PHTLS 10TH EDITION 100% VERIFIED ANSWERS 2023/2024 EXAM GUARANTEED SUCCESS

PHTLS 10TH EDITION 100% VERIFIED ANSWERS 2023/2024 EXAM GUARANTEED SUCCESS “1. Which of the following requires you to develop a plan of action, initiate the plan, reassess the plan as care for the patient moves forward, and adjust the plan as the patient's condition or circumstances change? A. Principles of PHTLS B. The Golden Period C. The XABCDE assessment D. Critical thinking process - CORRECT ANSWER Question 1: D To help achieve the PHTLS goals, you will apply your critical thinking skills in the field. Critical thinking in medicine is a process in which the healthcare practitioner assesses the situation, the patient, and the resources available and uses the information to decide on and provide the best care for the patient."n "2. When using the XABCDE assessment, which of the following takes precedence over all other actions? A. Controlling severe bleeding from a limb or other compressible site B. Airway stabilization and assessing circulatory status C. Exposing the body to allow a thorough evaluation D. Ensuring adequate breathing - CORRECT ANSWER Question 2: A The "X" placed before "ABCDE" in the primary survey refers to the need to address exsanguinating hemorrhage immediately after establishing scene safety and before addressing airway. Severe exsanguinating hemorrhage, particularly arterial bleeding, has the potential to lead to loss of total or near total blood volume in a relatively short period of time."n "3. Which of the following is the basis on which a patient's chance of survival is maximized? A. Preferences B. Phases C. Principles D. Transport - CORRECT ANSWER Question 3: C The science of medicine provides the principles of medical care. Simply stated, principles define the duties required of the prehospital care practitioner in optimizing patient survival and outcome."n "4. Which of the following is a goal of the Golden Period? A. Provide written documentation from field care to receiving hospital. B. Expedite the field care and transport of the patient. C. Use a team approach for optimal patient care. D. Use the XABCDE approach to patient assessment. - CORRECT ANSWER Question 4: B One of your most importantresponsibilities as a prehospital carepractitioner is to spend as little time onthe scene as possible and expedite yourfield care and transport of the patient.Studies show that the time from injuryto arrival at the appropriate site fordefinitive care is critical to survival."n "1. You are called to the scene of a possible mass casualty motor vehicle collision on the highway. Once you arrive on scene, what is your first priority? A. Immediately begin triaging patients. B. Treat the patient with the most visible blood loss. C. Determine the need for additional resources. D. Assess the scene and ensure it is safe. - CORRECT ANSWER Question 1: D Ensure safety for responders, bystanders, and patient(s). The first consideration when approaching any scene is the safety of all emergency responders. When EMS personnel become victims, they not only can no longer assist others, but also add to the number of patients."n "2. A trauma patient from the highway incident is holding her right arm, and you note a significant amount of blood steadily flowing from a long gash. This is an example of what type of hemorrhage? A. Capillary bleeding B. Venous bleeding C. Arterial bleeding D. Road rash - CORRECT ANSWER Question 2: B Venous bleeding typically results in a steady flow of dark red blood."n "3. What is the best way to control the bleeding? A. Direct pressure B. Elevation of the arm above the heart C. Tourniquet D. Occlusive dressing - CORRECT ANSWER Question 3: A With venous bleeds, direct pressure isusually sufficient to stop the flow."n "4. The patient is wearing long sleeves, and you are having trouble visualizing the wound. What should you do? A. Cut the cloth away from the site until the entire wound site is visible. B. Leave the clothing in place. Put gauze over the wound. C. Remove the patient's shirt. D. Cut through the slash on the sleeve, and use the material as a makeshift tourniquet. - CORRECT ANSWER Question 4: A Clothing can be quickly removed by cutting. You cannot treat what you cannot see."n "1. You are called to the scene of an explosion and fire at a chemical plant where you find multiple casualties.Triage has begun. Your first patient is a 40-year-old man who was near