ATLS POST TEST COMPLETE EXAM 2023-2024 COMPLETE
QUESTIONS AND ANSWERS A STUDY GUIDE.
• Which of the following is the recommended Method for trestemt frostbite?
• Vasodilators
• Anticigulants
• Warm (40 degrees) water
• Padding and elevation
• Application of heat from a hairdryer
• C. Warm (40 degrees) water
• Which of the following physical findings suggest a cause of hypotension
otherthan spinal cord injury?
• Prispism
• Bradycardia
• Diaphragmatic breathing
• Presence of deep tendon reflexes
• Ability to flex forearms but not extend them
• D. Presence of deep tendon reflexes. Spinal shock refers to loss
ofmuscle toe (flaccidty) and loss of reflexes.
• The primary indication for transferring A patient to a higher level trauma center
is:
• Unavailibility of surgeon or operating staff
• Multiple system injuries, including severe head injury
• Resource limitations as determined by the transferring doctor
• Resource limitations as determined by the hospital administration
• Widened mediastinum on chest x-ray following blunt trauma
• C. Resource limitations as determined by the transferring doctor
(MÅSJEKKES)
• A young man sustains a rifle wound to the mid-abdomen. He is brought
promptlyto the ED by prehospital personnel. His skin is cool and diaphoretic,
and his systolic blood pressure is 58mmHg. Warmed crystalloid fluids are
initiated without improvement in his vital signs. The next, most appropriate,
step is to perform:
• a laparotomy
• An abdominal CT-scan
• Diagnostic laparoscopy
• Abdominal ultrasonography
• A diagnostic peritoneal lavage
• A. Laparotomy because of hemodynamic abnormality
,• 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 venous access in this patient is:
• Percutaneous femoral vein cannulation
• Cutdown on the saphenous vein at the ankle
• Intraosseous catheter placement in the proximal tibia
• Percutaneous peripheral veins in the upper extremities
• Central venous access via the subclavian or internal jugular vein
• D. Percutaneous peripheral veins in the upper extremities
• A young man sustains a gunshot wound to the abdomen and is brought
promptlyto 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. Thedefinitive treatment in managing this patient is to:
• Administer O-negative blood
• Apply external warming devices
• Control internal hemorrhage operatively
• Apply a pneumatic antishock garment (PASG)
• Infuse large volumes of intravenous crystalloid solutions.
• C. Control internal hemorrhage operatively
• Regarding shock in the child, which of the following is FALSE?
• Vital signs are age-related
• Children have greater physiologic reserves than do adults
• Tachycardia is the primary physiologic response to hypovolemia
• The absolute volume of blood loss required to produce shock
isthe same as in adults
• An initial fluid bolus for resuscitation should approximate
20ml/kgRingers Lactate
• D. The absolute volume of blood loss required to produce shock
isthe same as in adults
• A 33-year-old man is struck by a car travelling at 56km/h (35mph). 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 respirartory rate decreases
to 36 breaths per minute and his blood pressure is 81/53 mmHg.
Warmed Ringers lactate is adminstered intravenously. The nextpriority
should be to:
• Perform external fixation of the pelvis
• Obtain abdominal and pelvic CT-scans
• Perform arterial embolization of the pelvic vessel
, • Perform diagnostic peritoneal lavage or FAST
• Perform a urethrogram and cystogram
• D. Perform diagnostic peritoneal lavage or FAST
• A 42-year-old 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 bag-mask device. It becomes more difficult to ventilate the
patient over the next 5minutes, and his hemoglobin oxygen saturation level
decreases from 98% to 89%. The most appropriate next step is to:
• Obtain a chest x-ray
• Decrease the tidal volume
• Decrease PEEP
• Increase the rate of assisted ventilations
• Perform needle decompression of the left chest.
• A. Obtain a chest x-ray (MÅ SJEKKES)
• A 30-year-old man sustains a severely comminuted, open, distal right femur
fracture in a motorcycle crash. The wound is actively bleeding. Normal
sensationis present over the lateral aspect of the foot but decreased over the
medial foot and great toe. Normal motion of the foot is observed. Dorsalis
pedis and posterior tibial pulses are easily palpable on the left, but heard only
by Doppler on the right. Immediate efforts to improve circulation to the injured
extremity should involve:
• Immediate angiography
• Tamponade of the wound with a pressure dressing
• Wound exploration and removal of bony fragments
• Realignment of the fracture segments with a traction splint
• Fasciotomy of all four compartments in the lower extremity
• B. Tamponade of the wound with a pressure dressing
• An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the ED
following a crash. He had decreased level of consciousness at the scene, but
then was alert and conversational during transportation. Now his GCS is only
11.Which of the following statements is TRUE?
