ATLS POST TEST

. Which of the following signs is LEAST reliable for diagnosing esophageal intubation? a. symmetrical chest wall movement b. end-tidal CO2 presence by colorimetry c. bilateral breath sounds d. oxygen saturation 92% e. ETT above carina on chest x-ray 2. Which of the following signs the necessitates a definitive airway in severe trauma patients? a. fascial lacerations b. repeated vomiting c. severe maxillofacial fractures d. sternal fracture e. Glasgow Coma Scale score of 12 3. Twenty-seven patients are seriously injured in an aircraft crash at a local airport. The principles of triage include: a. establish a triage site within the internal perimeter of the crash site b. treat only the most severely injured patients first c. immediately transport all patients to the nearest hospital d. treat the greatest number of patients in the shortest period of time e. produce the greatest number of survivors based on available resources 4. Which of the following statements is correct? a. Cerebral contusions may coalesce to form an intracerebral hematoma. b. Epidural hematomas are usually seen in the frontal region. c. Subdural hematomas are caused by injury to the middle meningeal artery. d. Subdural hematomas typically have a lenticular shape on CT scan. e. The associated brain damage is more severe in epidural hematomas. 5. An 18-ycar-old male is brought to the emergenc} department after having been shot. He has one bullet wound just below the right clavicle and another just below the costal margin in the right posterior axillary line. His blood pressure is110/60 mm Hg. ATLS Post Test. MCQ With Answers heart rate is 90 beats per minute, and respiratory rate is 34 breaths per minute. After ensuring a patent airway and inserting 2 large caliber IVlines., the next appropriate step is to: a. obtain a portable chest x-ray b. administer a bolus of additional IV fluid c. perform a laparotomy d. obtain an abdominal CT scan e. perform diagnostic peritoneal lavage 6. A 47-year-old house painter is brought to the hospital after falling 6 meters (20 feet) from a ladder and landing straddled on a fence. Examination of his perineum reveals extensive ecchymosis. There is a blood in the external urethral meatus. The initial diagnostic study for the evaluation of the urinary tract in this patient should be: a. cystoscopy b. cystography c. intravenous pyelography d. CT scan e. retrograde urethrography 7. Neurogenic shock has all of the following classic characteristics except which one? a. hypotension b. vasodilation c. bradycardia d. neurologic deficit e. narrowed pulse pressure 8. Which one of the following statements is false concerning Rh isoimmunization in pregnant trauma patients? a. It occurs in blunt or penetrating abdominal trauma. b. It is produced by minor degrees of fetomaternal hemorrhage. c. Rh immunoglobulin therapy should be administered to pregnant females who have sustained a gunshot wound to the leg. d. This is not a problem in traumatized, Rh-positive pregnant patients. e. Initiation of Rh immunoglobulin therapy does not require proof of fetomaternal hemorrhage. 9. An 18-year-old motorcyclist sustains massive facial injuries in a head-on crash with a pick-up truck. He is brought to the emergency department completely immobilized on a long spine board and wearing a cervical collar. His blood pressure is 150/88 mmHg, heart rate is 88 beats per minute and regular, and respiratory rate is 26 breaths per minute. His respirations are labored and sonorous. His Glasgow Coma Scale score is 7. Attempts at orotracheal intubation with manual inline stabilization of the c-spine are unsuccessful due to bleeding and distorted anatomy. The patient becomes apneic. The best procedure for airway management in this situation is: a. nasotracheal intubation b. emercency tracheostomy c. surgical cricothyroidotomy d. placement of an oropharyngeal airway e. placement of a nasopharyngeal airway 10. a 25-year-old male is brought to the hospital after sustaining partial and full-thickness burns involving 60% of his body surface area. His right arm and hand are severely burned. There are obvious full-thickness burns of the entire right hand and a circumferential burn of the right arm. Pulses are absent at the right wrist and are not detected by Doppler examination. The first step management of the right upper extremity should be: a. fasciotomy b. angiography c. escharotomy d. heparinization e. tangential excision 11. All of