ITLS Advanced Pre-Test Certification Actual Exam Newest Actual Exam With
Complete 100 Questions And Correct Detailed Answers (Verified Answers)
|Already Graded A+
Question 1
A 34-year-old male is injured in a motor vehicle collision. The physical examination is normal
except for diffuse abdominal tenderness. He is conscious and vital signs obtained en route to the
hospital are: respirations 20, heart rate 120 BPM, BP 100/60. How should this patient be
managed in the field?
A) IV fluid 20mL/kg bolus immediately
B) IV fluid TKVO (To Keep Vein Open)
C) Fentanyl 100mcg IV for pain management
D) Insert an OPA and assist ventilations
E) Immediate needle decompression of the abdomen
Correct Answer: A) IV fluid TKVO
Rationale: In the setting of trauma, if the patient is maintain a systolic blood pressure of at
least 80–90 mmHg and is mentating, aggressive fluid resuscitation is discouraged
(permissive hypotension). Rapidly increasing the blood pressure can "pop the clot" and
increase internal bleeding. Since his BP is 100/60, the goal is to maintain access and only
provide enough fluid to maintain perfusion, not to return the blood pressure to a normal
range.
Question 2
What is the Sellick's Maneuver (Cricoid Pressure)?
A) Pressure applied to the thyroid cartilage to improve the view of the vocal cords
B) Anteriorly directed pressure to the hyoid bone
C) Posteriorly directed pressure applied to the cricoid cartilage
D) Lateral pressure applied to the trachea to prevent air from entering the stomach
E) Manual stabilization of the cervical spine during intubation
Correct Answer: C) Posteriorly directed pressure applied to the cricoid cartilage
Rationale: Sellick’s maneuver involves applying downward (posterior) pressure on the
cricoid cartilage to occlude the esophagus. The goal is to prevent the regurgitation of
gastric contents into the pharynx during positive pressure ventilation and the induction of
, 2
anesthesia for intubation. Note: Current guidelines have downgraded its routine use, but it
remains a classic ITLS procedural definition.
Question 3
For which of the following viruses is there currently an effective vaccine available for healthcare
providers?
A) Delta hepatitis
B) Hepatitis B
C) Hepatitis C
D) Human Immunodeficiency Virus (HIV)
E) Human T-lymphotropic virus
Correct Answer: B) Hepatitis B
Rationale: Hepatitis B is the only bloodborne pathogen listed for which a highly effective
vaccine exists. Standard precautions (PPE) remain the primary defense against Hep C and
HIV, as no vaccines currently exist for them. Healthcare workers are typically required to
undergo the three-dose Hep B series to establish immunity.
Question 4
A 16-year-old girl is rescued from a burning house. She has 25% partial-thickness burns, and the
burned areas are hot to the touch. What is the appropriate initial treatment for the burn site?
A) Apply ice packs to the burned areas until they are cold
B) Apply clean water to burned areas for up to 1-2 minutes
C) Apply antibiotic ointment and a tight pressure dressing
D) Submerge the patient in a cold-water bath for 10 minutes
E) Cover with dry sterile dressings only without cooling
Correct Answer: B) apply clean water to burned areas for up to 1-2 minutes
Rationale: To stop the burning process, hot areas should be cooled briefly with room
temperature water or saline. Cooling should be limited to 1-2 minutes to prevent
hypothermia, which is a major complication in trauma. Following brief cooling, the burns
should be covered with dry, sterile dressings to prevent infection and heat loss.
, 3
Question 5
To properly immobilize a forearm fracture involving the radius and ulna, what specific areas
must be included in the splint?
A) The fracture site and the wrist
B) The fracture site and the elbow
C) The wrist, elbow, and the fracture site
D) The shoulder and the wrist
E) Only the site of the deformity
Correct Answer: C) wrist, elbow and fracture site
Rationale: The fundamental principle of splinting a long-bone fracture is to immobilize the
joint above and the joint below the injury. For a forearm fracture, this necessitates
stabilizing both the wrist and the elbow to prevent the bones from shifting or causing
further soft-tissue damage.
Question 6
Which treatment is NOT indicated in the routine management of a patient with a suspected head
injury?
