ATLS Post Test actual QUESTIONS AND verified

ATLS Post Test (actual ) QUESTIONS AND verified

ANSWERS

Supraglottic airway devices:

• Are equivalent to endotracheal intubation
• Require neck extension for proper placement
• Are preferable to endotracheal intubation in a patient who

cannot lie flat

• Are of value as part of a difficult or failed intubation plan
• Provide one form of definitive airway - ---Answers----D.

Are of value as part of a difficult or failed intubation plan

A 25 year old male is brought to the hospital after sustaining partial and full thickness burns involving 60% of his body surface area. His right arm and hand are severly burned.There are obvious full thickness burns of the entire right hand and a circumferential burn of the right arm. Pulses are absent at the right wrist and a circumferential burn of the right arm.Pulses are absent at the right wrist and are not detected by Doppler examination. The first step in management of the right

upper extremity should be:

• Fasciotomy
• Angiography
• Escharatomy
• Heparinization
• Tangenital excision - ---Answers----C. Escharatomy

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Early central venous pressure monitoring during fluid

resusciation in the ED has the greatest utility in a:

• Patient with a splenic laceration
• Patient with a inhalation injury
• 6 year-old child with a pelvic fracture
• Patient with a severe cardiac contusion
• 24-year-old man with a massive hemothorax - ---

Answers----D. Patient with a severe cardiac contusion

32 year old male is brought to the hospital unconscious with severe facial injuries and noisy respirations after an automobile collision. In the emergency department, he has no apparent injury to the anterior aspect of his neck. He suddenly becomes apneic, and alternative ventilation with a face mask is unsuccessful. Examination of his mouth reveals a large hematoma of the fairing with loss of normal atomic landmarks.

Initial management of his airway should consist of:

• Nasotracheal intubation
• Emergency tracheostomy
• Surgical cricothyroidotomy
• Placement of an oropharyngeal airway
• Placement of an nasopharyngeal airway - ---Answers----
• Surgical cricothyroidotomy

42 year old man injured in a motor vehicle crash, suffers a closed, head injury, multiple palpable left roof fracture, 2 / 4

bilateral femur fracture. He is intubated orotracheally without difficulty. Initially, has ventilations are easily assisted with a bag device. It becomes more difficult to ventilate the patient over the next five minutes, and his hemoglobin oxygen saturation level decreases from 90% to 89%. The most

appropriate next step is to: - ---Answers----Auscultate the

patient's chest

42 year olds man is trapped from the waist down beneath his overturned tractor for several hours before Medical systemized. He is awake and alert until just before arriving in emergency department. He is now unconscious in response only to painful stimulate by moaning. His pupils are 3 mm in diameter and symmetrically reactive delight. Prehospital personnel indicate that they have not seen the patient move

either of his lower extremities.: - ---Answers----A pelvic

fracture

An electrician is eletrocuted by a downed power line after a thunderstorm. He apparently made contact with the wire at the level of the right mid thigh. In the ED, his vital signs are normal and no dysrythmia is noted on ECG. On examination, there is an exit wound on the bottom of the right foot. His urine is positive for blood by dipstick but not RBCs are seen

microscopically. Initial management should include:

• Immediate angiography
• Aggressive fluid infusion
• Intravenous pyelography
• Debridement of necrotic muscle 3 / 4

• Admission to the ICU for observation - ---Answers----B.

Aggressive fluid infusion - suspected rhabdomyolyse

Which one of the following physical findings suggest the causes of hypertension, other than spinal cord injury? - --- Answers----Presence of deep tendon and reflexes

Hypertension following a head injury:

• Should be treated to reduce intracranial pressure
• Indicates pre-existing hypertension
• May indicate imminent hernation from critically high

intracranial pressure

• Mandates prompt administration of Mannitol
• Should prompt burr hole drainage of potential subdural

hematomas - ---Answers----A. Should be treated to reduce intracranial pressure

Regarding shock in the child, which of the following is FALSE?

• Vital signs are age-related
• Children have greater physiologic reserves than do adults
• Tachycardia is the primary physiologic response to

hypovolemia

• The absolute volume of blood loss required to produce

shock is the same as in adults

• An initial fluid bolus for resuscitation should approximate

20ml/kg Ringers Lactate - ---Answers----D. The absolute

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