the source of the explosion. He is unconscious and has extensive injuries. You note gurgling respirations. Why should you use the trauma jaw thrust maneuver first when dealing with a trauma patient? A. It's an easy technique that always works to open the airway. B. It allows you to open the airway with little or no movement of the head and cervical spine. C. Other techniques and interventions don't work as well. D. It can relieve a variety of anatomic airway obstructions in patients who are breathing spontaneously. - CORRECT ANSWER Question 1: B Manual maneuvers like the trauma jaw thrust or chin lift are always the first airway maneuver you should make when treating a trauma patient. In patients with suspected head, neck, orfacial trauma, the cervical spine is maintained in a neutral in-line position.The trauma jaw thrust maneuver allows you to open the airway with little or no movement of the head and cervical spine."n "2. The patient becomes apneic. You suspect he has a cervical injury. Which type of airway should you use? A. Supraglottic airway B. Blind nasotracheal intubation C. Oropharyngeal airway D. Surgical airway - CORRECT ANSWER Question 2: A The supraglottic airway's greatest advantage is that it can be inserted independent of the patient's position, which may be especially important in trauma patients with high suspicion of cervical injury."n "3. Why might it be more difficult to deal with an airway obstruction in a child? A. Children have longer tracheas. B. Children have larger heads and tongues so there is a greater potential for airway obstruction. C. Children have smaller heads, so there is less room to clear the obstruction. D. A child's epiglottis is smaller and stiffer than an adult's. - CORRECT ANSWER Question 3: B Children have larger heads and tongues as compared to an adult so there is a greater potential for airway obstruction in a pediatric patient. You must pay special attention to the proper positioning of a pediatric patient to maintain a patent airway."n "4. Why might you consider early mechanical ventilation via bag-mask device in a geriatric patient? A. Shorter tracheas in geriatric patients create the need for ventilation assistance. B. Laxity of the rib cage makes hyperventilation more likely. C. Geriatric patients have greatly limited physiologic reserve. D. Geriatric patients have a greater alveolar surface area of the lungs. - CORRECT ANSWER Question 4: C Early mechanical ventilation via bag mask device or advanced airway measures should be considered in geriatric trauma patients because of their greatly limited physiologic reserve."n "1. You have been performing ongoing management on a 35-year-old female patient who sustained thoracic trauma when a car hit her as she crossed the street. Originally, your electronic monitoring devices all produce results consistent with your patient's clinical condition. However, en route the trauma center, the monitors start to differ from your patient's current clinical condition each time you reassess. How should you handle this situation? A. Treat the patient's condition, not the monitor results. B. Continue to reassess the patient and record the results for the trauma center. C. Treat your patient based on the test results. D. Stop testing and wait until you arrive at the trauma center for them to perform an assessment. - CORRECT ANSWER Question 1: A If there are inconsistent data from electronic monitoring devices, reassess to be sure the monitor matches the patient's current clinical condition. However, it is most important to treat the patient, not the monitor, so use other signs and symptoms of potential patient deterioration."n "2. You have determined that you are going to need to perform orotracheal intubation on a 50-year-old male motor vehicle crash (MVC) critically injured trauma patient due to prolonged transport time. What do you need to do first? A. Preoxygenate to maximize oxygen saturation. B. Place the patient in a "sniffing"position. C. Clear the mouth of any obstructions. D. Prepare the patient for immediate transport. - CORRECT ANSWER Question 2: A Before insertion of any invasive airway, the patient is preoxygenated with a high concentration of oxygen using a simple airway adjunct or manual airway procedure."n "3. You are oxygenating a pediatric patient using a properly fitted oxygen mask and the "squeeze-release-release" timing technique. As you watch for the rise and fall of the