• Cerebral perfusion is intact
• Intravascular volume status is normal
• The patient is in a postictal state
• Intra-abdominal visceral injury is unlikely
• The patient probably has an acute epidural hematoma
• E. The patient probably has an acute epidural hematoma
• A previously healthy, 70kg (175 pound) man suffers an estimated acute
bloodloss of two liters. Which one of the following statements apply to this
patient?
• His pulse pressure will be widened
, • His urinary output will be at the lower limits of normal
• He will have tachycardia, but no change in systolic blood pressure
• His systolic blood pressure will be decreased with a narrowed,
pulsepressure
• His systolic blood pressure will be maintained with an
elevateddiastolic pressure.
• E. His systolic blood pressure will be maintained with an
elevateddiastolic pressure.
• The physioclogic hypervolemia of pregnancy has clinical significance in
themanagement of the severely injured gravid woman by
• Reducing the need for blood transfusion
• Increasing the risk of pulmonary edema
• Complicating the management of closed head injury
• Increasing the volume of blood loss to produce
shock/maternalhypotension
• Reducing the volume of crystalloid required for resuscitation
• D. Increasing the volume of blood loss to produce shock
• A 17-year-old helmeted motorcyclist loses consciousness when he is struck
broad side by an automobile at an intersection. He arrives in the ED with a
bloodpressure of 140/92, pulse rate 88 beats per minute, a respiratory rate of
18 breaths per minue, and a GCS of 7. Appropriate initial immobilization of
this patient should include a semi-rigid cervical collar and:
• A scoop stretcher
• A long spine board
• A short spine board
• Cervical traction tongs
• Pneumatic antishock garment
• B. A long spine board
• During an altercation, a 36-year-old man sustains a gunshot wound above
the nipple line on the right, with an exit wound posteriorly above the scapula
on theright. He is transported by ambulance to a community hospital. He is
endotracheally intubated, close tube thoracostomy is performed, and 2 liters
Ringers lactate solution are infused via 2 large-caliber IV´s. His blood
pressure now is 60/0mmHg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% O2). The most
appropriate next step inmanagin this patient is:
• Laparotomy
• Diagnostic peritoneal lavage
• Arterial blood gas determination
• Administer packed red blood cells
• Chest X-ray to confirm tube placement
• E. Chest X-ray to confirm tube placement
QUESTIONS AND ANSWERS A STUDY GUIDE.
• Which of the following is the recommended Method for trestemt frostbite?
• Vasodilators
• Anticigulants
• Warm (40 degrees) water
• Padding and elevation
• Application of heat from a hairdryer
• C. Warm (40 degrees) water
• Which of the following physical findings suggest a cause of hypotension
otherthan spinal cord injury?
• Prispism
• Bradycardia
• Diaphragmatic breathing
• Presence of deep tendon reflexes
• Ability to flex forearms but not extend them
• D. Presence of deep tendon reflexes. Spinal shock refers to loss
ofmuscle toe (flaccidty) and loss of reflexes.
• The primary indication for transferring A patient to a higher level trauma center
is:
• Unavailibility of surgeon or operating staff
• Multiple system injuries, including severe head injury
• Resource limitations as determined by the transferring doctor
• Resource limitations as determined by the hospital administration
• Widened mediastinum on chest x-ray following blunt trauma
• C. Resource limitations as determined by the transferring doctor
(MÅSJEKKES)
• A young man sustains a rifle wound to the mid-abdomen. He is brought
promptlyto the ED by prehospital personnel. His skin is cool and diaphoretic,
and his systolic blood pressure is 58mmHg. Warmed crystalloid fluids are
initiated without improvement in his vital signs. The next, most appropriate,
step is to perform:
• a laparotomy
• An abdominal CT-scan
• Diagnostic laparoscopy
• Abdominal ultrasonography
• A diagnostic peritoneal lavage
• A. Laparotomy because of hemodynamic abnormality
,• 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 venous access in this patient is:
• Percutaneous femoral vein cannulation
• Cutdown on the saphenous vein at the ankle
• Intraosseous catheter placement in the proximal tibia
• Percutaneous peripheral veins in the upper extremities
• Central venous access via the subclavian or internal jugular vein
• D. Percutaneous peripheral veins in the upper extremities
• A young man sustains a gunshot wound to the abdomen and is brought
promptlyto 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. Thedefinitive treatment in managing this patient is to:
• Administer O-negative blood
• Apply external warming devices
• Control internal hemorrhage operatively
• Apply a pneumatic antishock garment (PASG)
• Infuse large volumes of intravenous crystalloid solutions.
