ATLS Pretest 2022 10th Edition
d d d d
1. Ad22-year-
olddmandisdhypotensivedanddtachycardicdafterdadshotgundwounddtodthedleftdshoulder.dHi
sdblooddpressuredisdinitiallyd80/40dmmdHg.dAfterdinitialdfluiddresuscitationdhisdblooddpr
essuredincreasesdtod122/84dmmdHg.dHisdheartdratedisdnowd100dbeatsdperdminutedanddhi
sdrespiratorydratedisd28dbreathsdperdminute.dAdtubedthoracostomydisdperformeddforddec
reaseddleftdchestdbreathdsoundsdwithdthedreturndofdadsmalldamountdofdblooddanddnodairdl
eak.dAfterdchestdtubedinsertion,dthedmostdappropriatednextdstepdis:
- re-examinedthedchest
2. Adconstructiondworkerdfallsdtwodstoriesdfromdadbuildingdanddsustainsdbilateraldcalcanea
ldfractures.dIndthedemergencyddepartment,dhedisdalert,dvitaldsignsdarednormal,danddhedisdco
mplainingdofdseveredpaindindbothdheelsdanddhisdlowerdback.dLowerdextremitydpulsesdaredst
rongdanddtheredisdnodotherddeformity.dThedsuspectedddiagnosisdisdmostdlikelydtodbedconfir
meddby:
- completedspinedx-raydseries
3. Whichdofdthedfollowingdisdtruedregardingdthedinitialdresuscitationdofdadtraumadpatient?
- Evidencedofdimproveddperfusiondafterdfluiddresuscitationdcoulddinclud
edimprovementdindGlasgowdComadScaledscoredondreevaluation.
4. Indmanagingdadpatientdwithdadseveredtraumaticdbraindinjury,dthedmostdimportantdinitiald
stepdisdto:
-dsecuredthedairway
5. Adpreviouslydhealthy,d70-kgd(154-
pound)dmandsuffersdandestimateddacutedblooddlossdofd2dliters.dWhichdonedofdthedfollowingd
statementsdappliesdtodthisdpatient?
- AndABGdwouldddemonstratedadbaseddeficitdbetweend-6dandd-10dmEq/L.
6. Thedphysiologicaldhypervolemiadofdpregnancydhasdclinicaldsignificancedindthed
managementdofdthedseverelydinjured,dgraviddwomandby:
- increasingdthedvolumedofdblooddlossdtodproducedmaternaldhypotension
7. Thedbestdassessmentdofdfluiddresuscitationdofdthedadultdburndpatientdis:
- urinarydoutputdofd0.5dmL/kg/hr
8. Theddiagnosisdofdshockdmustdinclude:
- evidencedofdinadequatedorgandperfusion
9. Ad7-year-
olddboydisdbroughtdtodthedemergencyddepartmentdbydhisdparentsdseveraldminutesdafterdh
edfelldthroughdadwindow.dHedisdbleedingdprofuselydfromdad6-
cmdwounddofdhisdmedialdrightdthigh.dImmediatedmanagementdofdthedwounddshoulddconsi
stdof:
- directdpressuredondthedwound
10. Fordthedpatientdwithdseveredtraumaticdbraindinjury,dprofounddhypocarbiadshoulddbed
avoideddtodprevent:d-dcerebraldvasoconstrictiondwithddiminisheddperfusion
, 11. Afterdbeingdinvolveddindadmotordvehicledcrash,dad25-year-
olddmandisdbroughtdtodadhospitaldthatdhasdsurgerydcapabilitiesdavailable..dComputeddtom
ographydofdthedchestdanddabdomendshowsdandaorticdinjurydanddsplenicdlacerationdwithdfre
edabdominaldfluid.dHisdblooddpressuredfallsdtod70dmmdHgdafterdCT.dThednextdstepdis:
- performdandexploratorydlaparotomy
12. Whichdonedofdthedfollowingdstatementsdregardingdabdominaldtraumadindthedpregnantd
patientdisdTRUE?
- Leakagedofdamnioticdfluiddisdandindicationdfordhospitaldadmission.
