ATLS POST TEST – QUESTIONS AND ANSWERS (2022)
- The primary indication for transferring a
patient to a higher level trauma center is:
unavailability of a surgeon or operating room
staff.
multiple system injuries, including severe
head injury.
resource limitations as determined by the
transferring doctor.
resource limitations as determined by the
hospital administration.
widened mediastinum on chest x-ray
following blunt thoracic trauma. - 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:
obtain a lateral cervical spine x-ray.
insert a central venous pressure line.
administer 2 liters of crystalloid solution.
perform endotracheal intubation and
ventilation.
apply the PASG and inflate the leg
compartments. - Contraindication to nasogastric intubation is
the presence of a:
gastric perforation.
diaphragmatic rupture.
open depressed skull fracture.
fracture of the cervical spine. - Which one of the following sregarding patients with thoracicTRUE?
Log-rolling may be destafractures from TAdequate immobilizatiaccomplished with the scoopSpinal cord injury below T-10 usuabowel and bladdeHyperflexion fractures in tthoracic spine are inherentlyThese patients rarely present wshock in association with c5. young man sustains a ritle wabdomen. He is brought prompemergency department by preh personnel. His skin is cool and his systolic blood pressure is 58Warmed crystalloid fluids are inimprovement in his vital signs. appropriate step is to perform:
a can abdomindiagnostic lapabdominal ultrasoa diagnostic peritone6. young woman sustains a seveas the result of a motor vehiculaemergency department, her GC blood pressure is 140/90 mm Hrate is 80 beats per minute. Sheis being mechanically ventilate3 mm in size and equally reactiThere is no other apparent injurimportant principle to follow inmanagement of her head injuryATLS POST TEST – QUESTIONS AND ANSWERS (2
aggressively treat systemic hypertension.
reduce metabolic requirements of the
brain.
distinguish between intracranial hematoma
and cerebral edema. - 22-year-old man is brought to the hospital
after crashing his motorcycle into a telephone
pole. He is unconscious and in profound shock.
He has no open wounds or obvious fractures.
The cause of his shock is MOST LIKELY
caused by:
a subdural hematoma.
an epidural hematoma.
a transected lumbar spinal cord.
a transected cervical spinal cord.
hemorrhage into the chest or abdomen. - 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 breaths per
minute, and his blood pressure is 80/50 inm Hg.
Warmed Ringer’s lactate is administered
intravenously. The next priority should be to:
perform a urethrogram and cystogram.
perform external fixation of the pelvis.
obtain abdominal and pelvic CT scans.
perform arterial embolization of the pelvic
vessels.
performdiagnosticperitoneallavageor9. 8-year-old girl is an unrestraiin a vehicle struck from behindemergency department, her blo80/60 mm Hg, heart rate is 80 band respiratory rate is 16 breathHer GCS score is 14. She complegs feel “funny and won’t movhowever, her spine x-rays do nofracture or dislocation. A spinalthis child:
is most likely a central cord smust be diagnosed by magnetic rcan be excluded by obtaining a enmay exist in the absence offindings on x-rais unlikely because of the incalcification of the verteb10. Immediate chest tube insertfor which of the following condPneuPneumomeMassive heDiaphragmatSubcutaneous em11. 18-year-old, helmeted moto brought by ambulance to the emdepartment following a high-spPrehospital persormel report th15 meters (50 feet) off his bficehistory of hypotension prior to emergency department, but is nand conversational. Which of thstatements is TRUE?
Cerebral perfiision
Intraabdominal visceral injuries are
unlikely.
The patient probably has an acute
epidural hematoma. - crosstable, lateral x-ray of the cervical
spine:
must precede endotracheal intubation.
excludes serious cervical spine injury.
is an essential part of the primary survey.
is not necessary for unconscious patients
with penetrating cervical injuries.
is unacceptable unless 7 cervical vertebrae
and the C-7 to T-1 relationship are
visualized. - 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 - Which one of the following is the
recommended method for initially treating
frostbite?
Vasodilators
Anticoagulants
Warm (40°C) water
Padding and elevation
Topical application of silvasulphadiazine - young man sustains a gunshot wound to the
abdomen and is brought promptly to the
emergencydepartmentbyprehospitaldefmitive treatment in managinto:
administer 0-negatapply extemal warmincontrol internal hemorrhage opapply the pneumatic antishockinfuse large volumes of intcrystalloid16. To establish a diagnosis of ssystolic blood pressure must bethe presence of a closed head injubeacidosis should be present by arte\gathe patient must fail to reintravenous fluidclinical evidence of inadequperfusion must b17. Absence of breath sounds a percussion over the left hemith best explained by:
left hemcardiac cleft simple pneuleft diaphragmatright tension pneu18. 17-year-old helmeted motor broadside by an automobile at aHe is unconscious at the scene pressure of 140/90 mm Hg, hea beats per minute, and respirator breaths per minute. His respiratsonorous and deep. His GCS s