ATLS PRACTICE QUESTIONS
QUESTIONS AND SOLUTIONS
AGRADE
Assessed gbfirst gbin gbtrauma gbpatient gb- gbCorrect gb gbAnswer gb✔✔ gb- gbAirway
(*)Degree gbof gbburn gbthat gbis gbcharacterized gbby gbbone gbinvolvement gb- gbCorrect gb
gbAnswer gb✔✔ gb- gbFourth
Complications gbof gbhead gbtrauma gb- gbCorrect gb gbAnswer gb✔✔ gb- gbIntracerebral
gbhematoma
Extradural gbhematoma
Brain gbabscess
Most gbcommon gbcause gbof gblaryngotracheal gbstenosis gb- gbCorrect gb gbAnswer gb✔✔
gb- gbTrauma
Intervention gbthat gbcan gbhelp gbprevent gbdevelopment gbof gbacute gbrenal gbfailure gb-
gbCorrect gb gbAnswer gb✔✔ gb- gbInfusion gbof gbnormal gbsaline
A gb26-year-old gbmale gbis gbresuscitated gbwith gbblood gbtransfusion gbafter gba gbmotor
gbvehicle gbcollision gbthat gbwas gbcomplicated gbby gba gbfractured gbpelvis. gbA gbfew
gbhours gblater, gbthe gbpatient gbbecomes gbfebrile, gbhypotensive gbwith gba gbnormal
gbCVP, gband gboliguric. gbUpon gbexamination, gbthe gbpatient gbis gbfound gbto gbbe
gbbleeding gbfrom gbthe gbNG gbtube gband gbIV gbsites. gbWhich gbof gbthe gbfollowing gbis
gbthe gbmost gblikely gbdiagnosis?
A. gbHemorrhagic gbshock
B. gbAcute gbadrenal gbinsufficiency
C. gbFat gbembolism gbsyndrome
D. gbTransfusion gbreaction gb- gbCorrect gb gbAnswer gb✔✔ gb- gbD. gbTransfusion
gbreaction
Skin gbantiseptic gb- gbCorrect gb gbAnswer gb✔✔ gb- gb-Ethanol gb70% gbis gban gbeffective
gbskin gbantiseptic
-Acetic gbacid gbcan gbbe gbused gbto gbtreat gbGram- gbskin gbinfections
-Salicylic gbacid gbis gbused gbto gbtreat gbcertain gbskin gbyeast gbinfections
Class gbIV gbhemorrhage gbindicates gbwhat gb% gbblood gbloss gb- gbCorrect gb gbAnswer gb
✔✔ gb- gb55%
,How gbdoes gbshivering gbaffect gbbody gbtemperature gb- gbCorrect gb gbAnswer gb✔✔ gb-
gbIncreases gbbody gbtemperature
Class gbIII gbhemorrhage gbindicates gbwhat gb% gbof gbblood gbloss gb- gbCorrect gb gbAnswer
gb✔✔ gb- gb35%
Management gbof gba gbstable gbpatient gbwith gbkidney gbcontusion gb- gbCorrect gb gbAnswer
gb✔✔ gb- gbObservation
Associated gbwith gbhypovolemic gbshock gb- gbCorrect gb gbAnswer gb✔✔ gb- gb-Inadequate
gbtissue gbperfusion gbwith gbresultant gbtissue gbhypoxia
-Blood gbshunting gbto gbvital gborgans
-Decreased gbcirculating gbblood gbvolume gband gbdecreased gbvenous gbreturn
-Low gbcardiac gboutput
-Loss gbof gbless gbthan gb20% gbof gbthe gbblood gbvolume gbis gbusually gbwithout
gbsymptom gbexcept gbfor gbmild gbtachycardia gb
-Patients gbbecome gborthostatic gbwith gblosses gbbetween gb20 gband gb40% gb
