ATLS Post Test
18 year old helmeted motorcyclist is brought by ambulance to the emergency
department following a high speed crash. Pre-hospital personnel report that he was
thrown 50 feet off his bike. He has a history of hypotension prior to arrival in the ED, but
is now awake, alert, and conversational. Which of the following statements is true? -
ANS The patient probably has an acute epidural hematoma (lucid interval)
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 shocks is most likely caused by: - ANS Hemorrhage
into the chest or abdomen
nothing visible -> think chest or abdomen
23 year old man is brought immediately to the emergency department from the hospital
parking lot where he was shot in the lower abdomen. Examination reveals a single
bullet wound. He is breathing and has a thrash pulse. However, he is unconscious and
has no detectable blood pressure. Optimal immediate management is to: - ANS
Transfer the patient to the operating room while initiating fluid therapy
24 year old male sustains multiple fractured ribs bilaterally as a result of being crushed
in a press at plywood factory. Examination in the ED revealed a foil segment on the
patient's thorax. Primary resuscitation includes high flow, oxygen administration via a
non-breathing mask, and initiation of ringers lactate solution. The patient exhibits
progressive confusion, cyanosis, and kidney. Management at this time she consist of: -
ANS Endotracheal intubation and mechanical ventilation
24 year old woman passenger in an automobile, strikes the windscreen with her face
during a head-on collision. In the emergency apartment, she's talking and has marked
artificial demon crepitus. The highest priority should be given to: - ANS Upper
airway protection
25 year old woman is brought to the emergency department after a motor vehicle crash.
She was initially lucid at the scene and then developed the dilated people in
contralateral externally weakness. In the emergency department, she's unconscious
and has a GCS score of 6. The initial management step for this patient should be to: -
ANS Perform endotracheal intubation
,28 year old male is brought to ER. He was involved in a fight in which she was beaten
with a wooden stick. His chest has multiple severe bruises. Airways clear, respiratory
rate 22, heart rate is 126, and systemic blood pressure is 90. Which of the following
should be performed during the primary survey?
A. GCS
B. Cervical spine XR
C. TT administration
D. Blood alcohol level
E. Rectal exam - ANS A. GCS
30 year old man is struck by a car traveling 35mph. He has obvious fractures of the left
tibia near the knee, pain in the pelvis area, and severe dyspnea. His HR is 180, RR 48
bpm with no breath sounds heard in the left chest. A tension PTX is relieved by
immediate needle decompression and tube thoracostomy. Subsequently his HR
decreased to 140, his RR decreased to 36 bpm, and BP 80/50 mmHg. Warmed LR is
administered intravenously. The next priority should be to: - ANS Perform external
fixation of the pelvis
30 year old man sustains a severely, communities, open distal right femur fracture in a
motorcycle crash. The wound is actively bleeding. DP and PT are easily palpable on the
left, but heard only by Doppler on the right. Immediate effort to improve circulation the
injured extremity should involve: - ANS Tamponade of the wound with a pressure
dressing
32 year old male is brought to the hospital unconscious with severe facial injuries and
noisy respirations after an automobile collision. In the emergency department, he has
no apparent injury to the anterior aspect of his neck. He suddenly becomes apneic, and
alternative ventilation with a face mask is unsuccessful. Examination of his mouth
reveals a large hematoma of the fairing with loss of normal atomic landmarks. Initial
management of his airway should consist of:
A. Nasotracheal intubation
B. Emergency tracheostomy
C. Surgical cricothyroidotomy
D. Placement of an oropharyngeal airway
E. Placement of an nasopharyngeal airway - ANS C. Surgical cricothyroidotomy
42 year old man injured in a motor vehicle crash, suffers a closed, head injury, multiple
palpable left roof fracture, bilateral femur fracture. He is intubated orotracheally without
difficulty. Initially, has ventilations are easily assisted with a bag device. It becomes
, more difficult to ventilate the patient over the next five minutes, and his hemoglobin
oxygen saturation level decreases from 90% to 89%. The most appropriate next step is
to: - ANS Auscultate the patient's chest
42 year olds man is trapped from the waist down beneath his overturned tractor for
several hours before Medical systemized. He is awake and alert until just before arriving
in emergency department. He is now unconscious in response only to painful stimulate
by moaning. His pupils are 3 mm in diameter and symmetrically reactive delight.
