ATLS Post Test 2023 QUESTIONS AND ANSWERS

ATLS Post Test 2023 QUESTIONS AND ANSWERS The primary indication for transferring A patient to a higher level trauma center is: A. Unavailibility of surgeon or operating staff B. Multiple system injuries, including severe head injury C. Resource limitations as determined by the transferring doctor D. Resource limitations as determined by the hospital administration E. Widened mediastinum on chest x -ray following blunt trauma - ANS: -C. Resource limitations as determined by the transferri ng doctor (MÅ SJEKKES) A teen -aged bicycle rider is hit by a truck traveling at hig h speed. In the ED, she is actively bleeding from open fractures of her legs, and has abrasions on her chest and abdominal wall. Her blood pressure is 80/50 mmHg, heart rate is 140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6. The first step in managing this patient is to: A. Obtain a lateral cervical spine x -ray B. Insert av central venous pressure line C. Adminster 2 liters of crystalloid solution D. Perform endotracheal intubation and ventilation E. Apply a pneumatic ant ishock garment (PASG) and inflate the leg compartments. - ANS: -D. Perform endotracheal intubation and ventilation A contraindication to nasogastric intubation is the presence of a: A. Gastric perforation B. Diaphragmatic rupture C. Open depressed skull fr acture D. Fracture of the cervical spine E. Fracture of the cribiform plate - ANS: -E. Fracture of the cribiform plate Which one of the following statements r egarding abdominal trauma in the pregnant patient is TRUE? A. The fetus is in jeopardy only with major abdominal trauma B. Leakage of amniotic fluid is an indication for hospital admission C. Indications for peritoneal lavage are different from those in th e non -pregnant patient D. Penetration of an abdominal hollow viscus is mor common late than in early pregnancy E. The secondary survey follows a different pattern from that of the non -pregnant patient - ANS: -B. Leakage of amniotic fluid is an indication for hospital admission A young man sustains a rifle wound to the mid -abdomen. He is brought promptly to the ED by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58mmHg. Warmed crystalloid fluids are initiated without impro vement in his vital signs. The next, most appropriate, step is to perform: A. a laparotomy B. An abdominal CT -scan C. Diagnostic laparoscopy D. Abdominal ultrasonography E. A diagnostic peritoneal lavage - ANS: -A. Laparotomy because of hemodynamic abnormali ty young woman sustains a severe head injury as the result of a motor vehicular crash. In the emergency department, her GCS score is 6. Her blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is in tubated and is being mechanically ventilated. Her pupils are 3 mm in size and equally reactive to light. There is no other apparent injury. The most important principle to follow in the early management of her head injury is to: administer an osmotic diu retic. prevent secondary brain injury. aggressively treat systemic hypertension. reduce metabolic requirements of the brain. distinguish between intracranial hematoma and cerebral edema. A 22 -year -old man is brought to the hospital after crashing his motorcycle into a telephone pole. He is unconscious and in profound shock. He has no open wounds or obvious fractures. The cause of his shock is MOST LIKELY caused by: A. A subdural h ematoma B. An epidural hematoma C. A transected lumbar spinal cord D. A basilar skull fracture E. Hemorrhage into the chest or abdomen - ANS: -E. Hemorrhage into the chest or abdomen Which of the following is the recommended Method for trestemt frostbite ? A. Vasodilators B. Anticigulants C. Warm (40 degrees) water D. Padding and elevation E. Application of heat from a hairdryer - ANS: -C. Warm (40 degrees) water Which of the following physical findings suggest a cause of hypotension other than spinal cord injury? A. Prispism B. Bradycardia C. Diaphragmatic breathing D. Presence of deep tendon reflexes E. Ability to flex forearms but not extend them - ANS: -D. Presence of deep tendon reflexes. Spinal shock refers to loss of muscle toe (flaccidty) and loss of r eflexes. A 42 -year -old man is trapped from the waist down beneath his overturned tractor for several hours before medical assistance arrives. He is awake and alert until just before arriving in the ED. He is now unconscious and responds only to painful stimuli by m oaning. His pupils are 3mm in diameter and symmetrically reactive to light. Prehospital personnel indicate that they have not seen the patient move either of his lower extremities. On examination in the ED, no movement of his lower extremities are detected , even in response to painful stimuli. The most likely cause for this finding is: A. An epidural hematoma B. A pelvic fracture C. Central cord syndrome D. Intracerebral hemorrhage E. Bilateral compartment syndrome A 6-year -o boy is struck by an automobile and brought to the ED. He is lethargic, but withdraws purposefully from painful stimuli. His blood pressure is 90mmHg systolic, heart rate 140 beats per minute and his respiratory rate is 36 breaths per minute. The preferred route of veno us 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 - ANS: -D. Percutaneous peripheral veins in the upper extremities A young man sustains a gunshot wound to the abdomen and is brought promptly to the ED 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: