ATLS TEST 1 – 4 320+ Actual Exam
Questions With Reviewed 100%
Correct Detailed Answers
Guaranteed Pass!!
1. A teen-aged bicycle rider is hit by a truck traveling at high speed. In the ED, she
is actively bleeding from open fractures of her legs, and has abrasions on her
chest and abdominal wall. Her blood pressure is 80/50 mmHg, heart rate is 140
beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6.
The first step in managing this patient is to:
A. Obtain a lateral cervical spine x-ray
B. Insert av central venous pressure line
C. Adminster 2 liters of crystalloid solution
D. Perform endotracheal intubation and ventilation
E. Apply a pneumatic antishock garment (PASG) and inflate the leg compartments.
-ANSWER- D. Perform endotracheal intubation and ventilation
2. An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is brought to the
ED by his family. His vital signs are normal, but he complains of left upper
quadrant pain. An abdominal CT-scan reveals a moderately severe laceration
of the spleen. The receiving institution does not have 24-hour-a-day operating
room capabilities. The most appropriate management of this patient would be
to
A. Type and crossmatch for blood
B. Request consultation of a pediatrician
C. Transfer the patient to a trauma center
D. Admit the patient to the intensive care unit
E. Prepare the patient for surgery the next day -ANSWER- D. Admit the patient to
the intensive care unit
3. Which of the following statements regarding injury to the central nervous
system in children is TRUE?
A. Children suffer spinal cord injury without x-ray abnormality more commonly
than adults.
B. An infant with a traumatic brain injury may become hypotensive from
cerebral edema
C. Initial therapy for the child with traumatic brain injury includes
the administration of methylprednisolone intravenously
D. Children have more focal mass lesions as a result for traumatic brain
,injury when compared to adults.
E. Young children are less tolerant of expanding intracranial mass lesions than
adults -ANSWER- A. Children suffer spinal cord injury without x-ray abnormality
more commonly than adults.
4. A 17-year-old helmeted motorcyclist is struck broadside by an automobile at
an intersection. He is unconscious at the scene with a blood pressure of
140/90mmHg, heart rate of 90 beats per minute, and respiratory rate of 22
breaths per minute. His respirations are sonorous and deep. His GCS score is 6.
Immobilization of the entire patient may include the use of all the following
EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar -ANSWER- A. Air splints
5. Twenty-seven patients are seriously injured in an aircraft accident at a local
airport. The basic principle of triage should be to:
A. Treat the most severely injured patients first
B. Establish a field triage area directed by a
doctor
C. Rapidly transport all patients to the nearest appropriate hospital
D. Treat the greatest number of patients in the shortest period of
time
E. Produce the greatest number of survivors based on available resources -
ANSWER- E. Produce the greatest number of survivors based on available
resources
6. An electrician is eletrocuted by a downed power line after a thunderstorm. He
apparently made contact with the wire at the level of the right mid thigh. In the
ED, his vital signs are normal and no dysrythmia is noted on ECG. On
examination, there is an exit wound on the bottom of the right foot. His urine is
positive for blood by dipstick but not RBCs are seen microscopically. Initial
management should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic muscle
E. Admission to the ICU for observation -ANSWER- B. Aggressive fluid infusion
- suspected rhabdomyolyse
7. A young woman sustains a severe head injury as the result of a motor vehicular
crash. In the ED, her GCS is 6. Her blood pressure is 140/90 mmHg and her
, heart rate 80 beats per minute. She is intubated and is being mechanically
ventilated. Her pupils are 3mm in size and equally reactive to light. There is no
other apparent injury. The most important principle to follow in early
management of her head injury is to:
A. Administer an osmotic diuretic
B. Prevent secondary brain injury
C. Agressively treat systemic hypertension
Reduce meatbolic requirements of the brain
D. Distinguish between intracranial hematoma and cerebral edema. -ANSWER- B.
Prevent secondary brain injury
8. To establish a diagnosis of shock,
A. Systolic blood pressure must be below 90mmHg
B. The presence of a closed head injury should be excluded
C. Acidosis should be present by arterial blood gas
analysis
D. The patient must fail to respond to intravenous fluid infusion
E. Clinical evidence of inadequate organ perfusion must be present. -ANSWER- E.
Clinical evidence of inadequate organ perfusion must be present.
9. A 32-year-old is brought to the hospital unconscious with severe facial injuries
and noisy respirations after an automobile collision. In the ED, he has no
apparent injury to the anterior aspect of his neck. He suddenly becomes apneic,
and attempted ventilation with a face mask is unsuccessful. Examination of his
mouth reveals a large hematoma of the pharynx with loss of normal anatomic
landmarks. Initial management of his airways should be consist of:
A. Inserting an oropharyngeal airway
B. Inserting a nasopharyngeal airway
C. Performing a surgical cricothyroidotomy
D. Performing fiberoptic-guided nasotracheal intubation
E. Performin orotracheal intubation after obtaining a lateral c-spine x-ray -
ANSWER- A. Inserting an oropharyngeal airway
10.A 25-year-old woman is brought to the ED after a motor vehicle crash. She was
initially lucid at the scene and then developed a dilated pupil and contralateral
extremity weakness. In the ED, she is unconscious and has a GCS score of 6.