chest, you check end-tidal CO2 (ETCO2) monitoring aiming to maintain what level? A. Between 40 and 45 mm Hg B. Between 30 and 35 mm Hg C. Between 35 and 40 mm Hg D. The level is irrelevant because capnography is inaccurate in pediatric patients. - CORRECT ANSWER Question 3: C The proper level to maintain is between 35 and 40 mm Hg."n "4. What is one reason to use capnography as part of your patient reassessment? A. To get accurate readings for blood pressure B. To assure proper ET tube placement C. To measure arterial blood saturation D. To ensure proper placement for needle decompression - CORRECT ANSWER Question 4: B Capnography can monitor proper endotracheal tube placement. It doesn't read blood pressure, so it cannot beused to determine if a patient is hypotensive. Pulse oximetry, not capnography, measures arterial blood saturation. Capnography is not useful in needle decompression."n "1. Your partner is compressing the bleeding site of a male patient who was stabbed multiple times in the left chest. The bleeding seems to be controlled, yet the patient becomes combative. He is pale and is breathing rapidly, yet states that he "can't breathe" and feels that he is about to die. Your next step in patient management is to: A. start assisted ventilation. B. give high-flow oxygen. C. decompress the left chest. D. give a 250-mL fluid bolus. - CORRECT ANSWER Question 1: C After X come A and B. You can quickly auscultate the lungs (pneumothorax is almost certain with multiple stabs in the chest) and decompress the chest. Decompressing a tension pneumothorax is the quickest way to treat shock."n "2. The patient's respiration improves markedly, but he remains confused. He has an absent radial pulse, and his carotid pulse is fast and thready. Your partner asks if he can let the compression go to put in an IV. How should you respond? A. "Oh yes, that's a great idea!" B. "Yes, but we have to immobilize him first" C. "Take a blood pressure first to see if he needs an IV." D. "No, keep the pressure and let's get out of here!" - CORRECT ANSWER Question 2: D This patient is likely in decompensated shock with internal bleeding, so rapid transport is the next priority. You should maintain pressure on the wound, because having massive external bleeding start up again is the last thing you want in this situation."n "3. While en route to the hospital, you manage to put an 18-gauge IV in the right arm. Your patient is still confused, and you still have no radial pulse. Your next move is to: A. give 1-L fluid bolus. B. give one 250-mL fluid bolus, and then stop. C. give fluid until you get a radial pulse. D. administer TXA. - CORRECT ANSWER Question 3: C Now is the time to titrate IV fluids to restore tissue perfusion. Giving 1 liter blindly could overshoot your target pressure and reinforce internal bleeding. TXA is not a priority, although it can run parallel to fluids."n "4. After 400 mL of lactated Ringer solution, you get a radial pulse and his level of consciousness improves. The monitor shows heart rate 110 beats/minute, blood pressure 85/60mm Hg, SpO2 95%, ventilation rate 25 breaths/minute. What should you do? A. Give an additional 500 mL of lactated Ringer solution. B. Stop fluids and give 2 g of TXA. C. Give TXA and 500 mL of normal saline. D. Give 2 mg of morphine for analgesia. - CORRECT ANSWER Question 4: B The patient does not need more fluids right now. Giving morphine in a shocked patient is a risky move and could lead to dangerous hypotension."n "5. You now perform a secondary survey. You notice a sternotomy scar. Your patient tells you he is on oral clopidogrel since he had a coronary artery bypass graft 2 years ago. Is this information useful? A. No, he should stop talking and breathe. B. Yes, he should see a cardiologist once in the local hospital. C. Yes, he will need platelets and a heart surgeon ASAP. D. Yes, you should raise his blood pressure up to 130 mm Hg systolic. - CORRECT ANSWER Question 5: C Because he is on clopidogrel, his platelets are out of order for at least 5 days, so he will require urgent platelet transfusion."n "1. You're called out to an assisted living facility for a 72-year-old woman complaining of a severe headache and experiencing increased confusion. Staff reports she fell out of her wheelchair earlier in the week but didn't appear to be hurt; however, she's become increasingly disoriented over the last day or so. Vital signs show: BP 