ATLS: Pretests
(230 Verified Q&A)
1. Thoracic trauma. Chest tube insertion.
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 initial
fluid resuscitation 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. A tube thoracostomy is performed for decreased left chest 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
e) perform transesophageal echocardiography
answer: a.
info: chest tube insertion, p. 108.
2. Musculoskeletal trauma. Extremity trauma.
A construction worker falls two stories from a building and sustains bilateral
cutaneal
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) angiography
b) compartment pressures
c) retrograde urethrogram
,d) Doppler-ultrasound studies
e) complete spine x-ray series
answer: e.
3. Trauma in women.
During the third trimester of pregnancy, all of the following changes occur
normally EXCEPT a:
a) decrease in PaC02
b) decrease in leukocyte count
c) reduced gastric emptying rate
d) diminished residual lung volume
e) diminished pelvic ligament tension
answer: b.
info: p. 261.
4. Head Trauma.
In managing the head injured patient, the most important initial step is to
a) secure the airway
b) obtain c-spine film
c) support circulation
c) control scalp hemorrhage
e) determine the GCS score
answer: a.
info: p. 154.
5. Shock.
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
reassure. An ABG would demonstrate a base deficit between -6 and -10
mEq/L
e) his systolic blood pressure will be maintained with an elevated diastolic
pressure
answer: d.
info: p. 61.
6. Trauma in Women.
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) complicating the management of closed head injury
d) reducing the volume of crystalloid required for resuscitation
e) increasing the volume of blood loss to produce maternal hypotension
answer: e.
info: p. 261.
7. Thermal Injuries. Injury Due to Burn and Cold.
The best guide for adequate fluid resuscitation of the adult burn patient is
a) adequate urinary output of 0.5 mL/kg/hr
b) reversal of systemic acidosis
c) normalization of the heart rate
, d) a normal central venous pressure
e) providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid
answer: a.
info: p. 216-217.
8. Shock.
Establishing a diagnosis of shock must include
a) hypoxemia
b) acidosis
c) hypotension
d) increased vascular resistance
e) evidence of inadequate organ perfusion
answer: e.
info: p. 58.
9. Musculoskeletal trauma. Extremity Trauma.
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
e) debridement of devitalized tissue
answer: b
info: p. 79.
(230 Verified Q&A)
1. Thoracic trauma. Chest tube insertion.
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 initial
fluid resuscitation 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. A tube thoracostomy is performed for decreased left chest 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
e) perform transesophageal echocardiography
answer: a.
info: chest tube insertion, p. 108.
2. Musculoskeletal trauma. Extremity trauma.
A construction worker falls two stories from a building and sustains bilateral
cutaneal
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) angiography
b) compartment pressures
c) retrograde urethrogram
,d) Doppler-ultrasound studies
e) complete spine x-ray series
answer: e.
3. Trauma in women.
During the third trimester of pregnancy, all of the following changes occur
normally EXCEPT a:
a) decrease in PaC02
b) decrease in leukocyte count
c) reduced gastric emptying rate
d) diminished residual lung volume
e) diminished pelvic ligament tension
answer: b.
info: p. 261.
4. Head Trauma.
In managing the head injured patient, the most important initial step is to
a) secure the airway
b) obtain c-spine film
c) support circulation
c) control scalp hemorrhage
e) determine the GCS score
answer: a.
info: p. 154.
5. Shock.
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
reassure. An ABG would demonstrate a base deficit between -6 and -10
mEq/L
e) his systolic blood pressure will be maintained with an elevated diastolic
pressure
answer: d.
info: p. 61.
6. Trauma in Women.
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) complicating the management of closed head injury
d) reducing the volume of crystalloid required for resuscitation
e) increasing the volume of blood loss to produce maternal hypotension
answer: e.
info: p. 261.
7. Thermal Injuries. Injury Due to Burn and Cold.
The best guide for adequate fluid resuscitation of the adult burn patient is
a) adequate urinary output of 0.5 mL/kg/hr
b) reversal of systemic acidosis
c) normalization of the heart rate
, d) a normal central venous pressure
e) providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid
answer: a.
info: p. 216-217.
8. Shock.
Establishing a diagnosis of shock must include
a) hypoxemia
b) acidosis
c) hypotension
d) increased vascular resistance
e) evidence of inadequate organ perfusion
answer: e.
info: p. 58.
9. Musculoskeletal trauma. Extremity Trauma.
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
e) debridement of devitalized tissue
answer: b
info: p. 79.
