ATLS Pre-test 2021
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: Correct Answer: re-examine the chest
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: Correct Answer:
complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? Correct
Answer: Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation.
In managing a patient with a severe traumatic brain injury, the most important initial step is to:
Correct Answer: secure the airway
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? Correct Answer: An ABG would
demonstrate a base deficit between -6 and -10 mEq/L.
The physiological hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by: Correct Answer: increasing the volume of blood loss to
produce maternal hypotension
, The best assessment of fluid resuscitation of the adult burn patient is: Correct Answer: urinary
output of 0.5 mL/kg/hr
The diagnosis of shock must include: Correct Answer: evidence of inadequate organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he
fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh.
Immediate management of the wound should consist of: Correct Answer: direct pressure on the
wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to
prevent: Correct Answer: cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has
surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic
injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg
after CT. The next step is: Correct Answer: perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant patient is
TRUE? Correct Answer: Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is: Correct Answer: administer
supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department.
His pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he
does moan periodically. His right arm is deformed and does not respond to pressure; however,
his left hand reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS
score is: Correct Answer: 9
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: Correct Answer: re-examine the chest
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: Correct Answer:
complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? Correct
Answer: Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation.
In managing a patient with a severe traumatic brain injury, the most important initial step is to:
Correct Answer: secure the airway
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? Correct Answer: An ABG would
demonstrate a base deficit between -6 and -10 mEq/L.
The physiological hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by: Correct Answer: increasing the volume of blood loss to
produce maternal hypotension
, The best assessment of fluid resuscitation of the adult burn patient is: Correct Answer: urinary
output of 0.5 mL/kg/hr
The diagnosis of shock must include: Correct Answer: evidence of inadequate organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he
fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh.
Immediate management of the wound should consist of: Correct Answer: direct pressure on the
wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to
prevent: Correct Answer: cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has
surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic
injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg
after CT. The next step is: Correct Answer: perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant patient is
TRUE? Correct Answer: Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is: Correct Answer: administer
supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department.
His pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he
does moan periodically. His right arm is deformed and does not respond to pressure; however,
his left hand reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS
score is: Correct Answer: 9