110/90; heartrate 118 and irregularly regular; ventilation rate 20 and slightly labored; SpO2 93% on room air. She is taking warfarin for a clotting issue. Which of the following should you suspect? A. Cerebral contusion B. Epidural hematoma C. Subarachnoid hemorrhage D. Subdural hematoma - CORRECT ANSWER Question 1: D The patient's age, use of a blood thinner, and the fact she fell recently point to a subdural hematoma."n "2. Upon examination, you find the patient responsive to your presence, although she is clearly confused. Motor response shows reduced pain response but normal flexion. What's her GCS score? A. 15 B. 12 C. 10 D. 8 - CORRECT ANSWER Question 2: B Eye opening: 4; verbal response: 4; motor response: 4 = 12"n "3. What does the GCS score indicate? A. Mild TBI B. Moderate TBI C. Severe TBI D. No TBI - CORRECT ANSWER Question 3: B A total GCS score of 13 to 15 likely indicates a mild TBI whereas a score of 9 to 12 is indicative of moderate TBI. A GCS score of 3 to 8 suggests severe TBI."n "4. When you examine the patient's pupils, you notice the right one is dilated significantly and her motor response on the left is delayed. What does this suggest? A. Coup-countercoup injury B. Hyphema C. Hypoxia D. Uncal herniation - CORRECT ANSWER Question 4: D When the medial portion of the temporal lobe (uncus) is pushed toward the tentorium and puts pressure on the brain stem, herniation compresses CN III, the motor tract, and the reticular activating system on the same side, resulting in a dilated or blown pupil on the same side, motor weakness on the opposite side, and respiratory dysfunction, progressing to coma."n "5. Which of the following signs would be most concerning at this point? A. A drop in systolic blood pressure to 88 mm Hg B. SpO₂ of 93% C. A field GCS motor score of 4 D. Hemiplegia on the left side - CORRECT ANSWER Question 5: A A systolic blood pressure of less than 90 mm Hg indicates secondary brain injury. Her SpO2 is 90%, and a motor score of 4 is not as concerning."n "6. According to the Monro-Kellie doctrine, what happens to the brain when it is still in a compensated state after a TBI? A. CSF, ICP, heart rate, and blood pressure are still within normal range. B. CSF increases, ICP decreases, heart rate increases, and blood pressure decreases. C. CSF and blood volume decrease, while heart rate and blood pressure are still within normál range. D. CSF decreases, ICP increases, heart rate decreases, and blood pressure increases. - CORRECT ANSWER Question 6: C In a compensated state, CSF and blood volume decrease, while heart rate and blood pressure are still within normal range."n "1. You are responding to a call for 25-year-old, fit and healthy female who fell off a mountain bike. Upon arrival, you find the patient walking around. She is alert but complaining of pain in her clavicle and on her right side when she inhales. You notice that her helmet is split in two. What is the first thing you need to do? A. Complete a review of the ABCs. B. Check motor and sensory function. C. Perform manual in-line stabilization. D. Place her on a backboard. - CORRECT ANSWER Question 1: C Because there's a possibility of spinal injury, you should bring the patient's head into a neutral in-line position."n "2. During primary survey, you find the following: . LOC: alert and oriented; speaking in full sentences . GCS: 15 . Airway: good air entry to bases . Breathing: bilateral . Circulation: skin warm, flushed, dry . Pulse rate: 112 bpm, strong andregular . BP: 90/42 mm Hg . Pain: Patient complains of severe pain at clavicle site and pain on inspiration at site of possible fractured ribs. No other injuries detected. What is your next step? A. Apply a cervical collar and in-line immobilization device. B. Treat for hypovolemic shock. C. Apply an arm sling for the clavicle injury. D. Administer pain medication. - CORRECT ANSWER Question 2: A Although the patient's GCS is normal, she does have a distracting injury, and the state of her helmet indicates possible spinal compression/flexion, so you should immobilize the patient."n "3. When securing a patient to a backboard, which body part should you secure first? A. Head B. Torso C. Legs D. Pelvis - CORRECT ANSWER Question 3: B When immobilizing a patient, you should secure the torso first, then the head, the legs, and the pelvis."n "4. What type of padding should you provide for this patient? A. Use compressible padding under the