13. Thedfirstdmaneuverdtodimprovedoxygenationdafterdchestdinjurydis:
- administerdsupplementaldoxygen
14. Ad25-year-
olddman,dinjureddindadmotordvehiculardcrash,disdadmitteddtodthedemergencyddepartment.d
Hisdpupilsdreactdsluggishlydanddhisdeyesdopendtodpressure.dHeddoesdnotdfollowdcommand
s,dbutdheddoesdmoandperiodically.dHisdrightdarmdisddeformeddandddoesdnotdresponddtodpr
essure;dhowever,dhisdleftdhanddreachesdpurposefullydtowarddthedstimulus.dBothdlegsdareds
tifflydextended.dHisdGCSdscoredis:
-d 9
15. Ad20-year-
olddwomandwhodisdatd32dweeksdgestation,disdstabbeddindthedupperdrightdchest.dIndthede
mergencyddepartment,dherdblooddpressuredisd80/60dmmdHg.dShedisdgaspingdfordbrea
th,dextremelydanxious,danddyellingdfordhelp.dBreathdsoundsdareddiminisheddindthedrig
htdchest.dThedmostdappropriatedfirstdstepdisdto:
- performdneedledordfingerddecompressiondofdthedrightdchest
16. Whichdonedofdthedfollowingdfindingsdindandadultdisdmostdlikelydtodrequiredimmediated
managementdduringdthedprimarydsurvey?
- respiratorydratedofd40dbreathsdperdminute
17. Thedmostdimportant,dimmediatedstepdindthedmanagementdofdandopendpneumothoraxd
is:d-dplacementdofdandocclusiveddressingdoverdthedwound
18. Thedfollowingdaredcontraindicationsdfordtetanusdtoxoiddadministration:
- historydofdneurologicaldreactiondordseveredhypersensitivitydtodthedproduct
19. Ad56-year-
olddmandisdthrowndviolentlydagainstdthedsteeringdwheeldofdhisdtruckdduringdadmotordvehic
ledcrash.dOndarrivaldindthedemergencyddepartmentdhedisddiaphoreticdanddcomplainingdofd
chestdpain.dHisdblooddpressuredisd60/40dmmdHgdanddhisdrespiratorydratedisd40dbreathsdpe
rdminute.dWhichdofdthedfollowingdbestddifferentiatesdcardiacdtamponadedfromdtensiondpn
eumothoraxdasdthedcausedofdhisdhypotension?
- breathdsounds
20. Bronchialdintubationdofdthedrightdordleftdmainstemdbronchusdcandeasilydoccurdduringd
infantdendotrachealdintubationdbecause:
- Thedtracheadisdrelativelydshort.
d d d d
1. Ad22-year-
olddmandisdhypotensivedanddtachycardicdafterdadshotgundwounddtodthedleftdshoulder.dHi
sdblooddpressuredisdinitiallyd80/40dmmdHg.dAfterdinitialdfluiddresuscitationdhisdblooddpr
essuredincreasesdtod122/84dmmdHg.dHisdheartdratedisdnowd100dbeatsdperdminutedanddhi
sdrespiratorydratedisd28dbreathsdperdminute.dAdtubedthoracostomydisdperformeddforddec
reaseddleftdchestdbreathdsoundsdwithdthedreturndofdadsmalldamountdofdblooddanddnodairdl
eak.dAfterdchestdtubedinsertion,dthedmostdappropriatednextdstepdis:
- re-examinedthedchest
2. Adconstructiondworkerdfallsdtwodstoriesdfromdadbuildingdanddsustainsdbilateraldcalcanea
ldfractures.dIndthedemergencyddepartment,dhedisdalert,dvitaldsignsdarednormal,danddhedisdco
mplainingdofdseveredpaindindbothdheelsdanddhisdlowerdback.dLowerdextremitydpulsesdaredst
rongdanddtheredisdnodotherddeformity.dThedsuspectedddiagnosisdisdmostdlikelydtodbedconfir
meddby:
- completedspinedx-raydseries
3. Whichdofdthedfollowingdisdtruedregardingdthedinitialdresuscitationdofdadtraumadpatient?
- Evidencedofdimproveddperfusiondafterdfluiddresuscitationdcoulddinclud
edimprovementdindGlasgowdComadScaledscoredondreevaluation.
4. Indmanagingdadpatientdwithdadseveredtraumaticdbraindinjury,dthedmostdimportantdinitiald
stepdisdto:
-dsecuredthedairway
5. Adpreviouslydhealthy,d70-kgd(154-
pound)dmandsuffersdandestimateddacutedblooddlossdofd2dliters.dWhichdonedofdthedfollowingd
statementsdappliesdtodthisdpatient?
