International Trauma Life Support For Emergency Care Providers, 8th Edition Test Bank

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ExamName___________________________________MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)A ________ injury occurs when a patient is struck by flying shrapnel from a blast.1)A)primaryB)quaternaryC)tertiaryD)secondaryAnswer:DExplanation:A)B)C)D)2)All of the following are forms of protection to the occupant of a small-vehicle crash EXCEPT:2)A)helmet usage.B)evasive maneuvering.C)lap belts.D)protective clothing.Answer:CExplanation:A)B)C)D)3)Injuries to the thorax below the ________ should increase suspicions of abdominal injury as well.3)A)third intercostal spaceB)second intercostal spaceC)fourth intercostal spaceD)first intercostal spaceAnswer:CExplanation:A)B)C)D)4)Rollover, forward deceleration of the rider from vehicle impact with a stationary object, and therider falling off are common mechanisms of injury from what type of vehicle?4)A)SnowmobileB)MotorcycleC)WatercraftD)All-terrain vehicleAnswer:DExplanation:A)B)C)D)5)When does scene size-up begin?5)A)Once you are dispatchedB)During the first patient contactC)As you leave the ambulanceD)After you arrive on sceneAnswer:AExplanation:A)B)C)D)1

6)A car strikes a tree at 35 miles per hour. At that exact moment, how fast are the driver's organstraveling?6)A)0 miles/hourB)35 miles/hourC)50 miles/hourD)70 miles/hourAnswer:BExplanation:A)B)C)D)7)Which of the following is NOT one of the patient collisions associated with an MVC?7)A)Penetrating collisionB)Machine collisionC)Body collisionD)Organ collisionAnswer:AExplanation:A)B)C)D)8)Which of the following mechanisms would be considered a penetration injury?8)A)Rapid vertical decelerationB)Being struck with a baseball batC)Rapid forward decelerationD)Fall upon a fixed objectAnswer:DExplanation:A)B)C)D)9)Over three-fourths of all motorcycle deaths are due to what kind of injury?9)A)SpineB)ThoracicC)HeadD)NeckAnswer:CExplanation:A)B)C)D)10)The "clothesline" or "hangman" injury is a common injury from riding:10)A)snowmobiles.B)motorcycles.C)personal watercraft.D)all-terrain vehicles.Answer:AExplanation:A)B)C)D)2

11)Which of the following clues is NOT a consideration when determining the mechanism of injuryfrom a vehicle crash?11)A)Deformity of objects within the glove boxB)Deformity of interior structuresC)Deformity of the vehicleD)Deformity or injury patterns of the patientAnswer:AExplanation:A)B)C)D)12)Oxygen, cervical collars, backboards and personal protective equipment are all considered________ for trauma patients.12)A)specialized careB)essential equipmentC)universal necessitiesD)Standard PrecautionsAnswer:BExplanation:A)B)C)D)13)Windshield injuries occur MOST often with what type of vehicle collision?13)A)Lateral collisionB)Frontal collisionC)Rear-end collisionD)Rotational collisionAnswer:BExplanation:A)B)C)D)14)Being thrown by a blast wave and impacting the ground is what type of blast injury?14)A)TertiaryB)PrimaryC)QuaternaryD)SecondaryAnswer:AExplanation:A)B)C)D)15)Additional collisions with objects inside a vehicle that become missiles when the vehicle abruptlystops are an example of:15)A)secondary collisions.B)rotational collisions.C)rear-impact collisions.D)primary collisions.Answer:AExplanation:A)B)C)D)3