-Shock gbis gbevidenced gbby gbtachycardia, gbhypotension, gboliguria, gbflat gbneck gbveins
The gbmost gbeffective gbmethod gbof gbmonitoring gbthe gbsuccess gbof gbresuscitation
gbduring gbCPR? gb- gbCorrect gb gbAnswer gb✔✔ gb- gbReactivity gbof gbpupils gbto gblight
Used gbto gbensure gbcorrect gbplacement gbof gbendotracheal gbtube gb- gbCorrect gb
gbAnswer gb✔✔ gb- gb-Ultrasound gb
-Bilateral gbbreath gbsounds
-Sustained gbend-tidal gbCO2
Total gbbody gbsurface gbarea gbinvolved gbin gba gbburn gbin gban gbadult gbto gbthe gbanterior
gbchest gband gbabdomen gb- gbCorrect gb gbAnswer gb✔✔ gb- gb18%
What gbis gboften gbcaused gbby gbcarotid gbmassage? gb- gbCorrect gb gbAnswer gb✔✔ gb-
gbBradycardia
Step gbin gba gbpatient gbdiagnosed gbwith gbtension gbpneumothorax gb- gbCorrect gb
gbAnswer gb✔✔ gb- gb1. gbNeedle gbdecompression/ gbthoracotomy
2. gbChest gbtube
True gbstatements gbregarding gbdiaphragmatic gbinjuries gb- gbCorrect gb gbAnswer gb✔✔
gb- gb-Blunt gbdiaphragmatic gbinjuries gbare gbusually gbassociated gbwith gbskeletal
gbtrauma gb
-Penetrating gbdiaphragmatic gbinjuries gbmay gbbe gbmissed
-Repair gbof gbtraumatic gbdiaphragmatic gbinjuries gbusually gbdoes gbnot gbrequire
gbprosthetic gbmaterial
,First gbpriority gbin gbthe gbtreatment gbof gban gbunconscious gbpatient gb- gbCorrect gb
gbAnswer gb✔✔ gb- gbChecking gbthe gbpulse
A gbpatient gbinvolved gbin gba gbroad gbaccident gbis gbbrought gbto gbthe gbemergency
gbdepartment gbin gban gbunconscious gbstate. gbOn gbarrival, gbher gbvitals gbshow gba
gbtemperature gbof gb96.4 gbdegrees gbFahrenheit, gba gbrespiration gbrate gbof gb24
gbbreaths gbper gbminute, gba gbheart gbrate gbof gb140 gbbeats gbper gbminute, gband gba
gbblood gbpressure gbof gb80/40 gbmm gbHg. gbShe gbis gbcold, gbshivering, gband gbperspiring
gbprofusely. gbShe gbhas gbbilateral gbreactive gbpupils gbbut gbshe gbdoes gbnot gbrespond
gbto gbpain. gbOn gbphysical gbexamination, gbshe gbhas gbno gbobvious gbsign gbof gbexternal
gbbleeding. gbWhich gbof gbthe gbfollowing gbcannot gbbe gbthe gbcause gbof gbhypotension
gbin gbthis gbpatient?
A. gbPelvic gbfracture
B. gbFracture gbof gbfemur
C. gbIntracranial gbhemorrhage
D. gbHemothorax gb- gbCorrect gb gbAnswer gb✔✔ gb- gbC. gbIntracranial gbhemorrhage
A gbpatient gbsuffered gba gbslash gbto gbhis gbright gbneck. gbThe gbwound gbis gbover gbthe
gbmid-portion gbof gbthe gbsternocleidomastoid. gbThere gbis gba gblarge gbhematoma gband
gbbrisk gbbleeding gbwhen gbuncovered. gbHe gbis gbstable. gbWhat gbis gbthe gbnext gbstep
gbin gbmanagement?
