PHTLS UPDATED EXAM SCRIPT QUESTIONS AND
SOLUTIONS RATED A+
✔✔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. Aortic dissection
B. Liver laceration
C. Fractured pelvis
D. Spinal cord injury - ✔✔D. Spinal cord injury
✔✔Which of the following is a limitation of prehospital fluid resuscitation of the patient in
hemorrhagic shock?
A. Inability of fluids to carry oxygen
B. Pulmonary edema
C. Increased hemorrhage
D. All of the above - ✔✔D. All of the above
✔✔Which of the following statements regarding signs of intraabdominal injury is NOT
true?
A. Fresh blood in the abdominal cavity does not cause signs of peritonitis
B. A significant amount of blood loss occurs before abdominal distention can be noticed
C. Substantial intraabdominal hemorrhage always causes tenderness and abdominal
rigidity
D. Signs and symptoms of shock greater than can be explained by other injuries is a
reliable indicator of intraabdominal injury - ✔✔C. Substantial intraabdominal
hemorrhage always causes tenderness and abdominal rigidity
✔✔Which of the following assessment techniques is least useful in the prehospital
assessment of the patient with suspected intraabdominal trauma?
A. Palpation
B. Auscultation
C. Inspection
D. Scene assessment - ✔✔B. Auscultation
✔✔Pregnant trauma patients should be placed on the left side because:
A. This prevents seizures due to eclampsia
B. This prevents abruption of the placenta
C. This prevents compression of the vena cava
, D. This is the best way to auscultate fetal heart tones - ✔✔C. This prevents
compression of the vena cava
✔✔Survival of the fetus in a trauma situation is most dependent upon which of the
following factors?
A. Gestational age of the fetus
B. Prenatal care
C. Immediate cesarean section
D. Good resuscitation of the mother - ✔✔D. Good resuscitation of the mother
✔✔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. Frontal and occipital
B. Occipital
C. Parietal
D. Frontal - ✔✔B. Occipital
(probably too low velocity for Coup & Contre Coup)
✔✔In the context of the caring for an adult patient with traumatic brain injury who is
deteriorating and exhibiting signs of herniation, hyperventilation means ventilating with a
BVM and 100% oxygen at a rate of:
A. 12 to 16 per minute
B. 32 to 40 per minute
C. 8 to 12 per minute
D. 20 per minute - ✔✔D. 20
✔✔In the United State, which of the following mechanisms most frequently causes
spinal cord injury in adults?
A. Shallow water diving
B. Vehicle crashes
C. Falls
D. Pedestrian struck by a vehicle - ✔✔B. Vehicle crashes
✔✔Which of the following presentation indicate spinal cord injury?
A. Complete loss of sensory and motor function below the site of injury
B. Weakness and parethesia in the upper extremities, but normal function in the lower
extremities
C. Complete loss of function on one side of the body and loss of pain and temperature
sensation on the opposite side
D. All of the above - ✔✔D. All of the above
SOLUTIONS RATED A+
✔✔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. Aortic dissection
B. Liver laceration
C. Fractured pelvis
D. Spinal cord injury - ✔✔D. Spinal cord injury
✔✔Which of the following is a limitation of prehospital fluid resuscitation of the patient in
hemorrhagic shock?
A. Inability of fluids to carry oxygen
B. Pulmonary edema
C. Increased hemorrhage
D. All of the above - ✔✔D. All of the above
✔✔Which of the following statements regarding signs of intraabdominal injury is NOT
true?
A. Fresh blood in the abdominal cavity does not cause signs of peritonitis
B. A significant amount of blood loss occurs before abdominal distention can be noticed
C. Substantial intraabdominal hemorrhage always causes tenderness and abdominal
rigidity
D. Signs and symptoms of shock greater than can be explained by other injuries is a
reliable indicator of intraabdominal injury - ✔✔C. Substantial intraabdominal
hemorrhage always causes tenderness and abdominal rigidity
✔✔Which of the following assessment techniques is least useful in the prehospital
assessment of the patient with suspected intraabdominal trauma?
A. Palpation
B. Auscultation
C. Inspection
D. Scene assessment - ✔✔B. Auscultation
✔✔Pregnant trauma patients should be placed on the left side because:
A. This prevents seizures due to eclampsia
B. This prevents abruption of the placenta
C. This prevents compression of the vena cava
, D. This is the best way to auscultate fetal heart tones - ✔✔C. This prevents
compression of the vena cava
✔✔Survival of the fetus in a trauma situation is most dependent upon which of the
following factors?
A. Gestational age of the fetus
B. Prenatal care
C. Immediate cesarean section
D. Good resuscitation of the mother - ✔✔D. Good resuscitation of the mother
✔✔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. Frontal and occipital
B. Occipital
C. Parietal
D. Frontal - ✔✔B. Occipital
(probably too low velocity for Coup & Contre Coup)
✔✔In the context of the caring for an adult patient with traumatic brain injury who is
deteriorating and exhibiting signs of herniation, hyperventilation means ventilating with a
BVM and 100% oxygen at a rate of:
A. 12 to 16 per minute
B. 32 to 40 per minute
C. 8 to 12 per minute
D. 20 per minute - ✔✔D. 20
✔✔In the United State, which of the following mechanisms most frequently causes
spinal cord injury in adults?
A. Shallow water diving
B. Vehicle crashes
C. Falls
D. Pedestrian struck by a vehicle - ✔✔B. Vehicle crashes
✔✔Which of the following presentation indicate spinal cord injury?
A. Complete loss of sensory and motor function below the site of injury
B. Weakness and parethesia in the upper extremities, but normal function in the lower
extremities
C. Complete loss of function on one side of the body and loss of pain and temperature
sensation on the opposite side
D. All of the above - ✔✔D. All of the above
