ATLS Actual Exam Questions and

ATLS Actual Exam Questions and Answers| Verified Correct Answers Graded A+

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 2 liters of crystalloid solution 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. His breath sounds are decreased in the left hemithorax, and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for decreased left breath sounds with the ret Correct Answer a) reexamine the chest

Which one of the following physical findings suggests a cause of hypotension other than spinal cord injury?

• priapism.
• bradycardia.
• diaphragmatic breathing.
• presence of deep tendon reflexes. Correct Answer d) presence of

deep tendon reflexes.

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:

• compartment pressures
• retrograde urethrogram

c) Doppler-ultrasound studies

• complete spine x-ray series Correct Answer d) complete spine x-

ray series 1 / 4

In managing the head-injured patient, the most important initial step is

to:

• obtain c-spine film.
• secure the airway.
• support the circulation.
• control scalp hemorrhage. Correct Answer b) secure the airway.

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?

a) His pulse pressure will be widened.

b) His urinary output will be at the lower limits of normal.

c) He will have tachycardia, but no change in his systolic blood

pressure.

d) His systolic blood pressure will be decreased with a narrowed pulse

pressure. Correct Answer d) His systolic blood pressure will be decreased with a narrowed pulse pressure.

The physiologic hypervolemia of pregnancy has clinical significance

in the management of the severely injured, gravid woman by:

• reducing the need for blood transfusion.
• increasing the risk of pulmonary edema.
• increasing the volume of blood loss to produce maternal

hypotension.

• complicating the mangement of closed head injury. Correct

Answer c) increasing the volume of blood loss to produce maternal hypotension.

The best assessment of fluid resuscitation of the burn patient is:

• adequate urinary output.
• reversal of systemic acidosis.
• normalization of the heart rate. 2 / 4

• a normal central venous pressure. Correct Answer a) adequate

urinary output.

The diagnosis of shock must include:

• increased vascular resistance.
• evidence of inadequate organ perfusion.
• acidosis.
• hypoxemia. Correct Answer b) 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:

• application of a tourniquet.
• direct pressure on the wound.
• packing the wound with gauze.
• direct pressure on the femoral artery at the groin. Correct Answer
• direct pressure on the wound.

For the patient with severe traumatic brain injury, profound

hypocarbia should be avoided to prevent:

• respiratory acidosis.
• metabolic acidosis.
• cerebral vasoconstriction with diminished perfusion.
• neurogenic pulmonary edema. Correct Answer c) cerebral

vasoconstriction with diminished perfusion.

A 25-year-old man is brought to a hospital with a general surgeon after being involved in a motor vehicle crash. Computed tomography 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:

• contrast angiography. 3 / 4

ATLS Final EXAM

• transfer to a higher level trauma center.
• exploratory laparotomy.
• infuse additional crystalloids. Correct Answer c) exploratory

laparotomy.

Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE?

a) The fetus is in jeopardy only with major abdominal trauma.

b) Leakage of amniotic fluid is an indication for hospital admission.

c) Indications for peritoneal lavage are different from those in the

nonpregnant patient.

d) Penetration of an abdominal hollow viscus is more common in late

than in early pregnancy. Correct Answer b) Leakage of amniotic fluid is an indication for hospital admission.

The first maneuver to improve oxygenation after chest injury is:

• intubate the patient.
• assess arterial blood gases.
• administer supplemental oxygen.
• ascertain the need for a chest tube. Correct Answer c) administer

supplemental oxygen.

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 painful stimuli. He does not follow commands, but he does moan periodically. His right arm is deformed and does not respond to painful stimulus; however, his left hand reaches purposefully toward

the painful stimulus. Both legs are stiffly extended. His GCS Score is:

• 2
• 4
• 6
• 9 Correct Answer d) 9
• / 4