A. gbGet gban gbangiogram
B. gbClose gbthe gbwound gbin gbthe gbER
C. gbTake gbhim gbto gbthe gboperating gbroom
D. gbCT gbscan gbto gbevaluate gbneck gbstructure gb- gbCorrect gb gbAnswer gb✔✔ gb- gbC.
gbTake gbhim gbto gbthe gbOR
After gbabdominal gbinjury, gbwhich gbof gbthe gbfollowing gburinalysis gbfindings gbwould gbbe
gban gbindication gbfor gbfurther gbtesting?
A. gb0-5 gbcasts/HPF
B. gb5-10 gbWBC/HPF
C. gb10-20 gbRBC/HPF
D. gbGross gbhematuria gb- gbCorrect gb gbAnswer gb✔✔ gb- gbD. gbGross gbhematuria
A gblaceration gbof gbthe gbneck gbsuperficial gbto gbthe gbdeep gbcervical gbfascia gbalong
gbthe gbsternocleidomastoid gbmuscle gbat gbits gbmidpoint gbwould gbcause gbbleeding
gbfrom gbwhich gbstructure? gb- gbCorrect gb gbAnswer gb✔✔ gb- gbExternal gbjugular gbvein
Clinical gbfeatures gbassociated gbwith gbtension gbpneumothorax gb- gbCorrect gb gbAnswer
gb✔✔ gb- gbUnilateral gbdecrease gbin gbbreath gbsounds
Hyperresonance
Respiratory gbdistress
Tachycardia
Tracheal gbshift
Desatruation
Decreased gbbreath gbsounds
, Decreased gbcompliance
Asymmetric gbchest gbmovement
NOT gbhypertension, gbaudible gbbronchial gbsounds
Not gbrecommended gbas gba gbmode gbof gbventilation gbfor gba gbpatient gbwith gba
gbdiaphragmatic gbhernia
A. gbBag gband gbmask
B. gbLMA
C. gbEndotracheal gbintubation
D. gbJet gbventilation gb- gbCorrect gb gbAnswer gb✔✔ gb- gbA. gbBag gband gbmask
What gbis gbthe gbnext gbstep gbin gbthe gbassessment gbof gba gbtraumatic gbpatient gbafter
gbairway gbis gbestablished? gb- gbCorrect gb gbAnswer gb✔✔ gb- gbBreathing
Blood gbgroup gbthat gbis gbconsidered gba gbuniversal gbdonor gb- gbCorrect gb gbAnswer gb✔
✔ gb- gbO
A gbprovider gbis gbexamining gba gbpatient gbwho gbsustained gba gbsevere gbtraumatic
gbhead gbinjury. gbHe gbdocuments gbno gbDoll's gbeyes. gbWhat gbdoes gbthis gbsignify? gb-
gbCorrect gb gbAnswer gb✔✔ gb- gbBrainstem gbinjury
Which gbof gbthe gbfollowing gbis gbthe gbleast gbpreferred gbmethod gbof gbadministering gbIV
gbfluids?
