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Post-Test-ATLS/SOAL POST TEST-Answered-Latest 2023
Post-Test-ATLS/SOAL POST TEST-Answered-Latest 2023 Post-Test-ATLS/SOAL POST TEST-Answered-Latest 2023 1. Cardiac tamponade after trauma a. is seldom lif... [Show More] e-threatening b. can be excluded by an upright, AP chest x-ray c. can be confused with a tension pneumothorax d. causes a fall in systolic pressure of > 15 mm Hg with expiration e. most commonly occurs after blunt injury to the anterior chest wall 2. Which one of the following statements regarding patients with thoracic spine injuries is TRUE? a. Log-rolling may be destabilizing to fractures from T-12 to L-1. b. Adequate immobilization can be accomplished with the scoop stretcher. c. Spinal cord injury below T-10 usually spares bowel and bladder function. d. Hyperflexion fractures in the upper thoracic spine are inherently unstable. e. These patients rarely present with spinal shock in association with cord injury. 3. Absence of breath sounds and dullness to percussion over the left hemithorax are fmdings best explained by a. Left hemothorax. b. c. d. e. f. g. cardiac contusion h. left simple pneumothorax i. left diaphragmatic rupture j. right tension pneumothorax. 4. A young man sustains a gunshot wound to the abdomen and is brought promptly to the emergency department by prehospital personnel. His skin is cool and diaphoretic, and he is confused. His pulse is thready and his femoral pulse is only weakly palpable. The defmitive treatment in managing this patient is to a. administer 0-negative blood b. applyextemal warming devices. c. Control internal hemorrhage operatively d. apply the pneumatic antishock garment e. infuse large volumes of intravenous crystalloid solution. 5. To establish a diagnosis of shock, a. systolic blood pressure must be below 90 mm Hg. b. the presence of a closed head injury should be excluded c. acidosis should be present by arterial blood \gas analysis d. the patient must fail to respond to intravenous fluid infusion. e. clinical evidence of inadequate organ perfusion must be present. 6. A 23-year-old man is brought immediately to the emergency department from the hospital' s parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconscious and has no detectable blood pressure. Optimal immediate management is to a. perform diagnostic peritoneal lavage. b. initiate infusion of packed red blood cells. c. insert a nasogastric tube and urinary catheter. d. transfer the patient to the operating room, while initiating fluid therapy. e. initiate fluid therapy to return his blood pressure to normotensive 7. An electrician is electrocuted by a downed power line after a thunderstorm. He apparently made contact with the wire at the level of the right mid thigh. In the emergency department, his vital signs are normal and no dysrhythmia is noted on ECG. On examination, there is an exit wound on the bottom of the right foot. His urine is positive for blood by dip stick but no RBCs are seen microscopically. Initial management should include a. immediate angiography. b. aggressive fluid infusion. c. intravenouspyleography. d. debridement of necrotic muscle. e. admission to the intensive care unit for observation. 8. An 8-year-old girl is an unrestrained passenger in a vehicle struck from behind. In the emergency department, her blood pressure is 80/60 mm Hg, heart rate is 80 beats per minute, and respiratory rate is 16 breaths per minute. Her GCS score is 14. She complains that her legs feel "funny and won't move right;" however, her spine x-rays do not show a fracture or dislocation. A spinal cord injury in this child a. is most likely a central cord syndrome. b. must be diagnosed by magnetic resonance imaging. c. can be excluded by obtaining a CT of the entire spine. d. may exist in the absence of objective findings on x-ray studies. e. is unlikely because of the incomplete calcification of the vertebral bodies. 9. Immediate chest tube insertion is indicated for which of the following conditions? a. Pneumothorax b. Pneumomediastinum c. Massive hemothorax d. Diaphragmatic rupture e. Subcutaneous emphysema 10.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 a. inserting an oropharyngealairvvay. b. inserting a nasopharyngeal airway. c. performing a surgical cricothyroidotomy. d. performingfiberoptic-guided nasotracheal intubation. e. performingorotracheal intubation after obtaining a lateral c-spine x-ray. 11.The primary indication for transferring a patient to a higher level trauma center is a. unavailability of a surgeon or operating room staff. b. multiple system injuries, including severe head injury. c. resource limitations as determined by the transferring doctor. d. resource limitations as determined by the hospital administration. e. widened mediastinum on chest x-ray following blunt thoracic trauma. 12.A young man sustains a ritle wound to the mid-abdomen. He is brought promptly to the emergency department by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58 rnm Hg. Warmed crystalloid fluids are initiated without improvement in his vital signs. The next, most appropriate step is to perform a. celiotomy. b. an abdominal CT scan. c. diagnostic laparoscopy. d. abdominal ultrasonography. e. a diagnostic peritoneal lavage. 13.A teen-aged bicycle rider is hit by a truck traveling at a high rate of speed. In the emergency department, she is actively bleeding from open fractures of her legs, and has abrasions on her chest and abdominal wall. Her blood pressure is 80/50 mm Hg, heart rate is 140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6. The first step in managing this patient is to a. obtain a lateral cervical spine x-ray. b. insert a central venous pressure line. c. administer 2 liters of crystalloid solution. d. perform endotracheal intubation and ventilation. e. apply the PASG and inflate the leg compartments. 14.An 8-year-old boy falls 4.5 meters (15 feet) from a tree and is brought to the emergency department by his family. His vital signs are normal, but he complains of left upper quadrant pain. An abdominal CT scan reveals a moderately severe laceration of the spleen. The receiving institution does not have 24-hour-a-day operating room capabilities. The most appropriate management of this patient would be to a. type and crossmatch for blood. b. request consultation of a pediatrician. c. transfer the patient to a trauma center. d. admit the patient to the intensive care unit. e. prepare the patient for surgery the next day. 15.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 a. air splints. b. bolstering devices. c. a long spine board. d. a scoop-style stretcher. e. A semirigid cervical collar. 16.Which of the following statements regarding injury to the central nervous system in children is TRUE? a. Children suffer spinal cord injury without x-ray abnormality more commonly than adults. b. An infant with a traumatic brain injury may become hypotensive from cerebral edema. c. Initial therapy for the child with traumatic brain injury includes the administration of methylprednisolone intravenously. d. Children have more focal mass lesions as a result of traumatic brain injury when compared to adults . e. Young children are less tolerant of expanding intracranial mass lesions than adults. 17.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 a. celiotomy. b. diagnostic peritoneal lavage. c. arterial blood gas determination. d. administer packed red blood cells. e. chest x-ray to confinn tube placement. 18.A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury, multiple palpable left rib fractures, and bilateral femur fractures. He is intubated orotracheally without difficulty. Initially, his ventilations are easily assisted with a bag¬valve device. It becomes more difficult to ventilate the patient over the next 5 minutes, and his hemoglobin oxygen saturation level decreases from 98% to89 % . The most appropriate next step is to a. obtain a chest x-ray. b. decrease the tidal volume. c. auscultate the patient's chest. d. increase the rate of assisted ventilations. e. perform needle decompression of the left chest. 