ATLS post test 2022 QUESTIONS AND ANSWERS/ 1. The primary indication for transferring a1. The primary indication for transferring a
patient to a higher
... [Show More] level trauma center is: patient to a higher level trauma center is:
unavailability of a surgeon or operating roomunavailability of a surgeon or operating room
staff.staff.
multiple system injuries, including severemultiple system injuries, including severe
head injury.head injury.
resource limitations as determined by theresource limitations as determined by the
transferring doctor.transferring doctor.
resource limitations as determined by theresource limitations as determined by the
hospital administration.hospital administration.
widened mediastinum on chest x-raywidened mediastinum on chest x-ray
following blunt thoracic trauma.following blunt thoracic trauma.
2. teen-aged bicycle rider is hit b2. teen-aged bicycle rider is hit b y a trucky a truck
traveling at a high rate of speed. traveling at a high rate of speed. In theIn the
emergency department, she is actively bleedingemergency department, she is actively bleeding
from open fractures of her legs, and hasfrom open fractures of her legs, and has
abrasions 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 is
140 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 x-ray.obtain a lateral cervical spine x-ray.
insert a central venous pressure line.insert a central venous pressure line.
administer 2 liters of crystalloid solution.administer 2 liters of crystalloid solution.
perform endotracheal intubation andperform endotracheal intubation and
ventilation.ventilation.
apply the PASG and inflate the legapply the PASG and inflate the leg
compartments.compartments.
3. Contraindication to nasogastric intubation is3. Contraindication to nasogastric intubation is
the presence of a:the presence of a:
gastric perforation.gastric perforation.
diaphragmatic rupture.diaphragmatic rupture.
open depressed skull fracture.open depressed skull fracture.
fracture of the cervical spine.fracture of the cervical spine.
fracture of the cribriform plate.fracture of the cribriform plate.
4. Which one of the following statements4. Which one of the following statements
regarding patients with thoracic spine injuries isregarding patients with thoracic spine injuries is
TRUE?TRUE?
Log-rolling may be Log-rolling may be destabilizing todestabilizing to
fractures from T-12 to L-1.fractures from T-12 to L-1.
Adequate immobilization can beAdequate immobilization can be
accomplished with the scoop stretcher.accomplished with the scoop stretcher.
Spinal cord injury below T-10 usually sparesSpinal cord injury below T-10 usually spares
bowel and bladder function.bowel and bladder function.
Hyperflexion fractures in the upperHyperflexion fractures in the upper
thoracic spine are inherently unstable.thoracic spine are inherently unstable.
These patients rarely present with spinalThese patients rarely present with spinal
shock in association with cord injury.shock in association with cord injury.
5. young man sustains a ritle wound to the mid-5. young man sustains a ritle wound to the midabdomen.
He
is
brought
promptly
to
theabdomen.
He
is
brought
promptly
to
the
emergency
department
by
prehospitalemergency
department
by
prehospital
personnel.
His
skin
is
cool
and
diaphoretic,
and personnel.
His
skin
is
cool
and
diaphoretic,
and
his
systolic
blood
pressure
is
58
rnm
Hg.his
systolic
blood
pressure
is
58
rnm
Hg.
WWarmed
crystalloid
fluids
are
armed
crystalloid
fluids
are
initiated withoutinitiated without
improvement in his vital signs. The next, mostimprovement in his vital signs. The next, most
appropriate step is to perform:appropriate step is to perform:
a celiotomy.a celiotomy.
an abdominal CT scan.an abdominal CT scan.
diagnostic laparoscopy.diagnostic laparoscopy.
abdominal ultrasonography.abdominal ultrasonography.
a diagnostic peritoneal lavage.a diagnostic peritoneal lavage.
6. young woman sustains a severe he6. young woman sustains a severe he ad injuryad injury
as the result of a motor vehicular crash. In theas the result of a motor vehicular crash. In the
emergency 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 heart
rate is 80 beats per minute. She rate is 80 beats per minute. She is intubated andis intubated and
is being mechanically ventilated. Her pupils areis being mechanically ventilated. Her pupils are
3 mm in size and equall3 mm in size and equall y reactive to light.y reactive to light.
There is no other There is no other apparent injury. The mostapparent injury. The most
important principle to follow in the earlyimportant principle to follow in the early
management of her head injury is to:management of her head injury is to:
administer an osmotic diuretic.administer an osmotic diuretic.
prevent secondary brain injury.prevent secondary brain injury. [Show Less]