ATLS practice questions
Assessed first in trauma patient - Airway
(*)Degree of burn that is characterized by bone involvement - Fourth
Complications of head trauma - Intracerebral hematoma
Extradural hematoma
Brain abscess
Most common cause of laryngotracheal stenosis - Trauma
Intervention that can help prevent development of acute renal failure - Infusion of normal saline
A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was
complicated by a fractured pelvis. A few hours later, the patient becomes febrile, hypotensive with a
normal CVP, and oliguric. Upon examination, the patient is found to be bleeding from the NG tube and
IV sites. Which of the following is the most likely diagnosis?
A. Hemorrhagic shock
B. Acute adrenal insufficiency
C. Fat embolism syndrome
D. Transfusion reaction - D. Transfusion reaction
Skin antiseptic - -Ethanol 70% is an effective skin antiseptic
-Acetic acid can be used to treat Gram- skin infections
-Salicylic acid is used to treat certain skin yeast infections
Class IV hemorrhage indicates what % blood loss - 55%
,How does shivering affect body temperature - Increases body temperature
Class III hemorrhage indicates what % of blood loss - 35%
Management of a stable patient with kidney contusion - Observation
Associated with hypovolemic shock - -Inadequate tissue perfusion with resultant tissue hypoxia
-Blood shunting to vital organs
-Decreased circulating blood volume and decreased venous return
-Low cardiac output
-Loss of less than 20% of the blood volume is usually without symptom except for mild tachycardia
-Patients become orthostatic with losses between 20 and 40%
-Shock is evidenced by tachycardia, hypotension, oliguria, flat neck veins
The most effective method of monitoring the success of resuscitation during CPR? - Reactivity of pupils
to light
Used to ensure correct placement of endotracheal tube - -Ultrasound
-Bilateral breath sounds
-Sustained end-tidal CO2
Total body surface area involved in a burn in an adult to the anterior chest and abdomen - 18%
What is often caused by carotid massage? - Bradycardia
Step in a patient diagnosed with tension pneumothorax - 1. Needle decompression/ thoracotomy
2. Chest tube
,True statements regarding diaphragmatic injuries - -Blunt diaphragmatic injuries are usually associated
with skeletal trauma
-Penetrating diaphragmatic injuries may be missed
-Repair of traumatic diaphragmatic injuries usually does not require prosthetic material
First priority in the treatment of an unconscious patient - Checking the pulse
A patient involved in a road accident is brought to the emergency department in an unconscious state.
On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths
per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold,
shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain.
On physical examination, she has no obvious sign of external bleeding. Which of the following cannot be
the cause of hypotension in this patient?
A. Pelvic fracture
B. Fracture of femur
C. Intracranial hemorrhage
D. Hemothorax - C. Intracranial hemorrhage
A patient suffered a slash to his right neck. The wound is over the mid-portion of the
sternocleidomastoid. There is a large hematoma and brisk bleeding when uncovered. He is stable. What
is the next step in management?
A. Get an angiogram
B. Close the wound in the ER
C. Take him to the operating room
D. CT scan to evaluate neck structure - C. Take him to the OR
After abdominal injury, which of the following urinalysis findings would be an indication for further
testing?
A. 0-5 casts/HPF
B. 5-10 WBC/HPF
C. 10-20 RBC/HPF
D. Gross hematuria - D. Gross hematuria
, A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at
its midpoint would cause bleeding from which structure? - External jugular vein
Clinical features associated with tension pneumothorax - Unilateral decrease in breath sounds
Hyperresonance
Respiratory distress
Tachycardia
Tracheal shift
Desatruation
Decreased breath sounds
Decreased compliance
Asymmetric chest movement
NOT hypertension, audible bronchial sounds
Not recommended as a mode of ventilation for a patient with a diaphragmatic hernia
A. Bag and mask
B. LMA
C. Endotracheal intubation
D. Jet ventilation - A. Bag and mask
What is the next step in the assessment of a traumatic patient after airway is established? - Breathing
Blood group that is considered a universal donor - O
A provider is examining a patient who sustained a severe traumatic head injury. He documents no Doll's
eyes. What does this signify? - Brainstem injury
Assessed first in trauma patient - Airway
(*)Degree of burn that is characterized by bone involvement - Fourth
Complications of head trauma - Intracerebral hematoma
Extradural hematoma
Brain abscess
Most common cause of laryngotracheal stenosis - Trauma
Intervention that can help prevent development of acute renal failure - Infusion of normal saline
A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was
complicated by a fractured pelvis. A few hours later, the patient becomes febrile, hypotensive with a
normal CVP, and oliguric. Upon examination, the patient is found to be bleeding from the NG tube and
IV sites. Which of the following is the most likely diagnosis?