The initial management step for this patient should be to:
A. Obtain a CT-scan of the head
B. Administer decadron 20mg IV
C. Perform endotracheal intubation
D. Administer mannitol 1g/kg IV
E. Perform an emergency bone flap craniotomy on the side of the dilated pupil. -
ANSWER- C. Perform endotracheal intubation
, 11. A contraindication to nasogastric intubation is the presence of a:
A. Gastric perforation
B. Diaphragmatic rupture
C. Open depressed skull fracture
Fracture of the cervical spine
D. Fracture of the cribiform plate -ANSWER- E. Fracture of the cribiform plate
12.An 8-year-old girl is an unrestrained passenger in a vehicle struck from
behind. In the ED, her blood pressure is 80/60mmHg, heart rate is 80 beats per
minute, and respiratory rate is 16 breaths per minute. Her GCS score is 14. She
complains that her legs feel "funny and wont move right". However, her spine
x-rays do not show a fracture or dislocation. A spinal cord injury in this child:
A. Is most likely a central cord syndrome
B. Must be diagnosed by magnetic resonance imaging
C. Can be excluded by obtaining a CT-scan of the entire spine
D. May exist in the abscence of objective findings on x-ray studies
E. Is unlikely because of the incomplete calcification of the vertebral bodies. -
ANSWER- D. May exist in the abscence of objective findings on x-ray studies
13. Immediate chest tube insertion is indicated for which of the following
conditions?
A. Pneumothorax
B. Pneumomediastinum
C. Massive hemothorax
D. Diaphragmatic rupture
E. Subcutaneous emphysema -ANSWER- C. Massive hemothorax
14. Cardiac tamponade after trauma:
A. Is seldom life-threating
B. Can be excluded by an upright, AP chest x-ray
C. Can be confused with a tension pneumthorax
D. Causes a fall in systolic pressure of > 15mmHg with expiration
E. Most commonly occurs after blunt injury to the anterior chest wall -ANSWER-
C. Can be confused with a tension pneumthorax
15. A 22-year-old man is brought to the hospital after crashing his motorcycle into
a telephone pole. He is unconscious and in profound shock. He has no open
wounds or obvious fractures. The cause of his shock is MOST LIKELY caused
by:
A. A subdural hematoma
B. An epidural hematoma
C. A transected lumbar spinal cord
D. A basilar skull fracture
Questions With Reviewed 100%
Correct Detailed Answers
Guaranteed Pass!!
1. A teen-aged bicycle rider is hit by a truck traveling at high speed. In the ED, she
is actively bleeding from open fractures of her legs, and has abrasions on her
chest and abdominal wall. Her blood pressure is 80/50 mmHg, heart rate is 140
beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6.
The first step in managing this patient is to:
A. Obtain a lateral cervical spine x-ray
B. Insert av central venous pressure line
C. Adminster 2 liters of crystalloid solution
D. Perform endotracheal intubation and ventilation
E. Apply a pneumatic antishock garment (PASG) and inflate the leg compartments.
-ANSWER- D. Perform endotracheal intubation and ventilation
2. An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is brought to the
ED by his family. His vital signs are normal, but he complains of left upper
quadrant pain. An abdominal CT-scan reveals a moderately severe laceration
of the spleen. The receiving institution does not have 24-hour-a-day operating
room capabilities. The most appropriate management of this patient would be
to
A. Type and crossmatch for blood
B. Request consultation of a pediatrician
C. Transfer the patient to a trauma center
D. Admit the patient to the intensive care unit
E. Prepare the patient for surgery the next day -ANSWER- D. Admit the patient to
the intensive care unit
3. Which of the following statements regarding injury to the central nervous
system in children is TRUE?
A. Children suffer spinal cord injury without x-ray abnormality more commonly
than adults.
B. An infant with a traumatic brain injury may become hypotensive from
cerebral edema
C. Initial therapy for the child with traumatic brain injury includes
the administration of methylprednisolone intravenously
D. Children have more focal mass lesions as a result for traumatic brain
,injury when compared to adults.
E. Young children are less tolerant of expanding intracranial mass lesions than
adults -ANSWER- A. Children suffer spinal cord injury without x-ray abnormality
more commonly than adults.
4. A 17-year-old helmeted motorcyclist is struck broadside by an automobile at
an intersection. He is unconscious at the scene with a blood pressure of
140/90mmHg, heart rate of 90 beats per minute, and respiratory rate of 22
breaths per minute. His respirations are sonorous and deep. His GCS score is 6.
