ATLS POST TEST 4 ACTUAL LATEST

ATLS POST TEST 4 ACTUAL LATEST

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QUESTIONS AND CORRECT ANSWERS

|GRADED A+

A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His BP is initially 80/40 mmHg. After 2 liters of crystalloid solution his blood pressure increases to 122/84 mmHg. 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 sound with the return of small amount of blood and

no air leak. After chest tube insertion, the appropriate next step is to:

• Reexamine the chest
• Perform an aortogram
• Obtain a CT scan of the chest
• Obtain arterial blood gas analyses
• Perform transesophageal echocardiography - ANSWER✔✔A

A 22-year-old female athlete is stabbed in her left chest at the third interspace in the anterior axillary line. On admission to the ED and 15 minutes after the incident, she is awake and alert. Her heart rate is 100 beats per minute, BP 80/60 mmHg, and respiratory rate is 20 breaths per minute. A chest x-ray reveals a large left hemithorax.A left chest tube is placed with an immediate return of 1600 ml of blood. The next

management step for this patient is:

• Perform a thoracoscopy 1 / 4

• Perform an arch aortogram
• Insert a second left chest tube
• Prepare for an exploratory thoracotomy
• Perform a chest CT - ANSWER✔✔D

A 56-year-old man is thrown violently against the steering wheel of his truck during a motor vehicle crash. On arrival in the ED, he is diaphoretic and complaining of chest pain. His BP is 60/40 mmHg and his respiratory rate is 40 breaths per minute. Which of the following best differentiates cardiac tamponade from tension pneumothorax as the cause of his hypotension?

• Tachycardia
• Pulse volume
• Breath sounds
• Pulse pressure
• Jugular venous pressure - ANSWER✔✔C

All of the following are true of the Mallampati classification EXCEPT:

• Class IV is easiest intubation, while Class I is the most difficult
• It helps assess for difficult intubations
• It is part of the LEMON assessment
• It comprises a visual assessment of the distance from the tongue base to roof of

mouth, and therefore the amount of space there is to work

• A poor Mallampati score is associated with a higher incidence of obstructive sleep

apnea - ANSWER✔✔A 2 / 4

A 23-year-old man sustains three 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 intubates, closed tube thoracostomy is performed, and 2 liters of crystalloid solution are infused through 2 large-caliber IVs. His BP is 60/0 mmHg, 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:

• Perform FAST
• Obtain a CT of the chest
• Perform angiography
• Urgently transfer the patient to the operating room
• Immediately transfer the patient to a trauma center - ANSWER✔✔D

Which of the following signs is LEAST reliable for diagnosing esophageal intubation?

• Symmetrical chest movement
• End-tidal CO2 presence by colorimetry
• Bilateral breath sounds
• Oxygen saturation >92%
• ETT above carina chest x-ray - ANSWER✔✔D

Which one of the following necessitates a definitive airway in severe trauma patients?

• Facial lacerations
• Repeated vomiting 3 / 4

• Severe maxillofacial fracture
• Sternal fracture
• GCS score of 12 - ANSWER✔✔C

Which one of the following statements is correct?

• Cerebral contusion may coalesce to form an intracerebral hematoma
• Epidural hematomas are usually seen in frontal region
• Subdural hematomas are caused by injury to the middle meningeal artery
• Subdural hematomas typically have a lenticular shape on CT scan
• The associated brain damage is more severe in epidural hematomas -

ANSWER✔✔E

An 18-year-old male is brought to the ED after having been shot. He has one bullet wound just below the right clavicle and another just below the costal margin in the right posterior axillary line. His BP is 110/60, HR is 90 bpm, and RR is 34 breaths per minute.After ensuring a patent airway and inserting 2 large caliber IV line, the next appropriate

step is to:

• Obtain a chest x-ray
• Administer a bolus of additional IV fluid
• Perform a laparotomy
• Obtain abdominal CT scan
• Perform DPL - ANSWER✔✔A

A 22-year-old male sustains a shotgun wound to the left shoulder and chest at close range. His BP is 80/40 mmHg and his HR is 130 bpm. After 2 liters of crystalloid

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