A) Administration of 100% O2
B) Fluid resuscitation to a BP of 110-120 systolic if the patient is hypotensive
C) Hyperventilating to obtain an ETCO2 of less than 30 mmHg
D) Stabilization of the cervical spine
E) Frequent reassessment of the Glasgow Coma Scale (GCS)
Correct Answer: C) hyperventilating to obtain ETCO2 of less than 30
Rationale: Hyperventilation causes hypocapnia (low CO2), which leads to cerebral
vasoconstriction. While this may temporarily lower intracranial pressure, it significantly
reduces blood flow to the brain, causing cerebral ischemia and worsening the outcome.
Hyperventilation is only indicated as a last resort in cases of active herniation syndrome.
Question 7
Which of the following sets of vital signs is most compatible with a diagnosis of an isolated head
injury with increasing intracranial pressure (ICP)?
, 4
A) BP 170/100, HR 50 BPM
B) BP 80/60, HR 130 BPM
C) BP 80/60, HR 50 BPM
D) BP 170/100, HR 130 BPM
E) BP 120/80, HR 70 BPM
Correct Answer: A) BP 170/100, HR 50 BPM
Rationale: This represents Cushing’s Triad, a sign of increased ICP. It consists of
hypertension (increasing systolic pressure/widening pulse pressure), bradycardia, and
irregular respirations. Option B represents hypovolemic shock (low BP, high HR), which is
usually not caused by an isolated head injury.
Question 8
Which of the following patients would be classified as a "Load and Go" according to ITLS
standards?
A) An awake and alert patient who has blood coming out of one ear
B) A patient who had a brief loss of consciousness but is now awake and alert
C) A patient with abdominal tenderness, clammy skin, BP 100/70, and pulse 130/min
D) A patient with a tender, deformed lower leg and stable vitals
E) A patient with a minor laceration to the scalp with controlled bleeding
Correct Answer: C) pt with abdominal tenderness, clammy skin, blood pressure 100/70 and
pulse 130/min
Rationale: Patient C is showing signs of compensated shock (tachycardia and poor skin
perfusion) coupled with a suspicious mechanism (abdominal tenderness). This patient
likely has internal bleeding and requires immediate surgical intervention, making them a
high priority for rapid transport.
Question 9
Which of the following should be performed at the scene of a "Load and Go" patient before
moving them to the ambulance?
A) Apply a traction splint for a suspected femur fracture
B) Decompress a tension pneumothorax
Complete 100 Questions And Correct Detailed Answers (Verified Answers)
|Already Graded A+
Question 1
A 34-year-old male is injured in a motor vehicle collision. The physical examination is normal
except for diffuse abdominal tenderness. He is conscious and vital signs obtained en route to the
hospital are: respirations 20, heart rate 120 BPM, BP 100/60. How should this patient be
managed in the field?
A) IV fluid 20mL/kg bolus immediately
B) IV fluid TKVO (To Keep Vein Open)
C) Fentanyl 100mcg IV for pain management
D) Insert an OPA and assist ventilations
E) Immediate needle decompression of the abdomen
Correct Answer: A) IV fluid TKVO
Rationale: In the setting of trauma, if the patient is maintain a systolic blood pressure of at
least 80–90 mmHg and is mentating, aggressive fluid resuscitation is discouraged
(permissive hypotension). Rapidly increasing the blood pressure can "pop the clot" and
increase internal bleeding. Since his BP is 100/60, the goal is to maintain access and only
provide enough fluid to maintain perfusion, not to return the blood pressure to a normal
range.
Question 2
What is the Sellick's Maneuver (Cricoid Pressure)?
A) Pressure applied to the thyroid cartilage to improve the view of the vocal cords
B) Anteriorly directed pressure to the hyoid bone
C) Posteriorly directed pressure applied to the cricoid cartilage
D) Lateral pressure applied to the trachea to prevent air from entering the stomach
E) Manual stabilization of the cervical spine during intubation
Correct Answer: C) Posteriorly directed pressure applied to the cricoid cartilage
Rationale: Sellick’s maneuver involves applying downward (posterior) pressure on the
cricoid cartilage to occlude the esophagus. The goal is to prevent the regurgitation of
gastric contents into the pharynx during positive pressure ventilation and the induction of
, 2
anesthesia for intubation. Note: Current guidelines have downgraded its routine use, but it
remains a classic ITLS procedural definition.
Question 3
For which of the following viruses is there currently an effective vaccine available for healthcare
providers?
