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1. A 24-year-old male pedestrian, struck by an automobile, is admitted
to the emergency department 1 hour after injury. His blood pressure is
80/60 mmHg, heart rate 140 beats per minute and respiratory rate is 36
per minute. He is lethargic. Oxygen is delivered via face mask, and two
large-caliber IVs are initiated. Arterial blood gases are obtained. His
PaO2 is 118 mmHg (15.7 kPa), PaCO2 is 30 mmHg (4.0 kPa), and pH
is7.21. The treatment of his acid-base disorder is best accomplished by:
a. Hyperventilation
b. Restoration of normal perfusion
c. Initiation of low-dose dopamine
d. Administration of sodium bicarbonate
e. Initiation of phenylepinephrine infusion
2. The highest priority in managing a patient whose injuries include
closed extremity fractures is:
a. Assesing limb perfusion
b. Preventing necrosis of the skin
c. Decompressing compartment syndrome
d. Addressing
respiratory
insufficiencyIdentifyi
ng crush syndrome
,3. A 34-year-old female is involved in a motor vehicle crash is brought to
the emergency department. Sheis talking, but her voice is hoarse and on
exposure she has diagonal bruising of the chest and anterior neck. What
is the next step?
a. Direct laryngoscopy to exclude laryngeal trauma
b. Oxygen by non-rebreathing mask
, c. Protecting the spine by making her lie down
d. Palpation of the anterior neck
e. Attaching a pulse oximeter to her finger
4. A 30-year-old male sustains a gunshot wound to the right lower chest,
midway between the nipple and the costal margin. He is brought by
ambulance to a hospital that has full surgical capabilities. In the
emergency department he is endotracheally intubated, fluid
resuscitation is initiated through two large-caliber IV lines, and a