ADVANCED ITLS 8TH EDITION EXAM QUESTIONS

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ADVANCED ITLS 8TH EDITION EXAM QUESTIONS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -50 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: 28. A 45-year-old female is found unconscious at the scene of a motor vehicle collision. Her vital signs are BP 80/40, P 130, and R 30. Which of the following is the most likely cause for her vital signs?

• Fractured lower legs
• Intracranial hemorrhage
• Bleeding into the chest or abdomen
• Spinal cord injury with neurogenic shock

Answer:

• Bleeding into the chest or abdomen

Rationale: Hypovolemic shock victims usually have tachycardia, are pale, and have flat neck veins. So, if you find a trauma victim with a fast heart rate, who is pale, with weak radial pulses and flat neck veins, this patient is probably bleeding from some injury, either internally or externally (or possibly both).Question 2: 13. The gold standard to confirm that the endotracheal tube is placed in the trachea

is:

• Evaluation of breath sounds
• Equal chest rise and fall
• Waveform capnography

• Presence of condensation in the tube

Answer:

• Waveform capnography

Rationale: Although the most reliable method of ensuring proper placement is actually visualizing the tube passing through the glottic opening, even this is not 100% sure. In fact, it is only reliable for the moment you see it. The gold standard for confirming and monitoring ETT placement is waveform capnography.Question 3: 1. In a rear-impact motor vehicle crash, which area of the spine is most susceptible to injury?

• Cervical
• Thoracic
• Lumbar
• Sacral-coccygeal

Answer:

• Cervical

Rationale: The sudden increase in acceleration produces posterior displacement of the occupants and possible hyperextension of the cervical spine if the headrest is not properly adjusted. The potential for cervical-spine injuries is great.Question 4: 7. Which of the following mechanisms of injury does not commonly cause damage to the spinal cord?

• Hyperextension
• Hyperflexion
• Lateral stress
• Compression

Answer:

• Lateral stress

Rationale: Certain mechanisms of trauma can overcome the protective properties, injuring the spinal column and cord. The most common mechanisms are hyperextension, hyperflexion, compression, and rotation. Less commonly, lateral stress or distraction will injure the cord.

Question 5: 30. Which one of the following is a reason to interrupt the initial assessment?

• Cardiac arrest
• Multiple open (compound) fractures
• Severe head injury with brain tissue visible
• Severe shock

Answer:

• Cardiac arrest

Rationale: Remember, once you begin patient assessment in the ITLS Primary Survey, only four things should cause you to interrupt completion of the assessment. You may interrupt the assessment sequence only if (1) the scene becomes unsafe, (2) you must treat exsanguinating hemorrhage, (3) you must treat an airway obstruction, or (4) you must treat cardiac arrest.Question 6: 6. An unconscious 15-year-old male was struck on the head with a baseball bat. His arms and legs are extended and his right pupil is dilated and fixed. You should:

• Insert an oropharyngeal airway, administer oxygen, and restrict fluids
• Apply a non-rebreather mask, restrict fluids, and administer Mannitol
• Perform nasotracheal intubation, restrict fluids, and provide adequate ventilation
• Perform bag-mask ventilation at 20 per minute Exam

Answer:

• Perform bag-mask ventilation at 20 per minute Exam

Rationale: The classic findings of this life-threatening situation are a decreasing level of consciousness (LOC) that rapidly progresses to coma, dilation of the pupil and an outward- downward deviation of the eye on the side of the injury, paralysis of the arm and leg on the side opposite the injury, or decerebrate posturing (arms and legs extended). The danger of immediate herniation outweighs the risk of cerebral ischemia that can follow hyperventilation. The cerebral herniation syndrome is the only situation in which hyperventilation is still indicated. (You must ventilate every three seconds [20/minute] for adults.) Question 7: 18. Hemostatic agents applied directly to the source of bleeding must be used in

conjunction with:

• Direct pressure to the wound
• Tourniquets proximal to the wound
• Pressure points to arteries proximal to the wound

• Elevation of the wound above the level of the heart

Answer:

• Direct pressure to the wound

Rationale: Pack the hemostatic agent in the wound, and hold firm pressure. Hemostatic agent is an "adjunct" to assist in controlling hemorrhage, not a hemorrhage control by itself.Question 8: 47. What is the most common cause of cardiopulmonary arrest in the trauma patient?

• Brain injury
• Hypoxemia
• Myocardial contusion
• Ventricular arrhythmia

Answer:

• Hypoxemia

Rationale: Hypoxemia is the most common cause of traumatic cardiopulmonary arrest. Acute airway obstruction or ineffective breathing will be clinically manifested as hypoxemia.Question 9: 12. A 34-year-old man has a gunshot wound to the right groin area. Arterial bleeding, which cannot be controlled with direct pressure or tourniquet, is coming from the wound. The patient appears confused, diaphoretic, and has weak peripheral pulses. What is the appropriate fluid resuscitation regimen for this patient?

• Intravenous fluid at a "keep open" rate
• Intravenous fluid; give enough fluid to maintain peripheral pulses
• Intravenous fluid at a "wide open" rate
• Intravenous access should be established in this situation

Answer:

• Intravenous fluid; give enough fluid to maintain peripheral pulses

Rationale: Give only enough normal saline to maintain a blood pressure high enough for adequate peripheral perfusion. Maintaining peripheral perfusion may be defined as producing a peripheral pulse (such as a radial pulse).