ITLS Adult Advanced 3

Question 1

A patient with blunt thoracic trauma develops sudden cardiovascular collapse during positive pressure ventilation. What is the most likely cause?

Accepted Answer

Simple pneumothorax converting to tension pneumothorax

Answer

Positive pressure ventilation can convert a simple pneumothorax into a tension pneumothorax by forcing air through the lung injury into the pleural space, causing mediastinal shift and cardiovascular collapse.

Question 2

In ITLS Advanced, what is the Glasgow Coma Scale score for a patient who opens eyes to pain, makes incomprehensible sounds, and exhibits flexion withdrawal?

Accepted Answer

GCS 8

Answer

Eye opening to pain = 2, incomprehensible sounds = 2, flexion withdrawal = 4. Total GCS = 2 + 2 + 4 = 8.

Question 3

Which IV fluid strategy does ITLS Advanced recommend for hypotensive trauma patients with suspected internal hemorrhage?

Accepted Answer

Permissive hypotension with limited fluid boluses

Answer

ITLS Advanced recommends permissive hypotension (targeting systolic BP of 80-90 mmHg) with limited crystalloid boluses to avoid diluting clotting factors and disrupting forming clots.

Question 4

A motorcyclist has an open femur fracture with arterial bleeding. After applying a tourniquet, what is the next priority in ITLS Advanced assessment?

Accepted Answer

Continue the primary survey

Answer

After controlling life-threatening hemorrhage, the ITLS approach mandates continuing the primary survey (ABCDE) before addressing secondary concerns like splinting, IV access, or wound care.

Question 5

What finding during the ITLS detailed secondary survey would indicate a ruptured diaphragm?

Accepted Answer

Bowel sounds heard in the left chest

Answer

Bowel sounds in the chest indicate herniation of abdominal contents through a diaphragmatic rupture, most commonly on the left side where the liver does not provide protection.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS Adult Advanced 3