Page 1 of 45
ITLS 9TH EDITION EXAM ACTUAL EXAM 2 LATEST 2024-2025
VERSIONS AND STUDY GUIDE COMPLETE 300 QEUSTIONS AND
CORRECT ANSWERS ALREADY GRADED A+
ITLS 9th Edition EXAM A
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
You may have been exposed to a contaminant (air or fluid borne). You should: - ANSWER-Seek
treatment within hours of the exposure
1
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A 24 yo male is involved in a head on collision. If you suspect: - ANSWER-A chest injury, obtain
an EKG
Rationale: Consider a bruised chest wall as a myocardial contusion that requires monitoring of
cardiac rhythm and, if available, a 12-lead ECG
A brief neurologic exam of an AMS pt includes: - ANSWER-GCS, glucose check, pupil exam
Which of the following findings would indicate the airway needs to be suctioned? - ANSWER-
Gurgling sounds with respiration
Overinflation of an LMA mask can cause all of the following except: - ANSWER-Vomiting
Rationale: Overinflation may cause malposition, loss of seal or trauma
A 54 yo male is involved in a MVC. The steering wheel is bent. During your initial assessment,
you note his skin is pale, radial pulses are present and breath sounds are clear. Which one of
the following is most consistent with these findings - ANSWER-Cardiac contusion
Rationale: Bruising of the heart is basically the same injury as an acute MI
Which of the following is NOT a potential complication of performing chest decompression? -
ANSWER-Difficulty monitoring the site.
Which of the following is considered one of the four essential components to maintain normal
perfusion? - ANSWER-Fluid levels
2
,Page 3 of 45
Rationale: Its important to remember that BP requires a "steady state" activity of all the
preceding factors. The heart must be pumping, the blood volume must be adequate, the blood
vessels must be intact, and the lungs must be oxygenating the blood
What site is generally the easiest to landmark for IO access? - ANSWER-Proximal Tibia
As ICP rises after an isolated head injury, what does the systolic BP do? - ANSWER-Increases
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 BP
Which MOI meets the exclusion criteria for spinal motion restriction? - ANSWER-A 14yo F with
an isolated stab wound to the midaxillary chest wall
Rationale: Immobilization onto a long backboard is not indicated in penetrating wounds of:
Torso, neck, or head unless there is clinical evidence of spine injury
Which of the following organs sic obtained in the retroperitoneal region of the abdomen? -
ANSWER-Kidney
Which treatment is indicated for the PT who is entrapped for an extended period of time with
an isolated crush injury to the lower extremity? - ANSWER-Sodium Bicarbonate and IV fluids
Rationale: Initial administration of Sodium Bicarb should be at 1 mEg/kg bolus, followed by an
infusion of 0.25 mEq/kg body weight/hr of the solution.
3
, Page 4 of 45
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.
4
ITLS 9TH EDITION EXAM ACTUAL EXAM 2 LATEST 2024-2025
VERSIONS AND STUDY GUIDE COMPLETE 300 QEUSTIONS AND
CORRECT ANSWERS ALREADY GRADED A+
ITLS 9th Edition EXAM A
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
You may have been exposed to a contaminant (air or fluid borne). You should: - ANSWER-Seek
treatment within hours of the exposure
1
,Page 2 of 45
A 24 yo male is involved in a head on collision. If you suspect: - ANSWER-A chest injury, obtain
an EKG
Rationale: Consider a bruised chest wall as a myocardial contusion that requires monitoring of
cardiac rhythm and, if available, a 12-lead ECG
A brief neurologic exam of an AMS pt includes: - ANSWER-GCS, glucose check, pupil exam
Which of the following findings would indicate the airway needs to be suctioned? - ANSWER-
Gurgling sounds with respiration
Overinflation of an LMA mask can cause all of the following except: - ANSWER-Vomiting
Rationale: Overinflation may cause malposition, loss of seal or trauma
A 54 yo male is involved in a MVC. The steering wheel is bent. During your initial assessment,
you note his skin is pale, radial pulses are present and breath sounds are clear. Which one of
the following is most consistent with these findings - ANSWER-Cardiac contusion
Rationale: Bruising of the heart is basically the same injury as an acute MI
Which of the following is NOT a potential complication of performing chest decompression? -
ANSWER-Difficulty monitoring the site.
Which of the following is considered one of the four essential components to maintain normal
perfusion? - ANSWER-Fluid levels
2
,Page 3 of 45
Rationale: Its important to remember that BP requires a "steady state" activity of all the
preceding factors. The heart must be pumping, the blood volume must be adequate, the blood
vessels must be intact, and the lungs must be oxygenating the blood
What site is generally the easiest to landmark for IO access? - ANSWER-Proximal Tibia
As ICP rises after an isolated head injury, what does the systolic BP do? - ANSWER-Increases
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 BP
Which MOI meets the exclusion criteria for spinal motion restriction? - ANSWER-A 14yo F with
an isolated stab wound to the midaxillary chest wall
Rationale: Immobilization onto a long backboard is not indicated in penetrating wounds of:
Torso, neck, or head unless there is clinical evidence of spine injury
Which of the following organs sic obtained in the retroperitoneal region of the abdomen? -
ANSWER-Kidney
Which treatment is indicated for the PT who is entrapped for an extended period of time with
an isolated crush injury to the lower extremity? - ANSWER-Sodium Bicarbonate and IV fluids
Rationale: Initial administration of Sodium Bicarb should be at 1 mEg/kg bolus, followed by an
infusion of 0.25 mEq/kg body weight/hr of the solution.
3
, Page 4 of 45
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.
4
