PHTLS PRE & POST TEST, ATLS EXAM
The displacement of tissue away from the path of a projectile, both
temporarily and permanently, is known as:
A. Conization B. Cavitation
B. Cavitation
C. Crepitation
D. Contusion
The single most important factor in determining the potential for
injury due to energy exchange is:
A. Mass of the bodies involved B. Velocity of the bodies involved
B. Velocity of the bodies involved
C. Density of the tissues involved
D. Surface area of the impact involved
In the management of shock, isotonic crystalloid solutions, such
as Ringer's, are preferred because:
A. The protein molecules in crystalloid solutions act as volume
expanders C. These solutions will stay in the vascular space longer than water
B. These fluids draw interstitial fluid into the vascular space to solutions, such as D5W
enhance volume
C. These solutions will stay in the vascular space longer than water
solutions, such as D5W
D. Their pH enhance oxygen delivery to the tissues
With respect to the distance of a fall, which of the following is a
guideline for determining a critical fall?
A. 3 times the height of the patient A. 3 times the height of the patient
B. 2 times the height of the patient
C. 5 times the height of the patient
D. 1 ½ times the height of the patient
The phase of an explosion, or blast, in which hollow organs are
squeezed and may rupture is called the phase.
A. Tertiary phase D. Primary phase
B. Quaternary phase
C. Secondary phase
D. Primary phase
During the primary survey and management of a trauma patient,
the E in ABCDE stands for ?
A. Edema C. Expose/Environment
B. Eyes & ears
C. Expose/Environment
D. Electrical therapy
The time in which surgical intervention can make a difference in
patient outcome is the ?
A. Golden period A. Golden period (hour)
B. Golden time
C. Golden era
D. Golden minutes
In the absence of extenuating circumstances, the maximum
amount of time it should take to identify and manage immediate
threats to life, prepare the patient for transport and begin transport
is ? B. 10 minutes
A. 5 minutes
B. 10 minutes
,PHTLS PRE & POST TEST, ATLS EXAM
C. 15 minutes
D. 30 minutes
In which of the following situations is the use of a short spinal
immobilization device indicated?
A. 28 year old male, unrestrained driver in a frontal impact
crash. Awake, asks repeatedly what happened, complains of a
headache, has a hematoma on his forehead. BP 122/84, HR 92,
VR 20. D. None of the above
B. 40 year old female who was pushed down a flight of stairs
and is lying prone on the landing between two flights of stairs,
complaining of back pain. BP 118/78, HR 100, VR 20.
C. 17 year old female, restrained driver in a frontal impact crash.
Awake, pale and diaphoretic, complains of upper right quadrant
abdominal pain. BP 100/70, HR 108, VR 20. D. None of the above
Your patient is a 32 year old man, restrained driver of a vehicle that
has been involved in a frontal impact with a concrete bridge abut-
ment. The patient is awake, but has difficulty answering questions
due to shortness of breath. His ventilatory rate is 30 per minute.
Of the following choices, when is the first time the patient's breath
sounds should be checked? B. Prior to being removed from the vehicle
A. As soon as he is removed from the vehicle
B. Prior to being removed from the vehicle
C. As soon as he is immobilized on a long backboard
D. Enroute to the trauma center
Which of the following represents adequate spontaneous ventila-
tion in an adult?
A. Tidal volume 100 mL, ventilatory rate 40/minute D. Tidal volume 600 mL, ventilatory rate 12/minute
B. Tidal volume 500 mL, ventilatory rate 8/minute
C. Tidal volume 300 mL, ventilatory rate 16/minute
D. Tidal volume 600 mL, ventilatory rate 12/minute
Which of the following is 100% accurate in verifying endotracheal
tube placement?
D. None of the above ...(added info by ang: to verify you need
A. Pulse oximetry
B. End-tidal capnometry breath sounds, condensation in the tube and a confirmatory CXR)
C. Syringe aspiration
D. None of the above
When utilizing percutaneous transtracheal ventilation, the correct
ration of lung inflation to lung inflation time, in seconds, is:
A. 1:4 A. 1:4
B. 1:5
C. 1:2
D. 2:2
Which of the following is a possible complication of using a man-
ually triggered oxygen powered device for ventilation?
A. Gastric distention D. All of the above
B. Pneumothorax
C. Inability to feel lung compliance
D. All of the above
Which of the following procedures is considered an essential
airway skill?
C. Insertion of an oropharyngeal airway
A. Needle cricothyroidotomy
B. Endotracheal intubation
, PHTLS PRE & POST TEST, ATLS EXAM
C. Insertion of an oropharyngeal airway
D. Retrograde endotracheal intubation
Pericardial tamponade is most likely to occur in which of the
following situations?