Prehospital personnel indicate that they have not seen the patient move either of his
lower extremities.: - ANS A pelvic fracture
5 year old boy is struck by an automobile and brought to the emergency department. He
is lethargic, but withdraws purposefully from painfully stimuli. His blood pressure is 90
mmHg, HR 140 BPM, and RR is 36 bpm. The preferred route of venous access in this
patient is: - ANS Pertained veins in the upper extremities
8 year old girl is an unrestrained passenger in a vehicle struck from behind. In the ED,
her blood pressure is 80/60, heart rate is 80 bpm, and respiratory rate is 16 breaths per
minute. Her GCS score is 14. She complains that her legs "feel funny and won't move
right", however, her spine x-rays do not show a fracture dislocation. A spinal injury in
this child: - ANS Can be excluded by obtaining a CT of the entire spine
A 14 year old female is brought to the ED after falling from a horse. She is immoblized
on a long spine board with a hard collar and blocks. Cervical spine x-ray: - ANS
??
A 15 year old male presents following a motorcycle crash. Initial exam reveals normal
vital signs. There is a large bruise over his epigastrium that extends to the left flank. He
has no other apparent injuries. A CT scan of the abdomen demonstrates a ruptured
spleen surrounded by a large hematoma and fluid in the pelvis. The next best step in
the patient's management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laporotomy
D. Surgical consultation
E. Transfer to a pediatrician - ANS D. Surgical consultation
vs. peritonitis or abnormal vital signs --> urgent laporotomy
A 15-year-old male is brought to ER after being involved in a motor vehicle crash. He is
unconscious and was intubated at the scene by EMS. In ER, O2 is 92%. Heart rate is
18 year old helmeted motorcyclist is brought by ambulance to the emergency
department following a high speed crash. Pre-hospital personnel report that he was
thrown 50 feet off his bike. He has a history of hypotension prior to arrival in the ED, but
is now awake, alert, and conversational. Which of the following statements is true? -
ANS The patient probably has an acute epidural hematoma (lucid interval)
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 shocks is most likely caused by: - ANS Hemorrhage
into the chest or abdomen
nothing visible -> think chest or abdomen
23 year old man is brought immediately to the emergency department from the hospital
parking lot where he was shot in the lower abdomen. Examination reveals a single
bullet wound. He is breathing and has a thrash pulse. However, he is unconscious and
has no detectable blood pressure. Optimal immediate management is to: - ANS
Transfer the patient to the operating room while initiating fluid therapy
24 year old male sustains multiple fractured ribs bilaterally as a result of being crushed
in a press at plywood factory. Examination in the ED revealed a foil segment on the
patient's thorax. Primary resuscitation includes high flow, oxygen administration via a
non-breathing mask, and initiation of ringers lactate solution. The patient exhibits
progressive confusion, cyanosis, and kidney. Management at this time she consist of: -
ANS Endotracheal intubation and mechanical ventilation
24 year old woman passenger in an automobile, strikes the windscreen with her face
during a head-on collision. In the emergency apartment, she's talking and has marked
artificial demon crepitus. The highest priority should be given to: - ANS Upper
airway protection
25 year old woman is brought to the emergency department after a motor vehicle crash.
She was initially lucid at the scene and then developed the dilated people in
contralateral externally weakness. In the emergency department, she's unconscious
and has a GCS score of 6. The initial management step for this patient should be to: -
ANS Perform endotracheal intubation
,28 year old male is brought to ER. He was involved in a fight in which she was beaten
with a wooden stick. His chest has multiple severe bruises. Airways clear, respiratory
rate 22, heart rate is 126, and systemic blood pressure is 90. Which of the following
should be performed during the primary survey?
