ATLS PRE TEST 1 – 4 QUESTIONS AND
CORRECT ANSWERS 320+ QUESTIONS
AND ANSWERS| GRADED A+
,1.Which of the following physical findings suggest 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 not extend them
-ANSWER- D. Presence of deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidity) and loss of reflexes.
2.The primary indication for transferring A patient to a higher level trauma center is:
A. Unavailability 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
-ANSWER- C. Resource limitations as determined by the transferring doctor.
3.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 improvement 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
-ANSWER- A. Laparotomy because of hemodynamic abnormality
4.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
moaning. 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
-ANSWER- MÅ SJEKKES
5.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:
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
-ANSWER- D. Percutaneous peripheral veins in the upper extremities
6.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:
A. Administer O-negative 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 solutions.
-ANSWER- C. Control internal hemorrhage operatively
7.Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
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 Ringers Lactate
-ANSWER- D. The absolute volume of blood loss required to produce shock is the same as in
adults
8.A 33-year-old man is struck by a car traveling at 56 km/h (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 mmHg. Warmed Ringers 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 vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram
-ANSWER- D. Perform diagnostic peritoneal lavage or FAST
CORRECT ANSWERS 320+ QUESTIONS
AND ANSWERS| GRADED A+
,1.Which of the following physical findings suggest 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 not extend them
-ANSWER- D. Presence of deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidity) and loss of reflexes.
2.The primary indication for transferring A patient to a higher level trauma center is:
A. Unavailability 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
-ANSWER- C. Resource limitations as determined by the transferring doctor.
3.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 improvement 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
-ANSWER- A. Laparotomy because of hemodynamic abnormality
4.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
moaning. 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
-ANSWER- MÅ SJEKKES
5.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:
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
-ANSWER- D. Percutaneous peripheral veins in the upper extremities
6.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:
A. Administer O-negative 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 solutions.
-ANSWER- C. Control internal hemorrhage operatively
7.Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
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 Ringers Lactate
-ANSWER- D. The absolute volume of blood loss required to produce shock is the same as in
adults
8.A 33-year-old man is struck by a car traveling at 56 km/h (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 mmHg. Warmed Ringers 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 vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram
-ANSWER- D. Perform diagnostic peritoneal lavage or FAST
