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ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 1
1. Which of the following BEST defines the “windshield survey”?
a. Looking for broken windshields on crashed vehicles.
b. Performing a scene size-up through your windshield.
c. Form a general impression of the patient.
d. Assessing the scene for hazards to you and the crew.
2. A 25-year-old female weighing 132 lbs. (60 kg.) is involved in a motor vehicle collision.
Primary survey reveals: rapid breathing, cyanosis, weak and rapid pulse, distended neck
veins, midline trachea, contusion to anterior right chest and equal breath sounds. High
flow oxygen by mask is being given. The NEXT action is to:
a. Complete spinal motion restriction and transport.
b. Stabilize right anterior chest wall.
c. Stop the assessment and immediately transport.
d. Obtain vital signs.
3. A 27-year-old man weighing 154 lbs. (70 kg) with blunt chest trauma from a motor
vehicle collision was successfully intubated at the scene. En route to the hospital, while
ventilating the patient, you note resistance with an absence of left chest wall movement.
Which of the following is MOST likely?
a. Flail chest.
b. Gastric distention.
c. Mucus obstruction.
d. Tension pneumothorax.
4. Which is the first step in trauma assessment?
a. Initial assessment.
b. Scene size-up.
c. Rapid trauma survey.
d. Vital signs.
5. The primary survey, secondary survey and scene treatment should be performed on
which of the following trauma patient presentations?
a. Altered mental status.
b. Blunt chest injury.
c. Unstable pelvis.
d. Open femur fracture.
6. Which of the following would be the MOST appropriate indication for immediate
intubation of a patient?
a. Presence of stridor.
b. Poor respiratory effort.
c. Gurgling sounds with respiration.
d. Severe head injury.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 2
7. Which finding requires interruption of the primary survey?
a. Altered mental status.
b. Inadequate respirations.
c. Airway obstruction.
d. Weak distal pulse.
8. An appropriate response for an isolated sternal injury includes which one of the
following?
a. Establish cardiac monitoring.
b. Monitor EtCO2.
c. Perform manual sternal stabilization.
d. Initiate positive pressure ventilation.
9. For the “load and go” patient, which of the following should be performed prior to
transportation?
a. Apply splint to open femur fracture.
b. Apply tourniquet to bleeding extremity.
c. Perform a secondary survey.
d. Obtain initial vital signs.
10. A five year-old girl weighing 33 lbs. (15 kg.) struck by a car is unresponsive to verbal
stimuli with obvious retractions and nasal flaring on respiration. The airway is patent,
breathing is fast and shallow, and the carotid pulse is weak and slow. Which of the
following is the NEXT appropriate treatment?
a. Ventilatory assistance.
b. Orotracheal intubation.
c. Fluid bolus of 300 ml.
d. Thoracic needle decompression.
11. Which of the following physical findings is NOT common in cardiac tamponade?
a. Distended neck veins.
b. Narrow pulse pressure.
c. Hypotension.
d. Unequal breath sounds.
12. In a majority of head injured patients, ventilation once every 6 seconds with adequate
chest rise is:
a. An appropriate rate.
b. Too slow.
c. Too fast
d. Appropriate to hyperventilate.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 3
13. A 25-year-old woman weighing 165 lbs. (75 kg.) stabbed in the left arm presents with an
altered mental status and signs of shock. Bleeding is now controlled by direct pressure
and use of a tourniquet. Which intravenous fluid therapy is appropriate?
a. Estimate blood loss and fluid replace at a 3:1 ratio.
b. Fluid administration of 500 ml.
c. Fluid administration to maintain systolic pressure of 60 mmHg.
d. Intravenous infusion 20 ml/kg bolus, then reassess.
14. Maintenance of a minimum _______________ systolic blood pressure is required for the
adult patient with a severe head injury and a Glasgow Coma Scale of 7.
a. 80 – 90 mmHg.
b. 90 – 100 mmHg.
c. 100 – 110 mmHg.
d. 110 – 120 mmHg.
