ATLS Pretest
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:
(ANS- 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:
(ANS- complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma
patient?
(ANS- 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:
(ANS- secure the airway<\/p>\n\n\n\n
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?
(ANS- 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:
(ANS- increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is:
(ANS- urinary output of 0.5 mL\/kg\/hr
The diagnosis of shock must include:
(ANS- 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:
(ANS- direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent:
(ANS- cerebral vasoconstriction with diminished perfusion<\/p>\n\n\n\n
ATLS Pre-test Questions & Answers
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:
(Ans \u2013<\/p>\n\n\n\n
ATLS practice Questions & Answers
Assessed first in trauma patient
(Ans – Airway
Degree of burn that is characterized by bone involvement
(Ans – Fourth
Complications of head trauma
(Ans \u2013
Intracerebral hematoma
Extradural hematoma
Brain abscess
Most common cause of laryngotracheal stenosis
(Ans – Trauma
Intervention that can help prevent development of acute renal failure
(Ans – 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
(Ans – D. Transfusion reaction
Skin antiseptic
(Ans \u2013
-Ethanol 70% is an effective skin antiseptic<\/p>\n\n\n\n
-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
(Ans – 55%
How does shivering affect body temperature
(Ans – Increases body temperature
Class III hemorrhage indicates what % of blood loss
(Ans – 35%
Management of a stable patient with kidney contusion
(Ans – Observation
Associated with hypovolemic shock
(Ans \u2013
-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?
(Ans – Reactivity of pupils to light
Used to ensure correct placement of endotracheal tube
(Ans \u2013
-Ultrasound
-Bilateral breath sounds
-Sustained end-tidal CO2<\/p>\n\n\n\n
Total body surface area involved in a burn in an adult to the anterior chest
and abdomen
(Ans – 18%
What is often caused by carotid massage?
(Ans – Bradycardia
Step in a patient diagnosed with tension pneumothorax
(Ans \u2013<\/p>\n\n\n\n
(Ans – C. Intracranial hemorrhage
A patient suffered a slash to his right neck. The wound is over the midportion 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
(Ans – 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
(Ans – 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?
(Ans – External jugular vein
Clinical features associated with tension pneumothorax
(Ans \u2013
Unilateral decrease in breath sounds
Hyperresonance
Respiratory distress
Tachycardia
Tracheal shift
Desatruation
Decreased breath sounds
Decreased compliance<\/p>\n\n\n\n
ATLS Practice Questions & Answers
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:
(Ans- 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:
(Ans- complete spine x-ray series
What is true regarding the initial resuscitation of a trauma patient?
(Ans- 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:
(Ans- 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?
(Ans<\/p>\n\n\n\n
(Ans- increasing the volume of blood loss to produce maternal
hypotension.
The best assessment of fluid resuscitation of the adult burn patient is:
(Ans- urinary output of 0.5 mL\/kg\/hr
The diagnosis of shock must include:
(Ans- 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:
(Ans- direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia
should be avoided to prevent:
(Ans- 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:
(Ans- perform an exploratory laparotomy
What statements regarding abdominal trauma in the pregnant patient is
TRUE?
(Ans- Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is:
(Ans- administer supplemental oxygen<\/p>\n\n\n\n
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:
(Ans- 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:
(Ans- 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?
(Ans- respiratory rate of 40 breaths per minute
The most important, immediate step in the management of an open
pneumothorax is:
(Ans- placement of an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration:
(Ans- 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?
(Ans- breath sounds<\/p>\n\n\n\n
Bronchial intubation of the right or left mainstem bronchus can easily occur
during infant endotracheal intubation because:
(Ans- 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:
(Ans- 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:
(Ans- 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?
(Ans- Flaccidity of the lower extremities and loss of deep tendon reflexes
are expected.
What is the most effective method for initially treating frostbite?
(Ans- 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<\/p>\n\n\n\n
ATLS Practice Questions & Answers 3) Traumatic aortic disruption ATLS PretestA 22-year-old man is hypotensive and tachycardic after a shotgun wound to the leftshoulder. His blood pressure is initially 80\/40 mm Hg. After initial fluidresuscitation his blood pressure increases to 122\/84 mm Hg. His heart rate is now100 beats per minute and his respiratory rate is 28 breaths per minute. A tubethoracostomy is performed […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-117248","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117248","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=117248"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117248\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=117248"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=117248"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=117248"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Definitive control of the airway is achieved by __<\/strong><\/em><\/strong>
(Ans- Endotracheal intubation
How do you treat hypothermia in the ED?
(Ans- crystalloid fluids at 102.2 degrees F and warmed treatment area
What does definitive hemorrhage control refer to?
(3)
(Ans1) Possible surgery
2) Stabilizing of pelvis
3) Angioembolization
What are rates of fluid administration measured by?
(Ans- Size and length of catheter
Minimum flow rate of oxygen reservoir mask
(Ans- 11 L\/min
MCC of shock in trauma pt
(Ans- Hypovolemia due to hemorrhage
Describe the 3 for 1 rule
(Ans- Replace each mL of blood loss with 3 ml of crystalloid solution
What metabolic state can result from continued hemorrhage or decreased
perfusion?
(Ans- Metabolic acidosis
In what survey, primary or secondary, are these identified?
1) Simple PTX
2) Pulmonary contusion<\/p>\n\n\n\n
(Ans- Secondary
Via thorough PE, CXR, pulse ox, ECG and ABG
What imaging study is preferred for penetrating abdominal trauma?
(Ans- CT
What can FAST rapidly diagnose?
(Ans- Abdominal hemorrhage
When is a laparotomy indicated?
(Ans- Fascial penetration with intraperitoneal bleeding or peritonitis
What does the Monro Kellie doctrine describe?
(Ans- The relationship between IC volume and pressure
Normal resting ICP
(Ans- 10 mm Hg
How do you reduce elevated ICP?
(Ans- Mannitol in a 20% solution
How do you temporarily control pelvic hemorrhage and instability?
(Ans- Internal traction and external counter-pressure
How do you initially manage major arterial injury?
(Ans- Direct pressure and fluid resuscitation
Full thickness burn
(Ans- Third degree burn
What is used to estimate the size and depth of burns?
(AnsRule of 9’s
Head= 9%<\/p>\n","protected":false},"excerpt":{"rendered":"