19.A 24-year-old woman passenger in an automobile strikes the wind screen with her face during a head-on collision. In the emergency department, she is talking and has marked facial edema and crepitus. The highest priority should be given to a. lateral, c-spine x-ray. b. upper airway protection. c. carotid pulse assessment. d. management of blood loss. e. determination of associated Injuries. 20.Twenty-seven patients are seriously injured in an aircraft accident at a local airport. The basic principle of triage should be to a. treat the most severely injured patients first. b. establish a field triage area directed by a doctor. c. rapidly transport all patients to the nearest appropriate hospital. d. treat the greatest number of patients in the shortest period of time. e. produce the greatest number of survivors based on available resources. 21.Which one of the following statements is FALSE concerning Rh isoimmunization in the pregnant trauma patient? a. It occurs in blunt or penetrating abdominal trauma. b. Minor degrees of fetomaternal hemorrhage produce it. c. A negative Kleihauer-Betke test excludes Rh isoimmunization. d. This is not a problem in the traumatized Rh-positive pregnant patient [Show Less]
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ATLS PRACTICE TEST 1
ATLS PRACTICE TEST 1 ATLS PRACTICE TEST 1 2 1. Which one of the following is the recommended method for initially treating frostbite? a. vasodilators ... [Show More] b. anticoagulants c. warm (40°C) water d. padding and elevation e. application of heat from a hair dryer 2. A 6-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: a. percutaneous femoral vein cannulation. b. cutdown on the saphenous vein at the ankle. c. intraosseous catheter placement in the proximal tibia. d. percutaneous peripheral veins in the upper extremities. e. central venous access via the subclavian or internal jugular vein. 3. Which one of the following physical findings suggests a cause of hypotension other than spinal cord injury? a. priapism. b. bradycardia. c. diaphragmatic breathing. d. presence of deep tendon reflexes. e. ability to flex forearms but inability to extend them. 4. A young man sustains a gunshot wound to the abdomen and is brought promptly to the emergency department by prehospital personnel. His skin is cool and diaphoretic, and he is confused. His pulse is thready and his femoral pulse is only weakly palpable. The definitive treatment in managing this patient is to: a. administer O-negative blood. b. apply external warming devices. c. control internal hemorrhage operatively. d. apply a pneumatic antishock garment (PASG). e. infuse large volumes of intravenous crystalloid solution. 3 5. Regarding shock in the child, which of the following is FALSE? a. Vital signs are age-related. b. Children have greater physiologic reserves than do adults. c. Tachycardia is the primary physiologic response to hypovolemia. d. The absolute volume of blood loss required to produce shock is the same as in adults. e. An initial fluid bolus for resuscitation should approximate 20 mL/kg of Ringer's lactate. 6. A 33-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 182 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 144 beats per minute, his respiratory rate decreases to 36 breaths per minute, and his blood pressure is 81/53 mm Hg. Warmed Ringer's lactate is administered intravenously. The next priority should be to: a. perform external fixation of the pelvis. b. obtain abdominal and pelvic CT scans. c. perform arterial embolization of the pelvic vessels. d. perform diagnostic peritoneal lavage or FAST. e. perform a urethrogram and cystogram. 7. A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury, multiple palpable left rib fractures, and bilateral femur fractures. He is intubated orotracheally without difficulty. Initially, his ventilations are easily assisted with a bag-mask device. It becomes more difficult to ventilate the patient over the next 5 minutes, and his hemoglobin oxygen saturation level decreases from 98% to 89% . The most appropriate next step is to: a. obtain a chest x-ray. b. decrease the tidal volume. c. decrease PEEP. d. increase the rate of assisted ventilations. e. perform needle decompression of the left chest. 4 8. A young man sustains a rifle wound to the mid-abdomen. He is brought promptly to the emergency department by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58 mm Hg. Warmed crystalloid fluids are initiated without improvement in his vital signs. The next, most appropriate, step is to perform: a. a laparotomy. b. an abdominal CT scan. c. diagnostic laparoscopy. d. abdominal ultrasonography. e. a diagnostic peritoneal lavage. 9. The primary indication for transferring a patient to a higher level trauma center is: a. unavailability of a surgeon or operating room staff. b. multiple system injuries, including severe head injury. c. resource limitations as determined by the transferring doctor. d. resource limitations as determined by the hospital administration. e. widened mediastinum on chest x-ray following blunt thoracic trauma. 10. A 42-year-old man is trapped from the waist down beneath his overturned tractor for several hours before medical assistance arrives. He is awake and alert until just before arriving in the emergency department. He is now unconscious and responds only to painful stimuli by moaning. His pupils are 3 mm in diameter and symmetrically reactive to light. Prehospital personnel indicate that they have not seen the patient move either of his lower extremities. On examination in the emergency department, no movement of his lower extremities is detected, even in response to painful stimuli. The most likely cause for this finding is: a. an epidural hematoma. b. a pelvic fracture. c. central cord syndrome. d. intracerebral hemorrhage. e. bilateral compartment syndrome. 11. A 30-year-old man sustains a severely comminuted, open, distal right femur fracture in a motorcycle crash. The wound is actively bleeding. Normal sensation is present over the lateral aspect of the foot but decreased over the medial foot and great toe. Normal motion of the foot is observed. Dorsalis pedis and posterior tibial pulses are easily palpable on the left, but heard only by Doppler on the right. Immediate efforts to improve circulation to the injured extremity should involve: a. immediate angiography. b. tamponade of the wound with a pressure dressing. 5 c. wound exploration and removal of bony fragments. d. realignment of the fracture segments with a traction splint. e. fasciotomy of all four compartments in the lower extremity. 12. An 18-year-old, unhelmeted motorcyclist is brought by ambulance to the emergency department following a crash. He had decreased level of consciousness at the scene, but then was alert and conversational during transportation. Now his GCS is only 11. Which of the following statements is TRUE? a. Cerebral perfusion is intact. b. Intravascular volume status is normal. c. The patient is in a postictal state. d. Intra-abdominal visceral injuries are unlikely. e. The patient probably has an acute epidural hematoma. 13. During an altercation, a 36-year-old man sustains a gunshot wound above the nipple line on the right, 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 via 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: a. laparotomy. b. diagnostic peritoneal lavage. c. arterial blood gas determination. d. administer packed red blood cells. e. chest x-ray to confirm tube placement. 14. Absence of breath sounds and dullness to percussion over the left hemithorax are findings best explained by: a. left hemothorax. b. cardiac contusion c. left simple pneumothorax d. left diaphragmatic rupture e. right tension pneumothorax. 6 15. A 23-year-old man is brought immediately to the emergency department from the hospital's parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconscious and has no detectable blood pressure. Optimal immediate management is to: a. perform diagnostic peritoneal lavage. b. initiate infusion of packed red blood cells. c. insert a nasogastric tube and urinary catheter. d. transfer the patient to the operating room, while initiating fluid therapy. e. initiate fluid therapy to return his blood pressure to normotensive [Show Less]
