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
... [Show More] life-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]