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16)In what direction do the majority of tractor overturns occur?16)A)To the rearB)To the sideC)To the backD)To the frontAnswer:AExplanation:A)B)C)D)17)The procedure used to prevent contamination by a patient's body fluids is termed:17)A)Standard Precautions.B)essential equipment.C)O.P.I.M.D)ITLS primary survey.Answer:AExplanation:A)B)C)D)18)Which of the following has the largest effect regarding energy transfer into a patient?18)A)MassB)WeightC)VelocityD)HeightAnswer:CExplanation:A)B)C)D)19)The type of collision that is MOST likely to result in a cervical hyperextension injury is a:19)A)frontal collision.B)rotational collision.C)lateral collision.D)rear-end collision.Answer:DExplanation:A)B)C)D)20)When one part of a vehicle stops and the rest of the vehicle remains in motion, what type ofmechanism is it?20)A)RotationalB)LateralC)RolloverD)FrontalAnswer:AExplanation:A)B)C)D)21)Which of the following is NOT a consideration when assessing for injuries due to a fall?21)A)Distance of the fallB)Anatomical area struckC)Surface struckD)Acceleration forcesAnswer:DExplanation:A)B)C)D)4

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22)What is the MOST common mechanism of injury from a tractor accident?22)A)EjectionB)OverturnsC)BurnsD)FallsAnswer:AExplanation:A)B)C)D)23)The internal diameter of a muzzle on a gun is called what?23)A)RiflingB)YawC)CaliberD)TumblingAnswer:CExplanation:A)B)C)D)24)During a rollover accident, an ejected occupant is ________ times as likely to be killed.24)A)fiveB)twoC)fourD)threeAnswer:DExplanation:A)B)C)D)25)What is a major concern for a patient that was involved in a high-energy event?25)A)Checking vital signs before airwayB)The increased chance for serious injuryC)Rapid transportation via helicopterD)Securing the scene from onlookersAnswer:BExplanation:A)B)C)D)5

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ExamName___________________________________MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)The concept that immediately addresses problems encountered and yet does not interrupt theassessment sequence and does not increase scene time is called:1)A)delegating interventions.B)rapid survey.C)priority patients.D)load and go.Answer:AExplanation:A)B)C)D)2)The correct order for the first part of the ITLS secondary exam is:2)A)LOC, airway, breathing, radial pulse, general impression.B)general impression, LOC, airway, breathing, radial pulse.C)radial pulse, breathing, airway, LOC, general impression.D)airway, breathing, radial pulse, general impression, LOC.Answer:BExplanation:A)B)C)D)3)The choice between performing a rapid trauma survey or a focused exam depends on:3)A)initial assessment results.B)SAMPLE history.C)number of patients.D)weather conditions.Answer:AExplanation:A)B)C)D)4)Which of the following is NOT a reason to interrupt the ITLS primary survey?4)A)Scene dangerB)Airway obstructionC)Respiratory arrestD)Cardiac arrestAnswer:CExplanation:A)B)C)D)1

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5)When do you determine the need for extra resources?5)A)During the focused examB)During the rapid trauma surveyC)During the initial assessmentD)During the scene size-upAnswer:DExplanation:A)B)C)D)6)The ITLS ongoing exam should be repeated every ________ minutes for critical patients and________ minutes for stable patients.6)A)2; 5B)4; 10C)10; 15D)5; 15Answer:DExplanation:A)B)C)D)7)What does TIC abbreviate?7)A)Tenderness, instability, crepitusB)Tearing, instability, contusionsC)Tourniquet, insert airway, circulationD)Tenderness, IV fluid, compressionAnswer:AExplanation:A)B)C)D)8)If bleeding is not adequately controlled with pressure, what should be done immediately?8)A)Apply a new gauze every 2 minutes.B)Squeeze down with a gloved hand.C)Apply a tourniquet.D)Insert two large-bore IVs.Answer:CExplanation:A)B)C)D)9)A comprehensive head-to-toe exam to find additional injuries possibly missed during the primarysurvey is the ITLS:9)A)primary survey.B)focused exam.C)ongoing exam.D)secondary survey.Answer:DExplanation:A)B)C)D)2

