ATLS 10TH EDITION POST TEST
PRACTICE QUESTIONS AND CORRECT
VERIFIED ANSWERS LATEST UPGRADE
A 22-year-old male sustains a shotgun wound to the shoulder and chest at close
range. His BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly
infused, his BP increases to 122/84 and HR decreases to 100. He is tachypneic
with RR of 28. On PE, his breath sounds are decreased at the left upper chest
with dullness on percussion. A large caliber tube thoracostomy is inserted into
the fifth intercostal space with the return of 200 mL of blood and no air leak.
The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest --CORRECT ANSWER--E. Repeat
the physical exam of the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need
needle decompression followed by tube
Page 1 of 44
,Which one of the following statements concerning spine and spinal cord trauma
is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord
injury
C. A patient with a suspected spine injury requires immobilization on a short
spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign
of spine injury
E. Determination of whether a spinal cord lesion is complete or incomplete
must be made in the primary survey --CORRECT ANSWER--B. A vertebral
injury is unlikely in the absence of physical findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete.
She is unresponsive and found to have a RR of 32, BP of 90/60, and HR of 68.
The FIRST step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock --CORRECT ANSWER--D.
Applying oxygen and maintaining airway
First = ABCs
Page 2 of 44
,Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure --CORRECT ANSWER--E. Decreased pulse
pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a
ladder and landing straddled on a fence. Examination of his perineum reveals
extensive ecchymosis. There is blood in the external urethral meatus. The initial
diagnostic study for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography --CORRECT ANSWER--E. retrograde
urethrography
-> any ecchymosis, needs to be done before catheter!
A 22 year old male is brought by ambulance to a small community hospital after
falling from the top of an 8 foot ladder. Initially, he was found to have a large
Page 3 of 44
, right pneumothorax. A chest tube was inserted and connected to an underwater
seal drainage collection system with negative pressure. A repeat CXR
demonstrates a residual, large right pneumothorax. After transferring the patient
to a verified trauma center, a third chest x-ray reveals a persistent right
pneumothorax. The chest tube appears to be functioning and in good position.
He remains hemodynamically normal with no signs of respiratory distress. The
most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury --CORRECT ANSWER--E. Tracheobronchial
injury
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL
intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray --CORRECT ANSWER--D. oxygen
saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Page 4 of 44
PRACTICE QUESTIONS AND CORRECT
VERIFIED ANSWERS LATEST UPGRADE
A 22-year-old male sustains a shotgun wound to the shoulder and chest at close
range. His BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly
infused, his BP increases to 122/84 and HR decreases to 100. He is tachypneic
with RR of 28. On PE, his breath sounds are decreased at the left upper chest
with dullness on percussion. A large caliber tube thoracostomy is inserted into
the fifth intercostal space with the return of 200 mL of blood and no air leak.
The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest --CORRECT ANSWER--E. Repeat
the physical exam of the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need
needle decompression followed by tube
Page 1 of 44
,Which one of the following statements concerning spine and spinal cord trauma
is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord
injury
C. A patient with a suspected spine injury requires immobilization on a short
spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign
of spine injury
E. Determination of whether a spinal cord lesion is complete or incomplete
must be made in the primary survey --CORRECT ANSWER--B. A vertebral
injury is unlikely in the absence of physical findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete.
She is unresponsive and found to have a RR of 32, BP of 90/60, and HR of 68.
The FIRST step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock --CORRECT ANSWER--D.
Applying oxygen and maintaining airway
First = ABCs
Page 2 of 44
,Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure --CORRECT ANSWER--E. Decreased pulse
pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a
ladder and landing straddled on a fence. Examination of his perineum reveals
extensive ecchymosis. There is blood in the external urethral meatus. The initial
diagnostic study for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography --CORRECT ANSWER--E. retrograde
urethrography
-> any ecchymosis, needs to be done before catheter!
A 22 year old male is brought by ambulance to a small community hospital after
falling from the top of an 8 foot ladder. Initially, he was found to have a large
Page 3 of 44
, right pneumothorax. A chest tube was inserted and connected to an underwater
seal drainage collection system with negative pressure. A repeat CXR
demonstrates a residual, large right pneumothorax. After transferring the patient
to a verified trauma center, a third chest x-ray reveals a persistent right
pneumothorax. The chest tube appears to be functioning and in good position.
He remains hemodynamically normal with no signs of respiratory distress. The
most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury --CORRECT ANSWER--E. Tracheobronchial
injury
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL
intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray --CORRECT ANSWER--D. oxygen
saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Page 4 of 44
