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ATLS post test 2023 QUESTIONS AND ANSWERS

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ATLS post test 2023 QUESTIONS AND ANSWERS Course Medicine 108 Institution Medicine 108 1. The primary indication for transferring a1. The primary indication for transferring a patient to a higher level trauma center is: patient to a higher level trauma center is:unavailability of a surgeon or operating roomunavailability of a surgeon or operating .multiple system injuries, including severemultiple system injuries, including severehead injury.resource limitations as determined by theresource limitations as determined by thetransferring ferring doctor.resource limitations as determined by theresource limitations as determined by thehospital tal administration.widened mediastinum on chest x-raywidened mediastinum on chest x-rayfollowing blunt thoracic wing blunt thoracic trauma.2. teen-aged bicycle rider is hit b2. teen-aged bicycle rider is hit by a trucky a trucktraveling at a high rate of speed. traveling at a high rate of speed. In theIn theemergency department, she is actively bleedingemergency department, she is actively bleedingfrom open fractures of her legs, and hasfrom open fractures of her legs, and hasabrasions on her chest and abdominal abrasions on her chest and abdominal wall. Herwall. Her blood pressure is 80/50 mm Hg, heart rate is blood pressure is 80/50 mm Hg, heart rate is140 beats per minute, respiratory rate is 8140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6. breaths per minute, and GCS score is 6.The first step in managing this patient is to:The first step in managing this patient is to:obtain a lateral cervical spine n a lateral cervical spine x-ray.insert a central venous pressure t a central venous pressure line.administer 2 liters of crystalloid ister 2 liters of crystalloid solution.perform endotracheal intubation andperform endotracheal intubation lation.apply the PASG and inflate the legapply the PASG and inflate the rtments.3. Contraindication to nasogastric intubation is3. Contraindication to nasogastric intubation isthe presence of a:the presence of a:gastric ic perforation.diaphragmatic ragmatic rupture.open depressed skull depressed skull fracture.fracture of the cervical ure of the cervical spine.fracture of the cribriform ure of the cribriform plate.4. Which one of the following statements4. Which one of the following statementsregarding patients with thoracic spine injuries isregarding patients with thoracic spine injuries isTRUE?TRUE?Log-rolling may be Log-rolling may be destabilizing todestabilizing tofractures from T-12 to L-ures from T-12 to L-1.Adequate immobilization can beAdequate immobilization can beaccomplished with the scoop plished with the scoop stretcher.Spinal cord injury below T-10 usually sparesSpinal cord injury below T-10 usually sparesbowel and bladder and bladder function.Hyperflexion fractures in the upperHyperflexion fractures in the upperthoracic spine are inherently cic spine are inherently unstable.These patients rarely present with spinalThese patients rarely present with spinalshock in association with cord in association with cord injury.5. young man sustains a ritle wound to the mid-5. young man sustains a ritle wound to the mid-abdomen. He is brought promptly to theabdomen. He is brought promptly to theemergency department by prehospitalemergency department by prehospital personnel. His skin is cool and diaphoretic, and personnel. His skin is cool and diaphoretic, andhis systolic blood pressure is 58 rnm H systolic blood pressure is 58 rnm Hg.WWarmed crystalloid fluids are armed crystalloid fluids are initiated withoutinitiated withoutimprovement in his vital signs. The next, mostimprovement in his vital signs. The next, mostappropriate step is to perform:appropriate step is to perform:a celiotomy.a celiotomy.an abdominal CT abdominal CT scan.diagnostic ostic laparoscopy.abdominal inal ultrasonography.a diagnostic peritoneal lavage.a diagnostic peritoneal lavage.6. young woman sustains a severe he6. young woman

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ATLS post test 2023 QUESTIONS AND ANSWERS