A. GCS
B. Cervical spine XR
C. TT administration
D. Blood alcohol level
E. Rectal exam - ANS A. GCS
30 year old man is struck by a car traveling 35mph. He has obvious fractures of the left
tibia near the knee, pain in the pelvis area, and severe dyspnea. His HR is 180, RR 48
bpm with no breath sounds heard in the left chest. A tension PTX is relieved by
immediate needle decompression and tube thoracostomy. Subsequently his HR
decreased to 140, his RR decreased to 36 bpm, and BP 80/50 mmHg. Warmed LR is
administered intravenously. The next priority should be to: - ANS Perform external
fixation of the pelvis
30 year old man sustains a severely, communities, open distal right femur fracture in a
motorcycle crash. The wound is actively bleeding. DP and PT are easily palpable on the
left, but heard only by Doppler on the right. Immediate effort to improve circulation the
injured extremity should involve: - ANS Tamponade of the wound with a pressure
dressing
32 year old male is brought to the hospital unconscious with severe facial injuries and
noisy respirations after an automobile collision. In the emergency department, he has
no apparent injury to the anterior aspect of his neck. He suddenly becomes apneic, and
alternative ventilation with a face mask is unsuccessful. Examination of his mouth
reveals a large hematoma of the fairing with loss of normal atomic landmarks. Initial
management of his airway should consist of:
A. Nasotracheal intubation
B. Emergency tracheostomy
C. Surgical cricothyroidotomy
D. Placement of an oropharyngeal airway
E. Placement of an nasopharyngeal airway - ANS C. Surgical cricothyroidotomy
42 year old man injured in a motor vehicle crash, suffers a closed, head injury, multiple
palpable left roof fracture, bilateral femur fracture. He is intubated orotracheally without
difficulty. Initially, has ventilations are easily assisted with a bag device. It becomes
, more difficult to ventilate the patient over the next five minutes, and his hemoglobin
oxygen saturation level decreases from 90% to 89%. The most appropriate next step is
to: - ANS Auscultate the patient's chest
42 year olds man is trapped from the waist down beneath his overturned tractor for
several hours before Medical systemized. He is awake and alert until just before arriving
in emergency department. He is now unconscious in response only to painful stimulate
by moaning. His pupils are 3 mm in diameter and symmetrically reactive delight.
Prehospital personnel indicate that they have not seen the patient move either of his
lower extremities.: - ANS A pelvic fracture
5 year old boy is struck by an automobile and brought to the emergency department. He
is lethargic, but withdraws purposefully from painfully stimuli. His blood pressure is 90
mmHg, HR 140 BPM, and RR is 36 bpm. The preferred route of venous access in this
patient is: - ANS Pertained veins in the upper extremities
8 year old girl is an unrestrained passenger in a vehicle struck from behind. In the ED,
her blood pressure is 80/60, heart rate is 80 bpm, and respiratory rate is 16 breaths per
minute. Her GCS score is 14. She complains that her legs "feel funny and won't move
right", however, her spine x-rays do not show a fracture dislocation. A spinal injury in
this child: - ANS Can be excluded by obtaining a CT of the entire spine
A 14 year old female is brought to the ED after falling from a horse. She is immoblized
on a long spine board with a hard collar and blocks. Cervical spine x-ray: - ANS
??
A 15 year old male presents following a motorcycle crash. Initial exam reveals normal
vital signs. There is a large bruise over his epigastrium that extends to the left flank. He
has no other apparent injuries. A CT scan of the abdomen demonstrates a ruptured
spleen surrounded by a large hematoma and fluid in the pelvis. The next best step in
the patient's management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laporotomy
D. Surgical consultation
E. Transfer to a pediatrician - ANS D. Surgical consultation
vs. peritonitis or abnormal vital signs --> urgent laporotomy
A 15-year-old male is brought to ER after being involved in a motor vehicle crash. He is
unconscious and was intubated at the scene by EMS. In ER, O2 is 92%. Heart rate is
