ATLS TEST 1/40 QUESTIONS AND ANSWERS/ LATEST
WITHCOMPLETE SOLUTION
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure
increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory
rate is 28 breaths per minute. A tube thoracostomy is performed for decreased left chest breath
sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the
most appropriate next step is:
Select one:
a.
reexamine the chestb.
perform an aortogramc.
obtain a CT scan of the chestd.
obtain arterial blood gas analysese.
perform transesophageal echocardiography Correct ans - A)
Reexamine the chest
A construction worker falls two stories from a building and sustains bilateral calcaneal
fractures. In the emergency department, he is alert, vital signs are normal, and he is
complaining of severe pain in both heels and his lower back. Lower extremity pulses are
strong and there is no other deformity. The suspected diagnosis is most likely to be confirmed
by:
Select one:
a. angiography
b.
compartment pressuresc.
retrograde urethrogramd.
Doppler ultrasound studiese.
complete spine x-ray series Correct ans - e) Complete spine x-rayseries
Which of the following is true regarding the initial resuscitation of a traumapatient?
Select one:a.
,A patient that presents with a torso gunshot wound and is hypotensive should receive
crystalloid fluid resuscitation until the blood pressure is normal
b.
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow
coma scale score on reevaluation
c.
Massive transfusion is defined as transfusion of more than >10 of packed red blood cells and
plasma in 24 hours
d.
When tranexamic acid is administered by pre-hospital providers a second dose is required
within 24 hours
e.
Fluid resuscitation is far more important than bleeding control in traumapatients
Correct ans - b.
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow
coma scale score on reevaluation
In managing a patient with a severe traumatic brain injury, the mostimportant initial step is to:
Select one:
a.
Secure the airwayb.
obtain a c-spine filmc.
support the circulationd.
control scalp hemorrhagee.
determine the GCS score
Feedback
Your answer is corr Correct ans - a.
Secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acuteblood loss of 2 liters.
Which one of the following statements applies to this patient?Select one:
a.
His pulse pressure will be widened.b.
His urinary output will be at the lower limits of normal.c.
He will have tachycardia, but no change in his systolic blood pressure.d.
, An ABG would demonstrate a base deficit between -6 and -10 mEq/Le.
His systolic blood pressure will be maintained with an elevated diastolic pressure.
Correct ans - d.
An ABG would demonstrate a base deficit between -6 and -10 mEq/L
The physiologic hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by:
Select one:
a.
reducing the need for blood transfusionb.
resulting in an elevated hematocritc.
complicating the management of closed head injuryd.
reducing the volume of crystalloid required for resuscitatione.
increasing the volume of blood loss to produce maternal hypotension Correct ans
- e.
increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is:Select one:
a.
Urine output of 0.5 mL/kg/hrb.
normalization of blood pressurec.
normalization of the heart rated.
measuring a normal central venous pressuree.
providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid Correct ans
- a.
Urine output of 0.5 mL/kg/hr
The diagnosis of shock must include: Select
one:
a. hypoxemia
b.
acidosisc.
hypotensiond.
WITHCOMPLETE SOLUTION
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure
increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory
rate is 28 breaths per minute. A tube thoracostomy is performed for decreased left chest breath
sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the
most appropriate next step is:
Select one:
a.
reexamine the chestb.
perform an aortogramc.
obtain a CT scan of the chestd.
obtain arterial blood gas analysese.
perform transesophageal echocardiography Correct ans - A)
Reexamine the chest
A construction worker falls two stories from a building and sustains bilateral calcaneal
fractures. In the emergency department, he is alert, vital signs are normal, and he is
complaining of severe pain in both heels and his lower back. Lower extremity pulses are
strong and there is no other deformity. The suspected diagnosis is most likely to be confirmed
by:
Select one:
a. angiography
b.
compartment pressuresc.
retrograde urethrogramd.
Doppler ultrasound studiese.
complete spine x-ray series Correct ans - e) Complete spine x-rayseries
Which of the following is true regarding the initial resuscitation of a traumapatient?
Select one:a.
,A patient that presents with a torso gunshot wound and is hypotensive should receive
crystalloid fluid resuscitation until the blood pressure is normal
b.
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow
coma scale score on reevaluation
c.
Massive transfusion is defined as transfusion of more than >10 of packed red blood cells and
plasma in 24 hours
d.
When tranexamic acid is administered by pre-hospital providers a second dose is required
within 24 hours
e.
Fluid resuscitation is far more important than bleeding control in traumapatients
Correct ans - b.
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow
coma scale score on reevaluation
In managing a patient with a severe traumatic brain injury, the mostimportant initial step is to:
Select one:
a.
Secure the airwayb.
obtain a c-spine filmc.
support the circulationd.
control scalp hemorrhagee.
determine the GCS score
Feedback
Your answer is corr Correct ans - a.
Secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acuteblood loss of 2 liters.
Which one of the following statements applies to this patient?Select one:
a.
His pulse pressure will be widened.b.
His urinary output will be at the lower limits of normal.c.
He will have tachycardia, but no change in his systolic blood pressure.d.
, An ABG would demonstrate a base deficit between -6 and -10 mEq/Le.
His systolic blood pressure will be maintained with an elevated diastolic pressure.
Correct ans - d.
An ABG would demonstrate a base deficit between -6 and -10 mEq/L
The physiologic hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by:
Select one:
a.
reducing the need for blood transfusionb.
resulting in an elevated hematocritc.
complicating the management of closed head injuryd.
reducing the volume of crystalloid required for resuscitatione.
increasing the volume of blood loss to produce maternal hypotension Correct ans
- e.
increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is:Select one:
a.
Urine output of 0.5 mL/kg/hrb.
normalization of blood pressurec.
normalization of the heart rated.
measuring a normal central venous pressuree.
providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid Correct ans
- a.
Urine output of 0.5 mL/kg/hr
The diagnosis of shock must include: Select
one:
a. hypoxemia
b.
acidosisc.
hypotensiond.