shoulders and torso to prevent hyperflexion. B. Use firm padding between the back of the head and the backboard to prevent hyperextension. C. Do not use any padding. It can cause extension or flexion in the neck. D. No padding needed, but to avoid decreased venous return you should tip the backboard to a left lateral position. - CORRECT ANSWER Question 4: B Because the patient is an adult, you should use firm padding between the back of the head and the backboard to prevent hyperextension. You would pad a child's shoulder and torso to prevent hyperflexion, and you would tip the backboard for a pregnant patient to prevent decreased venous return."n "5. While attempting to lay the patient supine for spinal motion restriction she becomes increasingly distressed and complains of shortness of breath and difficulty breathing. The fractured clavicle appears to move distally and increases the difficulty of breathing as the patient lies back. What should you do? A. Tip the backboard to a left lateral position. B. Raise the back of the stretcher. C. Let her sit up in a position of comfort. D. Administer morphine. - CORRECT ANSWER Question 5: B Because laying the patient supine increases the risk of airway/ventilation problems, raising the back of the stretchers slightly fundamentally maintains spinal alignment while reducing the ventilation issues."n "1. You and your partner are responding to a call for a 2-year-old patient with a burn injury to the hand. He has a visible burn to the left hand, ending at the level above the wrist, red color, and wet in appearance. What type of burn do you suspect the patient has sustained? A. Superficial (first degree) B. Partial thickness (second degree) C. Full thickness (third degree) D. Subdermal (fourth degree) - CORRECT ANSWER Question 1: B Scald burns are the most common burns seen in the pediatric population ages 1 to 5 years. Scalds are partial thickness burns. The dermal layer is damaged, and blisters are present or popped. It is also the most painful type of burn."n "2. The patient's care giver is a babysitter who reports the child was crawling on the counter and placed his hand in a pot of water that was boiling on the stove. She is applying ice to the burn and the child is shivering. What is your next step? A. Administer analgesia for pain. B. Cover the patient with a blanket to stop the shivering. C. Start IV for fluid resuscitation. D. Stop the burning process and remove the ice pack. - CORRECT ANSWER Question 2: D A common error that results in damage to the zone of stasis is the application of ice by a bystander or prehospital care practitioner. When ice is applied to a burn, the patient will experience some reduction in pain; however, the pain relief will be at the expense of additional tissue destruction."n "3. After exposing the patient, no other burn injuries were found, but blisters have started to form on the hand and the child is crying from pain. How should you manage the blisters? A. Lance the blisters to drain the fluidand relieve the pressure. B. Cover the injury with a dry, loose, sterile dressing, being sure to leave the blisters intact. C. Use a topical antibiotic ointment and firmly wrap the burn injury. D. Establish an IV for fluid resuscitation. - CORRECT ANSWER Question 3: B In the prehospital setting, blisters are generally best left alone during the relatively short transport time. Blisters that have already ruptured should be covered with a clean, dry dressing."n "1. Your patient is experiencing severe pain after sustaining a femur fracture in a motorcycle crash. You have a 20 minute transport to the nearest trauma center. There are no other injuries noted on your primary and secondary assessments. Which of the following medications would be the best pain management choice? A. NSAIDs B. Acetaminophen C. Fentanyl D. Morphine - CORRECT ANSWER Question 1: C Fentanyl is often a first-line agent due to speed of onset, short duration of action, and minimal effect on hemodynamics. Fentanyl can beadministered IN, IM, IO, or IV. The IV route provides effects instantly whereasthe IN and IM route have an onset of 10 minutes. The duration of fentanyl is short at 30 minutes to an hour. This will provide enough time to ease pain during transport and let the traumacenter decide pain management upon arrival."n "2. You are responding to a call to an MVC involving one patient. When you perform your primary survey, you find a patent