A) Delta hepatitis
B) Hepatitis B
C) Hepatitis C
D) Human Immunodeficiency Virus (HIV)
E) Human T-lymphotropic virus
Correct Answer: B) Hepatitis B
Rationale: Hepatitis B is the only bloodborne pathogen listed for which a highly effective
vaccine exists. Standard precautions (PPE) remain the primary defense against Hep C and
HIV, as no vaccines currently exist for them. Healthcare workers are typically required to
undergo the three-dose Hep B series to establish immunity.
Question 4
A 16-year-old girl is rescued from a burning house. She has 25% partial-thickness burns, and the
burned areas are hot to the touch. What is the appropriate initial treatment for the burn site?
A) Apply ice packs to the burned areas until they are cold
B) Apply clean water to burned areas for up to 1-2 minutes
C) Apply antibiotic ointment and a tight pressure dressing
D) Submerge the patient in a cold-water bath for 10 minutes
E) Cover with dry sterile dressings only without cooling
Correct Answer: B) apply clean water to burned areas for up to 1-2 minutes
Rationale: To stop the burning process, hot areas should be cooled briefly with room
temperature water or saline. Cooling should be limited to 1-2 minutes to prevent
hypothermia, which is a major complication in trauma. Following brief cooling, the burns
should be covered with dry, sterile dressings to prevent infection and heat loss.
, 3
Question 5
To properly immobilize a forearm fracture involving the radius and ulna, what specific areas
must be included in the splint?
A) The fracture site and the wrist
B) The fracture site and the elbow
C) The wrist, elbow, and the fracture site
D) The shoulder and the wrist
E) Only the site of the deformity
Correct Answer: C) wrist, elbow and fracture site
Rationale: The fundamental principle of splinting a long-bone fracture is to immobilize the
joint above and the joint below the injury. For a forearm fracture, this necessitates
stabilizing both the wrist and the elbow to prevent the bones from shifting or causing
further soft-tissue damage.
Question 6
Which treatment is NOT indicated in the routine management of a patient with a suspected head
injury?
A) Administration of 100% O2
B) Fluid resuscitation to a BP of 110-120 systolic if the patient is hypotensive
C) Hyperventilating to obtain an ETCO2 of less than 30 mmHg
D) Stabilization of the cervical spine
E) Frequent reassessment of the Glasgow Coma Scale (GCS)
Correct Answer: C) hyperventilating to obtain ETCO2 of less than 30
Rationale: Hyperventilation causes hypocapnia (low CO2), which leads to cerebral
vasoconstriction. While this may temporarily lower intracranial pressure, it significantly
reduces blood flow to the brain, causing cerebral ischemia and worsening the outcome.
Hyperventilation is only indicated as a last resort in cases of active herniation syndrome.
Question 7
Which of the following sets of vital signs is most compatible with a diagnosis of an isolated head
injury with increasing intracranial pressure (ICP)?
, 4
A) BP 170/100, HR 50 BPM
B) BP 80/60, HR 130 BPM
C) BP 80/60, HR 50 BPM
D) BP 170/100, HR 130 BPM
E) BP 120/80, HR 70 BPM
Correct Answer: A) BP 170/100, HR 50 BPM
Rationale: This represents Cushing’s Triad, a sign of increased ICP. It consists of
hypertension (increasing systolic pressure/widening pulse pressure), bradycardia, and
irregular respirations. Option B represents hypovolemic shock (low BP, high HR), which is
usually not caused by an isolated head injury.
Question 8
Which of the following patients would be classified as a "Load and Go" according to ITLS
standards?
A) An awake and alert patient who has blood coming out of one ear
B) A patient who had a brief loss of consciousness but is now awake and alert
C) A patient with abdominal tenderness, clammy skin, BP 100/70, and pulse 130/min
D) A patient with a tender, deformed lower leg and stable vitals
E) A patient with a minor laceration to the scalp with controlled bleeding
Correct Answer: C) pt with abdominal tenderness, clammy skin, blood pressure 100/70 and
pulse 130/min
Rationale: Patient C is showing signs of compensated shock (tachycardia and poor skin
perfusion) coupled with a suspicious mechanism (abdominal tenderness). This patient
likely has internal bleeding and requires immediate surgical intervention, making them a
high priority for rapid transport.
Question 9
Which of the following should be performed at the scene of a "Load and Go" patient before
moving them to the ambulance?
A) Apply a traction splint for a suspected femur fracture
B) Decompress a tension pneumothorax
