HOSMERIT
ATLS (SOAL POST TEST VERSION 3
EXAM WITH 100% VERIFIED
QUESTIONS AND CORRECT
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 2 liters of crystalloid solution 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. His breath sounds are decreased in the left hemithorax,
and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for decreased
left 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. perform an aortogram.
c. obtain a CT scan of the chest.
d. obtain arterial blood gas analyses - ANSWER a) reexamine the chest
Which one of the following physical findings suggests a cause of hypotension other than spinal
cord injury?
a. priapism.
b. bradycardia.
c. diaphragmatic breathing.
d. presence of deep tendon reflexes. - ANSWER d) presence of deep tendon reflexes.
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. compartment pressures
b. retrograde urethrogram
c. Doppler-ultrasound studies
d. complete spine x-ray series - ANSWER d) complete spine x-ray series
In managing the head-injured patient, the most important initial step is to:
a. obtain c-spine film.
b. secure the airway.
c. support the circulation.
d. control scalp hemorrhage. - ANSWER b) 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?
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. His systolic blood pressure will be decreased with a narrowed pulse pressure. - ANSWER d)
His systolic blood pressure will be decreased with a narrowed pulse pressure.
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. increasing the risk of pulmonary edema.
c. increasing the volume of blood loss to produce maternal hypotension.
d. complicating the mangement of closed head injury. - ANSWER c) increasing the volume of
blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the burn patient is:
a. adequate urinary output.
b. reversal of systemic acidosis.
c. normalization of the heart rate.
d. a normal central venous pressure. - ANSWER a) adequate urinary output.
The diagnosis of shock must include:
a. increased vascular resistance.
b. evidence of inadequate organ perfusion.
c. acidosis.
d. hypoxemia. - ANSWER b) 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:
a. application of a tourniquet.
b. direct pressure on the wound.
c. packing the wound with gauze.
d. direct pressure on the femoral artery at the groin. - ANSWER b) direct pressure on the
wound.
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to
prevent:
a. respiratory acidosis.
, b. metabolic acidosis.
c. cerebral vasoconstriction with diminished perfusion.
d. neurogenic pulmonary edema. - ANSWER c) cerebral vasoconstriction with diminished
perfusion.
A 25-year-old man is brought to a hospital with a general surgeon after being involved in a
motor vehicle crash. Computed tomography 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:
a. contrast angiography.
b. transfer to a higher level trauma center.
c. exploratory laparotomy.
d. infuse additional crystalloids. - ANSWER c) exploratory laparotomy.
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. Penetration of an abdominal hollow viscus is more common in late than in early pregnancy. -
ANSWER b) Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is:
a. intubate the patient.
b. assess arterial blood gases.
c. administer supplemental oxygen.
d. ascertain the need for a chest tube. - ANSWER c) 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 painful stimuli. He does not follow
commands, but he does moan periodically. His right arm is deformed and does not respond to
painful stimulus; however, his left hand reaches purposefully toward the painful stimulus. Both
legs are stiffly extended. His GCS Score is:
a. 2
b. 4
c. 6
d. 9 - ANSWER d) 9
A 20-year-old woman, at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The
most appropriate first step is to:
ATLS (SOAL POST TEST VERSION 3
EXAM WITH 100% VERIFIED
QUESTIONS AND CORRECT
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 2 liters of crystalloid solution 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. His breath sounds are decreased in the left hemithorax,
and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for decreased
left 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. perform an aortogram.
c. obtain a CT scan of the chest.
d. obtain arterial blood gas analyses - ANSWER a) reexamine the chest
Which one of the following physical findings suggests a cause of hypotension other than spinal
cord injury?
a. priapism.
b. bradycardia.
c. diaphragmatic breathing.
d. presence of deep tendon reflexes. - ANSWER d) presence of deep tendon reflexes.
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. compartment pressures
b. retrograde urethrogram
c. Doppler-ultrasound studies
d. complete spine x-ray series - ANSWER d) complete spine x-ray series
In managing the head-injured patient, the most important initial step is to:
a. obtain c-spine film.
b. secure the airway.
c. support the circulation.
d. control scalp hemorrhage. - ANSWER b) 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?
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. His systolic blood pressure will be decreased with a narrowed pulse pressure. - ANSWER d)
His systolic blood pressure will be decreased with a narrowed pulse pressure.
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. increasing the risk of pulmonary edema.
c. increasing the volume of blood loss to produce maternal hypotension.
d. complicating the mangement of closed head injury. - ANSWER c) increasing the volume of
blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the burn patient is:
a. adequate urinary output.
b. reversal of systemic acidosis.
c. normalization of the heart rate.
d. a normal central venous pressure. - ANSWER a) adequate urinary output.
The diagnosis of shock must include:
a. increased vascular resistance.
b. evidence of inadequate organ perfusion.
c. acidosis.
d. hypoxemia. - ANSWER b) 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:
a. application of a tourniquet.
b. direct pressure on the wound.
c. packing the wound with gauze.
d. direct pressure on the femoral artery at the groin. - ANSWER b) direct pressure on the
wound.
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to
prevent:
a. respiratory acidosis.
, b. metabolic acidosis.
c. cerebral vasoconstriction with diminished perfusion.
d. neurogenic pulmonary edema. - ANSWER c) cerebral vasoconstriction with diminished
perfusion.
A 25-year-old man is brought to a hospital with a general surgeon after being involved in a
motor vehicle crash. Computed tomography 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:
a. contrast angiography.
b. transfer to a higher level trauma center.
c. exploratory laparotomy.
d. infuse additional crystalloids. - ANSWER c) exploratory laparotomy.
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. Penetration of an abdominal hollow viscus is more common in late than in early pregnancy. -
ANSWER b) Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is:
a. intubate the patient.
b. assess arterial blood gases.
c. administer supplemental oxygen.
d. ascertain the need for a chest tube. - ANSWER c) 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 painful stimuli. He does not follow
commands, but he does moan periodically. His right arm is deformed and does not respond to
painful stimulus; however, his left hand reaches purposefully toward the painful stimulus. Both
legs are stiffly extended. His GCS Score is:
a. 2
b. 4
c. 6
d. 9 - ANSWER d) 9
A 20-year-old woman, at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The
most appropriate first step is to:
