REVIEWED ATLS Exam Questions and Answers: A Comprehensive Trauma Life Support Study Guide

REVIEWED ATLS EXAM QUESTIONS AND a a a a




ANSWERS
True or false? Although the mechanism of injury may be similar to those for the younger population,
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data shows increased mortality with similar severity of injury in older adults. - CORRECT ANSWER-True
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In the elderly population, what is decreased physiological reserve? - CORRECT ANSWER-aging is
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acharacterized by impaired adaptive and homeostatic mechanisms that caused an increased
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asusceptibility to the stress of injury. Insults tolerated by the younger population can lead to devastating
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aresults in elderly patients.
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Pre-existing conditions that affect morbidity and mortality include: - CORRECT ANSWER-cirrhosis,
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coagulopathy, COPD, ischemic heart disease, DM
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What is the most common mechanism of injury in the elderly? - CORRECT ANSWER-Fall. Nonfatal falls
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are common in women and fractures are common in women who fall. Falls are the most common
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cause of TBI.
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In the elderly population, what are risk factors for falls? - CORRECT ANSWER-advanced age, physical
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aimpairment, history of previous fall, medication use, dementia, unsteady gait, and visual, cognitive
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aimpairment



Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve other
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vehicles. Why? - CORRECT ANSWER-Older people drive on more familiar roads and at lower speeds
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and tend to drive during the day. Older people have slower reaction time, a larger blind spot, limited
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cervical mobility, decreased hearing, and cognitive impairment.
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True or False? Mortality associated with small to moderate sized burns in older adults remains high -
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CORRECT ANSWER-True
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,Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an adequate
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number of hair follicles, will result in a full thickness burn in older patients. - CORRECT ANSWER-this is
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true
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Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are not
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obstructing the airway, leave them in place for what? - CORRECT ANSWER-bag mask ventilation, as it
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improves mask fitting.
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When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other sedatives
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should be reduced to what percentage to minimize the risk of cardiovascular depression? -
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CORRECT ANSWER-20-40%
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Functional changes in cardiac system include declining function, decreased sensitivity to
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acatecholamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
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ablockers)
- CORRECT ANSWER-this results in lack of classic response to hypovolemia, risk for cardiac ischemia,
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aelevated BP at baseline, and increased risk of dysrythmias.
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Functional changes in pulmonary system include decreased elastic recoil, reduced residual capacity,
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decreased gas exchange and decreased cough reflex - CORRECT ANSWER-thus they are at increased risk
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for respiratory failure, increased risk for pneumonia, and poor tolerance to rib fractures
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Functional changes in renal system include loss of renal mass, decreased GFR, and decreased sensitivity
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to ADH and aldosterone - CORRECT ANSWER-resulting in drug dosing for renal insufficiency, decreased
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ability to concentrate urine, increased risk for AKI and urine flow may be normal with hypovolemia
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Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
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cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat - CORRECT
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ANSWER-resulting in increased risk for fractures, decreased mobility, difficulty for oral intubation, risk
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of skin injury, increased risk for hypothermia, challenges in rehabiliation
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Functional changes in Endocrine system include decreased production and response to thyroxin and
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decreased dehydroepiandrosterone (DHEA) - CORRECT ANSWER-resulting in occult
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hypothyroidism, relative hypercortisone states and increased risk of infection
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, True or false: Arthritis can complicate the airway and cervical spine. Patients can have multilevel
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degenerative changes affecting disk spaces and posterior elements associated with severe central canal
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stenosis, cord compression, and myelomalacia - CORRECT ANSWER-true
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In elderly population, due to their changes in pulmonary system, placing a gauze between gums and
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acheek to achieve seal when using bag valve mask ventilation is okay. In addition, because aging causes
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aa suppressed heart rate response to hypoxia. .. - CORRECT ANSWER-respiratory failure may present
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insidiously in older adults. a a a




Age related changes in the cardiovascular system place the elderly trauma patient at significant risk for
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being inaccurately categorized as hemodynamically stable. - CORRECT ANSWER-Elderly patients have a
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fixed heart rate and fixed cardiac output, thus, their response to hypovolemia will involve increasing
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their systemic vascular resistance. Furthermore, since older patients have HTN, an acceptable BP may
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truly reflect a hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identifying
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hypotension in patients 65 and older.
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Do no equate blood pressure with shock in older patients - CORRECT ANSWER-BP in older patients may
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look normal due to the medications they are on. Use lactate and base deficit to evaluate for evidence
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of shock
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what 2 factors place elderly patients at risk for intracranial hemorrhage? - CORRECT ANSWER-
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aging causes dura to become more adherent to the skull increasing risk of injury and older patients
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are on anticoagulant and antiplatelet medications.
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Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly patients as
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risk for hypothermia and complications for immobility. - CORRECT ANSWER-Rapid evaluation and when
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possible early liberation from spine boards and cervical collars will minimize complications.
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True or False: Fall prevention is the mainstay of reducing the mortality associated with pelvic fractures. -
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CORRECT ANSWER-true
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