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, what is the
most appropriate next step?
Re-examine the chest
Perform an aortogram
Obtain a CT scan of the chest
Obtain arterial blood gas analysis
Perform transesophageal echocardiography
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. Which of the
following is most likely to confirm the suspected diagnosis?
Angiography
Compartment pressures
Retrograde urethrogram
Doppler ultrasound studies
Complete spine x-ray series
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 patients
In managing a patient with a severe traumatic brain injury, what is the most
important initial step?
Secure the airway
Obtain a c-spine film
Support the circulation
Control scalp hemorrhage
Determine the GCS score
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.
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.
How does the physiological hypervolemia of pregnancy have clinical significance
This study source was downloaded by 100000801626315 from CourseHero.com on 12-03-2024 07:44:21 GMT -06:00
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, in the management of the severely injured, gravid woman?
It reduces the need for blood transfusion.
It results in an elevated hematocrit.
It complicates the management of closed head injury.
It reduces the volume of crystalloid required for resuscitation.
It increases the volume of blood loss to produce maternal hypotension.
What is the best assessment of fluid resuscitation in the adult burn patient?
Urinary output of 0.5 mL/kg/hr
Normalization of blood pressure
Normalization of the heart rate
Measuring a normal central venous pressure
Providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid
What must the diagnosis of shock include?
Hypoxemia
Acidosis
Hypotension
Increased vascular resistance
Evidence of inadequate organ perfusion
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. What should immediate management of the
wound consist of?
Application of a tourniquet
Direct pressure on the wound
Packing the wound with gauze
Direct pressure on the femoral artery at the groin
Debridement of devitalized tissue
For the patient with severe traumatic brain injury, avoiding profound
hypocarbia will prevent what from happening?
Respiratory acidosis
Metabolic acidosis
Cerebral vasoconstriction with diminished perfusion
Neurogenic pulmonary edema
Shift of the oxyhemoglobin dissociation curve
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 (CT) 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. What is the next
step?
Obtain contrast angiography
Transfer to a higher level trauma center
Perform an exploratory laparotomy
Infuse additional crystalloid fluids
Obtain transesophageal echocardiography
What is the first maneuver to improve oxygenation after chest injury?
Intubate the patient
Assess arterial blood gases
Administer supplemental oxygen
Ascertain the need for a chest tube
Obtain a chest x-ray
This study source was downloaded by 100000801626315 from CourseHero.com on 12-03-2024 07:44:21 GMT -06:00
https://www.coursehero.com/file/214330418/ATLS-POST-module-final-testdocx/
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, what is the
most appropriate next step?
Re-examine the chest
Perform an aortogram
Obtain a CT scan of the chest
Obtain arterial blood gas analysis
Perform transesophageal echocardiography
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. Which of the
following is most likely to confirm the suspected diagnosis?
Angiography
Compartment pressures
Retrograde urethrogram
Doppler ultrasound studies
Complete spine x-ray series
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 patients
In managing a patient with a severe traumatic brain injury, what is the most
important initial step?
Secure the airway
Obtain a c-spine film
Support the circulation
Control scalp hemorrhage
Determine the GCS score
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.
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.
How does the physiological hypervolemia of pregnancy have clinical significance
This study source was downloaded by 100000801626315 from CourseHero.com on 12-03-2024 07:44:21 GMT -06:00
https://www.coursehero.com/file/214330418/ATLS-POST-module-final-testdocx/
, in the management of the severely injured, gravid woman?
It reduces the need for blood transfusion.
It results in an elevated hematocrit.
It complicates the management of closed head injury.
It reduces the volume of crystalloid required for resuscitation.
It increases the volume of blood loss to produce maternal hypotension.
What is the best assessment of fluid resuscitation in the adult burn patient?
Urinary output of 0.5 mL/kg/hr
Normalization of blood pressure
Normalization of the heart rate
Measuring a normal central venous pressure
Providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid
What must the diagnosis of shock include?
Hypoxemia
Acidosis
Hypotension
Increased vascular resistance
Evidence of inadequate organ perfusion
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. What should immediate management of the
wound consist of?
Application of a tourniquet
Direct pressure on the wound
Packing the wound with gauze
Direct pressure on the femoral artery at the groin
Debridement of devitalized tissue
For the patient with severe traumatic brain injury, avoiding profound
hypocarbia will prevent what from happening?
Respiratory acidosis
Metabolic acidosis
Cerebral vasoconstriction with diminished perfusion
Neurogenic pulmonary edema
Shift of the oxyhemoglobin dissociation curve
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 (CT) 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. What is the next
step?
Obtain contrast angiography
Transfer to a higher level trauma center
Perform an exploratory laparotomy
Infuse additional crystalloid fluids
Obtain transesophageal echocardiography
What is the first maneuver to improve oxygenation after chest injury?
Intubate the patient
Assess arterial blood gases
Administer supplemental oxygen
Ascertain the need for a chest tube
Obtain a chest x-ray
This study source was downloaded by 100000801626315 from CourseHero.com on 12-03-2024 07:44:21 GMT -06:00
https://www.coursehero.com/file/214330418/ATLS-POST-module-final-testdocx/