15. Which of the following is NOT an immediate life-threatening thoracic injury?
a. Tension pneumothorax.
b. Simple pneumothorax.
c. Pericardial tamponade.
d. Flail chest.
16. Which treatment is indicated for the patient who is still entrapped with an isolated crush
injury to the lower extremity?
a. Intravenous fluids only.
b. Sodium bicarbonate and intravenous fluids.
c. 5% Dextrose intravenous fluids.
d. Calcium chloride and tourniquet application.
17. Which of the following indicates a "load and go" situation?
a. Third trimester of pregnancy.
b. Extremity amputation with controlled bleeding.
c. Significant mechanism of injury.
d. Back pain with neurologic deficits.
18. The primary survey of a motorcyclist who struck a telephone pole presents as alert and
oriented with bilateral femur fractures. What is the MOST appropriate next action?
a. Complete a secondary survey.
b. Load and go.
c. Splint legs.
d. Take vital signs.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 4
19. An unresponsive trauma patient presents with respirations of 20 per minute and shallow;
radial pulse 96 per minute and slightly irregular; and skin pale, cool and diaphoretic with
a blood pressure of 128/76. Which of the following is MOST likely the problem?
a. Increased intracranial pressure.
b. Diabetic emergency.
c. Neurogenic shock.
d. Pericardial tamponade.
20. A 20-year-old female weighing 132 lbs. (60 kg.) who fell from a height of 30 ft. (9 m.)
becomes agitated with an increased respiratory rate during transport. What should you do
next?
a. Proceed to hospital with lights and siren.
b. Initiate bag mask ventilations.
c. Perform ongoing exam.
d. Repeat secondary survey.
21. Which one of the following is most reliable early indicator for determining shock in the
injured child?
a. Decreased blood pressure.
b. Skin mottling.
c. Central and distal pulse comparison.
d. Weak rapid pulse.
22. Which of the following actions would you delegate to a team member during the primary
survey?
a. Apply oxygen.
b. Determine level of consciousness.
c. Evaluate the posterior side of the patient.
d. Obtain vital signs.
23. A third trimester pregnant trauma patient becomes hypotensive after spinal motion
restriction. The next step is to:
a. Initiate infusion of intravenous fluids.
b. Tilt or rotate the board 15-30 degrees to the left.
c. Manually displace the uterus to the right.
d. Secure the patient in the left lateral recumbent position.
24. The use of external laryngeal manipulation:
a. Decreases the risk of airway trauma.
b. Reduces gastric distention.
c. Improves glottic visualization.
d. Prevents aspiration.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 5
25. Which mechanism of injury BEST meets the exclusion criteria for spinal motion
restriction?
a. 14-year-old with an isolated stab wound to the mid axillary chest wall.
b. 24-year-old with a gunshot wound to the neck.
c. 15-year-old female with extremity numbness and tingling after falling
backward.
d. 7-year-old pulled unresponsive from a pond.
26. What is the MOST frequent cause for developing poor lung compliance while ventilating
an intubated trauma patient?
a. Tracheal extubation.
b. Tension pneumothorax.
c. Gastric distention.
d. Right mainstem.
27. Hyperventilation is defined as:
a. A respiratory rate greater than 30 per minute.
b. A tidal volume of less than 400 ml.
c. An oxygen saturation greater than 98%.
d. A carbon dioxide level less than 35 mmHg.
28. By physical examination, which is the MOST reliable method of ensuring an
endotracheal tube is placed in the trachea?
a. Evaluation of breath sounds.
b. Equal chest rise and fall.
c. Visualization of tube through the cords.
d. Presence of condensation in the tube.
29. Which of the following is associated with neurogenic shock?
a. Increased pulse, cool clammy skin.
b. Increased pulse, normal skin color and temperature.
c. Decreased pulse, cool clammy skin.
d. Decreased pulse, normal skin color and temperature.