A. gbCubital gbveins
B. gbCephalic gbveins
C. gbSubclavian gbveins
D. gbSaphenous gbvein gb- gbCorrect gb gbAnswer gb✔✔ gb- gbSubclavian gbveins
Dermatome gblevel gbfor gbnipple gbsensation
Dermatome gblevel gbfor gbumbilicus gb- gbCorrect gb gbAnswer gb✔✔ gb- gbT4
T10
At gbwhich gbtemperature gbwould gba gbhypothermic gbpatient gbstop gbshivering? gb-
gbCorrect gb gbAnswer gb✔✔ gb- gb88 gbdegrees gbF
What gbis gbthe gbenergy gbrecommendation gbfor gbthe gbfirst gbdefibrillation gbin gban gbadult
gb(*) gb- gbCorrect gb gbAnswer gb✔✔ gb- gb300 gbJ
Pharmacologic gbeffects gbof gbMorphine gb- gbCorrect gb gbAnswer gb✔✔ gb- gbBehavioral
gbchanges
Analgesia
Respiratory gbdepression
QUESTIONS AND SOLUTIONS
AGRADE
Assessed gbfirst gbin gbtrauma gbpatient gb- gbCorrect gb gbAnswer gb✔✔ gb- gbAirway
(*)Degree gbof gbburn gbthat gbis gbcharacterized gbby gbbone gbinvolvement gb- gbCorrect gb
gbAnswer gb✔✔ gb- gbFourth
Complications gbof gbhead gbtrauma gb- gbCorrect gb gbAnswer gb✔✔ gb- gbIntracerebral
gbhematoma
Extradural gbhematoma
Brain gbabscess
Most gbcommon gbcause gbof gblaryngotracheal gbstenosis gb- gbCorrect gb gbAnswer gb✔✔
gb- gbTrauma
Intervention gbthat gbcan gbhelp gbprevent gbdevelopment gbof gbacute gbrenal gbfailure gb-
gbCorrect gb gbAnswer gb✔✔ gb- gbInfusion gbof gbnormal gbsaline
A gb26-year-old gbmale gbis gbresuscitated gbwith gbblood gbtransfusion gbafter gba gbmotor
gbvehicle gbcollision gbthat gbwas gbcomplicated gbby gba gbfractured gbpelvis. gbA gbfew
gbhours gblater, gbthe gbpatient gbbecomes gbfebrile, gbhypotensive gbwith gba gbnormal
gbCVP, gband gboliguric. gbUpon gbexamination, gbthe gbpatient gbis gbfound gbto gbbe
gbbleeding gbfrom gbthe gbNG gbtube gband gbIV gbsites. gbWhich gbof gbthe gbfollowing gbis
gbthe gbmost gblikely gbdiagnosis?
A. gbHemorrhagic gbshock
B. gbAcute gbadrenal gbinsufficiency
C. gbFat gbembolism gbsyndrome
D. gbTransfusion gbreaction gb- gbCorrect gb gbAnswer gb✔✔ gb- gbD. gbTransfusion
gbreaction
Skin gbantiseptic gb- gbCorrect gb gbAnswer gb✔✔ gb- gb-Ethanol gb70% gbis gban gbeffective
gbskin gbantiseptic
-Acetic gbacid gbcan gbbe gbused gbto gbtreat gbGram- gbskin gbinfections
-Salicylic gbacid gbis gbused gbto gbtreat gbcertain gbskin gbyeast gbinfections
Class gbIV gbhemorrhage gbindicates gbwhat gb% gbblood gbloss gb- gbCorrect gb gbAnswer gb
✔✔ gb- gb55%
,How gbdoes gbshivering gbaffect gbbody gbtemperature gb- gbCorrect gb gbAnswer gb✔✔ gb-
gbIncreases gbbody gbtemperature
Class gbIII gbhemorrhage gbindicates gbwhat gb% gbof gbblood gbloss gb- gbCorrect gb gbAnswer
gb✔✔ gb- gb35%
Management gbof gba gbstable gbpatient gbwith gbkidney gbcontusion gb- gbCorrect gb gbAnswer
gb✔✔ gb- gbObservation
Associated gbwith gbhypovolemic gbshock gb- gbCorrect gb gbAnswer gb✔✔ gb- gb-Inadequate
gbtissue gbperfusion gbwith gbresultant gbtissue gbhypoxia
-Blood gbshunting gbto gbvital gborgans