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10)An exam used when there is an isolated injury and that is limited to the area of injury is called a(n):10)A)focused exam.B)secondary survey.C)primary survey.D)ongoing exam.Answer:AExplanation:A)B)C)D)11)When you percuss the chest and hear hyperresonance, the patient may have a:11)A)cardiac tamponade.B)pulmonary contusion.C)pneumothorax.D)hemothorax.Answer:CExplanation:A)B)C)D)12)What does DCAP abbreviate?12)A)Deformities, compressions, abrasions, penetrationsB)Deformities, contusions, avulsions, puncturesC)Depressions, contusions, abrasions, penetrationsD)Deformities, contusions, abrasions, penetrationsAnswer:DExplanation:A)B)C)D)13)Ideally, the ITLS primary survey should take less than:13)A)3 minutes.B)4 minutes.C)2 minutes.D)5 minutes.Answer:CExplanation:A)B)C)D)14)All of the following are part of the ITLS ongoing exam EXCEPT:14)A)check interventions.B)vital signs.C)recheck monitors.D)general impression.Answer:DExplanation:A)B)C)D)3

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15)What type of maneuver should be used to open the airway of a suspected trauma patient?15)A)Jaw thrustB)HyperextensionC)Head tiltD)Chin liftAnswer:AExplanation:A)B)C)D)16)Which of the following would be considered a normal end-tidal CO2?16)A)35B)30C)20D)25Answer:AExplanation:A)B)C)D)17)During the formation of the general impression of your trauma patient, what does the first "C" inC-A-B-C stand for?17)A)Control bleedingB)CompressionC)CirculationD)Care on sceneAnswer:AExplanation:A)B)C)D)18)If a patient is responsive to your voice only, makes incomprehensible sounds, and withdraws frompain, the GCS is:18)A)7.B)9.C)11.D)5.Answer:BExplanation:A)B)C)D)19)If you have to move a patient, but she shouldn't be logrolled, it is best to use a:19)A)short backboard.B)scoop stretcher.C)long backboard.D)vacuum splint.Answer:BExplanation:A)B)C)D)4

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20)An abbreviated exam to determine changes in a patient's condition is called the ITLS:20)A)focused exam.B)primary survey.C)ongoing exam.D)secondary survey.Answer:CExplanation:A)B)C)D)21)The brief exam to find immediately life-threatening conditions is called the ITLS:21)A)ongoing exam.B)secondary survey.C)focused exam.D)primary survey.Answer:DExplanation:A)B)C)D)22)Procedures such as splinting, insertion of IV lines, and bandaging should be performed:22)A)just before the end of the focused exam.B)during the beginning of the ongoing exam.C)in a manner so as not to delay transport.D)as problems are detected in the primary survey.Answer:CExplanation:A)B)C)D)23)What is the normal range of ventilations for an adult?23)A)25 to 50B)6 to 10C)15 to 30D)10 to 20Answer:DExplanation:A)B)C)D)24)What does BLS abbreviate?24)A)Breaks, lividity, swellingB)Burns, lacerations, stabilityC)Burns, lacerations, swellingD)Bones, loose joints, severe painAnswer:CExplanation:A)B)C)D)5

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ExamName___________________________________MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)How do you determine minute volume?1)A)Pulse times stroke volumeB)Tidal volume times breathing rateC)Cardiac output times vascular resistanceD)Breathing rate times pulseAnswer:BExplanation:A)B)C)D)2)Which of the following is considered a blind insertion airway device?2)A)NPAB)LMAC)OPAD)SALTAnswer:BExplanation:A)B)C)D)3)What does the mnemonic MMAP represent?3)A)Mandible/maxilla ratio, 331 measurement, atlanto-occipital junction, pathologyB)Mallampati, 331 measurement, aspiration potential, pathologyC)Mallampati, 331 mortality, atlanto-occipital junction, pathologyD)Mallampati, 331 measurement, atlanto-occipital junction, pathologyAnswer:DExplanation:A)B)C)D)4)Respiration is defined as:4)A)the movement of air or gas in and out of the lung passages.B)the process of exhalation and inhalation through the pharynx.C)the exchange of oxygen and carbon dioxide at the alveoli.D)the contraction of the diaphragm and intercostal muscles.Answer:CExplanation:A)B)C)D)5)All of the following are potential airway obstructions EXCEPT the:5)A)hyoid bone.B)tongue.C)teeth.D)epiglottis.Answer:AExplanation:A)B)C)D)1