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ATLS test exam (With Answers, A+ Rated)
ATLS test exam ATLS test exam When something crashes in secondary survey, you... GO BACK TO PRIAMRY SURVEY If the question says you do not have capabil... [Show More] ities, you will most likely PREPARE FOR AND DO NOT DELAY TRANSPORT How much blood can femur lose 2L What is always going to be the shock type to pick Hemorrhagic What are the classes of hemorrhagic shock 0-15% is class 1 15-30 is class 2 30-40% is class 3 >40% is class 4 What is the EARLIEST predictor of shock at what class Narrowed pulse pressure in class 2 What will be base deficit for class 2 shock? -2 to -6 meQ What will be the deficit for class 4? -10 or less When will urine output start to decrease in shock? [Show Less]
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ATLS Test 1(Questions and Answers, 100% Verified)
ATLS Test 1 ATLS Test 1 A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood pressure is initially 80... [Show More] /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 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 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 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 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. 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 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 a. Urine output of 0.5 mL/kg/hr The diagnosis of shock must include: [Show Less]
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ATLS practice questions-Answered-Latest 2023
ATLS practice questions-Answered-Latest 2023 ATLS practice questions-Answered-Latest 2023 Assessed first in trauma patient Airway (*)Degree of burn t... [Show More] hat is characterized by bone involvement Fourth Complications of head trauma Intracerebral hematoma Extradural hematoma Brain abscess Most common cause of laryngotracheal stenosis Trauma Intervention that can help prevent development of acute renal failure Infusion of normal saline A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was complicated by a fractured pelvis. A few hours later, the patient becomes febrile, hypotensive with a normal CVP, and oliguric. Upon examination, the patient is found to be bleeding from the NG tube and IV sites. Which of the following is the most likely diagnosis? A. Hemorrhagic shock B. Acute adrenal insufficiency C. Fat embolism syndrome D. Transfusion reaction D. Transfusion reaction Skin antiseptic -Ethanol 70% is an effective skin antiseptic -Acetic acid can be used to treat Gram- skin infections -Salicylic acid is used to treat certain skin yeast infections Class IV hemorrhage indicates what % blood loss 55% How does shivering affect body temperature Increases body temperature Class III hemorrhage indicates what % of blood loss 35% Management of a stable patient with kidney contusion Observation Associated with hypovolemic shock -Inadequate tissue perfusion with resultant tissue hypoxia -Blood shunting to vital organs -Decreased circulating blood volume and decreased venous return -Low cardiac output -Loss of less than 20% of the blood volume is usually without symptom except for mild tachycardia -Patients become orthostatic with losses between 20 and 40% -Shock is evidenced by tachycardia, hypotension, oliguria, flat neck veins The most effective method of monitoring the success of resuscitation during CPR? Reactivity of pupils to light Used to ensure correct placement of endotracheal tube -Ultrasound -Bilateral breath sounds -Sustained end-tidal CO2 Total body surface area involved in a burn in an adult to the anterior chest and abdomen 18% What is often caused by carotid massage? Bradycardia Step in a patient diagnosed with tension pneumothorax 1. Needle decompression/ thoracotomy 2. Chest tube True statements regarding diaphragmatic injuries -Blunt diaphragmatic injuries are usually associated with skeletal trauma -Penetrating diaphragmatic injuries may be missed -Repair of traumatic diaphragmatic injuries usually does not require prosthetic material First priority in the treatment of an unconscious patient Checking the pulse A patient involved in a road accident is brought to the emergency department in an unconscious state. On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold, shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain. On physical examination, she has no obvious sign of external bleeding. Which of the following cannot be the cause of hypotension in this patient? A. Pelvic fracture B. Fracture of femur C. Intracranial hemorrhage D. Hemothorax C. Intracranial hemorrhage A patient suffered a slash to his right neck. The wound is over the mid-portion of the sternocleidomastoid. There is a large hematoma and brisk bleeding when uncovered. He is stable. What is the next step in management? A. Get an angiogram B. Close the wound in the ER C. Take him to the operating room D. CT scan to evaluate neck structure C. Take him to the OR After abdominal injury, which of the following urinalysis findings would be an indication for further testing? A. 0-5 casts/HPF B. 5-10 WBC/HPF C. 10-20 RBC/HPF D. Gross hematuria D. Gross hematuria A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at its midpoint would cause bleeding from which structure? External jugular vein Clinical features associated with tension pneumothorax Unilateral decrease in breath sounds Hyperresonance Respiratory distress Tachycardia Tracheal shift Desatruation Decreased breath sounds Decreased compliance Asymmetric chest movement NOT hypertension, audible bronchial sounds Not recommended as a mode of ventilation for a patient with a diaphragmatic hernia A. Bag and mask B. LMA C. Endotracheal intubation D. Jet ventilation A. Bag and mask What is the next step in the assessment of a traumatic patient after airway is established? Breathing Blood group that is considered a universal donor O A provider is examining a patient who sustained a severe traumatic head injury. He documents no Doll's eyes. What does this signify? Brainstem injury Which of the following is the least preferred method of administering IV fluids? A. Cubital veins B. Cephalic veins C. Subclavian veins D. Saphenous vein Subclavian veins Dermatome level for nipple sensation Dermatome level for umbilicus T4 T10 At which temperature would a hypothermic patient stop shivering? 88 degrees F What is the energy recommendation for the first defibrillation in an adult (*) 300 J Pharmacologic effects of Morphine Behavioral changes Analgesia Respiratory depression NOT diarrhea A patient with which condition should be triaged to receive medical attention first? A. Choking B. Dizziness C. Leg cramp D. Vomiting A. Choking For pediatric patients, what volume of fluid resuscitation should be given initially in the setting of shock? A. 750 mL of saline uniformly B. 1 liter of saline C. 20 mL/kg of 0.45% NaCl with 5% glucose D. 10 to 20 mL/kg of Ringers lactate D. 10 to 20 mL/kg of Ringers lactate A patient is found unconscious after a fire in his bedroom. He is found to have severe burns around his face. What is the first aspect of treatment? A. Tetanus toxoid B. Cover the wound C. Airway D. Obtain blood work C. Airway Basilar skull fracture PE: raccoon eyes, battle sign, CSF ottorrhea (rhinorrhea), loculated pneumoencephalocele Bone MC involved = Temporal A patient with von Willebrand disease is bleeding after sustaining a knife wound. Which of the following is most appropriate for the treatment of this patient? [Show Less]
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ATLS-Question and Answers-100% Verified Solutions-Complete-Newly updated 2023/2024
ATLS-Question and Answers-100% Verified Solutions-Complete-Newly updated 2023/2024 ATLS-Question and Answers-100% Verified Solutions-Complete-Newly upda... [Show More] ted 2023/2024 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: re-examine 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: complete spine x-ray series What is true regarding the initial resuscitation of a trauma patient? 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: secure the airway A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. What applies to this patient? [Show Less]