airway, but abnormalities with breathing and circulation. You suspect hypovolemic shock, but cannot determine the source. What does this finding most likely indicate? A. Hemothorax B. Intra-abdominal bleed C. Blunt cardiac injury D. Diaphragmatic rupture - CORRECT ANSWER Question 2: B The most reliable indicator of an intraabdominal bleed is the presence of hypovolemic shock from an unexplained source."n "3. You are transporting a 37-year-old male patient with a suspected intraabdominal bleed. His blood pressure is 70/50 mm Hg (MAP 57), and his skin is pale and diaphoretic. How will you manage fluid resuscitation for this patient? A. Aggressively administer IV fluids to compensate for internal blood loss. B. Do not administer IV fluids to patients with intra-abdominal bleeding. C. Obtain the patient's medical records and resuscitate to his normal blood pressure reading. D. Carefully administer IV fluids to raise the patient's systolic blood pressure to between 80 and 90 mm Hg. - CORRECT ANSWER Question 3: D Abdominal trauma represents one of the key situations in which a balanced resuscitation is indicated. Aggressive administration of IV fluid may elevate the patient's blood pressure to levels that will disrupt any clot that has formed and result in recurrence of bleeding that had ceased because of blood clotting and hypotension. Prehospital care practitioners must achieve a delicate balance: maintain a blood pressure that provides perfusion to vital organs without restoring blood pressure to elevated or even normal ranges, which may reinitiate bleeding sites in the abdomen or pelvis. In the absence of TBI, the target systolic blood pressure is 80 to 90 mm Hg (mean arterial pressure of 60 to 65 mmHg)." A 27 year old female has multi system trauma. Which life threat is your first priority? - CORRECT ANSWER Significant external hemorrhage" "Which type of skull fracture will cause leakage of cerebrospinal fluid from the ears and nose? - CORRECT ANSWER Basilar" "A 78 year old female was involved in a minor car crash. She is shivering and exhibits repetitive questioning. She is a type II diabetic and takes a daily anticoagulant. What should your initial treatment be? - CORRECT ANSWER Move patient to a warm environment" "A 14 year old male suffered from helmet-to-helmet contact during a football game followed by a 30 second period of unconsciousness. Initial exam shows that he is awake but slow to respond. He is nauseated and has a headache. He becomes unresponsive during transport. Examination of the pupils reveals a left pupil that is dilated and not reactive. What type of hemorrhage should you suspect? - CORRECT ANSWER Epidural" "An 80 year old female fell down a flight of stairs 3 days ago. Today the family reports she has a headache and is "going in and out of consciousness." Vital signs are BP 170/72, R 26 and irregular, HR 62, BGL 150 mg/dL (8.3 mol/L). What should you suspect? - CORRECT ANSWER Subdural hematoma" "An adult patient was involved in a motorcycle accident. Why should you remove his or her helmet? - CORRECT ANSWER To manage the airway" "A 28 year old male fell from his motorcycle during a low speed accident. He removed his own helmet after the accident. He has an open left femur fracture with severe external bleeding from the wound. What should you do? - CORRECT ANSWER Apply direct pressure to the wound" "An adult patient has an open angulated injury to the left lower leg. Distal pulses are absent. Why would you attempt to realign the extremity? - CORRECT ANSWER Restore blood flow" "A 20 year old male was hit in the chest with a baseball bat. He4 complains of severe pain and tenderness to the left side. He is unable to take a deep breath. Vital signs are BP 112/76, P 98, R 20 regular, and ETCO2 38mmHg. What should you do? - CORRECT ANSWER Administer 100 mcg of Fentanyl" "A 13 year old male was riding on an all-terrain vehicle when he drove into a wire fence. He's sitting on the ground with a towel over his lower face. He has an open jaw fracture. What is your primary concern? - CORRECT ANSWER Obstruction of the airway" "An adult patient has partial thickness burns to his or. her anterior chest and abdomen, the entire right arm, and the palm of the left hand. What percent of the total body surface area is affected? - CORRECT ANSWER 28%" "An 8 year old female is being treated in the red treatment area after a housing complex fire. Vital signs are P 140, R 12 