30. A 52-year-old male weighing 220 lbs. (100 kg.) was hit in the head and is unresponsive.
He has respirations of 8 per minute and shallow; radial pulse rate of 88 per minute and
regular; blood pressure 134/80; with pupils that are normal and reactive to light. The
patient should be managed with:
a. Oral intubation and assisted ventilation at a rate of 18-20/min.
b. Oral intubation with ventilation maintaining ETCO2 at 35-45 mmHg.
c. Oral intubation with ventilation maintaining ETCO2 at 30 mmHg.
d. Insertion of an oropharyngeal airway and administration of oxygen 12 L/min
non-rebreather.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 6
31. During transport a trauma patient develops shallow and rapid breathing, cyanosis and a
weak rapid carotid pulse with distended neck veins and diminished breath sounds on the
right. The MOST appropriate response to these findings is to:
a. Intubate the patient.
b. Decompress the chest.
c. Perform a pericardiocentesis.
d. Establish intravenous access.
32. A 34-year-old female weighing 165 lbs. (75 kg.) has been struck by a motor vehicle and
is found unconscious with asymmetrical chest wall movement and a flail segment on the
right. Following delegation of c-spine control and opening the airway, the NEXT
intervention should be:
a. Cervical collar placement.
b. Intubation.
c. Bag-mask ventilation.
d. Chest wall stabilization.
33. Which of the following is the preferred EtCO2 and peripheral oxygen saturation for a
patient with evidence of herniation syndrome secondary to a closed head injury?
a. EtCO2 40-45 mmHg, SpO2 90-95%.
b. EtCO2 25-30 mmHg, SpO2 95-100%.
c. EtCO2 35-45 mmHg, SpO2 95-99%.
d. EtCO2 30-35 mmHg, SpO2 95-100%.
34. Which of the following BEST distinguishes a tension pneumothorax from a simple
pneumothorax?
a. Tachycardia.
b. Shock.
c. Dyspnea.
d. Anxiety
35. An unresponsive 34-year-old man weighing 175 lbs. (80 kg.) has a gunshot wound to the
right groin area with bleeding that cannot be controlled by direct pressure. What is the
NEXT appropriate treatment for this patient?
a. Administer intravenous fluid at "wide open" rate.
b. Apply a hemostatic agent with direct pressure.
c. Open the airway and ventilate.
d. Transport immediately.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 7
36. A 23-year-old female weighing 198 lbs. (90 kg.) complains of the inability to feel her
legs after falling down a stairwell. Her respirations are rapid and shallow; radial pulses
are rapid and weak; and her skin is cool, clammy and ashen with no obvious external
bleeding. She has flat neck veins and an unstable pelvis. What type of shock is the patient
experiencing?
a. Hemorrhagic.
b. Neurogenic.
c. Hypoglycemic.
d. Psychogenic.
37. In which situation should an emergency rescue be performed?
a. Leaking antifreeze from a vehicle radiator.
b. Amputated upper extremity.
c. Sudden release of toxic fumes.
d. Third trimester pregnant patient having contractions.
38. An intubated adult trauma patient weighing 145 lbs. (65 kg.) and being ventilated at 8
times per minute with 650 cc tidal volume presents with a decreasing EtCO2 from 38
mmHg to 20 mmHg over 20 minutes. What is the MOST likely cause of this change?
a. Hypoventilation.
b. Endotracheal tube cuff failure.
c. Hyperventilation.
d. Impending circulatory collapse.
39. A 15-year-old boy weighing 130 lbs. (60 kg.) hit on the head with a baseball bat presents
as unresponsive with arms and legs extended, right pupil is dilated and fixed. Which of
the following is the MOST appropriate treatment?
a. Oropharyngeal airway, oxygen, fluid restriction.
b. Non-rebreather mask, fluid restriction, Mannitol.
c. Nasotracheal intubation, fluid resuscitation and adequate ventilation.
d. Oxygen, ventilation 20/min, intubation.