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ATLS EXAM – Latest update 2023/2024- Answered
ATLS EXAM – Latest update 2023/2024-Answered ATLS EXAM – Latest update 2023/2024- Answered A 23-year-old man is brought immediately to the ED from t... [Show More] he hospitals parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconsious and has no detectable blood pressure. Optimale immediate management is to: A. Perform a FAST B. Initiate infusion of packed red blood cells C. Insert a nasogastric tube and urinary catheter D. Transfer the patient to the operating room, while initiating fluid therapy E. Initiate fluid therapy to return his blood pressure to normotensive D. Transfer the patient to the operating room, while initiating fluid therapy A 22 year old male present following a motorcycle crash. He complains of the inability to move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His management should be: A: 1L of iv . crystalloid and two units of pRBCs B. 1L of iv. crystalloid, mannitol and iv steroids C. 1 unit of albumin and compression stockings D. Vasopressors and laparotomy E. 1 L of cystalloid and vasopressors if blood pressure does not respond E. 1 L of cystalloid and vasopressors if blood pressure does not respond Which of the following is MOST RELIABLE to confirm endotracheal intubation? a. presence of breath sounds bilaterally b. absence of borborygmi in the epigatrium on ascultation c. presence of CO2 in exhaled air via capnography d. appearance of fog in the endotracheal tube e. chest xray with endotracheal tube tip appearing above the carina e. chest xray with endotracheal tube tip appearing above the carina A 6 month old infant, being held in her mothers arms, is ejected on impact from a vehicle that is struck head on by an oncoming car traveling at 64kph. The infant arrives in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress. Respiratory support is not effective using a bag mask device, and her oxygen saturation is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most appropriate procedure to perform next is: A.Administer heliox and racemic epinephrine B. Perform nasotracheal intubation C.Perform surgical cricothyroidotomy D.Repeat orotracheal intubation E. Perform needle cricothyroidotomy with jet insufflation E. Perform needle cricothyroidotomy with jet insufflation A 28 year olf male is brought to the ED. He was involved in a fight, during which he was beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear, resp rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the following should be performed during the primary survey a. glasgow coma b. tetanus status c. cervical spine xray d. blood alcohol level e. rectal exam a. glasgow coma an 18yo male is brought to the emergency department after being dumped by a large wave while surfing. He landed head first on the firm beach sand. His vital signs are blood pressure 85/60 mmHg, heart rate 60, and respiratory rate 18; he is unable to move his lower extremities. He appears calm and asks if he will ever [Show Less]
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ATLS PRETEST EXAM 2023/2024-Complete 40 questions-Answered-100% verified
ATLS PRETEST EXAM 2023/2024-Complete 40 questions-Answered-100% verified ATLS PRETEST EXAM 2023/2024- Complete-Answered-100% verified A 22-year-old man ... [Show More] 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: re-examine 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: complete spine x-ray series What is true regarding the initial resuscitation of a trauma patient? 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: secure the airway A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. What applies to this patient? An ABG would demonstrate a base deficit between -6 and -10 mEq/L. The physiological hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by: increasing the volume of blood loss to produce maternal hypotension. The best assessment of fluid resuscitation of the adult burn patient is: urinary output of 0.5 mL/kg/hr The diagnosis of shock must include: 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: direct pressure on the wound For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: 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: perform an exploratory laparotomy What statements regarding abdominal trauma in the pregnant patient is TRUE? Leakage of amniotic fluid is an indication for hospital admission. The first maneuver to improve oxygenation after chest injury is: 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: 9 A 20-year-old woman who is at 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: perform needle or finger decompression of the right chest What findings in an adult is most likely to require immediate management during the primary survey? respiratory rate of 40 breaths per minute The most important, immediate step in the management of an open pneumothorax is: placement of an occlusive dressing over the wound The following are contraindications for tetanus toxoid administration: 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 in 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. What best differentiates cardiac tamponade from tension pneumothorax as the cause of his hypotension? breath sounds Bronchial intubation of the right or left mainstem bronchus can easily occur during infant endotracheal intubation because: The trachea is relatively short. A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation and is brought by ambulance to a hospital that has full surgical capabilities. His wounds are all above the nipple. He is endotracheally intubated, closed tube thoracostomy is performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal injuries. 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% O2). 1500 mL of blood has drained from the right chest. The most appropriate next step in managing this patient is to: urgently transfer the patient to the operating room A 39-year-old man is admitted to the emergency department after an automobile collision. He is cyanotic, has insufficient respiratory effort, and has a GCS score of 6. His full beard makes it difficult to fit the oxygen facemask to his face. The most appropriate next step is to: restrict cervical motion and attempt orotracheal intubation using 2 people A patient is brought to the emergency department after a motor vehicle crash. He is conscious and there is no obvious external trauma. He arrives at the hospital completely immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. His skin is warm. What do you expect to see with the patient? Flaccidity of the lower extremities and loss of deep tendon reflexes are expected. What is the most effective method for initially treating frostbite? Moist heat A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he is extricated. On arrival in the emergency department, his right lower extremity is cool, mottled, insensate, and motionless. Despite normal vital signs, pulses cannot be palpated below the right femoral artery and the muscles of the lower extremity are firm and hard. During the management of this patient, what is most likely to improve the chances for limb salvage? surgical consultation for right lower extremity fasciotomy A patient arrives in the emergency department after being beaten about the head and face with a wooden club. He is comatose and has a palpable depressed skull fracture. His face is swollen and ecchymotic. He has gurgling respirations and vomitus on his face and clothing. The most appropriate step after providing supplemental oxygen and elevating his jaw is to: suction the oropharynx A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small community hospital no surgical capabilities are available. In the emergency department, a chest tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the patient in transfer. Just before the patient is placed in