Prehospital Trauma Life Support (PHTLS) 5th Edition Edition Practice Test 1.
The displacement of tissue away from the path of a projectile, both temporarily and permanently, permanently, is known as: A. B. C. D.
2.
The single most important factor in determining the potential for injury due to energy exchange is: A. B. C. D.
3.
Tertiary phase Quaternary phase Secondary phase Primary phase
During the primary survey and management of a trauma patient, the E in ABCDE stands for _________? A. B. C. D.
7.
3 times the height of the patient 2 times the height of the patient 5 times the height of the patient 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. B. C. D.
6.
The protein prot ein molecules molecu les in crystalloid solutions act as volume expanders e xpanders These fluids draw interstitial fluid into the vascular space to enhance volume These solutions will stay in the vascular space longer than water solutions, such as D5W Their pH enhance oxygen delivery to the tissues
With respect to the distance of a fall, which of the following is a guideline guideline for determining a critical fall? A. B. C. D.
5.
Mass of o f the bodies involved Velocity of the bodies involved Density of the tissues involved Surface area of the impact involved
In the management manageme nt of shock, isotonic crystalloid solutions, such as Ringer’s, are preferred because: A. B. C. D.
4.
Conization Cavitation Crepitation Contusion
Edema Eyes & ears Expose/Environment Electrical therapy
The time in which surgical intervention can make a difference in patient outcome is the __________? A. B. C. D.
Golden period Golden time Golden era Golden minutes
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8.
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 _________? A. B. C. D.
9.
In which of the following situations is the use of a short spinal immobilization device indicated? A. B. C. D.
10.
Pulse oximetry End-tidal capnometry Syringe aspiration None of the above
When utilizing percutaneous percutaneous transtracheal transtracheal ventilation, ventilation, the correct ration of lung inflation to lung inflation time, in seconds, is: A. B. C. D.
14.
Tidal volume 100 mL, ventilatory rate 40/minute 4 0/minute Tidal volume 500 mL, ventilatory rate 8/minute Tidal volume 300 mL, ventilatory rate 16/minute Tidal volume 600 mL, ventilatory rate 12/minute
Which of the following is 100% accurate in verifying endotracheal tube placement? A. B. C. D.
13. 13.
As soon as he is removed from the vehicle Prior to being removed from the vehicle As soon as he is immobilized on a long backboard Enroute to the trauma center
Whic h of the following represents represent s adequate spontaneou s ventilation ventilati on in an adult? A. B. C. D.
12.
28 year old male, unrestrained driver in a frontal impact crash. cra sh. Awake, asks repeatedly what happened, complains of a headache, has a hematoma on his forehead. BP 122/84, HR 92, VR 20. 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. 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. 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 abutment. abutment. The patient is awake, but has difficulty difficulty answering questions due to shortness of breath. His ventilatory rate is 30 per minute. Of the following choi ces, when is the first time the patient’s breath sounds should be checked? A. B. C. D.
11.
5 minutes 10 minutes 15 minutes 30 minutes
1:4 1:5 1:2 2:2
Which of the following is a possible complication of using a manually triggered oxygen powered device for ventilation? A. B. C. D.
Gastric dis tention Pneumothorax Inability to feel lung compliance All of the above
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15.
Which of the following procedures is considered an essential airway skill? A. B. C. D.
16. 16.
Pericardial tamponade is most likely to occur in which of the following situations? situations? A. B. C. D.
17. 17.
Inability to generate gen erate negative intrapleura l pressure press ure Decrease in vital capacity due to collapse of the flail segment Increased intrathoracic intrathoracic pressur e Blood and fluid in the alveoli and interstitial spaces of the lung
Tension pneumothorax Simple pneumothorax pneumothorax Pulmonary contusion Hemothorax
Deterioratio n of ventilation and oxygenation after inflation of a PASG in a patient who has sustained a highpressure compression 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. B. C. D.
21.
th
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 uncooperati ve 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 th th jugular ve ins are flat while the patient is supine. There is isolated cre pitus over the 4 and 5 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. B. C. D.
20.
th
4 intercostal space, midclavicular line, just over the top of the 5 rib th th 4 intercostal space, midclavicular midclavicular line, just below the 4 rib nd rd 2 intercostal space, midclavicular line, just over top of the 3 rib nd nd 2 intercostal space, midclavicular midclavicular line, just below the 2 rib
Which of the following is the mechanism by which pulmonary contusion interferes with oxygenation? A. B. C. D.