1. The primary indication for transferring a 4. Which one of the following s
patient to a higher level trauma center is: regarding patients with thoracic
TRUE?
unavailability of a surgeon or operating room  Log-rolling may be destab
staff. fractures from T-
multiple system injuries, including severe  Adequate immobilizati
head injury. accomplished with the scoop
resource limitations as determined by the  Spinal cord injury below T-10 usua
transferring doctor. bowel and bladder
resource limitations as determined by the  Hyperflexion fractures in
hospital administration. thoracic spine are inherently
widened mediastinum on chest x-ray  These patients rarely present w
following blunt thoracic trauma. shock in association with co


2. teen-aged bicycle rider is hit by a truck 5. young man sustains a ritle wo
traveling at a high rate of speed. In the abdomen. He is brought promp
emergency department, she is actively bleeding emergency department by preh
from open fractures of her legs, and has personnel. His skin is cool and d
abrasions on her chest and abdominal wall. Her his systolic blood pressure is 58
blood pressure is 80/50 mm Hg, heart rate is Warmed crystalloid fluids are in
140 beats per minute, respiratory rate is 8 improvement in his vital signs.
breaths per minute, and GCS score is 6. appropriate step is to perform:
The first step in managing this patient is to: ac
an abdomina
obtain a lateral cervical spine x-ray.  diagnostic lap
insert a central venous pressure line.  abdominal ultraso
administer 2 liters of crystalloid solution.  a diagnostic periton
perform endotracheal intubation and 


ventilation.
6. young woman sustains a seve
apply the PASG and inflate the leg 

as the result of a motor vehicul
compartments.
emergency department, her GC
blood pressure is 140/90 mm H
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She
the presence of a: is being mechanically ventilated

,ATLS post test 2023 QUESTIONS AND ANSWERS
administer an osmoti
prevent secondary bra

,ATLS post test 2023 QUESTIONS AND ANSWERS



aggressively treat systemic hypertension. 
9. 8-year-old girl is an unrestrai
reduce metabolic requirements of the 
in a vehicle struck from behind.
brain. emergency department, her blo
distinguish between intracranial hematoma 
80/60 mm Hg, heart rate is 80 b
and cerebral edema. and respiratory rate is 16 breath
Her GCS score is 14. She compl
legs feel "funny and won't mov
7. 22-year-old man is brought to the hospital
however, her spine x-rays do n
after crashing his motorcycle into a telephone
fracture or dislocation. A spinal
pole. He is unconscious and in profound shock.
this child:
He has no open wounds or obvious fractures.
is most likely a central cord s
The cause of his shock is MOST LIKELY
must be diagnosed by magnetic r
caused by:
a subdural hematoma.
can be excluded by obtaining a



an epidural hematoma.
en



a transected lumbar spinal cord.
may exist in the absence of



a transected cervical spinal cord.
findings on x-ra



hemorrhage into the chest or abdomen. is unlikely because of the in




calcification of the vertebr
8. 30-year-old man is struck by a car traveling
at 56 kph (35 mph). He has obvious fractures of 10. Immediate chest tube inserti
the left tibia near the knee, pain in the pelvic for which of the following cond
area, and severe dyspnea. His heart rate is 180
Pneu
beats per minute, and his respiratory rate is 48
Pneumome
breaths per minute with no breath sounds heard
Massive he
in the left chest. A tension pneumothorax is
Diaphragma
relieved by immediate needle decompression
Subcutaneous em
and tube thoracostomy. Subsequently, his heart
rate decreases to 140 beats per minute, his
respiratory rate decreases to 36 breaths per 11. 18-year-old, helmeted motor
minute, and his blood pressure is 80/50 inm Hg. brought by ambulance to the e
Warmed Ringer's lactate is administered department following a high-sp
intravenously. The next priority should be to: Prehospital persormel report tha
perform a urethrogram and cystogram. 
15 meters (50 feet) off his bfice
history of hypotension prior to

, ATLS post test 2023 QUESTIONS AND ANSWERS

The patient has sensitive vasomotor 
reflexes.

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