50 Multiple Choice

Page 1 of 11 1.Upon arrival at a trauma scene, you should complete a(n): Scene Size-up A. Initial assessment B. Scene size-up C. Rapid trauma survey D. ITLS ongoing exam 2. Prolonged scene times may reflect: Ineffective team collaboration A. A decrease in death rates B. Better care being delivered C. Accomplishment of interventions D. Ineffective team collaboration 3. Which of the following indicates a state of hyperventilation? An end tidal CO2 level less than 30 mmHG a. An adult respiratory rate greater than 20 per minute b. A tidal volume of less than 400mL c. An Oxygen saturation greater than 94% d. An end tidal carbon dioxide level less than 30 mmHg 4. A 23 year old female fell from a 2nd floor balcony. Upon arrival, you find her lying in the grass. She responds to verbal commands and your assessment reveals flat neck veins, & normal chest/abdomen/pelvic examinations. Vital signs are: BP 74/40, P 54 & Weak, and R 16. You should suspect: Relative hypovolemic (high-space) shock a. Hypovolemic shock b. Relative hypovolemic (high-space) shock c. Mechanical (obstructive) shock d. Cardiogenic shock Rationale: The condition causing the vascular space to be too large for a normal amount of blood has been called "shock", or relative hypovolemia. Neurogenic shock, commonly called spinal shock, is a form of relative hypovolemia. The clinical presentation of neurogenic shock differs from hemorrhagic shock in that there is no catecholamine release and this no pallor (vasoconstriction), tachycardia, or sweating. The patient will have a decreased BP but the HR will be normal or slow, and the skin is usually warm, dry and pink 5. An unresponsive 34 y/o female was struck by a vehicle. You observe Asymmetrical chest wall movement with a flail segment on the right. Following delegation of c-spine control and opening the airway, you should? Stabilize the chest wall a.Place a cervicle colar b.Intubate c.Administer Oxygen at 8 lpm d.Stabilze the chest wall 6. Which of the following regarding PT positioning for external jugular cannulation is Incorrect? Elevate the head to distend the vein and prevent air embolism. a. The patient must be in the supine position b. Elevate the head to distend the vein and prevent air embolism c. If no suspicion of cervical-spine injury exists, turn the patient’s head to the opposite side d. If you suspect cervical-spine injury, the head must not be turned during cannulation Rationale: The PT must be in the supine position, preferably head down, to distend the vein and prevent air embolism. 7. Which of the following set of vital signs is most compatible with a diagnosis of isolated traumatic brain injury with increasing ICP? BP 170/100, P 50 Rationale: When the ICP increases, the systemic BP increases to try to preserve blood flow to the brain. The body senses the rise in systemic BP, and this triggers a drop in the pulse rate as the body tries to lower the systemic BP 8. Which of the following statements is incorrect regarding spinal motion restriction? Neck traction should be applied to extend the neck upward during cervical collar application

