REVISED ATLS POST TEST WITH
QUESTIONS AND ANSWERS 100%
SCORED A+
The primary indication for transferring a patient to a higher-level trauma
center is: unavailability of a surgeon or operating room staff.
multiple system injuries, including severe head injury.
resource limitations as determined by the transferring
doctor.
resource limitations as determined by the hospital
administration. widened mediastinum on chest x-ray following
blunt thoracic trauma.
teen-aged bicycle rider is hit by a truck traveling at a high rate of speed. In the
emergency department, 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 mm Hg, 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 the PASG and inflate the leg compartments.
Contraindication to nasogastric intubation is the presence
of a: gastric perforation.
diaphragmatic rupture.
, open depressed skull fracture.
fracture of the cervical spine. fracture of the cribriform plate.
Which one of the following
statements regarding patients with thoracic
spine injuries is TRUE?
Log-rolling may be destabilizing to fractures from T-12 to L-1.
Adequate immobilization can be accomplished with the scoop stretcher.
Spinal cord injury below T-10 usually spares bowel and bladder
function. Hyperflexion fractures in the upper thoracic spine are
inherently unstable. These patients rarely present with spinal shock in
association with cord injury.
young man sustains a ritle wound to the mid- abdomen. He is brought
promptly to the emergency department by prehospital
personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58 rnm Hg.
Warmed crystalloid fluids are initiated without improvement in his vital signs. The next,
most appropriate step is to perform:
a celiotomy. an abdominal CT scan.
diagnostic laparoscopy.
abdominal ultrasonography.
a diagnostic peritoneal lavage.
young woman sustains a severe head injury as the result of a motor vehicular
crash. In the emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is
intubated and is being mechanically ventilated. Her pupils are 3 mm in size and equally
reactive to light. There is no other apparent injury. The most important principle to follow
in the early management of her head injury is to:
administer an osmotic diuretic. prevent secondary brain injury. aggressively treat systemic
hypertension.
reduce metabolic requirements of the brain.
distinguish between intracranial hematoma
and cerebral edema.
, 22-year-old man is brought to the hospital after crashing his motorcycle into a telephone
pole. He is unconscious and in profound shock. He has no open wounds or obvious
fractures. The cause of his shock is MOST LIKELY caused by:
9. 8-year-old girl is an unrestrained passenger in a vehicle struck from behind. In the
emergency department, her blood pressure is 80/60 mm Hg, heart rate is 80 beats per
minute, and respiratory rate is 16 breaths per minute. Her GCS score is 14. She complains
that her legs feel "funny and won't move right;" however, her spine x-rays do not show a
fracture or dislocation. A spinal cord injury in this child: is most likely a central cord
syndrome.
must be diagnosed by magnetic resonance imaging.
a subdural hematoma.
an epidural hematoma. a transected lumbar spinal cord.
a transected cervical spinal cord. hemorrhage into the chest or abdomen.
8. 30-year-old man is struck by a car traveling at 56 kph (35 mph). He has obvious
fractures of the left tibia near the knee, pain in the pelvic area, and severe dyspnea. His
heart rate is 180
beats per minute, and his respiratory rate is 48 breaths per minute with no breath sounds
heard in the left chest. A tension pneumothorax is relieved by immediate needle
decompression and tube thoracostomy. Subsequently, his heart rate decreases to 140 beats
per minute, his respiratory rate decreases to 36 breaths per minute, and his blood
pressure is 80/50 inm Hg. Warmed Ringer's lactate is administered intravenously. The next
priority should be to: perform a urethrogram and cystogram.
perform external fixation of the pelvis.
obtain abdominal and pelvic CT scans.
perform arterial embolization of the pelvic vessels.
can be excluded by obtaining a CT of the entire spine.
may exist in the absence of objectivefindings on x-ray studies. is unlikely because
of the incomplete
calcification of the vertebral bodies.
