ATLS POST TEST ACTUAL EXAM TEST BANK/ACTUAL
H H H H H H
QUESTIONS AND CORRECT DETAILED ANSWERS ALL
H H H H H H
QUESTIONS AND CORRECT DETAILED ANSWERS TOP
H H H H H H
RATED VERSION FOR HIGHLY RECOMMENDED BY
H H H H H H
EXPERTS | NEW AND REVISED. H H H H H
A 22 year old male is brought by ambulance to a small community
H H H H H H H H H H H H
H hospital after falling from the top of an 8 foot ladder. Initially, he was
H H H H H H H H H H H H H
H found to have a large right pneumothorax. A chest tube was inserted
H H H H H H H H H H H
H and connected to an underwater seal drainage collection system with
H H H H H H H H H
H negative pressure. A repeat CXR demonstrates a residual, large right
H H H H H H H H H
H pneumothorax. After transferring the patient to a verified trauma center,
H H H H H H H H H
H a third chest x-ray reveals a persistent right pneumothorax. The chest
H H H H H H H H H H
H tube appears to be functioning and in good position. He remains
H H H H H H H H H H
H hemodynamically normal with no signs of respiratory distress. The most
H H H H H H H H H
H likely cause for the persistent right pneumothorax is:
H H H H H H H
A. Flail chest
H H
B. Diaphragmatic injury
H H
C. Pulmonary contusion
H H
D. Esophageal perforation
H H
E. Tracheobronchial injury - ANSWER-E. Tracheobronchial injury
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Which of the following is LEAST reliable for diagnosing ESOPHAGEAL
H H H H H H H H H
H intubation?
A. symmetrical chest wall movement
H H H H
B. end-tidal CO2
H H
C. bilateral breath sounds
H H H
,D. oxygen saturation >92%
H H H
E. ETT above carina on chest x-ray - ANSWER-D. oxygen saturation >92%
H H H H H H H H H H H
-> if it says ESOPHAGEAL, go with this answer
H H H H H H H H
Which of the following signs necessitates the need for a definitive airway
H H H H H H H H H H H
H in severe trauma patient?
H H H
A. facial lacerations
H H
B. repeated vomiting
H H
C. severe maxillofacial trauma
H H H
D. sternal fracture
H H
E. GCS 12 - ANSWER-C. Severe maxillofacial trauma
H H H H H H H
Twenty seven people are severely injured in an aircraft crash at a local
H H H H H H H H H H H H
H airport. The principles of triage include:
H H H H H
A. establish a triage site within the internal perimeter of the crash site
H H H H H H H H H H H H
B. treat only the most severely injured patients first
H H H H H H H H
C. immediately transport all patients to the nearest hospital
H H H H H H H H
D. treat the greatest number of patients in the shortest period of time
H H H H H H H H H H H H
E. produce the greatest number of survivors based on available
H H H H H H H H H
H resources - ANSWER-E. Produce the greatest number of survivors
H H H H H H H H
H based on available resources
H H H
Which of the following statements are correct?
H H H H H H
A. Cerebral contusions may coalesce to form an intracerebral hematoma
H H H H H H H H H
B. Epidural hematomas are usually seen in the frontal region
H H H H H H H H H
,C. Subdural hematomas are caused by injury to the middle meningeal
H H H H H H H H H H
H artery
D. Subdural hematomas typically have a lenticular shape on CT
H H H H H H H H H
E. The associated brain damage is more severe in epidural hematomas -
H H H H H H H H H H H
H ANSWER-A. Cerebral contusions may coalesce to form an intracerebral
H H H H H H H H
H hematoma
EM: Epidural, middle meningeal
H H H
SuB: Subdural, Bridging veins
H H H
An 18 year old male is brought to the ED after being shot. He has one
H H H H H H H H H H H H H H H
H bullet wound just below the right clavicle and another just below the
H H H H H H H H H H H
H costal margin in the right posterior axillary line. His blood pressure is
H H H H H H H H H H H
H 110/60, heart rate of 90, and respiratory rate of 34. After ensuring a
H H H H H H H H H H H H
H patent airway and inserting 2 large caliber IV lines, the next most
H H H H H H H H H H H
H appropriate step is to: H H H
A. Obtain a portable chest x-ray
H H H H H
B. Administer a bolus of additional IV fluid
H H H H H H H
C. Perform a laparatomy
H H H
D. Obtain an abdominal CT scan
H H H H H
E. Perform diagnostic peritoneal lavage - ANSWER-A. Obtain a portable
H H H H H H H H H
H chest x-ray H
need more info on chest, not abdomen
H H H H H H
Which of the following should be performed FIRST in any patient whose
H H H H H H H H H H H
H injuries may include multiple closed extremity fractures?