the following signs on the chest x-ray of a patient who sustained a blunt injury may suggest aortic rupture except which one? a. mediastinal emphysema b. presence of a pleural cap c. obliteration of the aortic knob d. deviation of the trachea to the right e. depression of the left mainstem bronchus 12. A 30-year-old woman fell down four stairs landing on concrete. Witnesses report she was unconscious for five minutes beginning immediately after the fall. She regained full consciousness during the ten minute transport to the hospital. Upon arrival in the emergency department, she is awake, alert, and responsive with a Glasgow Coma Scale score of 15. Her only complaint is a slight headache. Thirty minutes later, she becomes unresponsive with a Glasgow Coma Scale score of 6. On the exam, her left pupil is large and non-reactive. The right pupil is normal. The one type of neurological injury most consistent with this patient's entire clinical course since her fall is: a. a subdural hematoma b. an epidural hematoma c. an occipital lobe hemorrhage d. focal subarachnoid hemorrhage e. a cerebellar hemorrhage 13. 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 is 140 beats per minute, and respiratory rate is 36 breaths 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 is 7,21. 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 phenylephrine infusion 14. Which of the following should be performed first in any patient whose injuries may include multiple closed extremity fractures? a. A thorough assessment of four limb perfusion. b. Maneuvers to prevent necrosis of the skin. c. Extremity compartment syndrome release. d. Ensuring adequate oxygenation and ventilation. e. Evaluation for occult crush syndrome. 15. 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, 2 liters of crystalloid solution are infused rapidly through two large-caliber IV lines, and a closed tube thoracostomy is performed with the return of 200 mL of blood. A chest x-ray reveals correct placement of the chest tube and a small residual hemothorax. His blood pressure is now 70/0 mmHg, and his heart rate is 140 beat per minute. The most appropriate next step in managing this patient is to: a. insert a second chest tube b. obtain a CT scan of the abdomen c. perform a thoracotomy in the emergency department d. perform a laparotomy in the operating room e. perform a FAST exam 16. You are treating a trauma patient and attempt a definitive airway by intubation. However, the vocal cords are not visible. What tool would be the most valuable for achieving successful intubation? a. gum elastic bougie b. lateral cervical spine x-ray c. nasopharyngeal airway d. oxygen e. laryngeal mask airway 17. A 79-year-old female is involved in a motor vehicle crash and presents to the emergency department. She is on Coumadin and a beta-blocker. Which of the following statements is true concerning her management? a. The risk of subdural hemorrhage is decreased. b. Absensce of tachycardia indicates that the patient is hemodynamically normal. c. Non-operative management of abdominal injuries is more likely to be successful in older adults than in younger patients. d. Vigorous fluid resuscitation may be associated with cardiorespiratory failure e. Epinephrine should be infused immediately for hypotension 18. A 22-year-old male is brought by ambulance to a small community hospital after falling from the top of a 2.4-meter (8-foot) ladder. Initially, he was found to have a large right pneumothorax. A chest tube was inserted and connected to an underwater seal drainage collection system with negative pressure. A repeat AP portable chest x-ray demonstrates a residual, large right pneumothorax. After transferring the patient to a verified trauma center, a third chest x-ray reveals a persistent right pneumothorax. The chest tube appears to be funcioning and in good position. He remains hemodynamically normal with no signs of respiratory distress. The most likely cause for his persistent right pneumothorax is: a. flail chest b. diaphragmatic injury c. pulmonary contusion d. esophageal perforation e. tracheobronchial injury 19. A 22-year-old female who is 6 months pregnant presents following a motor vehicle crash. Paramedics report vaginal bleeding. What is the initial step in her treatment? a. assess fetal heart sounds b. check for fetal movement c. perform inspection of the cervic d. ask the patient what her name is e. insert a wedge under the patient's right hip