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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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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 10-
15 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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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 (<4mm) reactive pupils had a good chance of survival
35. Which of the following concerning blast injury is true?
Secondary blast injury is caused by objects propelled by the explosion (shrapnel)
36. The purpose of ITLS primary survey is to: Identify all immediate life threats within the first 2 mins.
37. Which of the following would be the most compelling reasons to intubate?:Inability to ventilate
38. The depth of the ET tube at the teeth should be approximately _____ times the diameter of the tube? :3
Rationale: The mark on the tube that is even with the teeth should be three times the diameter of the ET tube. Thus,
an 8.0mm tube in an adult should be at 24cm
39. During transport, a trauma PT develops shallow and rapid breathing, cyanosis and a weak, rapid carotid pulse
with distended neck beings and diminished breath sounds on the right, you should: Decompress the chest
40. A 23yo F fell from a 2nd floor balcony. Upon, you find her lying in the grass. She responds to verbal commands
and your assessment reveals flat neck veins, and normal chest, abdomen and pelvis examinations. Her skin is cool,
clammy and ashen; respirations are rapid and shallow; radial pulses are too rapid to count and thready. You place
her on the heart monitor and it shows a wide-complex tachycardia of about 280/min. You should suspect:
Cardiogenic shock
Rationale: If cardiac output falls (either due to dropping or a very fast HR or lowered stroke volume) blood pressure
will fall
41, Which of the following is the correct orientation for inserting an IO needle to the proximal tibia?
Medial to the midline, avoiding the growth plate
42. Barbituates should not be administered as a sedative for the head-injured PT because they, Decrease BP
43. In which situation should an Emergency Rescue be preformed? Sudden release of toxic fumes
44. Which of the following is the most common cause of abdominal trauma? Blunt force trauma
45. a 16yoF receives 25% partial thickness thermal burns. You should: Cool the burn and protect from heat loss
46. Proper immobilization of a forearm fracture includes splinting the: Wrist, Elbow and Flex site
Rationale: Use a splint that will immobilize one joint above and one joint below the injury site
47. A 3yoM fell 9 feet. He has decreased LOC and is making persistent "grunting" sounds with respirations. Your
initial treatment is to: Provide ventilatory support with supplementary O2
48. A 78yoF driver struck a parked car while she was traveling at a low rate of speed. She is complaining of shortness
of breath and chest pain. You assessment and treatment should include: Breath sounds, Hx, & EKG
Rationale: All elderly PTs should have cardiac monitoring, pulse oximetry and capnography
49. When transporting a 3rd trimester pregnant trauma PT in spinal motion restriction, you should:
Tilt or rotate the board or PT 15-30 degrees to the left.
Rationale: Supine hypotension syndrome causes acute hypotension due to decreased venous return. Usually occurs
when PTs are in a supine position with a 20+ week uterus. The transport of all pregnant trauma PTs to alleviate vena
cava compression: Tilt/rotate board 15-30 degrees to PT left
Elevate R hip 4-6 inches with a towel and manually displace the uterus to the left
50. Which of the following statements regarding SPO2 is correct?

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You should try to maintain a pulse oximeter reading of 95% or higher in your trauma PT

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1. Upon arrival at a trauma scene, you should complete a(n):Scene Size-up pg 2

A. Initial assessment
B. Scene size-up
C. Rapid trauma survey
D. ITLS ongoing exam

2. Prolonged scene times may reflect:Ineffective team collaboration/pg 34

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/pg 79
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 pg 161
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-pg 131
A. Place a cervicle colar
B. Intubate
C. Administer Oxygen at 8 lpm
D. Stabilze the chest wall
• Decompress the chest if needed.
summary • Load and go to appropriate level of care.
Chest injuries are common in multiple-trauma patients. Many of the • Obtain venous access.
injuries are life threatening. If you follow the ITLS Primary Survey, you
• Transport to appropriate level of care.
will be able to identify most of them. These are often load-and-go • Notify medical direction.
patients. Primary goals in treating the patient The thoracic injuries discussed are life threatening, but treatable by
with chest trauma are the following: prompt intervention and transport to the appropriate level of care.
• Ensure an open airway while protecting the cervical spine.
Early recognition along with appropriate interventions and rapid
• Administer high-flow oxygen and ventilate if necessary. transport may be life saving.
• Stabilize flail segments.
- Seal sucking chest wounds.
“high-flow oxygen (at least 12 liters per minute)”
Remember that intubation and positive pressure ventilation are the best way to stabilize a flail chest, but they may be very difficult
in the field if the patient still has a gag reflex. Drug-assisted intubation (DAI) is useful here if available. Also keep in mind that a
pneumothorax and pulmonary contusions are associated with a flail chest. Be alert for development of tension pneumothorax
and/or hypoxia.