the ambulance for transfer, his blood pressure decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute. The next step should be to: repeat the primary survey and proceed with transfer A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small hospital without surgical capabilities. He has a closed head injury with a GCS score of 13. He has a widened mediastinum on chest x-ray with fractures of left ribs 2 through 4, but no pneumothorax. After initiating fluid resuscitation, his blood pressure is 110/74 mm Hg, heart rate is 100 beats per minute, and respiratory rate is 18 breaths per minute. He has gross hematuria and a pelvic fracture. You decide to transfer this patient to a facility capable of providing a higher level of care. The facility is 128 km (80 miles) away. Before transfer, you should first: call the receiving hospital and speak to the surgeon on call Hemorrhage of 20% of the patient's blood volume is associated usually with tachycardia What statement concerning intraosseous infusion is TRUE? Aspiration of bone marrow confirms appropriate positioning of the needle. A young woman sustains a severe head injury as the result of a motor vehicle crash. In the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3 mm in size and equally reactive to light. There is no other apparent injury. The most important principle to follow in the early management of her head injury is to avoid hypotension A 33-year-old woman is involved in a head-on motor vehicle crash. It took 30 minutes to extricate her from the car. Upon arrival in the emergency department, her heart rate is 120 beats per minute, BP is 90/70 mm Hg, respiratory rate is 16 breaths per minute, and her GCS score is 15. Examination reveals bilaterally equal breath sounds, anterior chest wall ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not tender. Her pelvis is stable. Palpable distal pulses are found in all 4 extremities. Of the following, the most likely diagnosis is: cardiac tamponade A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III (moderately severe) splenic injury has been confirmed by computed tomography (CT). What mandates prompt celiotomy (laparotomy)? development of peritonitis on physical exam A 40-year-old woman who was a restrained driver in a motor vehicle crash is evaluated in the emergency department. She is hemodynamically normal and found to be paraplegic at the level of T10. What precaution should be taken during evaluation and management? Log rolling using 4 people is a safe approach to restrict spinal motion when moving her. A trauma patient presents to your emergency department with inspiratory stridor and a suspected c-spine injury. Oxygen saturation is 88% on high-flow oxygen via a nonrebreathing mask. The most appropriate next step is to: restrict cervical motion and establish a definitive airway When applying the Rule of Nines to infants The head is proportionally larger in infants than in adults A healthy young male is brought to the emergency department following a motor vehicle crash. His vital signs are a blood pressure of 84/60, pulse 123, GCS 10. The patient moans when his pelvis is palpated. After initiating fluid resuscitation, the next step in management is: placement of a pelvic binder What situations requires Rh immunoglobulin administration to an injured woman? positive pregnancy test, Rh negative, and has torso trauma A 22-year-old female athlete is stabbed in her left chest at the third interspace in the anterior axillary line. On admission to the emergency department and 15 minutes after the incident, she is awake and alert. Her heart rate is 100 beats per minute, blood pressure 80/60 mm Hg, and respiratory rate 20 breaths per minute. A chest x-ray reveals a large left hemothorax. A left chest tube is placed with an immediate return of 1600 mL of blood. The next management step for this [Show Less]
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ATLS pretest 2023
ATLS pretest 2023
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ATLS Written Review 2023/2024 (Questions and Answers, 100% Verified)
ATLS Written Review 2023/2024 (Questions and Answers, 100% Verified) ATLS Written Review 2023/2024 (Questions and Answers, 100% Verified) What is the p... [Show More] rimary goal of treating TBI? How is this done? preventing secondary brain injury. This is done by maintaining blood pressure and providing adequate profusion. After managing ABCDEs of TBI what MUST be identified if present? How is this done? mass lesion that requires surgical evacuation is critical! this is done with CT. NOTE: obtaining a CT should not delay patient transfer to trauma center. Which brain lobes do the following hold: 1. anterior fossa: 2. middle fossa: 3. posterior fossa: 1. anterior fossa: frontal lobes 2. middle fossa: temporal lobes 3. posterior fossa: lower brainstem and cerebellum What are the 3 layers of the meninges? dura mater, arachnoid mater, pia mater What does the dura mater adhere firmly to? the skull. it is tough and fibrous What layer of the meninges splits into two leaves as specific sites to enclose large venous sinuses? What do these sinuses do? dura mater. these sinuses provide major venous drainage from the brain. What is the midline sinus of of the brain that splits into two sinuses: bilateral transverse and sigmoid sinus? What side are these bigger on? The main sinus enclosed by the dura major is the midline superior sagital sinus. This splits into the sigmoid and bilateral transverse sinuses which are larger on the right side. What are the arteries that lie between the skull and the dura mater (epidural space)? meningeal arteries. What is the most commonly injured meningeal artery and where is it located? middle meningeal artery. Located over the temporal fossa T/F: the arachnoid mater is fused to the dura mater? FALSE: not attached. This produces a potential space for a subdural hematoma In a subdural hematoma, what is the cause? injury to bridging veins that extend from brain surface to the sinuses within the dura. _______ fills the space between the arachnoid and pia mater? CSF. this cushions the brain and spinal cord. What location of brain hemorrhage is frequently seen in brain contusion or injury to major blood vessels at base of brain? subarachnoid. The ____ and _____ contain the reticular activating system which is responsible for ____. midbrain and upper pons state of alertness What important function resides in the medulla? cardiorespiratory centers. What important functions are in the following brain segments: 1. left hemisphere: 2. frontal lobe: 3. parietal lobe: 4. temporal: 1. left hemisphere: language center 2. frontal lobe: executive function, emotions, motor 3. parietal lobe: sensory function/spatial orientation 4. temporal: memory functions What divides the brain into supratentorial and infratentorial compartments? tentorium cerebelli. (tent over cerebellum) What is the physiology behind a blown pupil? blown pupil: dilation of pupil -CN III runs along the tentorium cerebelli. parasympathetic fibers that constrict the pupil run along CN III (oculomotor). When temporal lobe is herniated, it can compress these fibers. Unapposed sympathetic activity causes pupillary dilation. What is the tentorial notch/hiatus this is where the midbrain passes through into the infratentorial compartment. what part of the brain most commonly herniates through the tentorial notch? Uncus (medial part of temporal lobe) does weakness occur on the same or opposite side of the uncal herniation? OPPOSITE. the corticospinal tract of the midbrain is compressed and then crosses at the foramen magnum. state: Ipsilateral/contralateral ____ pupillary dilation associated with _____ hemiparesis is the classic sign of uncial herniation. ipsi contra average ICP is _____ mmHg. [Show Less]
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ATLS EXAM 2023 (Questions and Answers, 100% Verified)