-Decreased gbcirculating gbblood gbvolume gband gbdecreased gbvenous gbreturn
-Low gbcardiac gboutput
-Loss gbof gbless gbthan gb20% gbof gbthe gbblood gbvolume gbis gbusually gbwithout
gbsymptom gbexcept gbfor gbmild gbtachycardia gb
-Patients gbbecome gborthostatic gbwith gblosses gbbetween gb20 gband gb40% gb
-Shock gbis gbevidenced gbby gbtachycardia, gbhypotension, gboliguria, gbflat gbneck gbveins
The gbmost gbeffective gbmethod gbof gbmonitoring gbthe gbsuccess gbof gbresuscitation
gbduring gbCPR? gb- gbCorrect gb gbAnswer gb✔✔ gb- gbReactivity gbof gbpupils gbto gblight
Used gbto gbensure gbcorrect gbplacement gbof gbendotracheal gbtube gb- gbCorrect gb
gbAnswer gb✔✔ gb- gb-Ultrasound gb
-Bilateral gbbreath gbsounds
-Sustained gbend-tidal gbCO2
Total gbbody gbsurface gbarea gbinvolved gbin gba gbburn gbin gban gbadult gbto gbthe gbanterior
gbchest gband gbabdomen gb- gbCorrect gb gbAnswer gb✔✔ gb- gb18%
What gbis gboften gbcaused gbby gbcarotid gbmassage? gb- gbCorrect gb gbAnswer gb✔✔ gb-
gbBradycardia
Step gbin gba gbpatient gbdiagnosed gbwith gbtension gbpneumothorax gb- gbCorrect gb
gbAnswer gb✔✔ gb- gb1. gbNeedle gbdecompression/ gbthoracotomy
2. gbChest gbtube
True gbstatements gbregarding gbdiaphragmatic gbinjuries gb- gbCorrect gb gbAnswer gb✔✔
gb- gb-Blunt gbdiaphragmatic gbinjuries gbare gbusually gbassociated gbwith gbskeletal
gbtrauma gb
-Penetrating gbdiaphragmatic gbinjuries gbmay gbbe gbmissed
-Repair gbof gbtraumatic gbdiaphragmatic gbinjuries gbusually gbdoes gbnot gbrequire
gbprosthetic gbmaterial
,First gbpriority gbin gbthe gbtreatment gbof gban gbunconscious gbpatient gb- gbCorrect gb
gbAnswer gb✔✔ gb- gbChecking gbthe gbpulse
A gbpatient gbinvolved gbin gba gbroad gbaccident gbis gbbrought gbto gbthe gbemergency
gbdepartment gbin gban gbunconscious gbstate. gbOn gbarrival, gbher gbvitals gbshow gba
gbtemperature gbof gb96.4 gbdegrees gbFahrenheit, gba gbrespiration gbrate gbof gb24
gbbreaths gbper gbminute, gba gbheart gbrate gbof gb140 gbbeats gbper gbminute, gband gba
gbblood gbpressure gbof gb80/40 gbmm gbHg. gbShe gbis gbcold, gbshivering, gband gbperspiring
gbprofusely. gbShe gbhas gbbilateral gbreactive gbpupils gbbut gbshe gbdoes gbnot gbrespond
gbto gbpain. gbOn gbphysical gbexamination, gbshe gbhas gbno gbobvious gbsign gbof gbexternal
gbbleeding. gbWhich gbof gbthe gbfollowing gbcannot gbbe gbthe gbcause gbof gbhypotension
gbin gbthis gbpatient?
A. gbPelvic gbfracture
B. gbFracture gbof gbfemur
C. gbIntracranial gbhemorrhage
D. gbHemothorax gb- gbCorrect gb gbAnswer gb✔✔ gb- gbC. gbIntracranial gbhemorrhage
A gbpatient gbsuffered gba gbslash gbto gbhis gbright gbneck. gbThe gbwound gbis gbover gbthe
gbmid-portion gbof gbthe gbsternocleidomastoid. gbThere gbis gba gblarge gbhematoma gband
gbbrisk gbbleeding gbwhen gbuncovered. gbHe gbis gbstable. gbWhat gbis gbthe gbnext gbstep
gbin gbmanagement?