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. -pg 178
A. The patient must be in the supine position

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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
Intra-Cranial Pressure ?BP 170/100, P 50-pg 193
A. BP 170/100 P50
B. BP 80/60 P130
C. BP 80/60 P50
D. BP 170/100 P130
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-pg 219
A. PT should be remove from the long spine board when it is safe and practical to do so
B. Neck traction should be applied to extend the neck upward during cervical collar application
C. Remaining on the board for prolonged periods can produce discomfort, pressure sore, and respiratory compromise
D. A long back board is not indicated in penetrate wounds of torso, neck, or head unless there is a clinical evidence of a
spine injury
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? Prepare
PT for transport & establish vascular access during transport.pg 259
A. Irrigate any protruding organs or viscera and gently push back into the wound
B. Pack the wound with a haemostatic agent and perform complete SMR
C. Cover any protruding organs or viscera with gauze moistened with a hypertonic dextrose solution
D. 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-pg 274
A. Apply a tourniquet proximal to the injury site
B. Administer sodium bicarbonate
C. Administer a pain management medication
D. Apply a traction splint
11. Establishing vascular access on scene is indicated:To administer medication-pg 311
A. To initiate fluid resuscitation based on the Parkland Formula
B. To administer medication
C. To cool a thermal burn
D. To dilute a chemical burn
12. Which of the following changes is most useful to monitor in the child with head injury?Level of consciousness-pg342
A. Frequency of vomiting

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B. Level of consciousness
C. Reflexes
D. Sensory exam

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-pg 353
A. Edema of the lower extremities
B. Hypotension
C. Lost of lung tissue elasticity
D. Decrease peripheral vision
14. A 31yo female was the restrained driver of a vehicle that hit a utility pole at moderate speed. The driver’s side airbag deployed.
She is A/O & anxious. She reports that she is 8mo pregnant and complains of abdominal, chest and lower extremity pain. Her
vital signs are BP 100/60, P 90, R 20. Your impression and interventions are:
A. Early signs of shock treated with oxygen, fluid administration at “keep open” rate
B. Anxiety treated with emotional support and transport
C. Normal vital signs, no intervention required except transport
D. Comensation shock treated with oxygen, fluid administration at 20ml/kg
Early signs of shock. Treat with O2, fluid administration, at "keep open" rate.-pg363
Rationale: Do not mistake normal vital signs in pregnant PTs. The pregnant PT has a normal resting pulse that is 10-15 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-pg373
A. Have the patient call a friend or family member and have them drive him home and sleep it off
B. Discuss the impact of alcohol abuse with him
C. Treat him as a head injured patient
D. Wait until the patient loses consciousness and then transport
16. What is the most common cause of cardiopulmonary arrest in the trauma PT?-Hypoxemia-pg 381
A. Brain injury
B. Hypoxemia
C. Myocardial contusion
D. Ventricular arrhythmia
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-Pg 404
A. Seek treatment within hours of the exposure
B. Report the exposure if testing shows a positive result
C. Only be concerned if the exposure was to hepatitis B
D. Only be concerned if the exposure was to HIV
18. A 24 yo male is involved in a head on collision. If you suspect:=A chest injury, obtain an EKG=pg10
Rationale: Consider a bruised chest wall as a myocardial contusion that requires monitoring of cardiac rhythm and, if available,
a 12-lead ECG
A. Lower leg INJ, administer fluid resuscitation at 20 mL/kg
B. An abdominal INJ, administer analgesia
C. A head INJ, administer an anti-seizure medication
D. A chest INJ, obtain EKG
19. A brief neurologic exam of an AMS pt includes:GCS, glucose check, pupil exam-pg 39
A. GCS, glucose check , pupil examination
B. Glucose check, pulse oximetry, pupil examination
C. GCS, corneal reflex, ETCO2
D. Corneal reflex, pupl examination, pulse / motor / sensory
20. Which of the following findings would indicate the airway needs to be suctioned?
Gurgling sounds with respiration=pg 73
A. Gurgling sounds with respiration
B. Poor respiratory effort
C. Shock

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D. Presence of dried blood in the nares

