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
... [Show More] excluded.
acidosis should be present by arterial blood \gas analysis.
the patient must fail to respond to intravenous fluid infu.sion.
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 [Show Less]