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6)What are two of the greatest threats to a patent airway?6)A)Vomiting and aspirationB)Laryngospasm and epiglottis relaxationC)Tracheal stenosis and burnsD)Mucous and oropharyngeal spasmAnswer:AExplanation:A)B)C)D)7)Which piece of equipment is considered the gold standard of airway care in patients who cannotprotect their airways or in those needing assistance with breathing?7)A)Endotracheal tubeB)Tracheostomy tubeC)Combitube®D)King LTDAnswer:AExplanation:A)B)C)D)8)Which of the following can be used to reduce the risk of gastric regurgitation during the process ofintubation?8)A)TransilluminationB)Direct visualizationC)Sellick maneuverD)Faster ventilationAnswer:CExplanation:A)B)C)D)9)Where does the airway end?9)A)Glottic openingB)Tertiary bronchiolesC)Alveolocapillary membraneD)Mainstem bronchiAnswer:CExplanation:A)B)C)D)10)The potential space between the internal chest wall and the lung surface is known as a/the:10)A)glottic passage.B)pleural space.C)sternal margin.D)pneumothorax.Answer:BExplanation:A)B)C)D)2

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11)Which type of ventilation is the MOST reliable and effective method when following StandardPrecautions?11)A)Bag-valve mask deviceB)FROPVDC)Mouth-to-maskD)Mouth-to-mouthAnswer:CExplanation:A)B)C)D)12)What is rapidly becoming the gold standard for monitoring proper endotracheal tube placement?12)A)Observing cm mark at the teethB)Invasive arterial linesC)Waveform capnographyD)Pulse oximetryAnswer:CExplanation:A)B)C)D)13)A simple face mask running at 10 to 12 liters per minute will supply which of the following oxygenconcentrations?13)A)40 to 50 percentB)60 to 90 percentC)80 to 100 percentD)50 to 65 percentAnswer:AExplanation:A)B)C)D)14)Which of the following is an abnormal end-tidal CO2reading?14)A)45B)35C)40D)50Answer:DExplanation:A)B)C)D)15)What mechanism causes the lungs to expand and air to rush into the airway?15)A)Expansion of the chest wall and upward movement of the diaphragmB)Relaxation of the chest wall and upward movement of the diaphragmC)Expansion of the chest wall and downward movement of the diaphragmD)Relaxation of the chest wall and downward movement of the diaphragmAnswer:CExplanation:A)B)C)D)3

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16)Abnormally high levels of this gas in the bloodstream can potentially lead to increased intracranialpressure.16)A)Carbon dioxideB)OxygenC)ArgonD)NitrogenAnswer:AExplanation:A)B)C)D)17)Manipulating the thyroid cartilage and helping to bring vocal cords into view during intubation iscalled:17)A)esophageal closure.B)Sellick pressure.C)external laryngeal manipulation.D)cricoid shift.Answer:CExplanation:A)B)C)D)18)Which of the following volumes is within the normal range for tidal volume?18)A)1000 mlB)700 mlC)500 mlD)300 mlAnswer:CExplanation:A)B)C)D)19)The ability of the lungs and chest wall to expand and therefore ventilate a patient is known as:19)A)respiration.B)expansion.C)ventilation.D)compliance.Answer:DExplanation:A)B)C)D)20)Predicting a difficult bag-valve mask seal uses which of the following mnemonics?20)A)MMAPB)SALTC)BOOTSD)FROPVDAnswer:CExplanation:A)B)C)D)4

