ATLS Post Test 2023 QUESTIONS AND ANSWERS

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S!!!
A 22-year-
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old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His bl
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ood pressure is initially 80/40 mm Hg. After 2 liters of crystalloid solution his blood pre
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ssure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his resp
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iratory rate is 28 breaths per minute. His breath sounds are decreased in the left hemithor
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ax, and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for d
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ecreased left breath sounds with the return of a small amount of blood and no air leak. Af
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ter chest tube insertion, the most appropriate next step is:
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a) reexamine the chest. l l



b) perform an aortogram. l l




c) obtain a CT scan of the chest. l l l l l l




d) obtain arterial blood gas analyses - ANSWER: a) reexamine the chest
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Which one of the following physical findings suggests a cause of hypotension other tha
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n spinal cord injury?
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a) priapism.
b) bradycardia.
c) diaphragmatic breathing. l




d) presence of deep tendon reflexes. - l l l l l


ANSWER: d) presence of deep tendon reflexes.
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A construction worker falls two stories from a building and sustains bilateral calcaneal
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fractures. In the emergency department, he is alert, vital signs are normal, and he is com
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plaining of severe pain in both heels and his lower back. Lower extremity pulses are str
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ong and there is no other deformity. The suspected diagnosis is most likely to be confir
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med by: l




a) compartment pressures l




b) retrograde urethrogram l




c) Doppler-ultrasound studies l




d) complete spine x-ray series - ANSWER: d) complete spine x-ray series
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In managing the head-injured patient, the most important initial step is to:
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a) obtain c-spine film. l l




b) secure the airway. l l




c) support the circulation. l l




d) control scalp hemorrhage. - ANSWER: b) secure the airway.
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A previously healthy, 70-kg (154-
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pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following
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statements applies to this patient? l l l l




a) His pulse pressure will be widened.
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b) His urinary output will be at the lower limits of normal.
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c) He will have tachycardia, but no change in his systolic blood pressure.
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d) His systolic blood pressure will be decreased with a narrowed pulse pressur
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e. - l


ANSWER: d) His systolic blood pressure will be decreased with a narrowed puls
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e pressure.
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The physiologic hypervolemia of pregnancy has clinical significance in the management of
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the severely injured, gravid woman by:
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a) reducing the need for blood transfusion. l l l l l




b) increasing the risk of pulmonary edema. l l l l l




c) increasing the volume of blood loss to produce maternal hypotension.
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d) complicating the mangement of closed head injury. - l l l l l l l


ANSWER: c) increasing the volume of blood loss to produce maternal hypot
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ension.


The best assessment of fluid resuscitation of the burn patient is:
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a) adequate urinary output. l l




b) reversal of systemic acidosis. l l l




c) normalization of the heart rate. l l l l




d) a normal central venous pressure. - ANSWER: a) adequate urinary output.
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The diagnosis of shock must include:
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a) increased vascular resistance. l l




b) evidence of inadequate organ perfusion. l l l l




c) acidosis.
d) hypoxemia. - ANSWER: b) evidence of inadequate organ perfusion. l l l l l l l l




A 7-year-
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old boy is brought to the emergency department by his parents several minutes after he f
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ell through a window. He is bleeding profusely from a 6-
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cm wound of his medial right thigh. Immediate management of the wound should cons
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ist of: l

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a) application of a tourniquet. l l l



b) direct pressure on the wound.
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c) packing the wound with gauze. l l l l




d) direct pressure on the femoral artery at the groin. -
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ANSWER: b) direct pressure on the wound.
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For the patient with severe traumatic brain injury, profound hypocarbia should be avoided t
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o prevent:
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a) respiratoryacidosis. l



b) metabolic acidosis. l




c) cerebral vasoconstriction with diminished perfusion.
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d) neurogenic pulmonary edema. - l l l


ANSWER: c) cerebral vasoconstriction with diminished perfusion.
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A 25-year- l


old man is brought to a hospital with a general surgeon after being involved in a motor ve
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hicle crash. Computed tomography shows an aortic injury and splenic laceration with fr
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ee abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next step is:
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a) contrast angiography. l




b) transfer to a higher level trauma center.
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c) exploratory laparotomy. l



d) infuse additional crystalloids. - ANSWER: c) exploratory laparotomy.
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Which one of the following statements regarding abdominal trauma in the pregnant patient i
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s TRUE?
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