ATLS Test 1 Exam Test Bank (340) Questions With Complete Solution

ATLS TEST 1 EXAM TEST BANK (340)
QUESTIONS WITH COMPLETE SOLUTION


1. A 22 year old male is brought by ambulance to a small community hospital after falling from the top
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of an 8 foot ladder. Initially, he was found to have
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a large right pneumothorax. A chest tube was inserted and connected to an underwater seal drainage
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collection system with negative pressure. A repeat CXR demonstrates a residual, large right
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pneumothorax. After transferring the patient to a verified trauma center, a third chest x-ray reveals a persistent
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right pneumothorax.The chest tube appears to be functioning and in good position. He remains
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hemodynamically normal with no signs of respiratory distress.
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The most likely cause for the persistent right pneumothorax is:
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A. Flail chest ix




B. Diaphragmatic injury ix




C. Pulmonary contusion ix




D. Esophageal perforation ix




E. Tracheobronchial injury ix




..ANS>> E.Tracheobronchial injury ix ix ix




2. Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
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A. symmetrical chest wall movement ix ix ix




B. end-tidal CO2 ix




C. bilateral breath sounds ix ix




D. oxygen saturation >92% ix ix




E. ETT above carina on chest x-ray ix ix ix ix ix




..ANS>> D. oxygen saturation >92% x ix ix ix



-> if it says ESOPHAGEAL, go with this answer
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,3. Which of the following signs necessitates the need for a definitive airway in severe trauma patient?
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A. facial lacerationsix




B. repeated vomiting ix




C. severe maxillofacial trauma
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D. sternal fracture ix




E. GCS 12 ix




..ANS>> C. Severe maxillofacial trauma
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4. Twenty seven people are severely injured in an aircraft crash at a local airport. The principles of
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ix triage include:
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A. establish a triage site within the internal perimeter of the crash site
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B. treat only the most severely injured patients first
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C. immediately transport all patients to the nearest hospital ix ix ix ix ix ix ix




D. treat the greatest number of patients in the shortest period of time
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E. produce the greatest number of survivors based on available resources
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..ANS>> E. Produce the greatest number of survivors based on available resources
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5. Which of the following statements are correct?
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A. Cerebral contusions may coalesce to form an intracerebral hematoma
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,B. Epidural hematomas are usually seen in the frontal region
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C. Subdural hematomas are caused by injury to the middle meningeal artery
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D. Subdural hematomas typically have a lenticular shape on CT
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E. The associated brain damage is more severe in epidural hematomas
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..ANS>> A. Cerebral contusions may coalesce to form an intracerebral hematoma
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EM: Epidural, middle meningeal SuB: Subdural,
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Bridging veins
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6. An 18 year old male is brought to the ED after being shot. He has one bullet wound just below the right
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ix clavicle and another just below the costal margin in the right posterior axillary line. His blood
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ix pressure is 110/60, heart rate of 90, and respiratory rate of 34. After ensuring a patent airway and
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ix inserting 2 large caliber IV lines, the next most appropriate step is to:
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A. Obtain a portable chest x-ray ix ix ix ix




B. Administer a bolus of additional IV fluid ix ix ix ix ix ix




C. Perform a laparatomy ix ix




D. Obtain an abdominal CT scan ix ix ix ix




E. Perform diagnostic peritoneal lavage ix ix ix




..ANS>> A. Obtain a portable chest x-ray need more info on chest, not abdomen
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7. Which of the following should be performed FIRST in any patient whose injuries may include
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ix multiple closed extremity fractures?
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A. A thorough assessment of four limb perfusion
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B. Manuevers to prevent necrosis of the skin ix ix ix ix ix ix




C. Extremity compartment syndrome release ix ix ix




D. Ensuring adequate oxygenation and ventilation ix ix ix ix




E. Evaluation for occult crush syndrome ix ix ix ix




..ANS>> D. Ensuring adequate oxygenation and ventilation
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(ABC's)


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, 8. A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His BP is
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ix 80/40 and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases to 122/84 and
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ix HR decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds are decreased at the
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ix left upper chest with dullness on percussion. A large caliber tube thoracostomy is inserted into the
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ix fifth intercostal space with the return of 200 mL of blood and no air leak.The most appropriate next
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ix step is: ix




A. Insert a foley catheter ix ix ix




B. Begin to transfuse O negative blood
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C. Perform thoracotomy ix




D. Obtain a CT Chest/Abd ix ix ix




E. Repeat the physical exam of the chest
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..ANS>> E. Repeat the physical exam of the
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