19.
Stab wound wo und to the chest che st Fall from a height Frontal impact vehicle crash Gunshot wound to the chest
Which of the following is the preferred site for needle decompression decompression of a tension pneumothorax? pneumothorax? A. B. C. D.
18.
Needle cricothyroidotomy cricothy roidotomy Endotracheal Endotracheal intubation Insertion of an oropharyngeal airway Retrograde endotracheal intubation
Abdominal aortic aneurysm Ruptured diaphragm Ruptured esophagus “Paper bag” syndrome of the lungs
Which of the following is NOT a component of the Fick Principle? A. B. C. D.
Adequate number of platelets in the blood Oxygenation of red blood cells Transportation of red blood cells to the tissues of the body Off-loading oxygen from the red blood cells to the tissues
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22. 22.
One of the earliest signs of hypovolemic shock is: A. B. C. D.
23. 23.
Which of the following characterizes characterizes the washout phase of shock? A. B. C. D.
24.
Palpation Palpa tion Auscultation Inspection Scene assessment
Pregnant trauma patients should be placed on the left side because: A. B. C. D.
29.
Fresh blood bl ood in the abdominal abdo minal cavity cav ity does not cause caus e signs of peritonitis perit onitis A significant amount of blood loss occurs before abdominal distention can be noticed Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity Signs and symptoms of shock greater than can be explained by other injuries is a reliable indicator of intraabdominal injury
Which of the following assessment techniques is least useful in the prehospital assessment of the patient with suspected intraabdominal trauma? A. B. C. D.
28.
Inability of fluids fluid s to carry oxygen oxy gen Pulmonary edema Increased hemorrhage All of the above
Which of the following statements regarding signs of intraabdominal injury is NOT true? A. B. C. D.
27. 27.
Aortic dissection dissectio n Liver laceration Fractured pelvis Spinal cord injury
Which Whic h of the following is a limitation of prehospital fluid resuscitation of the patient in hemorrhagic shock? A. B. C. D.
26. 26.
Systemic Syste mic acidos a cidosis is Localized tissue acidosis Edema Reduced capillary blood flow
A trauma patient who has fallen 20 feet from an apartment balcony is alert with warm, dry, pink skin, with normal capillary refilling time to the lower extremities, and is hypotensive. The upper extremities are cool, pale and diaphoretic. Which of the following injuries should be suspected? A. B. C. D.
25.
Hypotension Bradycardia Anxiety Reduced urine output
This prevents pre vents seizures seiz ures due to eclampsia eclamp sia This prevents abruption of the placenta This prevents compression of the vena cava This is the best way to auscultate fetal heart tones
Survival of the fetus in a trauma situation is most dependent upon which of the following factors? A. B. C. D.
Gestational age of the fetus Prenatal care Immediate cesarean section Good resuscitation of the mother PHTLS 5th Edition Practice Test – Page 4 of 7
30.
A patient struck in the back of the head with a baseball bat may sustain a cerebral contusion to which area of the brain? A. B. C. D.
31.
In the context of the caring for an adult patient with traumatic brain injury who is deteriorat ing and exhibiting signs of herniation, hyperventilation means ventilating with a BVM and 100% oxygen at a rate of: A. B. C. D.
32.
D.
Complete loss of sensory and motor mot or function below the sit e of injury Weakness and parethesia in the upper extremities, but normal function in the lower extremities Complete loss of function on one side of the body and loss of pain and temperature sensation on the opposite side All of the above
Of the following, which is the earliest indication of compartment compartment syndrome? A. B. C. D.
35.
Shallow water diving Vehicle crashes Falls Pedestrian struck by a vehicle
Which of the following presentation presentation indicate spinal cord injury? A. B. C.
34. 34.
12 to 16 per minute 32 to 40 per minute 8 to 12 per minute 20 to 24 per minute
In the United State, which of the following mechanisms most frequently causes spinal cord injury in adults? A. B. C. D.
33. 33.
