ATLS Post Test Complete Exam 2023 QUESTIONS AND
ANSWERS
1. 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
- C. Warm (40 degrees) water
2. 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
- D. Presence of deep tendon reflexes. Spinal shock refers to loss of
muscle toe (flaccidty) and loss of reflexes.
3. 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
- C. Resource limitations as determined by the transferring doctor (MÅ
SJEKKES)
4. 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
- A. Laparotomy because of hemodynamic abnormality
5. 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
- MÅ SJEKKES
6. 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
- D. Percutaneous peripheral veins in the upper extremities
7. 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.
- C. Control internal hemorrhage operatively
8. 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 20ml/kg
Ringers Lactate
- D. The absolute volume of blood loss required to produce shock is
the same as in adults
9. 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 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
- D. Perform diagnostic peritoneal lavage or FAST
10. 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 5
minutes, and his hemoglobin oxygen saturation level decreases from 98% to
89%. The most appropriate next step is to:
A. Obtain a chest x-ray
B. Decrease the tidal volume
C. Decrease PEEP
D. Increase the rate of assisted ventilations
E. Perform needle decompression of the left chest.
- A. Obtain a chest x-ray (MÅ SJEKKES)
11. A 30-year-old man sustains a severely comminuted, open, distal right femur
fracture in a motorcycle crash. The wound is actively bleeding. Normal sensation
is 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:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
E. Fasciotomy of all four compartments in the lower extremity
- B. Tamponade of the wound with a pressure dressing
12. 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?
A. Cerebral perfusion is intact
, B. Intravascular volume status is normal
C. The patient is in a postictal state
D. Intra-abdominal visceral injury is unlikely
E. The patient probably has an acute epidural hematoma
- E. The patient probably has an acute epidural hematoma
13. A previously healthy, 70kg (175 pound) man suffers an estimated acute blood
loss of two liters. Which one of the following statements apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
C. He will have tachycardia, but no change in systolic blood pressure
D. His systolic blood pressure will be decreased with a narrowed, pulse
pressure
E. His systolic blood pressure will be maintained with an elevated
diastolic pressure.
- E. His systolic blood pressure will be maintained with an elevated
diastolic pressure.
14. The physioclogic hypervolemia of pregnancy has clinical significance in the
management of the severely injured gravid woman by
A. Reducing the need for blood transfusion
B. Increasing the risk of pulmonary edema
C. Complicating the management of closed head injury
D. Increasing the volume of blood loss to produce shock/maternal
hypotension
E. Reducing the volume of crystalloid required for resuscitation
- D. Increasing the volume of blood loss to produce shock
15. 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 blood
pressure 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. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment
- B. A long spine board
16. 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 the
right. 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
ANSWERS
1. 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
- C. Warm (40 degrees) water
2. 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
- D. Presence of deep tendon reflexes. Spinal shock refers to loss of
muscle toe (flaccidty) and loss of reflexes.
3. 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
- C. Resource limitations as determined by the transferring doctor (MÅ
SJEKKES)
4. 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
- A. Laparotomy because of hemodynamic abnormality
5. 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
- MÅ SJEKKES
6. 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
- D. Percutaneous peripheral veins in the upper extremities
7. 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.
- C. Control internal hemorrhage operatively
8. 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 20ml/kg
Ringers Lactate
- D. The absolute volume of blood loss required to produce shock is
the same as in adults
9. 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 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
- D. Perform diagnostic peritoneal lavage or FAST
10. 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 5
minutes, and his hemoglobin oxygen saturation level decreases from 98% to
89%. The most appropriate next step is to:
A. Obtain a chest x-ray
B. Decrease the tidal volume
C. Decrease PEEP
D. Increase the rate of assisted ventilations
E. Perform needle decompression of the left chest.
- A. Obtain a chest x-ray (MÅ SJEKKES)
11. A 30-year-old man sustains a severely comminuted, open, distal right femur
fracture in a motorcycle crash. The wound is actively bleeding. Normal sensation
is 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:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
E. Fasciotomy of all four compartments in the lower extremity
- B. Tamponade of the wound with a pressure dressing
12. 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?
A. Cerebral perfusion is intact
, B. Intravascular volume status is normal
C. The patient is in a postictal state
D. Intra-abdominal visceral injury is unlikely
E. The patient probably has an acute epidural hematoma
- E. The patient probably has an acute epidural hematoma
13. A previously healthy, 70kg (175 pound) man suffers an estimated acute blood
loss of two liters. Which one of the following statements apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
C. He will have tachycardia, but no change in systolic blood pressure
D. His systolic blood pressure will be decreased with a narrowed, pulse
pressure
E. His systolic blood pressure will be maintained with an elevated
diastolic pressure.
- E. His systolic blood pressure will be maintained with an elevated
diastolic pressure.
14. The physioclogic hypervolemia of pregnancy has clinical significance in the
management of the severely injured gravid woman by
A. Reducing the need for blood transfusion
B. Increasing the risk of pulmonary edema
C. Complicating the management of closed head injury
D. Increasing the volume of blood loss to produce shock/maternal
hypotension
E. Reducing the volume of crystalloid required for resuscitation
- D. Increasing the volume of blood loss to produce shock
15. 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 blood
pressure 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. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment
- B. A long spine board
16. 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 the
right. 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
