PHTLS PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

PHTLS PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1) when caring for a trauma patient, a principle is what is necessary for patient improvement or survival. A preference is how the principle is achieved and depends upon four factors. The factor used to establish the preference in treating the patient include all except: - ANSWER research information 2) Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? - ANSWER 1 to 2 years of age 3) In addition to glucose, what is required to maintain the metabolic processes of life and energy production? - ANSWER oxygen 4) you response to a patient who has sustained a stab wound to the left upper thorax. she is barley responsive, pale and diaphoretic. Which of the following is the most appropriate for transport? - ANSWER scoop stretcher 5) Units responding to a motor vehicle accident on the highway should consider which of the following as part of their pre-arrival assessment? - ANSWER weather conditions 6) The most appropriate airway maneuver in the initial management of a trauma patient is which of the following? - ANSWER trauma jaw thrust 7) When verifying ET Tube placement on a perfusing patient, the "Gold standard" of monitoring is considered to be? - ANSWER waveform capnography 8) A patent presents with a blunt trauma injury to the chest. On exam, he has absent sounds on one side of his chest and respiratory distress. Which additional sign would indicate that the patient has a tension pneumothorax? - ANSWER distended neck veins 9) of the following, which is preventable cause of secondary brain injury addressable during the transport phase? - ANSWER systemic hypoxia 10) you are called to treat a patient who was knocked unconscious when he slipped and fell on a wet floor, striking his head. It is now several hours later. He is awake but confused, does not recalled the incident, and is vomiting which a headache. Which of the following inures is most likely? - ANSWER concussion 11) In a blast-related multiple patient situation, which of the following patients should be treated first? - ANSWER a 33 year old female with altered level of consciousness and decreased capillary refill 12) Excessive fluid resuscitation of the trauma patient can result in which of the following? - ANSWER worsening coagulopathy 13) the secondary survey should be accomplished: - ANSWER when time and situation allow 14) when approaching a trauma patient, what is the first assessment that must be made? - ANSWER scene safety 15) when of the following best guides the decision to provide spinal immobilization? - ANSWER history and complaint 16) a 38-year old male sustains a large wound to his right thigh while at work. Which of the following actions is the most important initial step? - ANSWER hemorrhage control 17) You respond to a local bar for an unconscious person. On arrival, you are met by a police officer who reports that one of their "regular alcoholics" was found in the ally behind their. On exam, you note the smell of an alcoholic beverage as well as the following: Patient flexes his arms to painful stimuli, has bilateral fixed and dilated pupils, irregular respirations at 12 breaths per minute and a BP of 210/100. What condition do you suspect? - ANSWER subdural hematoma 18) the pre-hospital assessment of the trauma patient beings with which of the following? - ANSWER information provided by the dispatcher 19) EMS responds for a patient involved in a motorcycle vs. motor vehicle collision. The patient is poorly responsive with no movement of lower extremities and loss of temperature sensation (hot vs cold) below the T10. Which of the following types of shock is the patient most likely experiencing? - ANSWER neurogenic 20) Which of the following is the best indicator of shock in a trauma patient? - ANSWER Depressed level of cognition 21) Which best describes the goal of airway management in a trauma patient? - ANSWER provide or adequate exchange of oxygen and CO2 22) What is the most common cause of airway obstruction in the unresponsive trauma patient? - ANSWER Tongue 23) while caring for a patient who was involved in an altercation, the patient vomits, causing his airway to become totally obstructed with vomitus and blood. What is the most important action? - ANSWER Suctioning