with noted stridor. Her eyebrows and hair are burnt. Suddenly, she becomes apenic. What should you do? - CORRECT ANSWER Insert an oropharyngeal airway and assist ventilations" "What type of burn should be treated as a life or limb threatening injury due to constriction of the injured tissues? - CORRECT ANSWER Circumferential" "A 26 year old female was the unrestrained driver of a head on collision. Her Glascow Coma Scale score is 4 (E1, V1, M2). Vital signs are BP 156/78, P 66, R 12 and irregular, and her pupils are unequal. What should you do? - CORRECT ANSWER Assist ventilations at a rate of 20 breaths per minute" "Which of the following presents the greatest risk for EMS provider fatalities? - CORRECT ANSWER Motor vehicle collision either in an EMS unit or on-scene" "A 50 year old male fell from a 6th story balcony. Intubation attempts have been unsuccessful. His Glasgow Coma Scale score is 6 (E1, V1, M4). You note agonal respirations. What should you do first? - CORRECT ANSWER Insert a superglottic airway device" "A 22 year old male was involved in a car crash and hit a tree head-on. The patient is on the ground outside the vehicle and is unconscious. His forearm is avulsed and you note a large pool of blood with active bleeding. His breathing is deep and labored. What should you do? - CORRECT ANSWER Apply a tourniquet" "A 46 year old male is trapped in his vehicle after a high speed front-end collision. He is slow to respond to questions. You note blood pooling on his seat. Vital signs are P 130, R 8. How should you remove this patient from the vehicle? - CORRECT ANSWER Rapidly extricate the patient" "A 24 year old construction worker amputated his thumb. How should you manage the amputation? - CORRECT ANSWER Wrap in moistened gauze" "A 36 weeks pregnant female has sustained an injury that requires spinal motion restriction. What intervention should be implemented to prevent hypotension during transport? - CORRECT ANSWER Elevate the right side of the back board 4-6 inches" "A 41 year old male was stabbed in the chest immediately below the sternum. He complains of shortness of breath and has engorged jugular veins. Vital signs are BP 108/84, P 130, R 26. What should you suspect? - CORRECT ANSWER Cardiac tamponade" "A 55 year old male has burns to both lower extremities from a car crash. He is awake and in severe pain. Assessment reveals dry, white, leathery appearance in both lower extremities. What is the burn classification? - CORRECT ANSWER Full thickness" "A 29 year old male falls 17 feet (5 m) to the ground from a tree. He complains of pain with movement and pain on the right side of his chest when he breaths. You not5e accessory muscle use, focal, tenderness, bony crepitus, and absent breath sounds on his right side. What should you suspect? - CORRECT ANSWER Simple pneumothorax" "A 47 year old female was stabbed with knife in her right upper quadrant. Her Glasgow Coma Scale score is 9 (E2, V2, M5). Vital signs are BP 78/50, P 130, R 26. What should you do? - CORRECT ANSWER Immediately transport to a trauma center and establish an IV en route." "A 44 year old male was ejected from a truck traveling at 44 mph (60 kph). He is lying supine on the ground with snoring respirations. What should you do first? - CORRECT ANSWER Manually stabilize the cervical spine" "A 13 year old male was a restrained passenger in a car crash at highway speed. He is alert and oriented on-scene and walking around. What should you do? - CORRECT ANSWER Consider spinal motion restriction and assess his c-spine" "A 44 year old male was involved in a motorcycle crash. He sustained severe blunt trauma to his chest and has deformity of the right femur. Multiple IV attempts were unsuccessful. Vital signs are BP 70/40, P 126, R 28. What should you do? - CORRECT ANSWER Establish intaosseous access" "Where is the preferred landmark for needle decompression? - CORRECT ANSWER Anterior axillary line, 5th intercostal space" "A 25 year old female has a gunshot wound to the abdomen. Vital signs are BP 80/40, P 122, R 18 clear, equal lung sounds. What is the most appropriate IV fluid to administer? - CORRECT ANSWER Warmed Lactated Ringer's" "A 16 year old male complains of chest pain and difficulty taking a deep breath. He was assaulted with metal pipe. He has unilateral chest rise and crepitus over the injured area. What should you do? - CORRECT ANSWER Apply high flow oxygen" "A 23 year old male was skateboarding