Post-Test-ATLS 2021

SOAL 1 1. To establish a diagnosis of shock, systolic blood pressure must be below 90 mm Hg. the presence of a closed head injury should be excluded. acidosis should be present by arterial blood gas analysis. the patient ...

SOAL 1 1. To establish a diagnosis of shock, systolic blood pressure must be below 90 mm Hg. the presence of a closed head injury should be excluded. acidosis should be present by arterial blood gas analysis. the patient must fail to respond to intravenous fluid . clinical evidence of inadequate organ perfusion must be present. 2. During resuscitation, which one of the following is the most reliable as a guide to volume replacement? Pulse rate Hematocrit Blood pressure Urinary output Jugular venous pressure 3. Twenty-seven patients are seriously injured in an aircraft accident at a local airport. The basic principle of triage should be to treat the most severely injured patients first. establish a field triage area directed by a doctor. rapidly transport all patients to the nearest appropriate hospital. treat the greatest number of patients in the shortest period of time. produce the greatest number of survivors based on available resources. 4. A 5-year-old boy is struck by an automobile and brought to the emergency department. He is lethargic, but withdraws purposefully from painful stimuli. His blood pressure is 90 mm Hg systolic, heart rate is 140 beats per minute, and his respiratory rate is 36 breaths per minute. The preferred route of venous access in this patient is percutaneous femoral vein cannulation ATLS cutdown on the saphenous vein at the ankle. intraosseous catheter placement in the proximal tibia. percutaneous peripheral veins in the upper extremities. central venous access via the subclavian or interna1 jugular vein. 5. During an altercation, a 32-year-old man sustains a gunshot wound to the right upper hemithorax, above the nipple line with an exit wound posteriorly above the scapula on the right. He is transported by ambulance to a community hospital. He is endotracheally intubated, closed tube thoracostomy is performed, and 2 liters of Ringer's lactate solution are infused through 2 large-caliber IVs. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% 02). The most appropriate next step in managing this patient is celiotomy. diagnostic peritoneal lavage. arterial blood gas determination. administer packed red blood cells. chest x-ray to confinn tube placement. 6. A 32-year-old man is brought to the hospital unconscious with severe facial injuries and noisy respirations after an automobile collision. In the emergency department, he has no apparent injury to the anterior aspect of his neck. He suddenly becomes apneic, and attempted ventilation with a face mask is unsuccessful. Examination of his mouth reveals a large hematoma of the pharynx with loss of normal anatomic landmarks. Initial management of his airway should consist of inserting an oropharyngeal airvvay. inserting a nasopharyngeal airway. performing a surgical cricothyroidotomy. performing fiberoptic-guided nasotracheal intubation. performing orotracheal intubation after obtaining a lateral c-spine x-ray. 7. The response to catecholamines in an injured, hypovolemic pregnant woman can be expected to result in placental abruption. fetal hypoxia and distress. fetal/maternal dysrhythmia. improved uterine blood flow. increased maternal renal blood flow. 8. all of the following signs on the chest x-ray of a blunt injury victim may suggest aortic rupture EXCEPT : A. Mediastinal emphysema B. Presence of a “pleural cap” C. Obliteration of the aortic knop D. Deviation of the trachea to the right E. Depression of the left mainstem bronchus 9.A 17-year-old helmeted motorcyclist is struck broadside by an automobile at an intersection. He is unconscious at the scene with a blood pressure of 140/90 mm Hg, heart rate of 90 beats per minute, and respiratory rate of 22 breaths per minute. His respirations are sonorous and deep. His GCS score is 6. Immobilization of the entire patient may include the use of all the following EXCEPT air splints. bolstering devices. a long spine board. a scoop-style stretcher. a semirigid cervical collar 10.A 30-year-old man is struck by a car traveling at 56 kph (35 mph). He has obvious fractures of the left tibia near the knee, pain in the pelvic area, and severe dyspnea. His heart rate is 180 beats per minute, and his respiratory rate is 48 breaths per minute with no breath sounds heard in the left chest. A tension pneumothorax is relieved by immediate needle decompression and tube thoracostomy. Subsequently, his heart rate decreases to 140 beats per minute, his respiratory rate decreases to 36 breat