21. Overinflation of an LMA mask can cause all of the following accept: Vomiting-pg 99
Rationale: Overinflation may cause malposition, loss of seal or trauma
A. Malposition
B. Vomiting
C. Loss of seal
D. 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-pg 139
Rationale: Bruising of the heart is basically the same injury as an acute MI
A. Cardiac contusion
B. Traumatic aortic rupture
C. Flail chest
D. Tension pneumothorax
23. Which of the following is NOT a potential complication of performing chest decompression?
Difficulty monitoring the site. -pg 146-148
A. Blood vessel laceration
B. Difficult in monitoring the site
C. Nerve damage
D. Causing pneumothorax
24. Which of the following is considered one of the four essential components to maintain normal perfusion?:Fluid levels-pg 154
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
A. Serum lactate levels
B. ETCO2
C. SàO2 level
D. Fluid levels
25. What site is generally the easiest to landmark for IO access?:Proximal Tibia-pg 179
A. Proximal tibia
B. Distal humerus
C. Proximal femur
D. Distal fibula
26. As ICP rises after an isolated head injury, what does the systolic BP do?:Increases-pg 193
A. Stays the same
B. Decreases
C. Increases
D. Change randomly
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 -pg 221
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
A. 14-year-old with an isolated stab wound to the midaxillary chest wall
B. 24-year-old with a gun shot 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
28. Which of the following organs sic obtained in the retroperitoneal region of the abdomen?-Kidney-pg 257
A. Stomach
B. Liver
C. Kidney
D. Uterus
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-pg 286
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.

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A. NSS intravenous fluids only

B. Sodium bicarbonate and intravenous fluids
C. 5% Dextrose intravenous fluids
D. Calcium chloride and tourniquet application
30. A 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.
A. Apply ice to burned areas until cool to the touch
B. Apply clean water to burned area for up to 5-10 minutes
C. Apply ice water to burned areas until cool to the touch
D. Do not apply anything to burned areas other than clean sheets
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-pg 334
A. Initiate ventilator assistance
B. Complete spinal motion restriction
C. Immediately load and transport
D. Call medical command
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-pg 353
A. Elderly patients are less likely to bleed internally than younger patients
B. Elderly patients have better outcome following burns than youngers patients
C. Fatal outcomes are more likely in the Elderly patients than in the young
D. Motor vehicle collisions are an uncommon mechanism of INJ
33. Supine hypotension syndrome is the pregnant PT is caused by?Uterine obstruction of venous bloodflow=pg364
Rationale: In supine hypotension syndrome, the hypotension is caused by the weight of the pregnant uterus pressing on the
inferior vena cava and decreasing the return of blood flow to the heart b 30%
A. Uterine obstruction of venous blood flow
B. Atelectasis of the lungs
C. Uterine pressure on the vagal nerve
D. Gastric reflux
34. Which of the following has a greater chance of surviving traumatic cardiopulmonary arrest?
PTs with non-dialated pupils-pg 380
Rationale: Trauma PTs who presented unconscious, without palpable pulse or spontaneous respiration, found that PTs with
Sinus rhythm and non-dialated (<4mm) reactive pupils had a good chance of survival
A. Patients who suffer blunt force trauma to the torso
B. PT with non-dilated pupils
C. PTs with dilated unresponsive pupils
D. PTs with penetrating chest trauma who are hypothermic
35. Which of the following concerning blast injury is true?
Secondary blast injury is caused by objects propelled by the explosion (shrapnel)-pg 24
A. Primary blast injury is caused by heat
B. Secondary blast INJ is caused by objects propelled by the explosion
C. Tertiary blast INJ is caused by toxic fumes
D. Quaternary blast INJ is cuased by the displacement of the body
36. The purpose of ITLS primary survey is to:Identify all immediate life threats within the first 2 mins.-pg34
A. Identify all immediately life threats within the first 2 minutes
B. Establish measured baseline vital signs
C. Obtain a detailed medical history
D. Determine if the patient has any medical allergies
37. Which of the following would be the most compelling reasons to intubate?Inability to ventilate=pg83
A. Snoring respirations
B. Gurgling respirations
C. Inability to ventilate
D. Traumatic arrest

