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ATLS Practice Test 1
1. Which one of the following is the recommended method for initially treating frostbite?
a. vasodilators
b. anticoagulants
c. warm (40°C) water
d. padding and elevation
e. application of heat from a hair dryer
2. A 6yearold boy is struck by an automobile and brought to the emergency department.
He is lethargic, but withdraws purposefully from painful stimuli. His blood pressure is 90
mm Hg systolic, heart rate is 140 beats per minute, and his respiratory rate is 36 breaths
per minute. The preferred route of venous access in this patient is:
a. percutaneous femoral vein cannulation.
b. cutdown on the saphenous vein at the ankle.
c. intraosseous catheter placement in the proximal tibia.
d. percutaneous peripheral veins in the upper extremities.
e. central venous access via the subclavian or internal jugular vein.
3. Which one of the following physical findings suggests a cause of hypotension
other than
spinal cord injury?
a. priapism.
b. bradycardia.
c. diaphragmatic breathing.
d. presence of deep tendon reflexes.
e. ability to flex forearms but inability to extend them.
4. A young man sustains a gunshot wound to the abdomen and is brought promptly to the
emergency department by prehospital personnel. His skin is cool and diaphoretic, and he
is confused. His pulse is thready and his femoral pulse is only weakly palpable. The
definitive treatment in managing this patient is to:
a. administer Onegative blood.
b. apply external warming devices.
c. control internal hemorrhage operatively.
d. apply a pneumatic antishock garment (PASG).
e. infuse large volumes of intravenous crystalloid solution.
1
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5. Regarding shock in the child, which of the following is
FALSE ?
a. Vital signs are agerelated.
b. Children have greater physiologic reserves than do adults.
c. Tachycardia is the primary physiologic response to hypovolemia.
d. The absolute volume of blood loss required to produce shock is the same as in
adults.
e. An initial fluid bolus for resuscitation should approximate 20 mL/kg of Ringer's
lactate.
6. A 33yearold 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 182 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 144 beats per minute, his respiratory rate decreases to 36 breaths per minute,
and his blood pressure is 81/53 mm Hg. Warmed Ringer's lactate is administered
intravenously. The next priority should be to:
a. perform external fixation of the pelvis.
b. obtain abdominal and pelvic CT scans.
c. perform arterial embolization of the pelvic vessels.
d. perform diagnostic peritoneal lavage or FAST.
e. perform a urethrogram and cystogram.
7. A 42yearold man, injured in a motor vehicle crash, suffers a closed head injury,
multiple palpable left rib fractures, and bilateral femur fractures. He is intubated
orotracheally without difficulty. Initially, his ventilations are easily assisted with a
bagmask device. It becomes more difficult to ventilate the patient over the next 5
minutes, and his hemoglobin oxygen saturation level decreases from 98% to 89% . The
most appropriate next step is to:
a. obtain a chest xray.
b. decrease the tidal volume.
c. decrease PEEP.
d. increase the rate of assisted ventilations.
e. perform needle decompression of the left chest.
2
ATLS Practice Test 1
1. Which one of the following is the recommended method for initially treating frostbite?
a. vasodilators
b. anticoagulants
c. warm (40°C) water
d. padding and elevation
e. application of heat from a hair dryer
2. A 6yearold boy is struck by an automobile and brought to the emergency department.
He is lethargic, but withdraws purposefully from painful stimuli. His blood pressure is 90
mm Hg systolic, heart rate is 140 beats per minute, and his respiratory rate is 36 breaths
per minute. The preferred route of venous access in this patient is:
a. percutaneous femoral vein cannulation.
b. cutdown on the saphenous vein at the ankle.
c. intraosseous catheter placement in the proximal tibia.
d. percutaneous peripheral veins in the upper extremities.
e. central venous access via the subclavian or internal jugular vein.
3. Which one of the following physical findings suggests a cause of hypotension
other than
spinal cord injury?
a. priapism.
b. bradycardia.
c. diaphragmatic breathing.
d. presence of deep tendon reflexes.
e. ability to flex forearms but inability to extend them.
4. A young man sustains a gunshot wound to the abdomen and is brought promptly to the
emergency department by prehospital personnel. His skin is cool and diaphoretic, and he
is confused. His pulse is thready and his femoral pulse is only weakly palpable. The
definitive treatment in managing this patient is to:
a. administer Onegative blood.
b. apply external warming devices.
c. control internal hemorrhage operatively.
d. apply a pneumatic antishock garment (PASG).
e. infuse large volumes of intravenous crystalloid solution.
1
, atls.yolasite.com
5. Regarding shock in the child, which of the following is
FALSE ?
a. Vital signs are agerelated.
b. Children have greater physiologic reserves than do adults.
c. Tachycardia is the primary physiologic response to hypovolemia.
d. The absolute volume of blood loss required to produce shock is the same as in
adults.
e. An initial fluid bolus for resuscitation should approximate 20 mL/kg of Ringer's
lactate.
6. A 33yearold 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 182 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 144 beats per minute, his respiratory rate decreases to 36 breaths per minute,
and his blood pressure is 81/53 mm Hg. Warmed Ringer's lactate is administered
intravenously. The next priority should be to:
a. perform external fixation of the pelvis.
b. obtain abdominal and pelvic CT scans.
c. perform arterial embolization of the pelvic vessels.
d. perform diagnostic peritoneal lavage or FAST.
e. perform a urethrogram and cystogram.
7. A 42yearold man, injured in a motor vehicle crash, suffers a closed head injury,
multiple palpable left rib fractures, and bilateral femur fractures. He is intubated
orotracheally without difficulty. Initially, his ventilations are easily assisted with a
bagmask device. It becomes more difficult to ventilate the patient over the next 5
minutes, and his hemoglobin oxygen saturation level decreases from 98% to 89% . The
most appropriate next step is to:
a. obtain a chest xray.
b. decrease the tidal volume.
c. decrease PEEP.
d. increase the rate of assisted ventilations.
e. perform needle decompression of the left chest.
2