ATLS EXAM 2023 (Questions and Answers, 100% Verified) ATLS EXAM 2023 (Questions and Answers, 100% Verified) Which of the following is the recommended M... [Show More] ethod for trestemt frostbite? A. Vasodilators B. Anticigulants C. Warm (40 degrees) water D. Padding and elevation E. Application of heat from a hairdryer C. Warm (40 degrees) water Which of the following physical findings suggest a cause of hypotension other than spinal cord injury? A. Prispism B. Bradycardia C. Diaphragmatic breathing D. Presence of deep tendon reflexes E. Ability to flex forearms but not extend them D. Presence of deep tendon reflexes. Spinal shock refers to loss of muscle toe (flaccidty) and loss of reflexes. The primary indication for transferring A patient to a higher level trauma center is: A. Unavailibility of surgeon or operating staff B. Multiple system injuries, including severe head injury C. Resource limitations as determined by the transferring doctor D. Resource limitations as determined by the hospital administration E. Widened mediastinum on chest x-ray following blunt trauma C. Resource limitations as determined by the transferring doctor (MÅ SJEKKES) A young man sustains a rifle wound to the mid-abdomen. He is brought promptly to the ED by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58mmHg. Warmed crystalloid fluids are initiated without improvement in his vital signs. The next, most appropriate, step is to perform: A. a laparotomy B. An abdominal CT-scan C. Diagnostic laparoscopy D. Abdominal ultrasonography E. A diagnostic peritoneal lavage A. Laparotomy because of hemodynamic abnormality A 42-year-old man is trapped from the waist down beneath his overturned tractor for several hours before medical assistance arrives. He is awake and alert until just before arriving in the ED. He is now unconscious and responds only to painful stimuli by moaning. His pupils are 3mm in diameter and symmetrically reactive to light. Prehospital personnel indicate that they have not seen the patient move either of his lower extremities. On examination in the ED, no movement of his lower extremities are detected, even in response to painful stimuli. The most likely cause for this finding is: A. An epidural hematoma B. A pelvic fracture C. Central cord syndrome D. Intracerebral hemorrhage E. Bilateral compartment syndrome MÅ SJEKKES A 6-year-o boy is struck by an automobile and brought to the ED. He is lethargic, but withdraws purposefully from painful stimuli. His blood pressure is 90mmHg systolic, heart rate 140 beats per minute and his respiratory rate is 36 breaths per minute. The preferred route of venous access in this patient is: A. Percutaneous femoral vein cannulation B. Cutdown on the saphenous vein at the ankle C. Intraosseous catheter placement in the proximal tibia D. Percutaneous peripheral veins in the upper extremities E. Central venous access via the subclavian or internal jugular vein D. Percutaneous peripheral veins in the upper extremities A young man sustains a gunshot wound to the abdomen and is brought promptly to the ED by prehospital personnel. His skin is cool and diaphoretic, and he is confused. His pulse is thready and his femoral pulse is only weakly palpable. The definitive treatment in managing this patient is to: A. Administer O-negative blood B. Apply external warming devices C. Control internal hemorrhage operatively D. Apply a pneumatic antishock garment (PASG) E. Infuse large volumes of intravenous crystalloid solutions. C. Control internal hemorrhage operatively Regarding shock in the child, which of the following is FALSE? A. Vital signs are age-related B. Children have greater physiologic reserves than do adults C. Tachycardia is the primary physiologic response to hypovolemia D. The absolute volume of blood loss required to produce shock is the same as in adults E. An initial fluid bolus for resuscitation should approximate 20ml/kg Ringers Lactate D. The absolute volume of blood loss required to produce shock is the same as in adults A 33-year-old man is struck by a car travelling at 56km/h (35mph). He has obvious fractures of the left tibia near the knee, pain in the pelvic area, and severe dyspnea. His heart rate is 182 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 144 beats per minute, his respirartory rate decreases to 36 breaths per minute and his blood pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered intravenously. The next priority should be to: A. Perform external fixation of the pelvis B. Obtain abdominal and pelvic CT-scans C. Perform arterial embolization of the pelvic vessel D. Perform diagnostic peritoneal lavage or FAST E. Perform a urethrogram and cystogram D. Perform diagnostic peritoneal lavage or FAST A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury, multiple palpable left rib fractures, and bilateral femur fractures. He is intubated orotracheally without difficulty. Initially, his ventilations are easily assisted with a bag-mask device. It becomes more difficult to ventilate the patient over the next 5 minutes, and his hemoglobin oxygen saturation level decreases from 98% to 89%. The most appropriate next step is to: A. Obtain a chest x-ray B. Decrease the tidal volume C. Decrease PEEP D. Increase the rate of assisted ventilations E. Perform needle decompression of the left chest. A. Obtain a chest x-ray (MÅ SJEKKES) A 30-year-old man sustains a severely comminuted, open, distal right femur fracture in a motorcycle crash. The wound is actively bleeding. Normal sensation is present over the lateral aspect of the foot but decreased over the medial foot and great toe. Normal motion of the foot is observed. Dorsalis pedis and posterior tibial pulses are easily palpable on the left, but heard only by Doppler on the right. Immediate efforts to improve circulation to the injured extremity should involve: A. Immediate angiography B. Tamponade of the wound with a pressure dressing C. Wound exploration and removal of bony fragments D. Realignment of the fracture segments with a traction splint E. Fasciotomy of all four compartments in the lower extremity B. Tamponade of the wound with a pressure dressing An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the ED following a crash. He had decreased level of consciousness at the scene, but then was alert and conversational during transportation. Now his GCS is only 11. Which of the following statements is TRUE? A. Cerebral perfusion is intact B. Intravascular volume status is normal C. The patient is in a postictal state D. Intra-abdominal visceral injury is unlikely E. The patient probably has an acute epidural hematoma E. The patient probably has an acute epidural hematoma A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss of two liters. Which one of the following statements apply to this patient? 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 systolic blood pressure D. His systolic blood pressure will be decreased with a narrowed, pulse pressure E. His systolic blood pressure will be maintained with an elevated diastolic pressure. E. His systolic blood pressure will be maintained with an elevated diastolic pressure. The physioclogic hypervolemia of pregnancy has clinical significance in the management of the severely injured gravid woman by A. Reducing the need for blood transfusion B. Increasing the risk of pulmonary edema C. Complicating the management of closed head injury D. Increasing the volume of blood loss to produce shock/maternal hypotension E. Reducing the volume of crystalloid required for resuscitation D. Increasing the volume of blood loss to produce shock A 17-year-old helmeted motorcyclist loses consciousness when he is struck broad side by an automobile at an intersection. He arrives in the ED with a blood pressure of 140/92, pulse rate 88 beats per minute, a respiratory rate of 18 breaths per minue, and a GCS of 7. Appropriate initial immobilization of this patient should include a semi-rigid cervical collar and: A. A scoop stretcher B. A long spine board C. A short spine board D. Cervical traction tongs E. Pneumatic antishock garment B. A long spine board During an altercation, a 36-year-old man sustains a gunshot wound above the nipple line on the right, with an exit wound posteriorly above the scapula on the right. He is transported by ambulance to a community hospital. He is endotracheally intubated, close