ATLSPOST TEST 4 LATEST VERSIONS
re-examine the chest - (correct Answer) - A 22-year-old man is hypotensive and
tachycardic after a shotgun wound to the left shoulder. His BP is initially 80/40
mm Hg. After 2 liters of crystalloid solution his BP increases to 122/84. His heart
rate is now 100 BPM and his RR is 28 breaths per minute. His breath sounds are
decreased in the left hemithorax, and after initial IV fluid resuscitation, a
closed tube thoracostomy is performed for decreased left 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 __________.
complete spine x-rays - (correct Answer) - 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
_________.
secure the airway - (correct Answer) - In managing the head-injured patient, the
most important initial step is to ________.
his systolic pressure will be decreased with a narrowed pulse pressure - (correct
Answer) - A previously healthy, 70 kg man suffers an estimated acute blood loss of
2 liters. How will this affect his blood pressure?
increasing the volume of blood loss to produce maternal hypotension - (correct
Answer) - The physiologic hypervolemia of pregnancy has clinical significance in
the management of the severely injured, gravid woman by ____________.
adequate urinary output - (correct Answer) - The best assessment of fluid
resuscitation of the adult burn patient is __________.
evidence of inadequate organ perfusion - (correct Answer) - The diagnosis of shock
must include _________.
direct pressure on the wound - (correct Answer) - 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 ________ (application of a
tourniquet vs. direct pressure on the wound).
cerebral vasoconstriction with diminished perfusion - (correct Answer) - For the
patient with severe TBI, profound hypocarbia should be avoided to prevent
__________.
exploratory laparotomy - (correct Answer) - A 25-year-old man is brought to a
hospital after being involved in a MVA. CT shows an aortic injury and splenic
laceration with free abdominal fluid. His BP falls to 70 mm Hg after CT. The next
step is _______.
leakage of amniotic fluid - (correct Answer) - Abdominal trauma in a pregnant
patient --> _________ is an indication for hospital admission.
administer supplemental oxygen - (correct Answer) - What is the first maneuver to
improve oxygenation after chest injury?
9 (eyes = 2, verbal = 2, motor = 5) - (correct Answer) - A 25-year old man, injured
in a MVA, is admitted to the emergency department. His pupils react sluggishly and
his eyes open to painful stimuli. He does not follow commands, but he does moan
periodically. His right arm is deformed and does not respond to painful stimulus;
however, his left hand reaches purposefully toward the painful stimulus. Both legs
are stiffly extended. His GCS score is ________.
RR of 40 BPM - (correct Answer) - Which one of the following findings in an adult
is most likely to require immediate management during the primary survey: distended
abdomen, GCS score of 11, deforming of the right thigh, RR of 40 BPM.
placement of an occlusive dressing over the wound - (correct Answer) - The most
important, immediate step in the management of an open pneumothorax is _________.
history of neurological reaction or severe hypersensitivity to the product -
(correct Answer) - The following are contraindications for tetanus toxoid
administration: history of neurological reaction or severe hypersensitivity to the
product, local side effects, muscular spasms, pregnancy, or all of the above.
, breath sounds - (correct Answer) - A 56-year-old man is thrown violently against
the steering wheel of his truck during a motor vehicle crash. On arrival in the
emergency department, he is diaphoretic and complaining of chest pain. His BP is
60/40 mm Hg and his RR is 40 breaths per minute. Which of the following best
differentiates cardiac tamponade from tension pneumothorax as the cause of his
hypotension?
the trachea is relatively short - (correct Answer) - Bronchial intubation of the
right or left mainstem bronchus can easily occur during infant ET intubation
because _______.
urgently transfer the patient to the operating room - (correct Answer) - A 23-year-
old man sustains 4 stab wounds to the upper right chest during an altercation and
is brought by ambulance to a hospital that has full surgical capabilities. His
wounds are all above the nipple. He is endotracheally intubated, closed tube
thoracostomy is performed, and 2 liters of crystalloid solution are infused through
2 large-caliber IVs. His blood pressure is now 60/0 mm Hg. Heart rate is 160 bpm,
and RR is 14 breaths per minute (ventilated with 100% O2). 1500 cc of blood has
drained from the right chest. The most appropriate next step in managing this
patient is to ______.
attempt orotracheal intubation using 2 people and inline stabilization of the
cervical spine - (correct Answer) - A 39-year-old man is admitted to the emergency
department after an automobile collision. He is cyanotic, has insufficient
respiratory effort, and has a GCS Score of 6. His full beard makes it difficult to
fit the oxygen facemask to his face. The most appropriate next step is to _______.