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21)Which of the following will provide 100 percent oxygen at a flow rate of 40 liters per minute?21)A)Flow-restricted oxygen-powered ventilation deviceB)Transtracheal jet insufflator deviceC)Bag-valve mask deviceD)Demand-valve oxygen-powered ventilation deviceAnswer:AExplanation:A)B)C)D)22)A patient suffering from head trauma may have a hypoxic brain and:22)A)a low level of carbon dioxide.B)a high level of carbon monoxide.C)a high level of carbon dioxide.D)a low level of carbon monoxide.Answer:CExplanation:A)B)C)D)23)The use of paralytic agents to quickly facilitate tube placement and to minimize the risk ofaspiration is termed:23)A)rapid sequence intubation.B)rapid anesthetic airway protection.C)rapid medication induction.D)rapid endotracheal tube placement.Answer:AExplanation:A)B)C)D)24)What is the mnemonic for the procedure of inserting a special cannula through the cricothyroidmembrane to provide ventilation and oxygenation when the airway cannot be maintained becauseof obstruction?24)A)BIADB)TLJVC)FROPVDD)RSI ETAnswer:BExplanation:A)B)C)D)25)What is the best way to lessen trauma to the turbinates during the insertion of a nasopharyngealairway?25)A)Do not use any lubricant, as it causes irritation.B)Point the bevel away from the septum.C)Use a twisting and upward motion.D)Slide it along the floor of the nasal cavity.Answer:DExplanation:A)B)C)D)5

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ExamName___________________________________MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)Your patient who was in a head-on MVC has asymmetric blood pressure measurements in theupper extremities, widened pulse pressure, and diminished lower extremity pulses. You suspect:1)A)traumatic asphyxia.B)neurogenic shock.C)cardiac contusion.D)tear of the aorta.Answer:DExplanation:A)B)C)D)2)What is the appropriate treatment regimen for a suspected hemothorax?2)A)Oxygen, IV fluids to maintain a peripheral pulse, transportB)IV fluids to increase output, cardiac monitor, pericardiocentesisC)Ventilation, needle decompression, IV fluid wide openD)Intubation, stabilization of the chest wall, manage shockAnswer:AExplanation:A)B)C)D)3)The best initial intervention for an open pneumothorax is:3)A)needle decompression, second intercostal space.B)applying an occlusive dressing taped on four sides.C)sealing the wound with a gloved hand.D)rapid recognition and transportation.Answer:CExplanation:A)B)C)D)4)The thoracic injury resulting in hemorrhage into lung parenchyma secondary to blunt force traumaor penetration injury is a(n):4)A)tension pneumothorax.B)pulmonary contusion.C)tracheal/bronchial tear.D)esophageal disruption.Answer:BExplanation:A)B)C)D)1

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5)Which of the following is NOT part of Beck's triad?5)A)Jugular vein distensionB)HypertensionC)Pulsus paradoxusD)Muffled heart tonesAnswer:BExplanation:A)B)C)D)6)What should be done with impaled objects in the thorax?6)A)Leave in place, and do not stabilize, in case it needs to be removed.B)Leave in place, stabilize with bulky dressings, and maintain airway.C)Remove to do a complete assessment of the lung sounds.D)Remove the object; cover opening with an occlusive dressing.Answer:BExplanation:A)B)C)D)7)Which of the following is a sign of a tension pneumothorax?7)A)There is hyperresonance to percussion on the affected side.B)The trachea deviates away from the injured side of the thorax.C)Jugular veins in the neck are flat and nondistended.D)There is hypertension and the associated change in breathing pattern.Answer:AExplanation:A)B)C)D)8)How large does a typical open wound to the thorax have to be to cause air to be drawn into thechest?8)A)1 cmB)2 cmC)>3 cmD)3 cmAnswer:CExplanation:A)B)C)D)9)Large flail segments are best treated with:9)A)ET intubation, assisted ventilation with PEEP.B)high doses of morphine for pain, bulky dressings.C)oxygen and continuous positive airway pressure.D)needle decompression and assisted ventilation.Answer:AExplanation:A)B)C)D)2