• C. Control internal hemorrhage operatively
• Regarding shock in the child, which of the following is FALSE?
• Vital signs are age-related
• Children have greater physiologic reserves than do adults
• Tachycardia is the primary physiologic response to hypovolemia
• The absolute volume of blood loss required to produce shock
isthe same as in adults
• An initial fluid bolus for resuscitation should approximate
20ml/kgRingers Lactate
• D. The absolute volume of blood loss required to produce shock
isthe same as in adults
• A 33-year-old man is struck by a car travelling at 56km/h (35mph). 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 respirartory rate decreases
to 36 breaths per minute and his blood pressure is 81/53 mmHg.
Warmed Ringers lactate is adminstered intravenously. The nextpriority
should be to:
• Perform external fixation of the pelvis
• Obtain abdominal and pelvic CT-scans
• Perform arterial embolization of the pelvic vessel
, • Perform diagnostic peritoneal lavage or FAST
• Perform a urethrogram and cystogram
• D. Perform diagnostic peritoneal lavage or FAST
• A 42-year-old 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 bag-mask device. It becomes more difficult to ventilate the
patient over the next 5minutes, and his hemoglobin oxygen saturation level
decreases from 98% to 89%. The most appropriate next step is to:
• Obtain a chest x-ray
• Decrease the tidal volume
• Decrease PEEP
• Increase the rate of assisted ventilations
• Perform needle decompression of the left chest.
• A. Obtain a chest x-ray (MÅ SJEKKES)
• A 30-year-old man sustains a severely comminuted, open, distal right femur
fracture in a motorcycle crash. The wound is actively bleeding. Normal
sensationis present over the lateral aspect of the foot but decreased over the
medial foot and great toe. Normal motion of the foot is observed. Dorsalis
pedis and posterior tibial pulses are easily palpable on the left, but heard only
by Doppler on the right. Immediate efforts to improve circulation to the injured
extremity should involve:
• Immediate angiography
• Tamponade of the wound with a pressure dressing
• Wound exploration and removal of bony fragments
• Realignment of the fracture segments with a traction splint
• Fasciotomy of all four compartments in the lower extremity
• B. Tamponade of the wound with a pressure dressing
• An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the ED
following a crash. He had decreased level of consciousness at the scene, but
then was alert and conversational during transportation. Now his GCS is only
11.Which of the following statements is TRUE?
• Cerebral perfusion is intact
• Intravascular volume status is normal
• The patient is in a postictal state
• Intra-abdominal visceral injury is unlikely
• The patient probably has an acute epidural hematoma
• E. The patient probably has an acute epidural hematoma
• A previously healthy, 70kg (175 pound) man suffers an estimated acute
bloodloss of two liters. Which one of the following statements apply to this
patient?
• His pulse pressure will be widened
, • His urinary output will be at the lower limits of normal
• He will have tachycardia, but no change in systolic blood pressure
• His systolic blood pressure will be decreased with a narrowed,
pulsepressure
• His systolic blood pressure will be maintained with an
elevateddiastolic pressure.
• E. His systolic blood pressure will be maintained with an
elevateddiastolic pressure.
• The physioclogic hypervolemia of pregnancy has clinical significance in
themanagement of the severely injured gravid woman by
• Reducing the need for blood transfusion
• Increasing the risk of pulmonary edema
• Complicating the management of closed head injury
• Increasing the volume of blood loss to produce
shock/maternalhypotension
• Reducing the volume of crystalloid required for resuscitation
• D. Increasing the volume of blood loss to produce shock
• A 17-year-old helmeted motorcyclist loses consciousness when he is struck
broad side by an automobile at an intersection. He arrives in the ED with a
bloodpressure of 140/92, pulse rate 88 beats per minute, a respiratory rate of
18 breaths per minue, and a GCS of 7. Appropriate initial immobilization of
this patient should include a semi-rigid cervical collar and:
• A scoop stretcher
• A long spine board
• A short spine board
• Cervical traction tongs
• Pneumatic antishock garment
• B. A long spine board
• During an altercation, a 36-year-old man sustains a gunshot wound above
the nipple line on the right, with an exit wound posteriorly above the scapula
on theright. He is transported by ambulance to a community hospital. He is
endotracheally intubated, close tube thoracostomy is performed, and 2 liters
Ringers lactate solution are infused via 2 large-caliber IV´s. His blood
pressure now is 60/0mmHg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% O2). The most
appropriate next step inmanagin this patient is:
• Laparotomy
• Diagnostic peritoneal lavage
• Arterial blood gas determination
• Administer packed red blood cells
• Chest X-ray to confirm tube placement
• E. Chest X-ray to confirm tube placement