A. Hemorrhagic shock
B. Acute adrenal insufficiency
C. Fat embolism syndrome
D. Transfusion reaction - D. Transfusion reaction
Skin antiseptic - -Ethanol 70% is an effective skin antiseptic
-Acetic acid can be used to treat Gram- skin infections
-Salicylic acid is used to treat certain skin yeast infections
Class IV hemorrhage indicates what % blood loss - 55%
,How does shivering affect body temperature - Increases body temperature
Class III hemorrhage indicates what % of blood loss - 35%
Management of a stable patient with kidney contusion - Observation
Associated with hypovolemic shock - -Inadequate tissue perfusion with resultant tissue hypoxia
-Blood shunting to vital organs
-Decreased circulating blood volume and decreased venous return
-Low cardiac output
-Loss of less than 20% of the blood volume is usually without symptom except for mild tachycardia
-Patients become orthostatic with losses between 20 and 40%
-Shock is evidenced by tachycardia, hypotension, oliguria, flat neck veins
The most effective method of monitoring the success of resuscitation during CPR? - Reactivity of pupils
to light
Used to ensure correct placement of endotracheal tube - -Ultrasound
-Bilateral breath sounds
-Sustained end-tidal CO2
Total body surface area involved in a burn in an adult to the anterior chest and abdomen - 18%
What is often caused by carotid massage? - Bradycardia
Step in a patient diagnosed with tension pneumothorax - 1. Needle decompression/ thoracotomy
2. Chest tube
,True statements regarding diaphragmatic injuries - -Blunt diaphragmatic injuries are usually associated
with skeletal trauma
-Penetrating diaphragmatic injuries may be missed
-Repair of traumatic diaphragmatic injuries usually does not require prosthetic material
First priority in the treatment of an unconscious patient - Checking the pulse
A patient involved in a road accident is brought to the emergency department in an unconscious state.
On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths
per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold,
shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain.
On physical examination, she has no obvious sign of external bleeding. Which of the following cannot be
the cause of hypotension in this patient?
A. Pelvic fracture
B. Fracture of femur
C. Intracranial hemorrhage
D. Hemothorax - C. Intracranial hemorrhage
A patient suffered a slash to his right neck. The wound is over the mid-portion of the
sternocleidomastoid. There is a large hematoma and brisk bleeding when uncovered. He is stable. What
is the next step in management?
A. Get an angiogram
B. Close the wound in the ER
C. Take him to the operating room
D. CT scan to evaluate neck structure - C. Take him to the OR
After abdominal injury, which of the following urinalysis findings would be an indication for further
testing?
A. 0-5 casts/HPF
B. 5-10 WBC/HPF
C. 10-20 RBC/HPF
D. Gross hematuria - D. Gross hematuria
, A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at
its midpoint would cause bleeding from which structure? - External jugular vein
Clinical features associated with tension pneumothorax - Unilateral decrease in breath sounds
Hyperresonance
Respiratory distress
Tachycardia
Tracheal shift
Desatruation
Decreased breath sounds
Decreased compliance
Asymmetric chest movement
NOT hypertension, audible bronchial sounds
Not recommended as a mode of ventilation for a patient with a diaphragmatic hernia
A. Bag and mask
B. LMA
C. Endotracheal intubation
D. Jet ventilation - A. Bag and mask
What is the next step in the assessment of a traumatic patient after airway is established? - Breathing
Blood group that is considered a universal donor - O
A provider is examining a patient who sustained a severe traumatic head injury. He documents no Doll's
eyes. What does this signify? - Brainstem injury