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10)Tissue hypoxia due to a chest injury can result from all of the following EXCEPT:10)A)ventilation/perfusion mismatch.B)pleural irritation and friction rub.C)hypovolemia from blood loss.D)pump failure from cardiac tamponade.Answer:BExplanation:A)B)C)D)11)What is the appropriate treatment regimen for a suspected tension pneumothorax?11)A)IV fluids to increase output, cardiac monitor, pericardiocentesisB)Ventilation, needle decompression, IV fluids to manage hypotensionC)Oxygen, IV fluids wide open, cardiac monitor, meds for dysrhythmiasD)Intubation, stabilization of the chest wall with dressings, manage shockAnswer:BExplanation:A)B)C)D)12)Any blunt or penetrating trauma at or below the fourth intercostal space could cause injury to:12)A)the thoracic and abdominal organs.B)the abdominal organs.C)the pelvic region.D)the thoracic organs.Answer:AExplanation:A)B)C)D)13)What is the one injury that is certain to result from a flail chest?13)A)Pulmonary contusionB)Bronchial tree injuryC)Traumatic aortic ruptureD)Myocardial contusionAnswer:AExplanation:A)B)C)D)14)The traumatic condition that results in increased intrathoracic pressure, thus displacing the heartand trachea and collapsing the superior and inferior vena cava, is a:14)A)traumatic aortic rupture.B)tension pneumothorax.C)pulmonary contusion.D)massive hemothorax.Answer:BExplanation:A)B)C)D)3

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15)Immediate scene deaths usually involve which of the following thoracic injuries?15)A)Pericardial tamponadeB)Disruption of the great vesselsC)Bilateral tension pneumothoraxD)Secondary blast injuriesAnswer:BExplanation:A)B)C)D)16)What is the primary blast phase injury caused by?16)A)ChemicalsB)Air blastC)BurnsD)ShrapnelAnswer:BExplanation:A)B)C)D)17)How much blood volume can be potentially lost into the entire thoracic cavity?17)A)6000 mlB)3000 mlC)1500 mlD)4500 mlAnswer:AExplanation:A)B)C)D)18)A suspected myocardial contusion should be managed in the same way as a:18)A)traumatic aortic rupture.B)cardiac tamponade.C)pulmonary contusion.D)tracheal disruption.Answer:BExplanation:A)B)C)D)19)Which of the following is a sign associated with a hemothorax?19)A)Jugular veins in the neck are flat and nondistended.B)There is no dullness to percussion on the affected side.C)There is hypertension and the associated change in mental status.D)There is tracheal deviation to the affected side of thorax.Answer:AExplanation:A)B)C)D)4

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20)The phrenic nerve origin is what part of the spinal cord?20)A)C5 to C7B)C1 to C2C)C3 to C5D)T1 to T3Answer:CExplanation:A)B)C)D)21)The easiest way to differentiate between a tension pneumothorax and cardiac tamponade is to:21)A)look at the mechanism of injury.B)listen to breath sounds bilaterally.C)decompress the chest bilaterally.D)look at the work of breathing.Answer:BExplanation:A)B)C)D)22)The accumulation of air in the potential space between the visceral and parietal pleura secondary topenetrating injury presenting as an open wound is a(n):22)A)pleural pneumothorax.B)open pneumothorax.C)simple pneumothorax.D)closed pneumothorax.Answer:BExplanation:A)B)C)D)23)Which injury is caused by a severe compression injury to the chest, such as from a steering wheel,conveyor belt, or heavy object?23)A)Airway obstructionB)Traumatic asphyxiaC)Open pneumothoraxD)Tertiary blast injuryAnswer:BExplanation:A)B)C)D)24)Which part of the ITLS trauma assessment will identify major thoracic injuries?24)A)Ongoing assessmentB)Primary surveyC)Focused examD)Secondary surveyAnswer:BExplanation:A)B)C)D)5

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