H H H H H H
A. A thorough assessment of four limb perfusion
H H H H H H H
, B. Manuevers to prevent necrosis of the skin
H H H H H H H
C. Extremity compartment syndrome release
H H H H
D. Ensuring adequate oxygenation and ventilation
H H H H H
E. Evaluation for occult crush syndrome - ANSWER-D. Ensuring
H H H H H H H H
H adequate oxygenation and ventilation
H H H
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest
H H H H H H H H H H H H H
H at close range. His BP is 80/40 and HR 130. After 2 L of crystalloid
H H H H H H H H H H H H H H
H solution are rapidly infused, his BP increases to 122/84 and HR
H H H H H H H H H H
H decreases to 100. He is tachypneic with RR of 28. On PE, his breath
H H H H H H H H H H H H H
H sounds are decreased at the left upper chest with dullness on
H H H H H H H H H H
H percussion. A large caliber tube thoracostomy is inserted into the fifth
H H H H H H H H H H
H intercostal space with the return of 200 mL of blood and no air leak.
H H H H H H H H H H H H H
H The most appropriate next step is:
H H H H H
A. Insert a foley catheter
H H H H
B. Begin to transfuse O negative blood
H H H H H H
C. Perform thoracotomy
H H
D. Obtain a CT Chest/Abd
H H H H
E. Repeat the physical exam of the chest - ANSWER-E. Repeat the
H H H H H H H H H H H
H physical exam of the chest
H H H H
decreased breath sounds w/dullness -> hemothorax, need tube to drain
H H H H H H H H H
vs.
decreased/absent breath sounds w/hyperresonance -> tension H H H H H
H pneumonia, need needle decompression followed by tube
H H H H H H
H H H H H H
QUESTIONS AND CORRECT DETAILED ANSWERS ALL
H H H H H H
QUESTIONS AND CORRECT DETAILED ANSWERS TOP
H H H H H H
RATED VERSION FOR HIGHLY RECOMMENDED BY
H H H H H H
EXPERTS | NEW AND REVISED. H H H H H
A 22 year old male is brought by ambulance to a small community
H H H H H H H H H H H H
H hospital after falling from the top of an 8 foot ladder. Initially, he was
H H H H H H H H H H H H H
H found to have a large right pneumothorax. A chest tube was inserted
H H H H H H H H H H H
H and connected to an underwater seal drainage collection system with
H H H H H H H H H
H negative pressure. A repeat CXR demonstrates a residual, large right
H H H H H H H H H
H pneumothorax. After transferring the patient to a verified trauma center,
H H H H H H H H H
H a third chest x-ray reveals a persistent right pneumothorax. The chest
H H H H H H H H H H
H tube appears to be functioning and in good position. He remains
H H H H H H H H H H
H hemodynamically normal with no signs of respiratory distress. The most
H H H H H H H H H
H likely cause for the persistent right pneumothorax is:
H H H H H H H
A. Flail chest
H H
B. Diaphragmatic injury
H H
C. Pulmonary contusion
H H
D. Esophageal perforation
H H
E. Tracheobronchial injury - ANSWER-E. Tracheobronchial injury
H H H H H H
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL
H H H H H H H H H
H intubation?
A. symmetrical chest wall movement
H H H H
B. end-tidal CO2
H H
C. bilateral breath sounds
H H H
,D. oxygen saturation >92%
H H H
E. ETT above carina on chest x-ray - ANSWER-D. oxygen saturation >92%
H H H H H H H H H H H
-> if it says ESOPHAGEAL, go with this answer
H H H H H H H H
Which of the following signs necessitates the need for a definitive airway
H H H H H H H H H H H
H in severe trauma patient?