10. Immediate chest tube insertion is indicated for which of the following conditions?
QUESTIONS AND ANSWERS 100%
SCORED A+
The primary indication for transferring a patient to a higher-level trauma
center is: unavailability of a surgeon or operating room staff.
multiple system injuries, including severe head injury.
resource limitations as determined by the transferring
doctor.
resource limitations as determined by the hospital
administration. widened mediastinum on chest x-ray following
blunt thoracic trauma.
teen-aged bicycle rider is hit by a truck traveling at a high rate of speed. In the
emergency department, 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 mm Hg, 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 the PASG and inflate the leg compartments.
Contraindication to nasogastric intubation is the presence
of a: gastric perforation.
diaphragmatic rupture.
, open depressed skull fracture.
fracture of the cervical spine. fracture of the cribriform plate.
Which one of the following
statements regarding patients with thoracic
spine injuries is TRUE?
Log-rolling may be destabilizing to fractures from T-12 to L-1.
Adequate immobilization can be accomplished with the scoop stretcher.
Spinal cord injury below T-10 usually spares bowel and bladder
function. Hyperflexion fractures in the upper thoracic spine are
inherently unstable. These patients rarely present with spinal shock in
association with cord injury.
young man sustains a ritle wound to the mid- abdomen. He is brought
promptly to the emergency department by prehospital
personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58 rnm Hg.
Warmed crystalloid fluids are initiated without improvement in his vital signs. The next,
most appropriate step is to perform:
a celiotomy. an abdominal CT scan.
diagnostic laparoscopy.
abdominal ultrasonography.
a diagnostic peritoneal lavage.
young woman sustains a severe head injury as the result of a motor vehicular
crash. In the emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is
intubated and is being mechanically ventilated. Her pupils are 3 mm in size and equally
reactive to light. There is no other apparent injury. The most important principle to follow
in the early management of her head injury is to:
administer an osmotic diuretic. prevent secondary brain injury. aggressively treat systemic
hypertension.
reduce metabolic requirements of the brain.
distinguish between intracranial hematoma
and cerebral edema.
, 22-year-old man is brought to the hospital after crashing his motorcycle into a telephone
pole. He is unconscious and in profound shock. He has no open wounds or obvious
fractures. The cause of his shock is MOST LIKELY caused by:
9. 8-year-old girl is an unrestrained passenger in a vehicle struck from behind. In the
emergency department, her blood pressure is 80/60 mm Hg, heart rate is 80 beats per
minute, and respiratory rate is 16 breaths per minute. Her GCS score is 14. She complains
that her legs feel "funny and won't move right;" however, her spine x-rays do not show a
fracture or dislocation. A spinal cord injury in this child: is most likely a central cord
syndrome.
must be diagnosed by magnetic resonance imaging.
a subdural hematoma.
an epidural hematoma. a transected lumbar spinal cord.
a transected cervical spinal cord. hemorrhage into the chest or abdomen.
8. 30-year-old man is struck by a car traveling at 56 kph (35 mph). He has obvious
fractures of the left tibia near the knee, pain in the pelvic area, and severe dyspnea. His
heart rate is 180
beats per minute, and his respiratory rate is 48 breaths per minute with no breath sounds
heard in the left chest. A tension pneumothorax is relieved by immediate needle
decompression and tube thoracostomy. Subsequently, his heart rate decreases to 140 beats
per minute, his respiratory rate decreases to 36 breaths per minute, and his blood
pressure is 80/50 inm Hg. Warmed Ringer's lactate is administered intravenously. The next
priority should be to: perform a urethrogram and cystogram.
perform external fixation of the pelvis.
obtain abdominal and pelvic CT scans.
perform arterial embolization of the pelvic vessels.
can be excluded by obtaining a CT of the entire spine.
may exist in the absence of objectivefindings on x-ray studies. is unlikely because
of the incomplete
calcification of the vertebral bodies.
10. Immediate chest tube insertion is indicated for which of the following conditions?
