ATLS POST TEST 4 LATEST VERSIONS REAL EXAM 160 QUESTIONS &
CORRECT ANSWERS |A+ GRADE
Which of the following injuries is addressed in the secondary survey?
A. Bilateral femur fractures with obvious deformity
B. Open fracture with bleeding
C. Mid-thigh amputation
D. Unstable pelvic fracture
E. Forearm fracture - CORRECT ANSWERS-E. Forearm fracture
Which of the following statements is false?
A. Hypotonic fluids should be used to limit brain edema in patients with severe head injury
B. Elevated intracranial pressure will not affect cerebral perfusion
C. CSF cannot be displaced from cranial vault
D. Cerebral blood flow is increased when PaCO2 is below 30 mmHg
E. Autoregulation of cerebral blood flow normally occurs between cerebral perfusion pressure of 50-150
mmHg - CORRECT ANSWERS-??
A 40 year old obese patient with GCS score of 8 requires a CT scan. Before transfer to the scanner, you
should:
A. Give more sedative drugs
B. Insert a definitive airway
C. Insert a multilumen esophageal airway
D. Request a lateral cervical spine film
E. Insert a nasogastric tube - CORRECT ANSWERS-B. Insert a definitive airway
GCS <8, intubate!
Which of the following should be performed FIRST in any patient whose injuries may include multiple
closed extremity fractures?
,A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - CORRECT ANSWERS-D. Ensuring adequate
oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His BP is 80/40
and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases to 122/84 and HR
decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds are decreased at the left
upper chest with dullness on percussion. A large caliber tube thoracostomy is inserted into the fifth
intercostal space with the return of 200 mL of blood and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest - CORRECT ANSWERS-E. Repeat the physical exam of
the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle decompression
followed by tube
Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury
, E. Determination of whether a spinal cord lesion is complete or incomplete must be made in the primary
survey - CORRECT ANSWERS-B. A vertebral injury is unlikely in the absence of physical
findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is unresponsive and
found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - CORRECT ANSWERS-D. Applying oxygen and
maintaining airway
First = ABCs
Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure - CORRECT ANSWERS-E. Decreased pulse pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a ladder and landing
straddled on a fence. Examination of his perineum reveals extensive ecchymosis. There is blood in the
external urethral meatus. The initial diagnostic study for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography - CORRECT ANSWERS-E. retrograde urethrography
-> any ecchymosis, needs to be done before catheter!
CORRECT ANSWERS |A+ GRADE
Which of the following injuries is addressed in the secondary survey?
A. Bilateral femur fractures with obvious deformity
B. Open fracture with bleeding
C. Mid-thigh amputation
D. Unstable pelvic fracture
E. Forearm fracture - CORRECT ANSWERS-E. Forearm fracture
Which of the following statements is false?
A. Hypotonic fluids should be used to limit brain edema in patients with severe head injury
B. Elevated intracranial pressure will not affect cerebral perfusion
C. CSF cannot be displaced from cranial vault
D. Cerebral blood flow is increased when PaCO2 is below 30 mmHg
E. Autoregulation of cerebral blood flow normally occurs between cerebral perfusion pressure of 50-150
mmHg - CORRECT ANSWERS-??
A 40 year old obese patient with GCS score of 8 requires a CT scan. Before transfer to the scanner, you
should:
A. Give more sedative drugs
B. Insert a definitive airway
C. Insert a multilumen esophageal airway
D. Request a lateral cervical spine film
E. Insert a nasogastric tube - CORRECT ANSWERS-B. Insert a definitive airway
GCS <8, intubate!
Which of the following should be performed FIRST in any patient whose injuries may include multiple
closed extremity fractures?
,A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - CORRECT ANSWERS-D. Ensuring adequate
oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His BP is 80/40
and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases to 122/84 and HR
decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds are decreased at the left
upper chest with dullness on percussion. A large caliber tube thoracostomy is inserted into the fifth
intercostal space with the return of 200 mL of blood and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest - CORRECT ANSWERS-E. Repeat the physical exam of
the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle decompression
followed by tube
Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury
, E. Determination of whether a spinal cord lesion is complete or incomplete must be made in the primary
survey - CORRECT ANSWERS-B. A vertebral injury is unlikely in the absence of physical
findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is unresponsive and
found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - CORRECT ANSWERS-D. Applying oxygen and
maintaining airway
First = ABCs
Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure - CORRECT ANSWERS-E. Decreased pulse pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a ladder and landing
straddled on a fence. Examination of his perineum reveals extensive ecchymosis. There is blood in the
external urethral meatus. The initial diagnostic study for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography - CORRECT ANSWERS-E. retrograde urethrography
-> any ecchymosis, needs to be done before catheter!
