ATLS Test 1 Latest with Complete Solution
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his
...
ATLS Test 1 Latest with Complete Solution
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for decreased left chest breath sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the most appropriate next step is:
Select one:
a.
reexamine the chest
b.
perform an aortogram
c.
obtain a CT scan of the chest
d.
obtain arterial blood gas analyses
e.
perform transesophageal echocardiography -Answer- A) Reexamine the chest
A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. In the emergency department, he is alert, vital signs are normal, and he is complaining of severe pain in both heels and his lower back. Lower extremity pulses are strong and there is no other deformity. The suspected diagnosis is most likely to be confirmed by:
Select one:
a.
angiography
b.
compartment pressures
c.
retrograde urethrogram
d.
Doppler ultrasound studies
e.
complete spine x-ray series -Answer- e) Complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient?
Select one:
a.
A patient that presents with a torso gunshot wound and is hypotensive should receive crystalloid fluid resuscitation until the blood pressure is normal
b.
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow coma scale score on reevaluation
c.
Massive transfusion is defined as transfusion of more than >10 of packed red blood cells and plasma in 24 hours
d.
When tranexamic acid is administered by pre-hospital providers a second dose is required within 24 hours
e.
Fluid resuscitation is far more important than bleeding control in trauma patients -Answer- b.
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow coma scale score on reevaluation
In managing a patient with a severe traumatic brain injury, the most important initial step is to:
Select one:
a.
Secure the airway
b.
obtain a c-spine film
c.
support the circulation
d.
control scalp hemorrhage
e.
determine the GCS score
Feedback
Your answer is corr -Answer- a.
Secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters.
Which one of the following statements applies to this patient?
Select one:
a.
His pulse pressure will be widened.
b.
His urinary output will be at the lower limits of normal.
c.
He will have tachycardia, but no change in his systolic blood pressure.
d.
An ABG would demonstrate a base deficit between -6 and -10 mEq/L
e.
His systolic blood pressure will be maintained with an elevated diastolic pressure. -Answer- d.
An ABG would demonstrate a base deficit between -6 and -10 mEq/L
The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by:
Select one:
a.
reducing the need for blood transfusion
b.
resulting in an elevated hematocrit
c.
complicating the management of closed head injury
d.
reducing the volume of crystalloid required for resuscitation
e.
increasing the volume of blood loss to produce maternal hypotension -Answer- e.
increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is:
Select one:
a.
Urine output of 0.5 mL/kg/hr
b.
normalization of blood pressure
c.
normalization of the heart rate
d.
measuring a normal central venous pressure
e.
providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid -Answer- a.
Urine output of 0.5 mL/kg/hr
The diagnosis of shock must include:
Select one:
a.
hypoxemia
b.
acidosis
c.
hypotension
d.
increased vascular resistance
e.
evidence of inadequate organ perfusion -Answer- e.
evidence of inadequate organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate management of the wound should consist of:
Select one:
a.
application of a tourniquet
b.
direct pressure on the wound
c.
packing the wound with gauze
d.
direct pressure on the femoral artery at the groin
e.
debridement of devitalized tissue -Answer- b.
direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent:
Select one:
a.
respiratory acidosis
b.
metabolic acidosis
c.
cerebral vasoconstriction with diminished perfusion
d.
neurogenic pulmonary edema
e.
shift of the oxyhemoglobin dissociation curve -Answer- c.
cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next step is:
Select one:
a.
obtain contrast angiography
b.
transfer to a higher level trauma center
c.
perform an exploratory laparotomy
d.
infuse additional crystalloid fluids
e.
Obtain transesophageal echocardiography -Answer- c.
perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE?
Select one:
a.
The fetus is in jeopardy only with major maternal abdominal trauma.
b.
Leakage of amniotic fluid is an indication for hospital admission.
c.
Indications for peritoneal lavage are different from those in the nonpregnant patient.
d.
With penetrating trauma, injury to the mother's abdominal hollow viscus is more common in late than in early pregnancy.
e.
The secondary survey follows a different pattern from that of the nonpregnant patient. -Answer- b.
Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is to:
Select one:
a.
intubate the patient
b.
assess arterial blood gases
c.
administer supplemental oxygen
d.
ascertain the need for a chest tube
e.
obtain a chest x-ray -Answer- c.
administer supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department. His pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he does moan periodically. His right arm is deformed and does not respond to pressure; however, his left hand reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS score is:
Select one:
a: 2
b: 4
c: 6
d: 9
e: 12 -Answer- d: 9
Which one of the following findings in an adult is most likely to require immediate management during the primary survey?
Select one:
a.
distended abdomen
b.
Glasgow Coma Scale score of 11
c.
temperature of 36.5°C (97.8°F)
d.
deformity of the right thigh
e.
respiratory rate of 40 breaths per minute -Answer- e.
respiratory rate of 40 breaths per minute
A 20-year-old woman that is 32 weeks gestation , is stabbed in the upper right chest. In the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath, extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The most appropriate first step is to:
Select one:
a.
perform tracheal intubation
b.
insert an oropharyngeal airway
c.
perform needle or finger decompression of the right chest
d.
manually displace the gravid uterus to the left side of the abdomen
e.
initiate 2, large-caliber peripheral IV lines and crystalloid infusion -Answer- c.
perform needle or finger decompression of the right chest
An important, immediate step in the management of an open pneumothorax is:
Select one:
a.
endotracheal intubation
b.
operation to close the wound
c.
placing a chest tube through the chest wound
d.
placement of an occlusive dressing over the wound secured on three sides
e.
initiation of 2, large-caliber IVs and infusing crystalloid solution -Answer- d.
placement of an occlusive dressing over the wound secured on three sides
Which of the following is a contraindication for tetanus toxoid administration?
Select one:
a.
history of neurological reaction or severe hypersensitivity to the product
b.
Local side effects
c.
muscular spasms
d.
pregnancy
e.
all of the above -Answer- a.
history of neurological reaction or severe hypersensitivity to the product
A 56-year-old man is thrown violently against the steering wheel of his truck during a motor vehicle crash. On arrival to the emergency department he is diaphoretic and complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per minute. Which of the following best differentiates cardiac tamponade from tension pneumothorax as the cause of his hypotension?
Select one:
a.
tachycardia
b.
pulse volume
c.
breath sounds
d.
pulse pressure
e.
jugular venous pressure -Answer- c.
breath sounds
[Show More]
.png)
.png)