A. Stab wound to the chest A. Stab wound to the chest
B. Fall from a height
C. Frontal impact vehicle crash
D. Gunshot wound to the chest
Which of the following is the preferred site for needle decompres-
sion of a tension pneumothorax?
A. 4th intercostal space, midclavicular line, just over the top of the
C. 2nd intercostal space, midclavicular line, just over top of the 3rd
5th rib B. Bradycardia
B. 4th intercostal space, midclavicular line, just below the 4th rib
C. 2nd intercostal space, midclavicular line, just over top of the 3rd
rib
D. 2nd intercostal space, midclavicular line, just below the 2nd rib
Which of the following is the mechanism by which pulmonary
contusion interferes with oxygenation?
A. Inability to generate negative intrapleural pressure
B. Decrease in vital capacity due to collapse of the flail segment
C. Increased intrathoracic pressure
D. Blood and fluid in the alveoli and interstitial spaces of the lung
Your patient is a 55 year old male who was struck in the right
side of the chest with a piece of steel pipe. He presents with
uncooperative behavior, his skin is pale and moist, the ventilatory
rate is 32, there is a weak radial pulse of 112, and breath sounds
are decreased on the right side. The trachea is midline and jugular
veins are flat while the patient is supine. There is isolated crepitus
over the 4th and 5th ribs in the midaxillary line on the patient's
right side. Based on the mechanism of injury and the assessment
findings, which of the following is the most likely cause of the
patient's signs and symptoms?
A. Tension pneumothorax
B. Simple pneumothorax
C. Pulmonary contusion
D. Hemothorax
Deterioration of ventilation and oxygenation after inflation of a
PASG in a patient who has sustained a high-pressure compres-
sion injury of the abdomen, such as a sudden deceleration with
the lap belt placed across the abdomen, most likely represents
which of the following injuries?
A. Abdominal aortic aneurysm
B. Ruptured diaphragm
C. Ruptured esophagus
D. "Paper bag" syndrome of the lungs
Which of the following is NOT a component of the Fick Principle?
A. Adequate number of platelets in the blood
B. Oxygenation of red blood cells
C. Transportation of red blood cells to the tissues of the body
D. Off-loading oxygen from the red blood cells to the tissues
One of the earliest signs of hypovolemic shock is:
A. Hypotension
The displacement of tissue away from the path of a projectile, both
temporarily and permanently, is known as:
A. Conization B. Cavitation
B. Cavitation
C. Crepitation
D. Contusion
The single most important factor in determining the potential for
injury due to energy exchange is:
A. Mass of the bodies involved B. Velocity of the bodies involved
B. Velocity of the bodies involved
C. Density of the tissues involved
D. Surface area of the impact involved
In the management of shock, isotonic crystalloid solutions, such
as Ringer's, are preferred because:
A. The protein molecules in crystalloid solutions act as volume
expanders C. These solutions will stay in the vascular space longer than water
B. These fluids draw interstitial fluid into the vascular space to solutions, such as D5W
enhance volume
C. These solutions will stay in the vascular space longer than water
solutions, such as D5W
D. Their pH enhance oxygen delivery to the tissues
With respect to the distance of a fall, which of the following is a
guideline for determining a critical fall?
A. 3 times the height of the patient A. 3 times the height of the patient
B. 2 times the height of the patient
C. 5 times the height of the patient
D. 1 ½ times the height of the patient
The phase of an explosion, or blast, in which hollow organs are
squeezed and may rupture is called the phase.
A. Tertiary phase D. Primary phase
B. Quaternary phase
C. Secondary phase
D. Primary phase
During the primary survey and management of a trauma patient,
the E in ABCDE stands for ?
A. Edema C. Expose/Environment
B. Eyes & ears
C. Expose/Environment
D. Electrical therapy
The time in which surgical intervention can make a difference in
patient outcome is the ?
A. Golden period A. Golden period (hour)
B. Golden time
C. Golden era
D. Golden minutes
In the absence of extenuating circumstances, the maximum
amount of time it should take to identify and manage immediate
threats to life, prepare the patient for transport and begin transport
is ? B. 10 minutes
A. 5 minutes
B. 10 minutes
,PHTLS PRE & POST TEST, ATLS EXAM
C. 15 minutes
D. 30 minutes
In which of the following situations is the use of a short spinal
immobilization device indicated?
A. 28 year old male, unrestrained driver in a frontal impact
crash. Awake, asks repeatedly what happened, complains of a
headache, has a hematoma on his forehead. BP 122/84, HR 92,
VR 20. D. None of the above
B. 40 year old female who was pushed down a flight of stairs
and is lying prone on the landing between two flights of stairs,
complaining of back pain. BP 118/78, HR 100, VR 20.