40. For a patient with an altered mental status, a brief neurologic exam includes the
following:
a. Glasgow Coma Scale, glucose check, pupil examination.
b. Glucose check, pulse oxymetry, pupil examination.
c. Glasgow Coma Scale, corneal reflex, EtCO2.
d. Corneal reflex, pupil examination, pulse/motor/sensory.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 8
41. Which of the following is the BEST position to manage the airway of a patient in spinal
motion restriction who is vomiting?
a. Remove patient from spinal motion restriction.
b. Tilt the spine board and patient to a lateral position.
c. Elevate the spine board and patient to a 20 degree head-up position and
perform suction.
d. Remain in supine position and provide continuous suction.
42. A 34-year-old man weighing 220 lbs. (100 kg.) injured in a motor vehicle collision
complains of diffuse abdominal tenderness. Vital signs are respirations 28 per minute and
shallow, a weak radial pulse of 120 per minute, and a blood pressure of 100/60.
Crystalloid fluid management for this patient would be:
a. Administer intravenous fluids at a “keep open” rate.
b. Perform an ongoing exam while your team starts a rapid extrication.
c. Complete spinal motion restriction, start ventilations as needed and transport
immediately.
d. Administer intravenous fluids at 20 ml/kg bolus and reassess.
43. A 16-year-old female weighing 110 lbs. (50 kg) receives 25% partial thickness thermal
burn. Which of the following is IMMEDIATE treatment?
a. After cleaning the burn, cover with an antimicrobial sheet.
b. Apply ice packs to burned area.
c. Cool burn area for 1-2 minutes and protect from heat loss.
d. Check patient for carbon monoxide poisoning and start high flow oxygen.
44. Which condition is MOST likely to result in permanent nerve and artery damage if not
treated immediately?
a. Shoulder dislocation.
b. Femur fracture.
c. Knee dislocation.
d. Fibula fracture.
45. A 37-year-old male weighing 154 lbs. (70 kg.) removed from a house fire is confused,
has stridor and is complaining of a headache and nausea. There is no evidence of
inhalation burns or external trauma. This patient is experiencing which of the following?
a. Laryngeal spasm.
b. Smoke inhalation.
c. Heat inhalation injury.
d. Concussion brain injury.ITLS Advanced Post-Test 7
th Edition
Revised July 01, 2012 Page 9
46. A three year-old child weighing 29 lbs. (13 kg.) has a decreased level of consciousness
after falling from a height. She is making persistent "grunting" sounds with respirations.
What is the MOST appropriate intervention?
a. Apply a cervical collar and transport immediately.
b. Suction the patient and apply oxygen via non-rebreather mask.
c. Provide ventilatory support.
d. Reposition the airway with a jaw-thrust.
47. The anterior axillary placement for a thoracic needle decompression is:
a. Below the second rib.
b. Above the fifth rib.
c. Below the fourth rib.
d. Above the fourth rib.
48. A 56-year-old man weighing 176 lbs. (80 kg.) sustains a gunshot wound to the abdomen.
Vital signs are respirations of 24 per minute, regular and shallow; absent radial pulse with
a weak carotid pulse of 136 per minute; and blood pressure of 74/42. Fluid resuscitation
is managed to achieve a target of:
a. Return of peripheral pulses.
b. Maintenance of central pulses.
c. Systolic blood pressure of 110 - 120 mmHg.
d. Alert mental status.
49. A 16-year-old male weighing 180 lbs, (82 kg.) sustained a gunshot wound to the left
chest. He complains of shortness of breath with rapid and shallow respirations, absent
radial pulses with cool, clammy and pale skin. The neck veins are distended and there is
an absence of breath sounds over the left side. What type of shock is the patient
experiencing?
a. Hemorrhagic.
b. Neurogenic.
c. Mechanical.
d. Cardiogenic.
50. You are assessing a 78-year-old female weighing 110 lbs. (50 kg.) who struck a parked
car while traveling at 20 mph (32 kph). The patient is complaining of chest pain. After
completing the initial assessment, you will perform a:
a. Rapid trauma survey.
b. Focused exam.
c. Secondary survey.
d. Ongoing exam.
This post was edited by Magnet0 on Aug 8 2013 03:57pm