ATLS Post Test 2021 QUESTIONS AND ANSWERS

1. The primary indication for transferring a patient to a higher level trauma center is:patient to a higher level trauma center is: unavailability of a surgeon or operating roomunavailability of a surgeon or operating room . multiple system injuries, including severemultiple system injuries, including severe head injury. resource limitations as determined by theresource limitations as determined by the transferring ferring doctor. resource limitations as determined by theresource limitations as determined by the hospital tal administration. widened mediastinum on chest x-raywidened mediastinum on chest x-ray following blunt thoracic wing blunt thoracic trauma. 2. teen-aged bicycle rider is hit b2. teen-aged bicycle rider is hit by a trucky a truck traveling at a high rate of ling at a high rate of speed. In theIn the emergency department, she is actively bleedingemergency department, she is actively bleeding from open fractures of her legs, and hasfrom open fractures of her legs, and has abrasions on her chest and abdominalabrasions on her chest and abdominal wall. Herwall. Her blood pressure is 80/50 mm Hg, heart rate isblood pressure is 80/50 mm Hg, heart rate is 140 beats per minute, respiratory rate is 8140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is hs per minute, and GCS score is 6. The first step in managing this patient is to:The first step in managing this patient is to: obtain a lateral cervical spine n a lateral cervical spine x-ray. insert a central venous pressure t a central venous pressure line. administer 2 liters of crystalloid ister 2 liters of crystalloid solution. perform endotracheal intubation andperform endotracheal intubation and lation. apply the PASG and inflate the legapply the PASG and inflate the leg rtments. 3. Contraindication to nasogastric intubation is3. Contraindication to nasogastric intubation is the presence of a:the presence of a: gastric ic perforation. diaphragmatic ragmatic rupture. open depressed skull depressed skull fracture. fracture of the cervical ure of the cervical spine. fracture of the cribriform ure of the cribriform plate. 4. Which one of the following statements4. Which one of the following statements regarding patients with thoracic spine injuries isregarding patients with thoracic spine injuries is TRUE?TRUE? Log-rolling may beLog-rolling may be destabilizing todestabilizing to fractures from T-12 to L-ures from T-12 to L-1. Adequate immobilization can beAdequate immobilization can be accomplished with the scoop plished with the scoop stretcher. Spinal cord injury below T-10 usually sparesSpinal cord injury below T-10 usually spares bowel and bladder and bladder function. Hyperflexion fractures in the upperHyperflexion fractures in the upper thoracic spine are inherently cic spine are inherently unstable. These patients rarely present with spinalThese patients rarely present with spinal shock in association with cord in association with cord injury. 5. young man sustains a ritle wound to the mid-5. young man sustains a ritle wound to the mid- abdomen. He is brought promptly to theabdomen. He is brought promptly to the emergency department by prehospitalemergency department by prehospital personnel. His skin is cool and diaphoretic, andpersonnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58 rnm H systolic blood pressure is 58 rnm Hg. WWarmed crystalloid fluids arearmed crystalloid fluids are initiated withoutinitiated without improvement in his vital signs. The next, mostimprovement in his vital signs. The next, most appropriate step is to perform:appropriate step is to perform: a celiotomy.a celiotomy. an abdominal CT abdominal CT scan. diagnostic ostic laparoscopy. abdominal inal ultrasonography. a diagnostic peritoneal lavage.a diagnostic perit