ATLS Chapter review (Latest 2026/ 2027
Update) 11th Edition Test Bank Questions
& Answers (Verified Answers) Complete
A+
When interpreting x ray films of the pelvis in a pregnant patient, the symphysis pubis
widens 4-8 mm and the sacroiliac joint spaces increase by the 7th month - correct
answer keep this in mind
Eclampsia - correct answer Maintain a high index of suspicion for eclampsia when
seizures are accompanied by HTN, proteinuria, hyperreflexia, and peripheral edema in
pregnant trauma patients. This can mimic head injury.
External contusions and abrasions of the abdominal wall are signs of blunt uterine
trauma. - correct answer true. Fetal injuries can occur when the abdominal wall
strikes an object, such as the dashboard or steering wheel, or when a pregnant patient
is struck by a blunt instrument.
Using a shoulder restraints in conjunction with a lap belt reduces the likelihood of
direct and indirect fetal injury, presumably because the shoulder belt dissipates
deceleration forces over a great surface area and helps prevent the mother from
flexing forward over the gravid uterus. - correct answer the deployment of air bags in
,vehicles does not appear to increase pregnancy specific risks. Using lap belt alone
allows for forward flexion and uterine compression with possible uterine rupture or
placental abruption. Lap belt worn too high over uterus may produce uterine rupture.
Penetrating injury to pregnant women - correct answer As uterus grows larger, other
viscera are protected from penetrating injury. Dense uterine musculature in early
pregnancy can absorb significant amount of energy from penetrating objects
decreasing their velocity and lowering risk of injury to other viscera. However, fetal
outcome is generally poor with penetrating injury to uterus.
Carefully observe pregnant patients with even minor injuries since occasionally minor
injuries are associated with placental abruption and fetal loss. - correct answer True.
AND to optimize outcomes for mother and baby, clinicians must assess and
resuscitate the mother first and then assess the fetus before conducting second
survey of the mother.
Failure to displace the uterus to the left side in a hypotensive pregnant patient -
correct answer logroll all patients appearing clinically pregnant (second and third
trimester) to the left 15-30 degrees and elevate the right side 4-6 inches and support
with a bolstering device to maintain spinal motion restriction and decompression of
the vena cava.
,Due to increases intravascular volume, pregnant patients can lose a significant
amount of blood before tachycardia, hypotension, and other signs of hypovolemia
occur. Thus, what do stable vital signs in a pregnant patient indicate about the fetus? -
correct answer The fetus may be in distress and the placenta deprived of vital
perfusion while the mother's condition and vital signs appear stable. Administer
crystalloid fluid resuscitation and blood to support the physiological hypervolemia of
pregnancy. Vasopressers should be an absolute last resort in restoring maternal blood
pressure as they further reduce uterine blood flow, resulting in fetal hypoxia.
What does a normal fibrinogen level indicate in a pregnant patient? - correct answer
Fibrinogen level may double in late pregnancy and a normal level may indicate early
disseminated intravascular coagulation
Most common cause of fetal death? - correct answer maternal shock and maternal
death. Placental abruption is second. Placental abruption is suggested by vaginal
bleeding, uterine tenderness, frequent uterine contractions, uterine tetany, and uterine
irritability (uterus contracts when touched). In 30% of cases of abruption, bleeding may
not occur. Uterine ultrasound may be helpful in diagnosis, but is NOT definitive.
Signs of uterine rupture - correct answer abdominal tenderness, guarding, rigidity, or
rebound tenderness. Signs of peritonitis are hard to tell due to expansion and
attenuation of the abdominal wall musculature. Other findings include abdominal fetal
, lie (oblique or transverse lie), easy palpation of the fetal parts because of their
extrauterine location and inability to readily palpate the uterine fundus when there is
fundal rupture. Xray evidence of rupture include extended fetal extremities, abnormal
fetal position, and free intraperitoneal air.
Perform continuous fetal monitoring with a tocodynamometer beyond 20-24 weeks of
gestation. - correct answer Patients with no risk factors for fetal loss should have
continuous monitoring for 6 hours, whereas, patients with risk factors for fetal loss or
placental abruption should be monitored for 24 hours. RISK FACTORS ARE: heart rate >
110, an injury severity score >9, evidence of placental abruption, fetal heart rate >160 or
less than 120, ejection during MV, and motorcycle or pedestrian collisions
REMEMBER: maternal bicarbonate is low during pregnancy to compensate for
respiratory alkalosis. - correct answer 17-22 in pregnant patient. (non pregnant patient
is 22-28)
Fetal heart rate is a sensitive indicator of maternal blood volume status and fetal well
being. - correct answer normal range for fetus is 120-160. Abnormal heart rate,
repetitive decelerations, absence of accelerations or beat to beat variability and
frequent uterine activity can be signs of impending maternal and or fetal
decompensation (hypoxia or acidosis) and should prompt immediate obstetrical
consultation.