A. gbGet gban gbangiogram
B. gbClose gbthe gbwound gbin gbthe gbER
C. gbTake gbhim gbto gbthe gboperating gbroom
D. gbCT gbscan gbto gbevaluate gbneck gbstructure gb- gbCorrect gb gbAnswer gb✔✔ gb- gbC.
gbTake gbhim gbto gbthe gbOR
After gbabdominal gbinjury, gbwhich gbof gbthe gbfollowing gburinalysis gbfindings gbwould gbbe
gban gbindication gbfor gbfurther gbtesting?
A. gb0-5 gbcasts/HPF
B. gb5-10 gbWBC/HPF
C. gb10-20 gbRBC/HPF
D. gbGross gbhematuria gb- gbCorrect gb gbAnswer gb✔✔ gb- gbD. gbGross gbhematuria
A gblaceration gbof gbthe gbneck gbsuperficial gbto gbthe gbdeep gbcervical gbfascia gbalong
gbthe gbsternocleidomastoid gbmuscle gbat gbits gbmidpoint gbwould gbcause gbbleeding
gbfrom gbwhich gbstructure? gb- gbCorrect gb gbAnswer gb✔✔ gb- gbExternal gbjugular gbvein
Clinical gbfeatures gbassociated gbwith gbtension gbpneumothorax gb- gbCorrect gb gbAnswer
gb✔✔ gb- gbUnilateral gbdecrease gbin gbbreath gbsounds
Hyperresonance
Respiratory gbdistress
Tachycardia
Tracheal gbshift
Desatruation
Decreased gbbreath gbsounds
, Decreased gbcompliance
Asymmetric gbchest gbmovement
NOT gbhypertension, gbaudible gbbronchial gbsounds
Not gbrecommended gbas gba gbmode gbof gbventilation gbfor gba gbpatient gbwith gba
gbdiaphragmatic gbhernia
A. gbBag gband gbmask
B. gbLMA
C. gbEndotracheal gbintubation
D. gbJet gbventilation gb- gbCorrect gb gbAnswer gb✔✔ gb- gbA. gbBag gband gbmask
What gbis gbthe gbnext gbstep gbin gbthe gbassessment gbof gba gbtraumatic gbpatient gbafter
gbairway gbis gbestablished? gb- gbCorrect gb gbAnswer gb✔✔ gb- gbBreathing
Blood gbgroup gbthat gbis gbconsidered gba gbuniversal gbdonor gb- gbCorrect gb gbAnswer gb✔
✔ gb- gbO
A gbprovider gbis gbexamining gba gbpatient gbwho gbsustained gba gbsevere gbtraumatic
gbhead gbinjury. gbHe gbdocuments gbno gbDoll's gbeyes. gbWhat gbdoes gbthis gbsignify? gb-
gbCorrect gb gbAnswer gb✔✔ gb- gbBrainstem gbinjury
Which gbof gbthe gbfollowing gbis gbthe gbleast gbpreferred gbmethod gbof gbadministering gbIV
gbfluids?
A. gbCubital gbveins
B. gbCephalic gbveins
C. gbSubclavian gbveins
D. gbSaphenous gbvein gb- gbCorrect gb gbAnswer gb✔✔ gb- gbSubclavian gbveins
Dermatome gblevel gbfor gbnipple gbsensation
Dermatome gblevel gbfor gbumbilicus gb- gbCorrect gb gbAnswer gb✔✔ gb- gbT4
T10
At gbwhich gbtemperature gbwould gba gbhypothermic gbpatient gbstop gbshivering? gb-
gbCorrect gb gbAnswer gb✔✔ gb- gb88 gbdegrees gbF
What gbis gbthe gbenergy gbrecommendation gbfor gbthe gbfirst gbdefibrillation gbin gban gbadult
gb(*) gb- gbCorrect gb gbAnswer gb✔✔ gb- gb300 gbJ
Pharmacologic gbeffects gbof gbMorphine gb- gbCorrect gb gbAnswer gb✔✔ gb- gbBehavioral
gbchanges
Analgesia
Respiratory gbdepression
