ATLS exam test with correct answers
25 yo female in the third trimester of preganacy is brought to the ED following a high speed
MVA. She is conscious, and her vital signs are RR 16, HR 120, BP 70/50. The laboratory results
show a PaCO2 of 50mmHg/5.3kPa (normal range 35-45). Which one of the following statments
concerning this patient is true?
a. fetal assessment should take priority
b. logrolling the patient to the right will decompress the vena cava
c. Rh immuno therapy sshould be immediately adminstered
d. normal PaCO2 is concerning for impending RR
e. vasopressors should be given to the patient - CORRECT ANSWERS-d. normal PaCO2 is
concerning for impending RR
30 year old male present with a stab wound to the abdomen. BP is 60/34, HR 130, RR 25 and
GCS 13 E3V4M6. Neck veins are flat and chest examination is clear with bilateral breath
sounds. Optimal resuscitation should include:
A. Transfusion of FFP and platelets
B. 500ml of hypertonic saline and transfusion of pRBCs
C. Resuscitation with crystalloid and pRBC until base excess is normal
D. Fluid resuscitation and angioembolization
E. Preparation for laparotomy while initiating fluid resuscitation - CORRECT ANSWERS-E.
Preparation for laparotomy while initiating fluid resuscitation
A 14 year old female is brought to the ED after falling from a horse. Cervical spinal motion is
restricted wit ha hard collar and cervical blocks and she is immobilized on a long spine board.
Which of the following IS TRUE REGARDING Cervical spine x-ray:
A. More than 20% of these patients will have cervical spine injury
B. Cervical spine injury is excluded if no abnormalities are found on lateral cervical spine xray
, C. Are not needed if she is awake, alert, neurologically normal, and has no neck pain or midline
tenderness
D. Should be performed before adressing potential breating or circulatory problems
E. She should reamin on teh long spine board until imaging excluded injuries - CORRECT
ANSWERS-C. Are not needed if she is awake, alert, neurologically normal, and has no neck
pain or midline tenderness
A 15 year old is brought to the ED after being involved in a MVA. He was intubated by
emergency medical personnal with subsequent bilateral breath sounds per their report. Upon
arrival to the ED the patients O2 saat is 92%, heart 96, and blood pressure 150/85. Breath
sounds are decreased in the left side of the thorax. The next step is
a. immediate needle cricothyroidotomy
b. immediate needle thoracentesis
c. chest tube insertion
d. reassess the position of the endotracheal tube
e. obtain a chest CT - CORRECT ANSWERS-d. reassess the position of the endotracheal tube
A 15 year old male present following a motorcycle crash. INitial examinations reveals normal
vital signs. There is a large bruise over his epigastrium that extends to the left flank. He has no
other apparent injuries. A CT-scan of the abdomen demonstrate a ruptured spleen surrounded
by a large hematoma and fluid in the pelvis. The next step in the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - CORRECT ANSWERS-D. Surgical consult
A 22 year old male present following a motorcycle crash. He complains of the inability to move
his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal
prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His
management should be:
A: 1L of iv . crystalloid and two units of pRBCs
B. 1L of iv. crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
25 yo female in the third trimester of preganacy is brought to the ED following a high speed
MVA. She is conscious, and her vital signs are RR 16, HR 120, BP 70/50. The laboratory results
show a PaCO2 of 50mmHg/5.3kPa (normal range 35-45). Which one of the following statments
concerning this patient is true?
a. fetal assessment should take priority
b. logrolling the patient to the right will decompress the vena cava
c. Rh immuno therapy sshould be immediately adminstered
d. normal PaCO2 is concerning for impending RR
e. vasopressors should be given to the patient - CORRECT ANSWERS-d. normal PaCO2 is
concerning for impending RR
30 year old male present with a stab wound to the abdomen. BP is 60/34, HR 130, RR 25 and
GCS 13 E3V4M6. Neck veins are flat and chest examination is clear with bilateral breath
sounds. Optimal resuscitation should include:
A. Transfusion of FFP and platelets
B. 500ml of hypertonic saline and transfusion of pRBCs
C. Resuscitation with crystalloid and pRBC until base excess is normal
D. Fluid resuscitation and angioembolization
E. Preparation for laparotomy while initiating fluid resuscitation - CORRECT ANSWERS-E.
Preparation for laparotomy while initiating fluid resuscitation
A 14 year old female is brought to the ED after falling from a horse. Cervical spinal motion is
restricted wit ha hard collar and cervical blocks and she is immobilized on a long spine board.
Which of the following IS TRUE REGARDING Cervical spine x-ray:
A. More than 20% of these patients will have cervical spine injury
B. Cervical spine injury is excluded if no abnormalities are found on lateral cervical spine xray
, C. Are not needed if she is awake, alert, neurologically normal, and has no neck pain or midline
tenderness
D. Should be performed before adressing potential breating or circulatory problems
E. She should reamin on teh long spine board until imaging excluded injuries - CORRECT
ANSWERS-C. Are not needed if she is awake, alert, neurologically normal, and has no neck
pain or midline tenderness
A 15 year old is brought to the ED after being involved in a MVA. He was intubated by
emergency medical personnal with subsequent bilateral breath sounds per their report. Upon
arrival to the ED the patients O2 saat is 92%, heart 96, and blood pressure 150/85. Breath
sounds are decreased in the left side of the thorax. The next step is
a. immediate needle cricothyroidotomy
b. immediate needle thoracentesis
c. chest tube insertion
d. reassess the position of the endotracheal tube
e. obtain a chest CT - CORRECT ANSWERS-d. reassess the position of the endotracheal tube
A 15 year old male present following a motorcycle crash. INitial examinations reveals normal
vital signs. There is a large bruise over his epigastrium that extends to the left flank. He has no
other apparent injuries. A CT-scan of the abdomen demonstrate a ruptured spleen surrounded
by a large hematoma and fluid in the pelvis. The next step in the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - CORRECT ANSWERS-D. Surgical consult
A 22 year old male present following a motorcycle crash. He complains of the inability to move
his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal
prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His
management should be:
A: 1L of iv . crystalloid and two units of pRBCs
B. 1L of iv. crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