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38. The depth of the ET tube at the teeth should be approximately _____ times the diameter of the tube?3/pg 104
Rationale: The mark on the tube that is even with the teeth should be three times the diameter of the ET tube. Thus, an 8.0mm
tube in an adult should be at 24cm
A. 2
B. 3
C. 4
D. 5
39. During transport, a trauma PT develops shallow and rapid breathing, cyanosis and a weak, rapid carotid pulse with distended
neck beings and diminished breath sounds on the right, you should:
Decompress the ® chest
A. Intubate the patient
B. Decompress the Rt chest
C. Perform a pericadiocentesis
D. Establish intravenous access
40. A 23yo F fell from a 2nd floor balcony. Upon, you find her lying in the grass. She responds to verbal commands and your
assessment reveals flat neck veins, and normal chest, abdomen and pelvis examinations. Her skin is cool, clammy and ashen;
respirations are rapid and shallow; radial pulses are too rapid to count and thready. You place her on the heart monitor and it
shows a wide-complex tachycardia of about 280/min. You should suspect:-Cardiogenic shock-pg154
Rationale: If cardiac output falls (either due to dropping or a very fast HR or lowered stroke volume) blood pressure will fall
A. Hypovolemic shock
B. Relative hypovolemic (high-space) shock
C. Mechanical (obstructive) shock
D. Cardiogenic shock
41. Which of the following is the correct orientation for inserting an IO needle to the proximal tibia?
Medial to the midline, avoiding the growth plate-pg 179
A. Medial to the midline, avoiding the growth plate
B. Medial to the midline, pointing toward the growth plate
C. Lateral to the midline, avoiding the growth plate
D. Lateral to the midline, pointing toward the growth plate
42. Barbituates should not be administered as a sedative for the head-injured PT because they,Decrease BP=pg 205
A. Decrease BP
B. Increase ICP
C. Increase the likelihood of seizures
D. Increase cerebral oxygen demand
43. In which situation should an Emergency Rescue be preformed?=Sudden release of toxic fumes-pg 218
A. Leaking antifrezze from a vehicle radiator
B. Amputated upper extremity
C. Sudden release of toxic fumes
D. Third trimester pregnant PT
44. Which of the following is the most common cause of abdominal trauma?:Blunt force trauma-pg 257
A. Blunt force trauma
B. Caustic ingestion
C. Aggressive bag-mask ventilation
D. Penetrating trauma
45. a 16yoF receives 25% partial thickness thermal burns. You should:Cool the burn and protect from heat loss=pg 311
A. Clean and cover the burns with an antimicrobial sheet
B. Clean and apply ice packs to the burned area
C. Cool and then protect from heat loss
D. Apply burn cream
46. Proper immobilization of a forearm fracture includes splinting the:Wrist, Elbow and Fx site-pg 274
Rationale: Use a splint that will immobilize one joint above and one joint below the injury site
A. Elbow and fracture site
B. Fracture site only
C. Wrist and fracture site
D. Wrist, elbow and fracture site

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47. A 3yoM fell 9 feet. He has decreased LOC and is making persistent "grunting" sounds with respirations. Your initial treatment
is to:Provide ventilatory support with supplementary O2-pg 334
A. Apply a cervical collar and transport immediately
B. Suction the patient and apply oxygen with a nasal cannula
C. Provide ventilatory support with supplementary oxygen
D. Quickly complete a rapid trauma survey
48. A 78yoF driver struck a parked car while she was traveling at a low rate of speed. She is complaining of shortness of breath
and chest pain. You assessment and treatment should include:Breath sounds, Hx, & EKG=pg 356
Rationale: All elderly PTs should have cardiac monitoring, pulse oximetry and capnography
A. Breath sounds, history, place in a position of comfort
B. Breath sounds, history, EKG
C. Breath sounds, history, nitroglycerines administration
D. Breath sounds, history, aspirin administration
49. When transporting a 3rd trimester pregnant trauma PT in spinal motion restriction, you should:
Tilt or rotate the board or PT 15-30 degrees to the left.=pg 364
Rationale: Supine hypotension syndrome causes acute hypotension due to decreased venous return. Usually occurs when
PTs are in a supine position with a 20+ week uterus. The transport of all pregnant trauma PTs to alleviate vena cava
compression:Tilt/rotate board 15-30 degrees to PT left
Elevate R hip 4-6 inches with a towel and manually displace the uterus to the left
A. Initial IV fluids at 20ml/kg
B. Tilt or rotate the board or patient 15-30 degrees to the left
C. Manually displace the uterus to the right
D. Secure the PT in the left lateral recumbent position
50. Which of the following statements regarding SPO2 is correct?
You should try to maintain a pulse oximeter reading of 95% or higher in your trauma PT=pg 92
A. An SpO2 reading of 90% is equivalent to a PAO2 reading of 90 mmHg
B. As a general rule, any pulse oximeter reading below 95% is cause for concern
C. You should try to maintain a pulse oximeter reading of 95% or higher in your trauma PT
D. SpO2 is unreliable in trauma PTs and has no value in their assessment

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