Update) 11th Edition Test Bank Questions
& Answers (Verified Answers) Complete
A+
When interpreting x ray films of the pelvis in a pregnant patient, the symphysis pubis
widens 4-8 mm and the sacroiliac joint spaces increase by the 7th month - correct
answer keep this in mind
Eclampsia - correct answer Maintain a high index of suspicion for eclampsia when
seizures are accompanied by HTN, proteinuria, hyperreflexia, and peripheral edema in
pregnant trauma patients. This can mimic head injury.
External contusions and abrasions of the abdominal wall are signs of blunt uterine
trauma. - correct answer true. Fetal injuries can occur when the abdominal wall
strikes an object, such as the dashboard or steering wheel, or when a pregnant patient
is struck by a blunt instrument.
Using a shoulder restraints in conjunction with a lap belt reduces the likelihood of
direct and indirect fetal injury, presumably because the shoulder belt dissipates
deceleration forces over a great surface area and helps prevent the mother from
flexing forward over the gravid uterus. - correct answer the deployment of air bags in
,vehicles does not appear to increase pregnancy specific risks. Using lap belt alone
allows for forward flexion and uterine compression with possible uterine rupture or
placental abruption. Lap belt worn too high over uterus may produce uterine rupture.
Penetrating injury to pregnant women - correct answer As uterus grows larger, other
viscera are protected from penetrating injury. Dense uterine musculature in early
pregnancy can absorb significant amount of energy from penetrating objects
decreasing their velocity and lowering risk of injury to other viscera. However, fetal
outcome is generally poor with penetrating injury to uterus.
Carefully observe pregnant patients with even minor injuries since occasionally minor
injuries are associated with placental abruption and fetal loss. - correct answer True.
AND to optimize outcomes for mother and baby, clinicians must assess and
resuscitate the mother first and then assess the fetus before conducting second
survey of the mother.
Failure to displace the uterus to the left side in a hypotensive pregnant patient -
correct answer logroll all patients appearing clinically pregnant (second and third
trimester) to the left 15-30 degrees and elevate the right side 4-6 inches and support
with a bolstering device to maintain spinal motion restriction and decompression of
the vena cava.
,Due to increases intravascular volume, pregnant patients can lose a significant
amount of blood before tachycardia, hypotension, and other signs of hypovolemia
occur. Thus, what do stable vital signs in a pregnant patient indicate about the fetus? -
correct answer The fetus may be in distress and the placenta deprived of vital
perfusion while the mother's condition and vital signs appear stable. Administer
crystalloid fluid resuscitation and blood to support the physiological hypervolemia of
pregnancy. Vasopressers should be an absolute last resort in restoring maternal blood
pressure as they further reduce uterine blood flow, resulting in fetal hypoxia.
What does a normal fibrinogen level indicate in a pregnant patient? - correct answer
Fibrinogen level may double in late pregnancy and a normal level may indicate early
disseminated intravascular coagulation
Most common cause of fetal death? - correct answer maternal shock and maternal
death. Placental abruption is second. Placental abruption is suggested by vaginal
bleeding, uterine tenderness, frequent uterine contractions, uterine tetany, and uterine
irritability (uterus contracts when touched). In 30% of cases of abruption, bleeding may
not occur. Uterine ultrasound may be helpful in diagnosis, but is NOT definitive.
Signs of uterine rupture - correct answer abdominal tenderness, guarding, rigidity, or
rebound tenderness. Signs of peritonitis are hard to tell due to expansion and
attenuation of the abdominal wall musculature. Other findings include abdominal fetal
, lie (oblique or transverse lie), easy palpation of the fetal parts because of their
extrauterine location and inability to readily palpate the uterine fundus when there is
fundal rupture. Xray evidence of rupture include extended fetal extremities, abnormal
fetal position, and free intraperitoneal air.
Perform continuous fetal monitoring with a tocodynamometer beyond 20-24 weeks of
gestation. - correct answer Patients with no risk factors for fetal loss should have
continuous monitoring for 6 hours, whereas, patients with risk factors for fetal loss or
placental abruption should be monitored for 24 hours. RISK FACTORS ARE: heart rate >
110, an injury severity score >9, evidence of placental abruption, fetal heart rate >160 or
less than 120, ejection during MV, and motorcycle or pedestrian collisions
REMEMBER: maternal bicarbonate is low during pregnancy to compensate for
respiratory alkalosis. - correct answer 17-22 in pregnant patient. (non pregnant patient
is 22-28)
Fetal heart rate is a sensitive indicator of maternal blood volume status and fetal well
being. - correct answer normal range for fetus is 120-160. Abnormal heart rate,
repetitive decelerations, absence of accelerations or beat to beat variability and
frequent uterine activity can be signs of impending maternal and or fetal
decompensation (hypoxia or acidosis) and should prompt immediate obstetrical
consultation.
