A patient is involved in a MVA and suffers multiorgan trauma. He is brought to the ER by
EMS and found to be hypotensive with bradycardia and his abdomen is not distended.
He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses
thready. His CVP is 9, his HR is 42, and his BP is 80/40. What is the most likely cause of
his shock state?
A. Closed head injury
B. Ongoing intra-abdominal hemorrhage
C. Pneumothorax
D. Neurogenic shock - ANSWER>>D. Neurogenic shock
Which one of the following findings in an adult is most likely to require immediate
management during the primary survey?
A. distended abdomen
B. Glasgow Coma Scale score of 11
C. temperature of 36.5°C (97.8°F)
D. deforming of the right thigh
E. Respiratory rate of 40 breaths per minute - ANSWER>>E. Respiratory rate of 40
breaths per minute
Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE?
A. The fetus is in jeopardy only with major abdominal trauma.
B. Leakage of amniotic fluid is an indication for hospital admission.
C. Indications for peritoneal lavage are different from those in the nonpregnant patient.
,D. With penetrating trauma, injury to the mother's abdominal hollow viscus is more
common in late than in early pregnancy.
E. The secondary survey follows a different pattern from that of the nonpregnant
patient. - ANSWER>>B. Leakage of amniotic fluid is an indication for hospital admission.
The most important, immediate step in the management of an open pneumothorax is:
A. endotracheal intubation
B. operation to close the wound
C. placing a chest tube through the chest wound
D. placement of an occlusive dressing over the wound
E. initiation of 2, large-caliber IVs with crystalloid solutionE. - ANSWER>>D. placement of
an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration:
A. history of neurological reaction or severe hypersensitivity to the product
B. local side effects
C. muscular spasms
D. pregnancy
E. all of the above - ANSWER>>A. history of neurological reaction or severe
hypersensitivity to the product
A 56-year-old man is thrown violently against the steering wheel of his truck during a
motor vehicle crash. On arrival in the emergency department he is diaphoretic and
complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is
40 breaths per minute. Which of the following best differentiates cardiac tamponade
from tension pneumothorax as the cause of his hypotension?
A. Tachycardia
,B. pulse volume
C. breath sounds
D. pulse pressure
E. jugular venous pressure - ANSWER>>C. breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur during
infant endotracheal intubation because:
A. The trachea is relatively short.
B. The distance from the lips to the larynx is relatively short.
C. The use of cuffed endotracehal tubes eliminates this issue.
D. The mainstem bronchi are less angulated in their relation to the trachea.
E. So little friction exists between the endotracheal tube and the wall of the trachea. -
ANSWER>>A. The trachea is relatively short.
Which one of the following is the most effective method for initially treating frostbite?
A. moist heat
B. early amputation
C. padding and elevation
D. vasodilators and heparin
E. topical application of silver sulfadiazine - ANSWER>>A. moist heat
Which one of the following statements concerning intraosseous infusion is TRUE?A.
Only crystalloid solutions may be safely infused through the needle.
B. Aspiration of bone marrow confirms appropriate positioning of the needle.
C. Intraosseous infusion is the preferred route for volume resuscitation in small children.
, D. Intraosseous infusion may be utilized indefinitely.
E. Swelling in the soft tissues around the intraosseous site is not a reason to discontinue
infusion. - ANSWER>>B. Aspiration of bone marrow confirms appropriate positioning of
the needle.
A young woman sustains a severe head injury as the result of a motor vehicle crash. In
the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her
heart rate is 80 beats per minute. She is intubated and mechanically ventilated. Her
pupils are 3 mm in size and equally reactive to light. There is no other apparent injury.
The most important principle to follow in the early management of her head injury is to:
A. avoid hypotension
B. administer an osmotic diuretic
C. aggressively treat systemic hypertension
D. reduce metabolic requirements of the brain
E. distinguish between intracranial hematoma and cerebral edema - ANSWER>>A. avoid
hypotension
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade
III (moderately severe) splenic injury has been confirmed by computed tomography (CT).
Which of the following mandates prompt celiotomy (laparotomy)?
A. a serum amylase of 200
B. a leukocyte count of 14,000
C. evidence of retroperitoneal hematoma on CT scan
D. development of peritonitis on physical exam
E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours - ANSWER>>D.
development of peritonitis on physical exam
EMS and found to be hypotensive with bradycardia and his abdomen is not distended.