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Page 2 of 11 9. A 15 y/o male was stabbed and has an abdominal evisceration. The PT is A/O, BP 112/68, P 94, R18. You should? (A/O : aware and oriented or alert and oriented.) Prepare PT for transport & establish vascular access during transport. 10. A 33yo female's leg was trapped in a piece of industrial equipment and has been extricated. She is now complaining of secure lower leg pain. PT is A/O with no signs of external hemorrhage. Vital signs are: BP 132/78, P 96, R 20. Which of the following is indicated? Administer pain medication 11. Establishing vascular access on scene is indicated: To administer medication 12. Which of the following changes is most useful to monitor in the child with head injury? Level of consciousness Rationale: changing of LOC is the best indicator of traumatic brain injury 13. In the geriatric PT, which of the following findings is most likely caused by an acute injury? Hypotension 14. A 31yo female was the restrained driver of a vehicle that hit a utility pole at moderate speed. The drivers side airbag deployed. She is A/O & anxious. She reports that she is 8mo pregnant and complain of abdominal, chest and lower extremity pain. Her vital signs are BP 100/60, P 90, R 20. Your impression and interventions are: Early signs of shock. Treat with O2, fluid administration, at "keep open" rate. Rationale: Do not mistake normal vital signs in pregnant PTs. The pregnant PT has a normal resting pulse that is 1015 beats faster than usual, and the BP is 10-15mmHG lower than usual. However, it is also important to realize that a BP loss of 30% can occur in these PTs before there is a significant change in BP 15. A disoriented 23yo male is injured in a motorcycle collision. The PT appears to be intoxicated and does not want medical attention despite a large laceration on his scalp, which is actively bleeding. You should: Treat him as a head injury PT 16. What is the most common cause of cardiopulmonary arrest in the trauma PT? Hypoxemia Rationale: Hypoxemia is the most common cause of traumatic cardiopulmonary arrest. Acute airway obstruction or ineffective breathing will be clinically manifested in hypoxemia 17. You may have been exposed to a contaminant (air or fluid borne). You should: Seek treatment within hours of the exposure 18. A brief neurologic exam of an AMS pt includes:; GCS, glucose check, pupil exam 19.A 24 yo male is involved in a head on collision. If you suspect:A chest injury, obtain an EKG Rationale: Consider a bruised chest wall as a myocardial contusion that requires monitoring of cardiac rhythm and, if available, a 12-lead ECG 20. Which of the following findings would indicate the airway needs to be suctioned? Gurgling sounds with respiration 21. Overinflation of an LMA mask can cause all of the following except: Vomiting Rationale: Overinflation may cause malposition, loss of seal or trauma 22, A 54 yo male is involved in a MVC. The steering wheel is bent. During your initial assessment, you note his skin is pale, radial pulses are present and breath sounds are clear. Which one of the following is most consistent with these findings :Cardiac contusion/Rationale: Bruising of the heart is basically the same injury as an acute MI 23. Which of the following is NOT a potential complication of performing chest decompression? Difficulty monitoring the site. 24. Which of the following is considered one of the four essential components to maintain normal perfusion? Fluid levels Rationale: Its important to remember that BP requires a "steady state" activity of all the preceding factors. The heart must be pumping, the blood volume must be adequate, the blood vessels must be intact, and the lungs must be oxygenating the blood 25. What site is generally the easiest to landmark for IO access? Proximal Tibia 26. As ICP rises after an isolated head injury, what does the systolic BP do? Increases Rationale: When the ICP increases, the systemic BP increases to try to preserve blood flow to the brain. The body senses the rise in systemic BP and this triggers a drop in the pulse rate as the body tries to lower the BP 27. Which MOI meets the exclusion criteria for spinal motion restriction?: A 14yo F with an isolated stab wound to the midaxillary chest wall Rationale: Immobilization onto a long backboard is not indicated in penetrating wounds of: Torso, neck, or head unless there is clinical evidence of spine injury 28. Which of the following organs sic obtained in the retroperitoneal region of the abdomen?: Kidney 29. Which treatment is indicated for the PT who is entrapped for an extended period of time with an isolated crush injury to the lower extremity?: Sodium Bicarbonate and IV fluids

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Page 3 of 11 Rationale: Initial administration of Sodium Bicarb should be at 1 mEg/kg bolus, followed by an infusion of 0.25 mEq/kg body weight/hr of the solution. 30. 16yo F is rescued from a burning house. She has 25% partial thickness burns, and the nursed areas are hot to the touch. What is the appropriate treatment?: Apply clean water to burned areas for up to 5-10 mins. 31. An unresponsive 5yo F was struck by a car. She presents with retractions and nasal flaring. The airway is patent, breathing is fast and shallow, and the carotid pulse is weak and slow. Which of the steps in her management should be done first?:Initiate ventilatory assistance Rationale: If you have any doubt that the child is breathing adequately on his/her own, immediately assist the child's breathing 32. Which of the following regarding trauma in the elderly is true? Fatal outcomes are more likely in the elderly than in the young 33. Supine hypotension syndrome in the pregnant PT is caused by?: Uterine obstruction of venous bloodflow Rationale: In supine hypotension syndrome, the hypotension is caused by the weight of the pregnant uterus pressing on the inferior vena caba and decreasing the return of blood flow to the heart b 30% 34. Which of the following has a greater chance of surviving traumatic cardiopulmonary arrest? PTs with non-dialated pupils Rationale: Trauma PTs who presented unconscious, without palpable pulse or spontaneous respiration, found that PTs with Sinus rhythm and non-dialated (