Structured approach MCQ

ALS for Pacific Family Medicine pre-course test.

This is an open book exam, and candidates may refer to the Youtube videos, ALS handbook, or other resources. However, candidates may not ask other candidates for their answers - this is cheating!

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* 1. Please enter your name in the textbox ...

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* 2. Which of the following is FALSE regarding a structured approach to the critically ill patient?

The structured approach involves a rapid orderly assessment.

The structured approach is based on the priorities of getting oxygen into the body, then into the blood, and then to the organs and tissues of the body.

The structured approach focuses on making a precise diagnosis followed by definitive treatment.

The structured approach consists of the primary survey, resuscitation, secondary survey and definitive treatment.

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* 3. Which of the following is FALSE regarding a structured approach to a critically ill patient?

The first step is to make a quick assessment of the scene for dangers to the rescuer, patient or bystanders.

After assessing dangers, the patient is next assessed for response to verbal and painful stimuli.

After assessing response, the airway is next assessed for patency.

After assessing the airway, breathing is next assessed for effort and effectiveness.

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* 4. Which of the following is FALSE regarding establishing a patent airway?

A foreign body obstructing the airway should be removed by finger sweep.

After excluding foreign body, head tilt/ chin lift or jaw thrust may be tried first to overcome airway obstruction.

If airway opening manoeuvres are unsuccessful, then oropharyngeal or nasopharyngeal airways may be tried next to overcome airway obstruction.

If airway adjuncts are unsuccessful, then a laryngeal mask airway may next be tried to establish a patent airway.

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* 5. Which of the following is FALSE regarding advanced airway interventions?

In patients who have lost their gag and cough reflexes, the only way to protect the airway is with a cuffed endotracheal or tracheostomy tube.

Endotracheal intubation is required in actual or impending airway obstruction due to burns, trauma, anaphylaxis or infection.

Endotracheal intubation is required for transporting patients not responding to verbal stimuli.

Surgical airway is required for patients who can't be intubated.

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* 6. Which of the following is FALSE regarding the primary survey of the critically ill patient?

To determine whether or not a patient is breathing, the rescuer looks for chest movement, and listens and feels for air movement at the nose and mouth for up to 10 seconds.

If the patient is found to be breathing, next the circulation should be assessed by examining the pulse, BP and capillary refill.

Capillary refill should be assessed by pressing over the sternum for 5 seconds and then observing the capillary refill time.

A capillary refill time greater than 5 seconds is delayed, indicating poor tissue perfusion.

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* 7. Which of the following is FALSE regarding the primary survey of the critically ill patient?

After the circulation has been assessed and managed, next neurological disability assesses the level of consciousness and pupil size and reaction.

After the assessment of neurological disability, the critically ill patient should next be undressed to allow the examination of all remaining areas.

After examining all remaining areas, next the patient should be assessed for any conditions in the SHAVED acronym which would then require interventions.

Once the primary survey is complete, next the secondary survey aims to reach a definitive diagnosis.

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* 8. Which of the following is FALSE regarding critically ill children?

Children have greater physiological reserves and are less likely to suddenly crash from hypoxia, shock, and acidosis.

When the exact weight isn't known, a reasonable calculation for children over 12 months of age is:
(Age + 4) multiplied by 2.

A calculation for the endotracheal tube size is:
(Age divided by 4) plus 4.

The initial fluid bolus to use in shock is:
20 mls per kg.

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* 9. Which of the following is FALSE regarding the trauma patient?

The trauma patient should be assessed using the sequence of primary survey, resuscitation, secondary survey and definitive treatment.

In the trauma patient, the cervical spine must be protected in accordance with local or state guidelines.

In the trauma patient, the cervical spine should be protected as soon as the airway, breathing and circulation have been assessed, until it has been cleared by clinical and radiological examination.

When exposing the trauma patient for a wider examination, the log roll should be used to examine the patient's back, and to transfer the patient on or off a spinal board.