ATLS Pre Module Exam Questions with Well
Elaborated Solutions
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood
pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to 122/84
mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest 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:
A) Reexamine the chest
B) Aortogram
C) Chest CT
D) ABG
E) TOE - Answer A
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:
A) Angiography
B) Compartment pressures
C) Retrograde urethrogram
D) Doppler ultrasound studies
E) Complete spine x-ray series - Answer E
Which of the following is true regarding the initial resuscitation of a trauma patient?
A) A patient that presents with a torso gunshot wound and is hypotensive should receive crystalloid fluid
resuscitation until the blood pressure is normal
B) Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow coma
scale score on reevaluation
C) Massive transfusion is defined as transfusion of more than >10 of packed red blood cells and plasma
in 24 hours
, D) When tranexamic acid is administered by pre-hospital providers a second dose is required within 24
hours
E) Fluid resuscitation is far more important than bleeding control in trauma patients - Answer B
In managing a patient with a severe traumatic brain injury, the most important initial step is to:
A) Secure the airway
B) Obtain a c-spine film
C) Support the circulation
D) Control scalp hemorrhage
E) Determine the GCS score - Answer A
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters.
Which one of the following statements applies to this patient?
A) His pulse pressure will be widened.
B) His urinary output will be at the lower limits of normal.
C) He will have tachycardia, but no change in his systolic blood pressure.
D) An ABG would demonstrate a base deficit between -6 and -10 mEq/L
E) His systolic blood pressure will be maintained with an elevated diastolic pressure. - Answer D
The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely
injured, gravid woman by:
A) Reducing the need for blood transfusion
B) Resulting in an elevated hematocrit
C) Complicating the management of closed head injury
D) Reducing the volume of crystalloid required for resuscitation
E) Increasing the volume of blood loss to produce maternal hypotension - Answer E
The best assessment of fluid resuscitation of the adult burn patient is:
A) Urine output of 0.5 mL/kg/hr
Elaborated Solutions
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood
pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to 122/84
mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest 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:
A) Reexamine the chest
B) Aortogram
C) Chest CT
D) ABG
E) TOE - Answer A
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:
A) Angiography
B) Compartment pressures
C) Retrograde urethrogram
D) Doppler ultrasound studies
E) Complete spine x-ray series - Answer E
Which of the following is true regarding the initial resuscitation of a trauma patient?
A) A patient that presents with a torso gunshot wound and is hypotensive should receive crystalloid fluid
resuscitation until the blood pressure is normal
B) Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow coma
scale score on reevaluation
C) Massive transfusion is defined as transfusion of more than >10 of packed red blood cells and plasma
in 24 hours
, D) When tranexamic acid is administered by pre-hospital providers a second dose is required within 24
hours
E) Fluid resuscitation is far more important than bleeding control in trauma patients - Answer B
In managing a patient with a severe traumatic brain injury, the most important initial step is to:
A) Secure the airway
B) Obtain a c-spine film
C) Support the circulation
D) Control scalp hemorrhage
E) Determine the GCS score - Answer A
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters.
Which one of the following statements applies to this patient?
A) His pulse pressure will be widened.
B) His urinary output will be at the lower limits of normal.
C) He will have tachycardia, but no change in his systolic blood pressure.
D) An ABG would demonstrate a base deficit between -6 and -10 mEq/L
E) His systolic blood pressure will be maintained with an elevated diastolic pressure. - Answer D
The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely
injured, gravid woman by:
A) Reducing the need for blood transfusion
B) Resulting in an elevated hematocrit
C) Complicating the management of closed head injury
D) Reducing the volume of crystalloid required for resuscitation
E) Increasing the volume of blood loss to produce maternal hypotension - Answer E
The best assessment of fluid resuscitation of the adult burn patient is:
A) Urine output of 0.5 mL/kg/hr
