ATLS Review Exam 1 2024
1. A 22-year-old male is hypotensive and tachycardic after a shotgun wound
to the left shoulder. His initial BP is 80/40. After receiving 2L of fluids, his BP
increases to 122/84, HR is 100 bpm, and RR is 28. Breath sounds are
decreased in the left hemithorax, and a closed tube thoracotomy is
performed with minimal blood return and no air leak. What is the next
step?
Answer: Reexamine the chest.
2. A construction worker falls 2 stories and suffers bilateral calcaneal
fractures. He now has back pain. What would confirm the diagnosis?
Answer: Complete spine x-ray series.
3. What is the principle of balanced resuscitation?
Answer: Permissive hypotension and early plasma infusion.
4. In managing a head-injured patient, what is the most important initial step?
Answer: Secure the airway.
5. A previously healthy 70 kg man suffered ~2L of acute blood loss. What
applies to this patient?
Answer: His systolic BP will be decreased with a narrowed pulse pressure.
(Not: pulse pressure widened, lower urinary output, tachycardia with no BP
change, or maintained systolic BP with elevated diastolic BP).
6. The physiologic hypovolemia of pregnancy has clinical significance in
managing severely injured pregnant women by:
Answer: Increasing the volume of blood to produce maternal hypotension.
, 7. The best assessment of fluid resuscitation in a burn patient is:
Answer: Adequate urinary output.
8. The diagnosis of shock MUST include:
Answer: Evidence of inadequate organ perfusion.
9. A 7-year-old male is brought to the ED by his parents after falling through a
window. He has a 6 cm wound on the medial right thigh. Immediate
management should include?
Answer: Direct pressure on the wound.
10.For a patient with severe traumatic brain injury, avoiding hypocarbia
(decreased CO2) is crucial to prevent:
Answer: Cerebral vasoconstriction with diminished perfusion.
11.A 25-year-old male is brought in after a motor vehicle accident. CT shows
aortic injury and splenic lac with abdominal fluid. BP is 70 mm Hg after CT.
What is the next step?
Answer: Exploratory laparotomy.
12.Which statement regarding abdominal trauma in pregnant patients is true?
Answer: Leakage of amniotic fluid is an indication for hospital admission.
13.What is the first maneuver to improve oxygenation after a chest injury?
Answer: Administer supplemental oxygen.
14.A 25-year-old male in an MVC is admitted to the ED. His pupils react
sluggishly, and he opens his eyes to painful stimuli. He does not follow
commands but moans periodically. His right arm is non-responsive to pain,
while his left hand reaches purposefully toward the pain. Both legs are
stiffened. What is his GCS?
Answer: 9.
1. A 22-year-old male is hypotensive and tachycardic after a shotgun wound
to the left shoulder. His initial BP is 80/40. After receiving 2L of fluids, his BP
increases to 122/84, HR is 100 bpm, and RR is 28. Breath sounds are
decreased in the left hemithorax, and a closed tube thoracotomy is
performed with minimal blood return and no air leak. What is the next
step?
Answer: Reexamine the chest.
2. A construction worker falls 2 stories and suffers bilateral calcaneal
fractures. He now has back pain. What would confirm the diagnosis?
Answer: Complete spine x-ray series.
3. What is the principle of balanced resuscitation?
Answer: Permissive hypotension and early plasma infusion.
4. In managing a head-injured patient, what is the most important initial step?
Answer: Secure the airway.
5. A previously healthy 70 kg man suffered ~2L of acute blood loss. What
applies to this patient?
Answer: His systolic BP will be decreased with a narrowed pulse pressure.
(Not: pulse pressure widened, lower urinary output, tachycardia with no BP
change, or maintained systolic BP with elevated diastolic BP).
6. The physiologic hypovolemia of pregnancy has clinical significance in
managing severely injured pregnant women by:
Answer: Increasing the volume of blood to produce maternal hypotension.
, 7. The best assessment of fluid resuscitation in a burn patient is:
Answer: Adequate urinary output.
8. The diagnosis of shock MUST include:
Answer: Evidence of inadequate organ perfusion.
9. A 7-year-old male is brought to the ED by his parents after falling through a
window. He has a 6 cm wound on the medial right thigh. Immediate
management should include?
Answer: Direct pressure on the wound.
10.For a patient with severe traumatic brain injury, avoiding hypocarbia
(decreased CO2) is crucial to prevent:
Answer: Cerebral vasoconstriction with diminished perfusion.
11.A 25-year-old male is brought in after a motor vehicle accident. CT shows
aortic injury and splenic lac with abdominal fluid. BP is 70 mm Hg after CT.
What is the next step?
Answer: Exploratory laparotomy.
12.Which statement regarding abdominal trauma in pregnant patients is true?
Answer: Leakage of amniotic fluid is an indication for hospital admission.
13.What is the first maneuver to improve oxygenation after a chest injury?
Answer: Administer supplemental oxygen.
14.A 25-year-old male in an MVC is admitted to the ED. His pupils react
sluggishly, and he opens his eyes to painful stimuli. He does not follow
commands but moans periodically. His right arm is non-responsive to pain,
while his left hand reaches purposefully toward the pain. Both legs are
stiffened. What is his GCS?
Answer: 9.