flaccidity of the lower extremities and loss of deep tendon reflexes are expected -
(correct Answer) - A patient is brought to the emergency department after a motor
vehicle crash. He is conscious and there is no obvious external trauma. He arrives
at the hospital completely immobilized on a long spine board. His BP is 60/40 mm Hg
and his heart rate is 70 beats per minute. His skin is warm. Which one of the
following statements is TRUE?
moist heat - (correct Answer) - What is the most effective method for initially
treating frostbite?
suction the oropharynx - (correct Answer) - A patient arrives in the emergency
department after being beaten about the head and face with a wooden club. He is
comatose and has a palpable depressed skull fracture. His face is swollen and
ecchymotic. He has gurgling respirations and vomitus on his face and clothing. The
most appropriate step after providing supplemental oxygen and elevating his jaw is
to _______.
repeat the primary survey and proceed with the transfer - (correct Answer) - A 22-
year-old man sustains a gunshot wound to the left chest and is transported to a
small community hospital at which surgical capabilities are not available. In the
emergency dept, a chest tube is inserted and 700 mL of blood is evacuated. The
trauma center accepts the patient in transfer. Just before the patient is placed in
the ambulance for transfer, his BP decreases to 80/68 and his HR increases to 136
beats per minute. The next step should be to ______.
call the receiving hospital and speak to the surgeon on call - (correct Answer) - A
64-year-old man involved in a high-speed car crash is resuscitated initially in a
small hospital without surgical capabilities. He has a closed head injury with a
GCS score of 13. He has a widened mediastinum on CXR with fractures of left ribs 2-
4, but no pneumothorax. After infusing 2 liters of crystalloid solution, bis BP is
110/74, his heart rate is 100 bpm, and his RR is 18 breaths per minute. He has
gross hematuria and a pelvic fracture. You decided to transfer this patient to a
facility capable of providing a higher level of care. The facility is 80 miles
away. Before transfer, you should first _______.
tachycardia - (correct Answer) - Hemorrhage of 20% of the patient's blood volume is
usually a/w _______.
aspiration of bone marrow confirms appropriate positioning of the needle - (correct
Answer) - Which one of the following statements concerning intraosseous infusion is
TRUE?
avoid hypotension - (correct Answer) - A young woman sustains a severe head injury
re-examine the chest - (correct Answer) - A 22-year-old man is hypotensive and
tachycardic after a shotgun wound to the left shoulder. His BP is initially 80/40
mm Hg. After 2 liters of crystalloid solution his BP increases to 122/84. His heart
rate is now 100 BPM and his RR is 28 breaths per minute. His breath sounds are
decreased in the left hemithorax, and after initial IV fluid resuscitation, a
closed tube thoracostomy is performed for decreased left 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 __________.
complete spine x-rays - (correct Answer) - 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
_________.
secure the airway - (correct Answer) - In managing the head-injured patient, the
most important initial step is to ________.
his systolic pressure will be decreased with a narrowed pulse pressure - (correct
Answer) - A previously healthy, 70 kg man suffers an estimated acute blood loss of
2 liters. How will this affect his blood pressure?
increasing the volume of blood loss to produce maternal hypotension - (correct
Answer) - The physiologic hypervolemia of pregnancy has clinical significance in
the management of the severely injured, gravid woman by ____________.
adequate urinary output - (correct Answer) - The best assessment of fluid
resuscitation of the adult burn patient is __________.
evidence of inadequate organ perfusion - (correct Answer) - The diagnosis of shock
must include _________.
direct pressure on the wound - (correct Answer) - 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 ________ (application of a
tourniquet vs. direct pressure on the wound).
cerebral vasoconstriction with diminished perfusion - (correct Answer) - For the
patient with severe TBI, profound hypocarbia should be avoided to prevent
__________.
exploratory laparotomy - (correct Answer) - A 25-year-old man is brought to a
hospital after being involved in a MVA. CT shows an aortic injury and splenic
laceration with free abdominal fluid. His BP falls to 70 mm Hg after CT. The next
step is _______.
leakage of amniotic fluid - (correct Answer) - Abdominal trauma in a pregnant
patient --> _________ is an indication for hospital admission.
administer supplemental oxygen - (correct Answer) - What is the first maneuver to
improve oxygenation after chest injury?
9 (eyes = 2, verbal = 2, motor = 5) - (correct Answer) - A 25-year old man, injured
in a MVA, is admitted to the emergency department. His pupils react sluggishly and
his eyes open to painful stimuli. He does not follow commands, but he does moan
periodically. His right arm is deformed and does not respond to painful stimulus;
however, his left hand reaches purposefully toward the painful stimulus. Both legs
are stiffly extended. His GCS score is ________.