tube thoracostomy is performed, and 2 liters Ringers lactate solution are infused via 2 large-caliber IV´s. His blood pressure now is 60/0mmHg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% O2). The most appropriate next step in managin this patient is: A. Laparotomy B. Diagnostic peritoneal lavage C. Arterial blood gas determination D. Administer packed red blood cells E. Chest X-ray to confirm tube placement E. Chest X-ray to confirm tube placement Abscence of breath sounds and dullness to percussion over the left hemithorax are findings best explained by: A. Left hemothorax B. Cardiac contusion C. Left simple pneumothorax D. Left diaphragmatic rupture E. Right tension pneumothorax A. Left hemothorax A 23-year-old man is brought immediately to the ED from the hospitals parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconsious and has no detectable blood pressure. Optimale immediate management is to: A. Perform a diagnostic peritoneal lavage B. Initiate infusion of packed red blood cells C. Insert a nasogastric tube and urinary catheter D. Transfer the patient to the operating room, while initiating fluid therapy E. Initiate fluid therapy to return his blood pressure to normotensive D. Transfer the patient to the operating room, while initiating fluid therapy A teen-aged bicycle rider is hit by a truck traveling at high speed. In the ED, she is actively bleeding from open fractures of her legs, and has abrasions on her chest and abdominal wall. Her blood pressure is 80/50 mmHg, heart rate is 140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6. The first step in managing this patient is to: A. Obtain a lateral cervical spine x-ray B. Insert av central venous pressure line C. Adminster 2 liters of crystalloid solution D. Perform endotracheal intubation and ventilation E. Apply a pneumatic antishock garment (PASG) and inflate the leg compartments. D. Perform endotracheal intubation and ventilation An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is brought to the ED by his family. His vital signs are normal, but he complains of left upper quadrant pain. An abdominal CT-scan reveals a moderately severe laceration of the spleen. The receiving institution does not have 24-hour-a-day operating room capabilities. The most appropriate management of this patient would be to [Show Less]
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ATLS post test 2023 QUESTIONS AND ANSWERS
ATLS post test 2023 QUESTIONS AND ANSWERS 1. The primary indication for transferring a1. The primary indication for transferring a patient to a higher lev... [Show More] el trauma center is: patient to a higher level trauma center is:unavailability of a surgeon or operating roomunavailability of a surgeon or operating .multiple system injuries, including severemultiple system injuries, including severehead injury.resource limitations as determined by theresource limitations as determined by thetransferring ferring doctor.resource limitations as determined by theresource limitations as determined by thehospital tal administration.widened mediastinum on chest x-raywidened mediastinum on chest x-rayfollowing blunt thoracic wing blunt thoracic trauma.2. teen-aged bicycle rider is hit b2. teen-aged bicycle rider is hit by a trucky a trucktraveling at a high rate of speed. traveling at a high rate of speed. In theIn theemergency department, she is actively bleedingemergency department, she is actively bleedingfrom open fractures of her legs, and hasfrom open fractures of her legs, and hasabrasions on her chest and abdominal abrasions on her chest and abdominal wall. Herwall. Her blood pressure is 80/50 mm Hg, heart rate is blood pressure is 80/50 mm Hg, heart rate is140 beats per minute, respiratory rate is 8140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6. breaths per minute, and GCS score is 6.The first step in managing this patient is to:The first step in managing this patient is to:obtain a lateral cervical spine n a lateral cervical spine x-ray.insert a central venous pressure t a central venous pressure line.administer 2 liters of crystalloid ister 2 liters of crystalloid solution.perform endotracheal intubation andperform endotracheal intubation lation.apply the PASG and inflate the legapply the PASG and inflate the rtments.3. Contraindication to nasogastric intubation is3. Contraindication to nasogastric intubation isthe presence of a:the presence of a:gastric ic perforation.diaphragmatic ragmatic rupture.open depressed skull depressed skull fracture.fracture of the cervical ure of the cervical spine.fracture of the cribriform ure of the cribriform plate.4. Which one of the following statements4. Which one of the following statementsregarding patients with thoracic spine injuries isregarding patients with thoracic spine injuries isTRUE?TRUE?Log-rolling may be Log-rolling may be destabilizing todestabilizing tofractures from T-12 to L-ures from T-12 to L-1.Adequate immobilization can beAdequate immobilization can beaccomplished with the scoop plished with the scoop stretcher.Spinal cord injury below T-10 usually sparesSpinal cord injury below T-10 usually sparesbowel and bladder and bladder function.Hyperflexion fractures in the upperHyperflexion fractures in the upperthoracic spine are inherently cic spine are inherently unstable.These patients rarely present with spinalThese patients rarely present with spinalshock in association with cord in association with cord injury.5. young man sustains a ritle wound to the mid-5. young man sustains a ritle wound to the mid-abdomen. He is brought promptly to theabdomen. He is brought promptly to theemergency department by prehospitalemergency department by prehospital personnel. His skin is cool and diaphoretic, and personnel. His skin is cool and diaphoretic, andhis systolic blood pressure is 58 rnm H systolic blood pressure is 58 rnm Hg.WWarmed crystalloid fluids are armed crystalloid fluids are initiated withoutinitiated withoutimprovement in his vital signs. The next, mostimprovement in his vital signs. The next, mostappropriate step is to perform:appropriate step is to perform:a celiotomy.a celiotomy.an abdominal CT abdominal CT scan.diagnostic ostic laparoscopy.abdominal inal ultrasonography.a diagnostic peritoneal lavage.a diagnostic peritoneal lavage.6. young woman sustains a severe he6. young woman sustains a severe head injuryad injuryas the result of a motor vehicular crash. In theas the result of a motor vehicular crash. In theemergency department, her GCS score is 6. Heremergency department, her GCS score is 6. Her blood pressure is 140/90 mm Hg and her heart blood pressure is 140/90 mm Hg and her heartrate is 80 beats per minute. She rate is 80 beats per minute. She is intubated andis intubated andis being mechanically ventilated. Her pupils areis being mechanically ventilated. Her pupils are3 mm in size and equall3 mm in size and equally reactive to light.y reactive to light.There is no other There is no other apparent injury. The mostapparent injury. The mostimportant principle to follow in the earlyimportant principle to follow in the earlymanagement of her head injury is to:management of her head injury is to:administer an osmotic ister an osmotic diuretic.prevent secondary brain nt secondary brain injury. [Show Less]
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ATLS10 2022/2023 Post-Test-Latest Update