Frontal and occipital oc cipital Occipital Parietal Frontal
Paralysis of the affected muscles Loss of pulses Loss of feeling in the web space between the thumb and index finger or between the first and second toes Tense swelling of the involved area
A traction splint may be used for which of the following injuries? A. B. C. D.
Knee dislocation dislocat ion Pelvic fractures fractures Femur fractures All of the above
36. Which of the following descriptions meets the criteria for transport to a facility with a burn unit? A. B. C. D.
A 49 year old female with a partial thickness bu rn from her elbow to her shoulder A 25 year old male with an electrical burn across his chest A 9 year old make with superficial burns on the backs of both legs A 32 year old female with a partial thickness burn about twice the size of her hand on her back
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37.
The preferred method of dressing burns in the prehospital setting is: A. B. C. D.
38.
Dry sterile dressing Moist sterile dressing Wet dressings Petroleum gauze
In assessing the hypothermic patient in the prehospital setting, setting, the most reliable indicator of the severity of hypothermia is: A. B. C. D.
39. 39.
Rectal tempe rature Oral temperature Heart rate < 60 Presence or absence of shivering
In the normal child, which general statement is most accurate in comparison comparison with the adult patient? A. B. C. D.
40.
Blood pressure pr essure is Blood pressure is Blood pressure is Blood pressure is
A patient who withdraws from painful stimuli, opens eyes on verbal command, and cannot speak because of intubation has a Glasgow Coma Scale of which of the following: A. B. C. D.
41. 41.
8 8T 7 7T
The earliest site for intraosseous infusion is: A. B. C. D.
42. 42.
Anterior tibia, just above abov e the tibial tuberosity t uberosity Anterior fibula Anterior tibia, just below the tibial tuberosity Posterior fibula
Which of the following behaviors is the most reliable indication of confusion in the elderly trauma patient? A. B. C. D.
43.
Inability to recall his/her name Inability to recall the day of the week Inability to identify his/her present location when out of his/her normal residence Focus on repeated retelling of events that occurred years ago
In the elderly trauma patient a high index of suspicion for shock should occur beginning when the systolic blood pressure is less than: A. B. C. D.
44.
higher, hear rate rat e is higher, and ventilatory venti latory rate ra te is higher lower, heart rate is lower, and ventilatory rate is higher lower, heart rate is higher, and ventilatory rate is higher lower, heart rate is higher, and ventilatory rate is lower
90 mmHg m mHg 150 mmHg 120 mmHg 100 mmHg
In an adult patient, blood loss into the tissue from a fractured femur may be as much as which of the following? A. B. C. D.
150 to 500 mL 500 to to 1000 1000 mL 1000 2000 mL 2500 to 5000 mL PHTLS 5th Edition Practice Test – Page 6 of 7
45.
Delayed death due to trauma is usually a result of: A. B. C. D.
46.
A regional resource center with a full spectrum of trauma services from prevention to rehabilitation which serves as the leader in trauma care for a geographical region is a: A. B. C. D.
47.
EMTs must mus t treat all trauma trau ma patien t based on protoc ols EMTs EMTs are capable of sound patient care judgment, given an adequate knowledge base EMTs must work only under on-line on-line medical direction when caring for trauma patients EMTs are capable of working independently independently of medical direction
Which of the following warrants classificatio n of a patient as a critical trauma patient? A. B. C. D.
50. 50.
Intoxicated Intoxicat ed patient pati ent in a MVC Patient who fell 8 feet and lost consciousness consciousness Patient complaining of pain on palpation of the neck Patient with a knife wound to the chest and a GCS of 15
The premise of PHTLS is that: A. B. C. D.
49.
Level IV trauma center Level III trauma center Level II trauma center Level I trauma center
Which of the following patients is not indicated for spinal immobilization? A. B. C. D.
48. 48.
Biochemical Biochemic al and pathophysi ological effects of inadequate inade quate initial i nitial resuscitati r esuscitation on Acute circulatory failure Brain injury Acute hypoxia
An extremit y fracture Preexisting major medical problem Bleeding from the nose Deployment of air bags in a motor vehicle crash
Which of the following is the foundation of effective trauma care? A. B. C. D.
Protocols permitting invasive airway procedures pr ocedures The ability to administer large amounts of crystalloid fluids The ability to quickly locate and manage life-threaten ing and potentially potent ially life-threatening injuries Effective spinal immobilization skills
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