RR of 40 BPM - (correct Answer) - Which one of the following findings in an adult
is most likely to require immediate management during the primary survey: distended
abdomen, GCS score of 11, deforming of the right thigh, RR of 40 BPM.
placement of an occlusive dressing over the wound - (correct Answer) - The most
important, immediate step in the management of an open pneumothorax is _________.
history of neurological reaction or severe hypersensitivity to the product -
(correct Answer) - The following are contraindications for tetanus toxoid
administration: history of neurological reaction or severe hypersensitivity to the
product, local side effects, muscular spasms, pregnancy, or all of the above.
, breath sounds - (correct Answer) - A 56-year-old man is thrown violently against
the steering wheel of his truck during a motor vehicle crash. On arrival in the
emergency department, he is diaphoretic and complaining of chest pain. His BP is
60/40 mm Hg and his RR is 40 breaths per minute. Which of the following best
differentiates cardiac tamponade from tension pneumothorax as the cause of his
hypotension?
the trachea is relatively short - (correct Answer) - Bronchial intubation of the
right or left mainstem bronchus can easily occur during infant ET intubation
because _______.
urgently transfer the patient to the operating room - (correct Answer) - A 23-year-
old man sustains 4 stab wounds to the upper right chest during an altercation and
is brought by ambulance to a hospital that has full surgical capabilities. His
wounds are all above the nipple. He is endotracheally intubated, closed tube
thoracostomy is performed, and 2 liters of crystalloid solution are infused through
2 large-caliber IVs. His blood pressure is now 60/0 mm Hg. Heart rate is 160 bpm,
and RR is 14 breaths per minute (ventilated with 100% O2). 1500 cc of blood has
drained from the right chest. The most appropriate next step in managing this
patient is to ______.
attempt orotracheal intubation using 2 people and inline stabilization of the
cervical spine - (correct Answer) - A 39-year-old man is admitted to the emergency
department after an automobile collision. He is cyanotic, has insufficient
respiratory effort, and has a GCS Score of 6. His full beard makes it difficult to
fit the oxygen facemask to his face. The most appropriate next step is to _______.
flaccidity of the lower extremities and loss of deep tendon reflexes are expected -
(correct Answer) - A patient is brought to the emergency department after a motor
vehicle crash. He is conscious and there is no obvious external trauma. He arrives
at the hospital completely immobilized on a long spine board. His BP is 60/40 mm Hg
and his heart rate is 70 beats per minute. His skin is warm. Which one of the
following statements is TRUE?
moist heat - (correct Answer) - What is the most effective method for initially
treating frostbite?
suction the oropharynx - (correct Answer) - A patient arrives in the emergency
department after being beaten about the head and face with a wooden club. He is
comatose and has a palpable depressed skull fracture. His face is swollen and
ecchymotic. He has gurgling respirations and vomitus on his face and clothing. The
most appropriate step after providing supplemental oxygen and elevating his jaw is
to _______.
repeat the primary survey and proceed with the transfer - (correct Answer) - A 22-
year-old man sustains a gunshot wound to the left chest and is transported to a
small community hospital at which surgical capabilities are not available. In the
emergency dept, a chest tube is inserted and 700 mL of blood is evacuated. The
trauma center accepts the patient in transfer. Just before the patient is placed in
the ambulance for transfer, his BP decreases to 80/68 and his HR increases to 136
beats per minute. The next step should be to ______.
call the receiving hospital and speak to the surgeon on call - (correct Answer) - A
64-year-old man involved in a high-speed car crash is resuscitated initially in a
small hospital without surgical capabilities. He has a closed head injury with a
GCS score of 13. He has a widened mediastinum on CXR with fractures of left ribs 2-
4, but no pneumothorax. After infusing 2 liters of crystalloid solution, bis BP is
110/74, his heart rate is 100 bpm, and his RR is 18 breaths per minute. He has
gross hematuria and a pelvic fracture. You decided to transfer this patient to a
facility capable of providing a higher level of care. The facility is 80 miles
away. Before transfer, you should first _______.
tachycardia - (correct Answer) - Hemorrhage of 20% of the patient's blood volume is
usually a/w _______.
aspiration of bone marrow confirms appropriate positioning of the needle - (correct
Answer) - Which one of the following statements concerning intraosseous infusion is
TRUE?
avoid hypotension - (correct Answer) - A young woman sustains a severe head injury