ATLS10 2022 Post-Test-Latest Update ATLS10 exam questions with answers (answers outlined!!) 1. A 24-year-old male pedestrian, struck by an automobile, is... [Show More] admitted to the emergency department 1 hour after injury. His blood pressure is 80/60 mmHg, heart rate 140 beats per minute and respiratory rate is 36 per minute. He is lethargic. Oxygen is delivered via face mask, and two large-caliber IVs are initiated. Arterial blood gases are obtained. His PaO2 is 118 mmHg (15.7 kPa), PaCO2 is 30 mmHg (4.0 kPa), and pH is7.21. The treatment of his acid-base disorder is best accomplished by: a. Hyperventilation b. Restoration of normal perfusion c. Initiation of low-dose dopamine d. Administration of sodium bicarbonate e. Initiation of phenylepinephrine infusion 2. The highest priority in managing a patient whose injuries include closed extremity fractures is: a. Assesing limb perfusion b. Preventing necrosis of the skin c. Decompressing compartment syndrome d. Addressing respiratory insufficiency Identifying crush syndrome 3. A 34-year-old female is involved in a motor vehicle crash is brought to the emergency department. She is talking, but her voice is hoarse and on exposure she has diagonal bruising of the chest and anterior neck. What is the next step? a. Direct laryngoscopy to exclude laryngeal trauma b. Oxygen by non-rebreathing mask c. Protecting the spine by making her lie down d. Palpation of the anterior neck e. Attaching a pulse oximeter to her finger 4. A 30-year-old male sustains a gunshot wound to the right lower chest, midway between the nipple and the costal margin. He is brought by ambulance to a hospital that has full surgical capabilities. In the emergency department he is endotracheally intubated, fluid resuscitation is initiated through two large-caliber IV lines, and a closed tube thoracostomy is performed, with the return of 200 ml of blood. A chest xray reveals correct placement of the chest tube and a small residual hemothorax. His blodd pressure is now 70/0 mmHg, and his heart rate is 140 beats per minute. His hypotension is most likely due to: a. Tension pneumothorax b. Massive hemothorax c. Pericardial tamponade d. Intraabdominal bleeding e. Insufficient isotonic crystalloid infusion 5. A 20-year-old athlete is involved in a motorcycle crash after having ridden for hours on a very hot day. When he arrives in the emergency department, he shouts that he cannot move his legs. On physical examination, there are no abnormalities of the chest, abdomen, or pelvis. The patient has no sensation in his legs and cannot move them, but his arms are moving. The patient’s respiratory rate is 22, heart rate is 88, and blood pressure is 80/60 mmHg. He is pale and sweaty. What is the most likely cause of his hypotension? a. Neurogenic shock b. Cardiac tamponade c. Myocardial contusion d. Hyperthermia e. Hemorrhagic shock 6. Comapred with adults, children have: a. A longer, wider, funnel-shaped airway b. A less pliable, calcified skeleton c. Greater mobility of mediastinal structures d. A relatively smaller head and larger jaw e. Anterior displacement of C5 on C6 7. Which one of the findings below requires a definitive airway in trauma patients? a. Facial lacerations b. Repeated vomiting c. Partial thickness facial burns, cough, and hoarseness d. Sternal fracture e. Glascow Coma Scale score of 12 8. In a patient with spinal cord injury, sacral sparing: a. Refers to a fracure of the sacrum b. Is part of the spinal shock syndrome c. Is a good prognostic sign d. Indicates a complete spinal cord injury e. Occurs only with complete transection of the lumbosacral spinal cord 9. A 22-year-old woman falls whil skiing. She is evaluated at a small community hospital that does not have neurological services. Spinal motion is restricted, supplemental oxygen by mask is administered, and two antecubital IVs are placed. Her Glascow Coma Scale score is 12, pupils are equal, blood pressure is 135/76 mmHg, heart rate is 105, and respiratory rate is 19. Chest x-ray is normal. This patient’s management priorities are: a. Repeat primary survey and transfer to a trauma center b. Definitive airway, CT of the head, and intracranial pressure monitor c. IV mannitol, definitive airway, CT of the head, and neurosurgery consult d. CT of the head, EEG, cerebral perfusion pressure monitoring, and hypertonic saline e. IV Dilantin, IV mannitol, mild hyperventilation, and serial arterial blood gases 10. A young male patient is brought to the emergency department following a 5-meter (16-foot) fall from a roof. He responds to pressure by pushing away your hand, opening his eyes, and verbalizing inappropriate words. Pupils are equal. The most important step is management of this patient would be: a. Immidiate intubation to protect his airway b. Administer 25 mg/kg IV bolus mannitol c. Insert two large-bore IVs d. Alcohol and drug screening e. Determine whether amnesia is present and, if so, for what period of time 11. Twenty-seven patients are seriously injured in an airplane crash at a local airport. The principles of triage include: a. Establish a triage site whthin the hot zone of the crash site b. Treat only the most severely injured patients first c. Immidiately transport all patients to the nearest hospital d. Treat the greatest number of patients in the shortest period of time e. Produce the greatest number of survivors based on available resources 12. A 35-year-old female falls down a flight of stairs. She has extensive bruising of her face and head. Her heart rate is 120, blood pressure 90/70 mmHg, and respiratory rate is 26. The patient`s condition is most readily explained by: a. Associated head injury b. Hypovolemia from hemorrhagic shock c. Alcohol intoxication d. Spinal shock from cervical spine injury e. Neurogenic shock from cervical spine injury 13. Which one of the following statements is correct: a. Cerebral contusions may coalesce to form an intracerebral hematoma b. Epidural hematomas are usually seen in the frontal region c. Subdural hematomas are caused by injury to the middle meningeal artery d. Subdural hematomas typically have a lenticular shape on CT scan e. The associated brain damage is more severe in epidural hematomas 14. An 18-year-old is brought to the emergency department after having been shot. He has one bullet wound just below the right clavicle and another just below the costal margin in the right posterior axillary line. His blood pressure is 110/60 mmHg, heart rate is 90 beats per minute, and respiratory rate is 34 breaths per minute. After ensuring a patent airway and inserting two large-caliber IV lines, the next appropriate step is to: a. Obtain a portable chest x-ray b. Administer a bolus of additional IV fluid c. Perform a laparotomy d. Obtain an abdominal CT scan e. Perform diagnostic peritoneal lavage 15. Which one of the following statements is true concerning cranial anatomy related to traumatic injury? a. A scalp laceration is an unlikely source of bleeding in a patient with a long transport time. b. The meninges are comprised of the dure, pia, and arachnoid. c. The middle meningeal artery lies between the dura and pia mater. d. Effacement or shift of the ventricles occurs commonly with concussions. e. A dilated pupil is produced when the sympathetic nerve fibers located on the third cranial nerve are compressed by the temporal lobe. 16. A 47-year-old house painter is brought to the hospital after falling 6 meters (20 feet) from a ladder and landing straddling a fence. Examination of his perineum reveals extensive ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study for evaluation of the urinary tract in this patent should be: a. Cystoscopy b. Cystography c. Intravenous pyelography d. CT scan e. Retrograde urethrography 17. Which of the following statements is true? a. The laryngeal mask airway is an infraglottic device. b. The multilumen esophageal airway occludes the supraglottic lumen and ventilates through the port placed distal to the vocal cords. c. The nasopharyngeal airway is an ideal supraglottic device for patients with cribiform plate fractures. d. Nasotracheal tubes position a cuffed airway in the infraglottic space. e. Tracheostomy tubes are placed in apneic, hypoxic patients in the supraglottic space. 18. Neurogenic shock has all of the following characteristics except which? a. Hypotension b. Vasodilation c. Bradycardia d. Neurologic deficit e. Narrowed pulse pressure 19. Which one of the following statements concerning spinal cord trauma is true? a. A normal lateral c-spine film excludes injury. b. A vertebral fracture or dislocation is unlikely in the absence of physical findings of spinal cord injury. c. A patient should remain on a long board until injury is excluded radiographycally. d. Diaphragmatic breathing in an unconscious patient whi has fallen may [Show Less]
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