C. 17 year old female, restrained driver in a frontal impact crash.
Awake, pale and diaphoretic, complains of upper right quadrant
abdominal pain. BP 100/70, HR 108, VR 20. D. None of the above
Your patient is a 32 year old man, restrained driver of a vehicle that
has been involved in a frontal impact with a concrete bridge abut-
ment. The patient is awake, but has difficulty answering questions
due to shortness of breath. His ventilatory rate is 30 per minute.
Of the following choices, when is the first time the patient's breath
sounds should be checked? B. Prior to being removed from the vehicle
A. As soon as he is removed from the vehicle
B. Prior to being removed from the vehicle
C. As soon as he is immobilized on a long backboard
D. Enroute to the trauma center
Which of the following represents adequate spontaneous ventila-
tion in an adult?
A. Tidal volume 100 mL, ventilatory rate 40/minute D. Tidal volume 600 mL, ventilatory rate 12/minute
B. Tidal volume 500 mL, ventilatory rate 8/minute
C. Tidal volume 300 mL, ventilatory rate 16/minute
D. Tidal volume 600 mL, ventilatory rate 12/minute
Which of the following is 100% accurate in verifying endotracheal
tube placement?
D. None of the above ...(added info by ang: to verify you need
A. Pulse oximetry
B. End-tidal capnometry breath sounds, condensation in the tube and a confirmatory CXR)
C. Syringe aspiration
D. None of the above
When utilizing percutaneous transtracheal ventilation, the correct
ration of lung inflation to lung inflation time, in seconds, is:
A. 1:4 A. 1:4
B. 1:5
C. 1:2
D. 2:2
Which of the following is a possible complication of using a man-
ually triggered oxygen powered device for ventilation?
A. Gastric distention D. All of the above
B. Pneumothorax
C. Inability to feel lung compliance
D. All of the above
Which of the following procedures is considered an essential
airway skill?
C. Insertion of an oropharyngeal airway
A. Needle cricothyroidotomy
B. Endotracheal intubation
, PHTLS PRE & POST TEST, ATLS EXAM
C. Insertion of an oropharyngeal airway
D. Retrograde endotracheal intubation
Pericardial tamponade is most likely to occur in which of the
following situations?
A. Stab wound to the chest A. Stab wound to the chest
B. Fall from a height
C. Frontal impact vehicle crash
D. Gunshot wound to the chest
Which of the following is the preferred site for needle decompres-
sion of a tension pneumothorax?
A. 4th intercostal space, midclavicular line, just over the top of the
C. 2nd intercostal space, midclavicular line, just over top of the 3rd
5th rib B. Bradycardia
B. 4th intercostal space, midclavicular line, just below the 4th rib
C. 2nd intercostal space, midclavicular line, just over top of the 3rd
rib
D. 2nd intercostal space, midclavicular line, just below the 2nd rib
Which of the following is the mechanism by which pulmonary
contusion interferes with oxygenation?
A. Inability to generate negative intrapleural pressure
B. Decrease in vital capacity due to collapse of the flail segment
C. Increased intrathoracic pressure
D. Blood and fluid in the alveoli and interstitial spaces of the lung
Your patient is a 55 year old male who was struck in the right
side of the chest with a piece of steel pipe. He presents with
uncooperative behavior, his skin is pale and moist, the ventilatory
rate is 32, there is a weak radial pulse of 112, and breath sounds
are decreased on the right side. The trachea is midline and jugular
veins are flat while the patient is supine. There is isolated crepitus
over the 4th and 5th ribs in the midaxillary line on the patient's
right side. Based on the mechanism of injury and the assessment
findings, which of the following is the most likely cause of the
patient's signs and symptoms?
A. Tension pneumothorax
B. Simple pneumothorax
C. Pulmonary contusion
D. Hemothorax
Deterioration of ventilation and oxygenation after inflation of a
PASG in a patient who has sustained a high-pressure compres-
sion injury of the abdomen, such as a sudden deceleration with
the lap belt placed across the abdomen, most likely represents
which of the following injuries?
A. Abdominal aortic aneurysm
B. Ruptured diaphragm
C. Ruptured esophagus
D. "Paper bag" syndrome of the lungs
Which of the following is NOT a component of the Fick Principle?
A. Adequate number of platelets in the blood
B. Oxygenation of red blood cells
C. Transportation of red blood cells to the tissues of the body
D. Off-loading oxygen from the red blood cells to the tissues
One of the earliest signs of hypovolemic shock is:
A. Hypotension