down a ramp when he flipped over and landed on his head. He is clenching his jaw and you are unable to insert and oral airway. He thrashes his head when yo9u attempt to provide bag-mask ventilations. His oxygen saturation is decreasing, and his ETCO2 is increasing. What is the best option to secure his airway and provide effective ventilations? - CORRECT ANSWER Pharmacologically assisted intubation" "A 29 year old male was injured in a high speed motor vehicle collision with lateral impact and intrusion into the side of a sedan. He has pale and diaphoretic skin, appears anxious, and is coughing up blood-tinged sputum. He complains of chest pain, has decreased breath sounds on the left lateral side, has crepitus on palpation of his ribs, and his jugular veins are flat. Vital signs are BP 88/56, P 120, R 24, SpO2 92%. What should you suspect? - CORRECT ANSWER Hemothorax" "Which of the following is true when log rolling a patient? - CORRECT ANSWER The provider maintaining spinal motion restriction is in charge" "A 10 year old male fell from his bicycle and sustained abrasions to his left leg and left arm. He is alert and oriented. What should you do first? - CORRECT ANSWER Complete a primary and secondary assessment" "What is a sign oof brain stem herniation? - CORRECT ANSWER Decerebrate posturing" "Which type of shock includes neurogenic and anaphylactic shock? - CORRECT ANSWER Distributive" "A 3 year old female was involved in a car crash with 2 feet (61 cm) of intrusion into the passenger compartment. She is crying and has an obvious deformed right humerus. Her car seat has a crack on the side of impact. What should you suspect? - CORRECT ANSWER Significant energy has been distributed to this patient" "A 33 year old female has a Glasgow Coma Scale score of 3 (E1, V1, M1) after being ejected from a motor vehicle. How should you prepare to intubate? - CORRECT ANSWER Maintain spinal precautions and use a video laryngoscope if available" "What is a priority treatment for an internal hemorrhage due to a pelvic fracture? - CORRECT ANSWER Binder application" "What is an early finding in compartment syndrome? - CORRECT ANSWER Pain" "A 28 year old female has suffered a head injury after falling from a horse. He Glasgow Coma Scale score is 6 (E1, V1, M4) and she has snoring respirations at 8 per minute. Which should you do first? - CORRECT ANSWER Place an oropharyngeal airway" "Upon examining a 43 year old male, you note unequal breath sounds. What is a sign or sympton of a simple pneumothorax? - CORRECT ANSWER Shortness of breath, decreased lung sounds on affected side" "A 78 year old female fell 12 hours ago. Now she complains of 10/10 hip and groin pain during movement. Vital signs are BP 98/50, P 132, R 26. What should you administer? - CORRECT ANSWER Ketamine" "A 42 year old female has been pulled from a smoke-filled apartment. Her mouth and nose are covered in soot. She has a weak, hoarse cry with inspiratory stridor. What should you do? - CORRECT ANSWER Prepare for a difficult intubation" "An anxious 54 year old female complains of chest pain. She hit the steering wheel after a car crash at highway speeds. Her sternum is red and tender. Vital signs are BP 100/68, P 112, R 28 and clear, SpO2 92%. What should you suspect? - CORRECT ANSWER Cardiac contusion" "A 28 year old male was ejected during a car crash. He is unconscious and has no obvious bleeding. Vital signs are BP 70/40, P 120, R 22. What type of shock would you expect? - CORRECT ANSWER Hemorrhagic shock" "A 4 year old female fell down approximately 8 carpeted stairs. Her parents said she initially complained of neck pain and a tingling sensation in all four extremities, but the symptoms have since resolved. What should you do? - CORRECT ANSWER Initiate spinal motion restriction and transport" "A 26 year old male is supine on the ground. He was assaulted and has obvious head and facial trauma. He has snoring respirations at a rate of 8 per minute. What should you do? - CORRECT ANSWER Perform a modified jaw thrust" "Which of the following physiological changes associated with aging may contribute to an increased incidence of falls among the elderly? - CORRECT ANSWER Declining visual acuity" "A 32 year old male was ejected from a motor vehicle. He is unconscious with agonal respirations. Upon assessment, you not a dilated right pupil. What is the best device to secure the airway? - CORRECT ANSWER Endotracheal tube"