ATLS EXAM PRE AND POST EXAMS NEWEST -

• | P a g e

ATLS EXAM PRE AND POST EXAMS NEWEST -

300 FREQUENTLY TESTED

QUESTIONS AND CORRECT DETAILED ANSWER S

(VERIFIED ANSWERS ) |ALREADY GRADED

A+||BRAND NEW VERSION!!

A 30-year-old man sustains a severely comminuted, open, distal right femur fracture in a motorcycle crash. The wound is actively bleeding.Normal sensation is present over the lateral aspect of the foot but decreased over the medial foot and great toe. Normal motion of the foot is observed. Dorsalis pedis and posterior tibial pulses are easily palpable on the left, but heard only by Doppler on the right. Immediate efforts to

improve circulation to the injured extremity should involve:

• Immediate angiography
• Tamponade of the wound with a pressure dressing
• Would exploration and removal of bony fragments
• Realignment of the fracture segments with a traction splint
• Fasciotomy of all four compartments in the lower extremity -

ANSWER- D

An 18-year-old, unhelmeted motorcyclist is brought by ambulance to the ED following a crash. He had decreased level of consciousness at the scene, but then was alert and conversational during transportation. Now his GCS is only 11. Which of the following statements is TRUE?

• Cerebral perfusion is intact 1 / 4

• | P a g e

• Intravascular volume status is normal
• The patient is in a postictal state
• Intra-abdominal visceral injury is unlikely
• The patient probably has an acute epidural hematoma - ANSWER- E

A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss of two liters. Which one of the following statements apply to this patient?

• His pulse pressure will be widened
• His urinary output will be at the lower limits of normal
• He will have tachycardia, but no change in systolic blood pressure
• His systolic blood pressure will be decreased with a narrowed, pulse

pressure

• His systolic blood pressure will be maintained with an elevated

diastolic pressure - ANSWER- D

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
• Complicating the management of closed head injury
• Increasing the volume of blood loss to produce shock/maternal

hypotension

• Reducing the volume of crystalloid required for resuscitation -

ANSWER- D 2 / 4

• | P a g e

A 17-year-old helmeted motorcyclist loses consciousness when he is struck broadside by an automobile at an intersection. He arrives in the ED with a blood pressure of 140/92, pulse rate 88 beats per minute, a respiratory rate of 18 breaths per minute, and a GCS of 7. Appropriate initial immobilization of this patient should include a semi-rigid cervical

collar and:

• A scoop stretcher
• A long spine board
• A short spine board
• Cervical traction tongs
• Pneumatic antishock - ANSWER- B

During an altercation, a 36-year-old man sustains a gunshot wound above the nipple line on the right, with an exit wound posteriorly above the scapula on the right. He is transported by ambulance to a community hospital. He is endotracheally intubated, close tube thoracostomy is performed, and 2 liters Ringers lactate solution are infused via 2 large- caliber IV's. His blood pressure now is 60/0 mmHg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% O2). The most appropriate next step in managing

this patient is:

• Laparotomy
• Diagnostic peritoneal lavage
• Arterial blood gas determination
• Administer packed red blood cells
• Chest X-ray to confirm tube placement - ANSWER- E 3 / 4

• | P a g e

A 23-year-old man is brought immediately to the ED 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:

• Perform a diagnostic peritoneal lavage
• Initiate infusion of packed red blood cells
• Insert a nasogastric tube and urinary catheter
• Transfer the patient to the operating room, while initiating fluid

therapy

• Initiate fluid therapy to return his blood pressure to normotensive -

ANSWER- D

A teen-aged bicycle rider is hit by a truck traveling at high speed. In the ED, 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 mmHg, 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 a pneumatic antishock garment (PASG) and inflate the leg

compartments - ANSWER- D

• / 4