edition UPDATED ACTUAL Questions and CORRECT
Answers
1. 1. In a rear-impact motor vehicle A. Cervical
crash, which area of the spine is
most susceptible to injury? Rationale: The sudden increase in acceleration produces
A. Cervical posterior displacement of the occupants and possible
B. Thoracic hyperextension of the cervical spine if the headrest is
C. Lumbar not properly adjusted. The potential for cervical-spine
D. Sacral-coccygeal injuries is great.
2. 2. A 36-year-old male sustains D. Assess for other potentially life-threatening condi-
blunt force thoracic trauma and tions
fits the criteria for a load- and-go
patient. Which of the following Rationale: The purpose of the initial assessment is to
should be performed on the prioritize the patient and to identify all immediately
scene? life-threatening conditions. The information gathered is
A. Obtain an EKG B. used to make decisions about critical interventions and
B. Establish vascular access time of transport.
C. Obtain a finger-stick serum lac-
tate level
D. Assess for other potentially
life-threatening conditions
3. 3. The use of external laryngeal C. Improves glottic visualization
manipulation:
A. Decreases the risk of airway Rationale: Manipulating the thyroid cartilage can help
trauma bring the vocal cords into view during endotracheal in-
B. Reduces gastric distention tubation. This is called external laryngeal manipulation
C. Improves glottic visualization (ELM). The movement is usually pressing the thyroid car-
D. Causes aspiration tilage backward against the esophagus and then upward
and slightly to the patient's right side.
4. 4. A pericardiocentesis is per- B. To remove fluid from the lining around the heart
formed to:
,Rationale: The pericardial sac is an inelastic membrane
, A. To remove fluid from the lining that surrounds the heart. If blood collects rapidly be-
around the lungs tween the heart and pericardium from a cardiac injury,
B. To remove fluid from the lining the ventricles of the heart will be compressed, making
around the heart the heart less able to refill, and cardiac output falls.
C. To inject medications directly
into the heart
D. To monitor stroke volume
5. 5. A 56-year-old male sustains a A. Return of peripheral pulses
gunshot wound to the abdomen.
Vital signs are BP 74/32, P 136 pre- Rationale: This is an example of internal, uncontrolled
sent only at the carotid, and R 24 hemorrhage. Administer suflcient normal saline to
and shallow. The target of fluid re- maintain peripheral perfusion, following local or EMS
suscitation is: agency medical direction policies. Maintaining periph-
A. Return of peripheral pulses eral perfusion is generally defined as giving enough
B. Maintenance of central pulses fluid—usually in boluses—to return a peripheral pulse,
C. Systolic blood pressure of such as a radial pulse.
110-120
D. Pulse rate of 100
6. 6. An unconscious 15-year-old D. Perform bag-mask ventilation at 20 per minute Exam
male was struck on the head with
a baseball bat. His arms and legs Rationale: The classic findings of this life-threatening
are extended and his right pupil is situation are a decreasing level of consciousness (LOC)
dilated and fixed. You should: that rapidly progresses to coma, dilation of the pupil
A. Insert an oropharyngeal air- and an outward- downward deviation of the eye on the
way, administer oxygen, and re- side of the injury, paralysis of the arm and leg on the
strict fluids side opposite the injury, or decerebrate posturing (arms
B. Apply a non-rebreather mask, and legs extended). The danger of immediate herniation
restrict fluids, and administer outweighs the risk of cerebral ischemia that can follow
Mannitol hyperventilation. The cerebral herniation syndrome is the
C. Perform nasotracheal intuba- only situation in which hyperventilation is still indicated.
Answers
1. 1. In a rear-impact motor vehicle A. Cervical
crash, which area of the spine is
most susceptible to injury? Rationale: The sudden increase in acceleration produces
A. Cervical posterior displacement of the occupants and possible
B. Thoracic hyperextension of the cervical spine if the headrest is
C. Lumbar not properly adjusted. The potential for cervical-spine
D. Sacral-coccygeal injuries is great.
2. 2. A 36-year-old male sustains D. Assess for other potentially life-threatening condi-
blunt force thoracic trauma and tions
fits the criteria for a load- and-go
patient. Which of the following Rationale: The purpose of the initial assessment is to
should be performed on the prioritize the patient and to identify all immediately
scene? life-threatening conditions. The information gathered is
A. Obtain an EKG B. used to make decisions about critical interventions and
B. Establish vascular access time of transport.
C. Obtain a finger-stick serum lac-
tate level
D. Assess for other potentially
life-threatening conditions
3. 3. The use of external laryngeal C. Improves glottic visualization
manipulation:
A. Decreases the risk of airway Rationale: Manipulating the thyroid cartilage can help
trauma bring the vocal cords into view during endotracheal in-
B. Reduces gastric distention tubation. This is called external laryngeal manipulation
C. Improves glottic visualization (ELM). The movement is usually pressing the thyroid car-
D. Causes aspiration tilage backward against the esophagus and then upward
and slightly to the patient's right side.
4. 4. A pericardiocentesis is per- B. To remove fluid from the lining around the heart
formed to:
,Rationale: The pericardial sac is an inelastic membrane
, A. To remove fluid from the lining that surrounds the heart. If blood collects rapidly be-
around the lungs tween the heart and pericardium from a cardiac injury,
B. To remove fluid from the lining the ventricles of the heart will be compressed, making
around the heart the heart less able to refill, and cardiac output falls.
C. To inject medications directly
into the heart
D. To monitor stroke volume
5. 5. A 56-year-old male sustains a A. Return of peripheral pulses
gunshot wound to the abdomen.
Vital signs are BP 74/32, P 136 pre- Rationale: This is an example of internal, uncontrolled
sent only at the carotid, and R 24 hemorrhage. Administer suflcient normal saline to
and shallow. The target of fluid re- maintain peripheral perfusion, following local or EMS
suscitation is: agency medical direction policies. Maintaining periph-
A. Return of peripheral pulses eral perfusion is generally defined as giving enough
B. Maintenance of central pulses fluid—usually in boluses—to return a peripheral pulse,
C. Systolic blood pressure of such as a radial pulse.
110-120
D. Pulse rate of 100
6. 6. An unconscious 15-year-old D. Perform bag-mask ventilation at 20 per minute Exam
male was struck on the head with
a baseball bat. His arms and legs Rationale: The classic findings of this life-threatening
are extended and his right pupil is situation are a decreasing level of consciousness (LOC)
dilated and fixed. You should: that rapidly progresses to coma, dilation of the pupil
A. Insert an oropharyngeal air- and an outward- downward deviation of the eye on the
way, administer oxygen, and re- side of the injury, paralysis of the arm and leg on the
strict fluids side opposite the injury, or decerebrate posturing (arms
B. Apply a non-rebreather mask, and legs extended). The danger of immediate herniation
restrict fluids, and administer outweighs the risk of cerebral ischemia that can follow
Mannitol hyperventilation. The cerebral herniation syndrome is the
C. Perform nasotracheal intuba- only situation in which hyperventilation is still indicated.
