ATLS POST TEST EVALUATION TEST QUESTIONS
AND ANSWERS SURE A+
✔✔For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent:
A. Respiratory alkalosis
B. Metabolic acidosis
C. Cerebral vasoconstriction with diminished perfusion
D. Neurogenic pulmonary edema
E. Shift of the oxyhemoglobin dissociation curve. - ✔✔C. Cerebral vasoconstriction with
diminished perfusion
✔✔A 33-year-old woman is involved in a head-on motor vehicle crash. It took 30
minutes to extricate her from the car. Upon arrival in the ED, her heart rate is 120 beats
per minute, BP is 90/70mmHg, respiratory rate is 16 breaths per minute, and GCS is 15.
Examination reveals bilaterally equal breath sounds, anterior chest wall ecchymosis,
and distended neck veins. Her abdomen is flat, soft, and not tender. Her pelvis is stable.
Palpable distal pulses are found in all 4 extremities. Of the following, the most likely
diagnosis is:
A. hemorrhagic shock
B. Cardiac tamponade
C. Massive hemothorax
D. Tension pneumothorax
E. Diaphragmatic rupture. - ✔✔B. Cardiac tamponade
✔✔A hemodynamically normal 10-year-old girls is admitted to the pediatric intensive
care unit for observation after a grade III (moderately severe) splenic injury has been
confirmed by CT. Which of the following mandates prompt laparotomy?
A. Serum amylase of 200
B. Leukocyte count of 14,000
C. Extraperitoneal bladder rupture
D. Free peritoneal air demonstrated on follow up CT
,E. A fall in the hemoglobin level from 12g/dl to 8g/dl over 24 hours - ✔✔D. Free
peritoneal air demonstrated on follow up CT
✔✔A 40-year-old woman restrained driver is transported to the ED in full spinal
immobilization. She is hemodynamically stable and found to be paraplegic at the level of
T10. Neurologic examination also determines that there is loss of pain and temperature
sensation with preservation of proprioception and vibration. These finding are consistent
with the diagnosis of :
A. Central cord syndrome
B. Spinal shock syndrome
C. Anterior cord syndrome
D. Complete cord syndrome
E. Brown-Sequard syndrome - ✔✔C. Anterior cord syndrome
✔✔Hemorrhage of 20% of the patients blood volume is associated usually with:
A. Oliguria
B. Confusion
C. Hypotension
D. Tachycardia
E. Blood transfusion requirement - ✔✔D. Tachycardia
✔✔Which of the follow 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. - ✔✔B. Aspiration of bone marrow confirms appropriate positioning
of the needle
✔✔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 solution - ✔✔D. Placement of an
occlusive dressing over the wound
✔✔Which one of the following situations requires Rh immunoglobulin administration to
an injured woman?
A. Negative pregnancy test, Rh negative, and torso trauma
B. Positive pregnancy test, Rh positive, and has torso trauma
C. Positive pregnancy test, Rh negative, and has torso trauma
D. Positive pregnancy test, Rh positive, and has an isolated wrist fracture
, E. Positive pregnancy test, Rh negative, and has an isolated wrist fracture - ✔✔C.
Positive pregnancy test, Rh negative, and has torso trauma
✔✔A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is initially 80/40mmHg. After 2 liters of crystalloid solution his blood
pressure increases to 122/84mmHg. 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 resusciation, a closed tube thoracostomy is
performed for decreased left breath sound with the return of small amount of blood and
no air leak. After chest tube insertion, the most appropriate next step is to:
A. Reexamine the chest
B. Perform an aortogram
C. Obtain a CT-scan of the chest
D. Obtain arterial blood gas analyses
E. Perform transesophageal echocardiography - ✔✔A. Reexamine the chest
✔✔A construction worker falls two stories from a building and sustain bilateral calcaneal
fractures. In the ED, 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
deformity. The suspected diagnosis is most likely to be confirmed by:
A. Angiography
B. Compartment pressures
C. Retrograde urethrogram
D. Doppler-ultrasound studies
E. Complete spine x-ray series - ✔✔E. Complete spine x-ray series
✔✔A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
awake and alert. Her heart rate is 100 beats per minute, BP 80/60mmHg, and
respiratory rate is 20 breaths per minute. A chest x-ray reveals a large left hemithorax.