H H H
A. facial lacerations
H H
B. repeated vomiting
H H
C. severe maxillofacial trauma
H H H
D. sternal fracture
H H
E. GCS 12 - ANSWER-C. Severe maxillofacial trauma
H H H H H H H
Twenty seven people are severely injured in an aircraft crash at a local
H H H H H H H H H H H H
H airport. The principles of triage include:
H H H H H
A. establish a triage site within the internal perimeter of the crash site
H H H H H H H H H H H H
B. treat only the most severely injured patients first
H H H H H H H H
C. immediately transport all patients to the nearest hospital
H H H H H H H H
D. treat the greatest number of patients in the shortest period of time
H H H H H H H H H H H H
E. produce the greatest number of survivors based on available
H H H H H H H H H
H resources - ANSWER-E. Produce the greatest number of survivors
H H H H H H H H
H based on available resources
H H H
Which of the following statements are correct?
H H H H H H
A. Cerebral contusions may coalesce to form an intracerebral hematoma
H H H H H H H H H
B. Epidural hematomas are usually seen in the frontal region
H H H H H H H H H
,C. Subdural hematomas are caused by injury to the middle meningeal
H H H H H H H H H H
H artery
D. Subdural hematomas typically have a lenticular shape on CT
H H H H H H H H H
E. The associated brain damage is more severe in epidural hematomas -
H H H H H H H H H H H
H ANSWER-A. Cerebral contusions may coalesce to form an intracerebral
H H H H H H H H
H hematoma
EM: Epidural, middle meningeal
H H H
SuB: Subdural, Bridging veins
H H H
An 18 year old male is brought to the ED after being shot. He has one
H H H H H H H H H H H H H H H
H bullet wound just below the right clavicle and another just below the
H H H H H H H H H H H
H costal margin in the right posterior axillary line. His blood pressure is
H H H H H H H H H H H
H 110/60, heart rate of 90, and respiratory rate of 34. After ensuring a
H H H H H H H H H H H H
H patent airway and inserting 2 large caliber IV lines, the next most
H H H H H H H H H H H
H appropriate step is to: H H H
A. Obtain a portable chest x-ray
H H H H H
B. Administer a bolus of additional IV fluid
H H H H H H H
C. Perform a laparatomy
H H H
D. Obtain an abdominal CT scan
H H H H H
E. Perform diagnostic peritoneal lavage - ANSWER-A. Obtain a portable
H H H H H H H H H
H chest x-ray H
need more info on chest, not abdomen
H H H H H H
Which of the following should be performed FIRST in any patient whose
H H H H H H H H H H H
H injuries may include multiple closed extremity fractures?
H H H H H H
A. A thorough assessment of four limb perfusion
H H H H H H H
, B. Manuevers to prevent necrosis of the skin
H H H H H H H
C. Extremity compartment syndrome release
H H H H
D. Ensuring adequate oxygenation and ventilation
H H H H H
E. Evaluation for occult crush syndrome - ANSWER-D. Ensuring
H H H H H H H H
H adequate oxygenation and ventilation
H H H
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest
H H H H H H H H H H H H H
H at close range. His BP is 80/40 and HR 130. After 2 L of crystalloid
H H H H H H H H H H H H H H
H solution are rapidly infused, his BP increases to 122/84 and HR
H H H H H H H H H H
H decreases to 100. He is tachypneic with RR of 28. On PE, his breath
H H H H H H H H H H H H H
H sounds are decreased at the left upper chest with dullness on
H H H H H H H H H H
H percussion. A large caliber tube thoracostomy is inserted into the fifth
H H H H H H H H H H
H intercostal space with the return of 200 mL of blood and no air leak.
H H H H H H H H H H H H H
H The most appropriate next step is:
H H H H H
A. Insert a foley catheter
H H H H
B. Begin to transfuse O negative blood
H H H H H H
C. Perform thoracotomy
H H
D. Obtain a CT Chest/Abd
H H H H
E. Repeat the physical exam of the chest - ANSWER-E. Repeat the
H H H H H H H H H H H
H physical exam of the chest
H H H H
decreased breath sounds w/dullness -> hemothorax, need tube to drain
H H H H H H H H H
vs.
decreased/absent breath sounds w/hyperresonance -> tension H H H H H
H pneumonia, need needle decompression followed by tube
H H H H H H