the airway 24) When energy proceeded by the cells occurs during a state of adequate oxygenation, it is referred to as which of the following conditions? - ANSWER Aerobic Metabolism 25) Which of the following information is assessed during the secondary surgery? - ANSWER vital signs 26) Principles vs Preference - ANSWER Principle describes the "what" of care and preference describes the "how" of care. 27) Ethical Principles: - ANSWER Nonmaleficence, Beneficence, Autonomy Justice = Do no harm, Do good, Right to consent / refusal, fair distribution of goods / services 28) Advanced Directives & Order of Importance - ANSWER Means of patient making medical decisions in advance in case of incapacitated condition; Order for life sustaining treatment (POLST) / Out of Hospital medical order / DNR order Medical Power of Attorney (MPOA) Living will 29) Golden Hour / Period - ANSWER Short period of time from injury to definitive care after which chance of survival is significantly lower; We abide by the Platinum 10, where we transport within 10 minutes of arrival 30) Why Trauma Patients Die - ANSWER Massive acute blood loss Injury to vital organs Airway obstruction and ventilatory failure 31) Golden Principle #1 - ANSWER Ensure Safety of Care Provider and Patient (Scene Safety / BSI) 32) Golden Principle #2 - ANSWER Assess scene for need of additional resources 33) Golden Principle #3 - ANSWER Recognize physics of trauma (how did this happen / what happened / how bad is it) 34) Golden Principle #4 - ANSWER Identify life threats (XABCDE) 35) Golden Principle #5 - ANSWER Manage Airway while ensuring C-Spine immobilization 36) Golden Principle #6 - ANSWER Support breathing 37) Golden Principle #7 - ANSWER Control significant external hemorrhages (Every Red Blood Cell Counts) 38) Golden Principle #8 - ANSWER Provide basic shock therapy such as splinting injuries and maintaining BODY TEMPERATURE 39) Golden Principle #9 - ANSWER Determine need for spinal stabilization 40) Golden Principle #10 - ANSWER Initial transport to appropriate Trauma center 41) Golden Principle #11 - ANSWER Initiate fluid recovery 42) Golden Principle #12 - ANSWER SAMPLE history and Secondary Check 43) Golden Principle #13 - ANSWER Relieve patient pain 44) Golden Principle #14 - ANSWER Communicate patient and circumstance of the injury to receiving facility (Prearrival // Verbal upon arrival // PCR) 45) Critical Trauma Signs - ANSWER Threatened airway // Impaired ventilation // Shock of any kind / GCS 13 // Seizure or motor deficits // Penetrating trauma to head, neck, torso. 46) Shock - ANSWER Hypo-perfusion 47) Organ Tolerance to Ischemia - ANSWER Heart / Brain / Lungs (4-6 minutes) //Kidney, Liver, GI (45-1.5 hours) // Musculoskeletal (4-6 hours) 48) Fick Principle - ANSWER Steps of Oxygenation: Loading O2 on RBC in lung, Delivering RBS to tissue, Off-loading oxygen from RBC to tissue cells 49) How we can maintain Fick Principle - ANSWER Ventilation // Maintain cardio system // Maintain body temperature 50) Pulse pressure - ANSWER Systolic - Diastolic Narrow = difference is minimal Wide = difference is wide 51) Mean Arterial Pressure - ANSWER Diastolic + (1/3) Pulse Pressure 52) causes for hypotension - ANSWER heart not filling up with enough volume or heart is filled to much and overstretch causes failure to deliver good stroke volume 53) Oncotic pressure - ANSWER Total influence of a protein and minerals on the osmotic activity of plasma water. 54) Movement of fluid through capillaries is determined by... - ANSWER Difference in hydrostatic pressure within capillary (pushes out) and outside capillary (pushes in) // Permeability of capillaries // Oncotic pressure difference inside and outside the capillary 55) Autonomic nervous system - ANSWER Involuntary functions with sympathetic nervous system = the GO system and parasympathetic system = the PAUSE system 56) Hypovolemic shock signs - ANSWER Cool and Clammy // Pale and Cyanotic // Hypotensive // Altered LOC // Slow Cap. refill // Drop in BP // Weak but quick pulse // Narrow Pulse Pressure 57) Neurogenic shock signs - ANSWER Warm and Dry // Pink Skin // Hypotensive // Lucid LOC // Normal Cap. refill // Drop in BP // Wider Pulse Pressure 58) Cardiogenic shock signs - ANSWER Cool and Clammy // Pale and Cyanotic // Hypotensive // Altered LOC // Slow Cap. refill