A left chest tube is placed with an immediate return of 1600ml of blood. The next
management step for this patient is:
A. perform a thoracoscopy
B. Perform an arch aortogram
C. Insert a second left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ✔✔D. Prepare for an exploratory thoracotomy
✔✔A 56-year-old man is thrown violently against the steering wheel of his truck during a
motor vehicle crash. On arrival in the ED he is diaphoretic and complaining of chest
pain. His BP is 60/40mmHg 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
AND ANSWERS SURE A+
✔✔For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent:
A. Respiratory alkalosis
B. Metabolic acidosis
C. Cerebral vasoconstriction with diminished perfusion
D. Neurogenic pulmonary edema
E. Shift of the oxyhemoglobin dissociation curve. - ✔✔C. Cerebral vasoconstriction with
diminished perfusion
✔✔A 33-year-old woman is involved in a head-on motor vehicle crash. It took 30
minutes to extricate her from the car. Upon arrival in the ED, her heart rate is 120 beats
per minute, BP is 90/70mmHg, respiratory rate is 16 breaths per minute, and GCS is 15.
Examination reveals bilaterally equal breath sounds, anterior chest wall ecchymosis,
and distended neck veins. Her abdomen is flat, soft, and not tender. Her pelvis is stable.
Palpable distal pulses are found in all 4 extremities. Of the following, the most likely
diagnosis is:
A. hemorrhagic shock
B. Cardiac tamponade
C. Massive hemothorax
D. Tension pneumothorax
E. Diaphragmatic rupture. - ✔✔B. Cardiac tamponade
✔✔A hemodynamically normal 10-year-old girls is admitted to the pediatric intensive
care unit for observation after a grade III (moderately severe) splenic injury has been
confirmed by CT. Which of the following mandates prompt laparotomy?
A. Serum amylase of 200
B. Leukocyte count of 14,000
C. Extraperitoneal bladder rupture
D. Free peritoneal air demonstrated on follow up CT
,E. A fall in the hemoglobin level from 12g/dl to 8g/dl over 24 hours - ✔✔D. Free
peritoneal air demonstrated on follow up CT
✔✔A 40-year-old woman restrained driver is transported to the ED in full spinal
immobilization. She is hemodynamically stable and found to be paraplegic at the level of
T10. Neurologic examination also determines that there is loss of pain and temperature
sensation with preservation of proprioception and vibration. These finding are consistent
with the diagnosis of :
A. Central cord syndrome
B. Spinal shock syndrome
C. Anterior cord syndrome
D. Complete cord syndrome
E. Brown-Sequard syndrome - ✔✔C. Anterior cord syndrome
✔✔Hemorrhage of 20% of the patients blood volume is associated usually with:
A. Oliguria
B. Confusion
C. Hypotension
D. Tachycardia
E. Blood transfusion requirement - ✔✔D. Tachycardia
✔✔Which of the follow 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. - ✔✔B. Aspiration of bone marrow confirms appropriate positioning
of the needle
✔✔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 solution - ✔✔D. Placement of an
occlusive dressing over the wound
✔✔Which one of the following situations requires Rh immunoglobulin administration to
an injured woman?
A. Negative pregnancy test, Rh negative, and torso trauma
B. Positive pregnancy test, Rh positive, and has torso trauma
C. Positive pregnancy test, Rh negative, and has torso trauma
D. Positive pregnancy test, Rh positive, and has an isolated wrist fracture
, E. Positive pregnancy test, Rh negative, and has an isolated wrist fracture - ✔✔C.
Positive pregnancy test, Rh negative, and has torso trauma
✔✔A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is initially 80/40mmHg. After 2 liters of crystalloid solution his blood
pressure increases to 122/84mmHg. 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 resusciation, a closed tube thoracostomy is
performed for decreased left breath sound with the return of small amount of blood and
no air leak. After chest tube insertion, the most appropriate next step is to:
A. Reexamine the chest
B. Perform an aortogram
C. Obtain a CT-scan of the chest
D. Obtain arterial blood gas analyses
E. Perform transesophageal echocardiography - ✔✔A. Reexamine the chest
✔✔A construction worker falls two stories from a building and sustain bilateral calcaneal
fractures. In the ED, 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
deformity. The suspected diagnosis is most likely to be confirmed by:
A. Angiography
B. Compartment pressures
C. Retrograde urethrogram
D. Doppler-ultrasound studies
E. Complete spine x-ray series - ✔✔E. Complete spine x-ray series
✔✔A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
awake and alert. Her heart rate is 100 beats per minute, BP 80/60mmHg, and
respiratory rate is 20 breaths per minute. A chest x-ray reveals a large left hemithorax.
A left chest tube is placed with an immediate return of 1600ml of blood. The next
management step for this patient is:
A. perform a thoracoscopy
B. Perform an arch aortogram
C. Insert a second left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ✔✔D. Prepare for an exploratory thoracotomy
✔✔A 56-year-old man is thrown violently against the steering wheel of his truck during a
motor vehicle crash. On arrival in the ED he is diaphoretic and complaining of chest
pain. His BP is 60/40mmHg 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
