ATLS PRE TEST COMPLETED 2024 QUESTIONS WITH
ANSWERS (ANSWERS OUTLINED!!)
1. A 22-year-old man is hypotensive and tachycardic after a shotgun
wound to the left shoulder. His blood pressure is initially 80/40 mm Hg.
After initial fluid resuscitation his blood pressure increases to 122/84 mm
Hg. His heart rate is now 100 beats per minute and his respiratory rate is
28 breaths per minute. A tube thoracostomy is performed for decreased
left chest breath sounds with the return of a small amount of blood and
no air leak. After chest tube insertion, the most appropriate next step is::
- *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
2. A construction worker falls two stories from a building and sustains
bilateral calcaneal fractures. In the emergency department, he is alert,
vital signs are normal, and he is complaining of severe pain in both heels
and his lower back. Lower extremity pulses are strong and there is no
other deformity. The suspected diagnosis is most likely to be confirmed
by:: - complete spine x-ray series
3. Which of the following is true regarding the initial resuscitation of a
trauma patient?: - A patient with a torso gunshot wound and hypotension
should receive crystalloid fluid resuscitation until the blood pressure is
normal
-* Evidence of improved perfusion after fluid resuscitation could include
improvement in Glasgow Coma Scale score on reevaluation*
- Massive transfusion is defined as transfusion of more than 10 units of
packed red blood cells and plasma within 24 hours
- When tranexamic acid is administered by pre-hospital providers, a
second dose is required within 24 hours
- Fluid resuscitation is far more important than bleeding control in trauma
patient4. In managing a patient with a severe traumatic brain injury, the
most important initial step is to:: - Secure the airway
1/9
, 5. A previously healthy, 70-kg (154-pound) man suffers an estimated
acute blood loss of 2 liters. Which one of the following statements applies
to this patient?: - His pulse pressure will be widened.
- His urinary output will be at the lower limits of normal. xxx
- He will have tachycardia, but no change in his systolic blood pressure.
- *An ABG would demonstrate a base deficit between -6 and -10 mEq/L.*
- His systolic blood pressure will be maintained with an elevated diastolic
pressure.6. The physiological hypervolemia of pregnancy has clinical
significance in the management of the severely injured, gravid woman
by:: - increasing the volume of blood loss to produce maternal hypotension.
7. The best assessment of fluid resuscitation of the adult burn patient
is:: - urinary output of 0.5 mL/kg/hr
8. The diagnosis of shock must include:: - evidence of inadequate organ
perfusion
9. A 7-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding
profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of:: - direct pressure on the
wound
10. For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent:: - respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
11. After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available. Computed
tomography of the chest and abdomen shows an aortic injury and splenic
laceration with free abdominal fluid. His blood pressure falls to 70 mm
Hg after CT. The next step is:: - perform an exploratory laparotomy
12. Which one of the following statements regarding abdominal trauma
in the pregnant patient is TRUE?: - The fetus is in jeopardy only with
major abdominal trauma.
- *Leakage of amniotic fluid is an indication for hospital admission.*
2/9
ANSWERS (ANSWERS OUTLINED!!)
1. A 22-year-old man is hypotensive and tachycardic after a shotgun
wound to the left shoulder. His blood pressure is initially 80/40 mm Hg.
After initial fluid resuscitation his blood pressure increases to 122/84 mm
Hg. His heart rate is now 100 beats per minute and his respiratory rate is
28 breaths per minute. A tube thoracostomy is performed for decreased
left chest breath sounds with the return of a small amount of blood and
no air leak. After chest tube insertion, the most appropriate next step is::
- *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
2. A construction worker falls two stories from a building and sustains
bilateral calcaneal fractures. In the emergency department, he is alert,
vital signs are normal, and he is complaining of severe pain in both heels
and his lower back. Lower extremity pulses are strong and there is no
other deformity. The suspected diagnosis is most likely to be confirmed
by:: - complete spine x-ray series
3. Which of the following is true regarding the initial resuscitation of a
trauma patient?: - A patient with a torso gunshot wound and hypotension
should receive crystalloid fluid resuscitation until the blood pressure is
normal
-* Evidence of improved perfusion after fluid resuscitation could include
improvement in Glasgow Coma Scale score on reevaluation*
- Massive transfusion is defined as transfusion of more than 10 units of
packed red blood cells and plasma within 24 hours
- When tranexamic acid is administered by pre-hospital providers, a
second dose is required within 24 hours
- Fluid resuscitation is far more important than bleeding control in trauma
patient4. In managing a patient with a severe traumatic brain injury, the
most important initial step is to:: - Secure the airway
1/9
, 5. A previously healthy, 70-kg (154-pound) man suffers an estimated
acute blood loss of 2 liters. Which one of the following statements applies
to this patient?: - His pulse pressure will be widened.
- His urinary output will be at the lower limits of normal. xxx
- He will have tachycardia, but no change in his systolic blood pressure.
- *An ABG would demonstrate a base deficit between -6 and -10 mEq/L.*
- His systolic blood pressure will be maintained with an elevated diastolic
pressure.6. The physiological hypervolemia of pregnancy has clinical
significance in the management of the severely injured, gravid woman
by:: - increasing the volume of blood loss to produce maternal hypotension.
7. The best assessment of fluid resuscitation of the adult burn patient
is:: - urinary output of 0.5 mL/kg/hr
8. The diagnosis of shock must include:: - evidence of inadequate organ
perfusion
9. A 7-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding
profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of:: - direct pressure on the
wound
10. For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent:: - respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
11. After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available. Computed
tomography of the chest and abdomen shows an aortic injury and splenic
laceration with free abdominal fluid. His blood pressure falls to 70 mm
Hg after CT. The next step is:: - perform an exploratory laparotomy
12. Which one of the following statements regarding abdominal trauma
in the pregnant patient is TRUE?: - The fetus is in jeopardy only with
major abdominal trauma.
- *Leakage of amniotic fluid is an indication for hospital admission.*
2/9