He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses
thready. His CVP is 9, his HR is 42, and his BP is 80/40. What is the most likely cause of
his shock state?
A. Closed head injury
B. Ongoing intra-abdominal hemorrhage
C. Pneumothorax
D. Neurogenic shock - ANSWER>>D. Neurogenic shock
Which one of the following findings in an adult is most likely to require immediate
management during the primary survey?
A. distended abdomen
B. Glasgow Coma Scale score of 11
C. temperature of 36.5°C (97.8°F)
D. deforming of the right thigh
E. Respiratory rate of 40 breaths per minute - ANSWER>>E. Respiratory rate of 40
breaths per minute
Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE?
A. The fetus is in jeopardy only with major abdominal trauma.
B. Leakage of amniotic fluid is an indication for hospital admission.
C. Indications for peritoneal lavage are different from those in the nonpregnant patient.
,D. With penetrating trauma, injury to the mother's abdominal hollow viscus is more
common in late than in early pregnancy.
E. The secondary survey follows a different pattern from that of the nonpregnant
patient. - ANSWER>>B. Leakage of amniotic fluid is an indication for hospital admission.
The most important, immediate step in the management of an open pneumothorax is:
A. endotracheal intubation
B. operation to close the wound
C. placing a chest tube through the chest wound
D. placement of an occlusive dressing over the wound
E. initiation of 2, large-caliber IVs with crystalloid solutionE. - ANSWER>>D. placement of
an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration:
A. history of neurological reaction or severe hypersensitivity to the product
B. local side effects
C. muscular spasms
D. pregnancy
E. all of the above - ANSWER>>A. history of neurological reaction or severe
hypersensitivity to the product
A 56-year-old man is thrown violently against the steering wheel of his truck during a
motor vehicle crash. On arrival in the emergency department he is diaphoretic and
complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is
40 breaths per minute. Which of the following best differentiates cardiac tamponade
from tension pneumothorax as the cause of his hypotension?
A. Tachycardia
,B. pulse volume
C. breath sounds
D. pulse pressure
E. jugular venous pressure - ANSWER>>C. breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur during
infant endotracheal intubation because:
A. The trachea is relatively short.
B. The distance from the lips to the larynx is relatively short.
C. The use of cuffed endotracehal tubes eliminates this issue.
D. The mainstem bronchi are less angulated in their relation to the trachea.
E. So little friction exists between the endotracheal tube and the wall of the trachea. -
ANSWER>>A. The trachea is relatively short.
Which one of the following is the most effective method for initially treating frostbite?
A. moist heat
B. early amputation
C. padding and elevation
D. vasodilators and heparin
E. topical application of silver sulfadiazine - ANSWER>>A. moist heat
Which one of the following statements concerning intraosseous infusion is TRUE?A.
Only crystalloid solutions may be safely infused through the needle.
B. Aspiration of bone marrow confirms appropriate positioning of the needle.
C. Intraosseous infusion is the preferred route for volume resuscitation in small children.
, D. Intraosseous infusion may be utilized indefinitely.
E. Swelling in the soft tissues around the intraosseous site is not a reason to discontinue
infusion. - ANSWER>>B. Aspiration of bone marrow confirms appropriate positioning of
the needle.
A young woman sustains a severe head injury as the result of a motor vehicle crash. In
the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her
heart rate is 80 beats per minute. She is intubated and mechanically ventilated. Her
pupils are 3 mm in size and equally reactive to light. There is no other apparent injury.
The most important principle to follow in the early management of her head injury is to:
A. avoid hypotension
B. administer an osmotic diuretic
C. aggressively treat systemic hypertension
D. reduce metabolic requirements of the brain
E. distinguish between intracranial hematoma and cerebral edema - ANSWER>>A. avoid
hypotension
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade
III (moderately severe) splenic injury has been confirmed by computed tomography (CT).
Which of the following mandates prompt celiotomy (laparotomy)?
A. a serum amylase of 200
B. a leukocyte count of 14,000
C. evidence of retroperitoneal hematoma on CT scan
D. development of peritonitis on physical exam
E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours - ANSWER>>D.
development of peritonitis on physical exam
