ATLS Practice Test 2 Answers & Explanations | 2022 latest
update
1. d. 21. e.
2. a. 22. c.
3. c. 23. d.
4. d. 24. d.
5. e. 25. d.
6. a. 26. b.
7. c. 27. c.
8. b. 28. b.
9. b. 29. d.
10. d. 30. c.
11. c. 31. d.
12. d. 32. b.
13. b. 33. d.
14. a. 34. c.
15. d. 35. a.
16. e. 36. e.
17. c. 37. d.
18. c. 38. c.
19. c. 39. a.
20. e. 40. d.
1
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1. d.
The patient has taken a turn for the worse. He is in shock. It is imperative that you now
repeat the primary survey, going through the ABCDE’s, in an effort to stabilize the
patient prior to transfer. Questions that need to be answered include: Is the airway
compromised? Is breathing compromised? Is the patient bleeding from elsewhere besides
the chest? And so forth. Once relatively stable, the transfer should proceed because the
patient will certainly need surgical intervention emergently. Note: Clamping the chest
tube will not stop any hemorrhage in the chest, and would probably only impair
breathing.
2. a.
Traumatic brain injuries tend to cause increased intracranial pressure (ICP) due to
bleeding and swelling. In order to prevent secondary brain injury, it is important to
maintain normal cerebral perfusion pressure (CPP). CPP = MAP – ICP. If the MAP is
too low, ischemia and infarction will result. Therefore, hypotension must be avoided.
Note: Administering an osmotic diuretic, such as mannitol, is an intervention reserved
for when ICP is dangerously high; giving it inappropriately may lower the blood
pressure too much .
3. c.
The pliability, or compliance, of a child’s chest wall allows impacting forces to be
transmitted to the underlying pulmonary parenchyma, causing a pulmonary contusion.
Rib fractures and mediastinal injuries are not common. Therefore, a pulmonary
contusion may be present in the absence of rib fractures.
4. d.
This patient requires an airway and assisted ventilation immediately. Bagmask
ventilation is not effective. A cspine injury must be assumed. Therefore, one member
of the trauma team should manually stabilize the patient’s head and neck using inline
immobilization techniques while another member of the trauma team intubates him.
5. e.
The presentation is that of neurogenic shock. The only correct choice is e., which is the
presentation of spinal shock. Neurogenic shock results from impairment of the
descending sympathetic pathways in the cervical or upper thoracic spinal cord. This
condition results in the loss of vasomotor tone and sympathetic stimulation to the heart.
Loss of vasomotor tone causes vasodilation of visceral and lowerextremity blood vessels,
pooling of blood, and, consequently, hypotension. Loss of sympathetic innervation to the
heart may cause the development of bradycardia, or at least a failure of tachycardia in
response to hypovolemia. In this condition, the blood pressure may not be restored by
fluid infusion alone, and massive fluid resuscitation may result in fluid overload and
pulmonary edema. The blood pressure may often be restored by the judicious use of
vasopressors after moderate volume replacement. Atropine may be used to counteract
hemodynamically significant bradycardia. Spinal shock refers to the flaccidity (loss of
muscle tone) and loss of reflexes seen after spinal cord injury. The
2
update
1. d. 21. e.
2. a. 22. c.
3. c. 23. d.
4. d. 24. d.
5. e. 25. d.
6. a. 26. b.
7. c. 27. c.
8. b. 28. b.
9. b. 29. d.
10. d. 30. c.
11. c. 31. d.
12. d. 32. b.
13. b. 33. d.
14. a. 34. c.
15. d. 35. a.
16. e. 36. e.
17. c. 37. d.
18. c. 38. c.
19. c. 39. a.
20. e. 40. d.
1
, atls.yolasite.com
1. d.
The patient has taken a turn for the worse. He is in shock. It is imperative that you now
repeat the primary survey, going through the ABCDE’s, in an effort to stabilize the
patient prior to transfer. Questions that need to be answered include: Is the airway
compromised? Is breathing compromised? Is the patient bleeding from elsewhere besides
the chest? And so forth. Once relatively stable, the transfer should proceed because the
patient will certainly need surgical intervention emergently. Note: Clamping the chest
tube will not stop any hemorrhage in the chest, and would probably only impair
breathing.
2. a.
Traumatic brain injuries tend to cause increased intracranial pressure (ICP) due to
bleeding and swelling. In order to prevent secondary brain injury, it is important to
maintain normal cerebral perfusion pressure (CPP). CPP = MAP – ICP. If the MAP is
too low, ischemia and infarction will result. Therefore, hypotension must be avoided.
Note: Administering an osmotic diuretic, such as mannitol, is an intervention reserved
for when ICP is dangerously high; giving it inappropriately may lower the blood
pressure too much .
3. c.
The pliability, or compliance, of a child’s chest wall allows impacting forces to be
transmitted to the underlying pulmonary parenchyma, causing a pulmonary contusion.
Rib fractures and mediastinal injuries are not common. Therefore, a pulmonary
contusion may be present in the absence of rib fractures.
4. d.
This patient requires an airway and assisted ventilation immediately. Bagmask
ventilation is not effective. A cspine injury must be assumed. Therefore, one member
of the trauma team should manually stabilize the patient’s head and neck using inline
immobilization techniques while another member of the trauma team intubates him.
5. e.
The presentation is that of neurogenic shock. The only correct choice is e., which is the
presentation of spinal shock. Neurogenic shock results from impairment of the
descending sympathetic pathways in the cervical or upper thoracic spinal cord. This
condition results in the loss of vasomotor tone and sympathetic stimulation to the heart.
Loss of vasomotor tone causes vasodilation of visceral and lowerextremity blood vessels,
pooling of blood, and, consequently, hypotension. Loss of sympathetic innervation to the
heart may cause the development of bradycardia, or at least a failure of tachycardia in
response to hypovolemia. In this condition, the blood pressure may not be restored by
fluid infusion alone, and massive fluid resuscitation may result in fluid overload and
pulmonary edema. The blood pressure may often be restored by the judicious use of
vasopressors after moderate volume replacement. Atropine may be used to counteract
hemodynamically significant bradycardia. Spinal shock refers to the flaccidity (loss of
muscle tone) and loss of reflexes seen after spinal cord injury. The
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