Immobilization of the entire patient may include the use of all the following
EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar -ANSWER- A. Air splints
5. Twenty-seven patients are seriously injured in an aircraft accident at a local
airport. The basic principle of triage should be to:
A. Treat the most severely injured patients first
B. Establish a field triage area directed by a
doctor
C. Rapidly transport all patients to the nearest appropriate hospital
D. Treat the greatest number of patients in the shortest period of
time
E. Produce the greatest number of survivors based on available resources -
ANSWER- E. Produce the greatest number of survivors based on available
resources
6. An electrician is eletrocuted by a downed power line after a thunderstorm. He
apparently made contact with the wire at the level of the right mid thigh. In the
ED, his vital signs are normal and no dysrythmia is noted on ECG. On
examination, there is an exit wound on the bottom of the right foot. His urine is
positive for blood by dipstick but not RBCs are seen microscopically. Initial
management should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic muscle
E. Admission to the ICU for observation -ANSWER- B. Aggressive fluid infusion
- suspected rhabdomyolyse
7. A young woman sustains a severe head injury as the result of a motor vehicular
crash. In the ED, her GCS is 6. Her blood pressure is 140/90 mmHg and her
, heart rate 80 beats per minute. She is intubated and is being mechanically
ventilated. Her pupils are 3mm in size and equally reactive to light. There is no
other apparent injury. The most important principle to follow in early
management of her head injury is to:
A. Administer an osmotic diuretic
B. Prevent secondary brain injury
C. Agressively treat systemic hypertension
Reduce meatbolic requirements of the brain
D. Distinguish between intracranial hematoma and cerebral edema. -ANSWER- B.
Prevent secondary brain injury
8. To establish a diagnosis of shock,
A. Systolic blood pressure must be below 90mmHg
B. The presence of a closed head injury should be excluded
C. Acidosis should be present by arterial blood gas
analysis
D. The patient must fail to respond to intravenous fluid infusion
E. Clinical evidence of inadequate organ perfusion must be present. -ANSWER- E.
Clinical evidence of inadequate organ perfusion must be present.
9. A 32-year-old is brought to the hospital unconscious with severe facial injuries
and noisy respirations after an automobile collision. In the ED, he has no
apparent injury to the anterior aspect of his neck. He suddenly becomes apneic,
and attempted ventilation with a face mask is unsuccessful. Examination of his
mouth reveals a large hematoma of the pharynx with loss of normal anatomic
landmarks. Initial management of his airways should be consist of:
A. Inserting an oropharyngeal airway
B. Inserting a nasopharyngeal airway
C. Performing a surgical cricothyroidotomy
D. Performing fiberoptic-guided nasotracheal intubation
E. Performin orotracheal intubation after obtaining a lateral c-spine x-ray -
ANSWER- A. Inserting an oropharyngeal airway
10.A 25-year-old woman is brought to the ED after a motor vehicle crash. She was
initially lucid at the scene and then developed a dilated pupil and contralateral
extremity weakness. In the ED, she is unconscious and has a GCS score of 6.
The initial management step for this patient should be to:
A. Obtain a CT-scan of the head
B. Administer decadron 20mg IV
C. Perform endotracheal intubation
D. Administer mannitol 1g/kg IV
E. Perform an emergency bone flap craniotomy on the side of the dilated pupil. -
ANSWER- C. Perform endotracheal intubation
, 11. A contraindication to nasogastric intubation is the presence of a:
A. Gastric perforation
B. Diaphragmatic rupture
C. Open depressed skull fracture
Fracture of the cervical spine
D. Fracture of the cribiform plate -ANSWER- E. Fracture of the cribiform plate
12.An 8-year-old girl is an unrestrained passenger in a vehicle struck from
behind. In the ED, her blood pressure is 80/60mmHg, heart rate is 80 beats per
minute, and respiratory rate is 16 breaths per minute. Her GCS score is 14. She
complains that her legs feel "funny and wont move right". However, her spine
x-rays do not show a fracture or dislocation. A spinal cord injury in this child:
A. Is most likely a central cord syndrome
B. Must be diagnosed by magnetic resonance imaging
C. Can be excluded by obtaining a CT-scan of the entire spine
D. May exist in the abscence of objective findings on x-ray studies
E. Is unlikely because of the incomplete calcification of the vertebral bodies. -
ANSWER- D. May exist in the abscence of objective findings on x-ray studies
13. Immediate chest tube insertion is indicated for which of the following
conditions?
A. Pneumothorax
B. Pneumomediastinum
C. Massive hemothorax
D. Diaphragmatic rupture
E. Subcutaneous emphysema -ANSWER- C. Massive hemothorax
14. Cardiac tamponade after trauma:
A. Is seldom life-threating
B. Can be excluded by an upright, AP chest x-ray
C. Can be confused with a tension pneumthorax
D. Causes a fall in systolic pressure of > 15mmHg with expiration
E. Most commonly occurs after blunt injury to the anterior chest wall -ANSWER-
C. Can be confused with a tension pneumthorax
15. A 22-year-old man is brought to the hospital after crashing his motorcycle into
a telephone pole. He is unconscious and in profound shock. He has no open
wounds or obvious fractures. The cause of his shock is MOST LIKELY caused
by:
A. A subdural hematoma
B. An epidural hematoma
C. A transected lumbar spinal cord
D. A basilar skull fracture