- AndABGdwouldddemonstratedadbaseddeficitdbetweend-6dandd-10dmEq/L.
6. Thedphysiologicaldhypervolemiadofdpregnancydhasdclinicaldsignificancedindthed
managementdofdthedseverelydinjured,dgraviddwomandby:
- increasingdthedvolumedofdblooddlossdtodproducedmaternaldhypotension
7. Thedbestdassessmentdofdfluiddresuscitationdofdthedadultdburndpatientdis:
- urinarydoutputdofd0.5dmL/kg/hr
8. Theddiagnosisdofdshockdmustdinclude:
- evidencedofdinadequatedorgandperfusion
9. Ad7-year-
olddboydisdbroughtdtodthedemergencyddepartmentdbydhisdparentsdseveraldminutesdafterdh
edfelldthroughdadwindow.dHedisdbleedingdprofuselydfromdad6-
cmdwounddofdhisdmedialdrightdthigh.dImmediatedmanagementdofdthedwounddshoulddconsi
stdof:
- directdpressuredondthedwound
10. Fordthedpatientdwithdseveredtraumaticdbraindinjury,dprofounddhypocarbiadshoulddbed
avoideddtodprevent:d-dcerebraldvasoconstrictiondwithddiminisheddperfusion
, 11. Afterdbeingdinvolveddindadmotordvehicledcrash,dad25-year-
olddmandisdbroughtdtodadhospitaldthatdhasdsurgerydcapabilitiesdavailable..dComputeddtom
ographydofdthedchestdanddabdomendshowsdandaorticdinjurydanddsplenicdlacerationdwithdfre
edabdominaldfluid.dHisdblooddpressuredfallsdtod70dmmdHgdafterdCT.dThednextdstepdis:
- performdandexploratorydlaparotomy
12. Whichdonedofdthedfollowingdstatementsdregardingdabdominaldtraumadindthedpregnantd
patientdisdTRUE?
- Leakagedofdamnioticdfluiddisdandindicationdfordhospitaldadmission.
13. Thedfirstdmaneuverdtodimprovedoxygenationdafterdchestdinjurydis:
- administerdsupplementaldoxygen
14. Ad25-year-
olddman,dinjureddindadmotordvehiculardcrash,disdadmitteddtodthedemergencyddepartment.d
Hisdpupilsdreactdsluggishlydanddhisdeyesdopendtodpressure.dHeddoesdnotdfollowdcommand
s,dbutdheddoesdmoandperiodically.dHisdrightdarmdisddeformeddandddoesdnotdresponddtodpr
essure;dhowever,dhisdleftdhanddreachesdpurposefullydtowarddthedstimulus.dBothdlegsdareds
tifflydextended.dHisdGCSdscoredis:
-d 9
15. Ad20-year-
olddwomandwhodisdatd32dweeksdgestation,disdstabbeddindthedupperdrightdchest.dIndthede
mergencyddepartment,dherdblooddpressuredisd80/60dmmdHg.dShedisdgaspingdfordbrea
th,dextremelydanxious,danddyellingdfordhelp.dBreathdsoundsdareddiminisheddindthedrig
htdchest.dThedmostdappropriatedfirstdstepdisdto:
- performdneedledordfingerddecompressiondofdthedrightdchest
16. Whichdonedofdthedfollowingdfindingsdindandadultdisdmostdlikelydtodrequiredimmediated
managementdduringdthedprimarydsurvey?
- respiratorydratedofd40dbreathsdperdminute
17. Thedmostdimportant,dimmediatedstepdindthedmanagementdofdandopendpneumothoraxd
is:d-dplacementdofdandocclusiveddressingdoverdthedwound
18. Thedfollowingdaredcontraindicationsdfordtetanusdtoxoiddadministration:
- historydofdneurologicaldreactiondordseveredhypersensitivitydtodthedproduct
19. Ad56-year-
olddmandisdthrowndviolentlydagainstdthedsteeringdwheeldofdhisdtruckdduringdadmotordvehic
ledcrash.dOndarrivaldindthedemergencyddepartmentdhedisddiaphoreticdanddcomplainingdofd
chestdpain.dHisdblooddpressuredisd60/40dmmdHgdanddhisdrespiratorydratedisd40dbreathsdpe
rdminute.dWhichdofdthedfollowingdbestddifferentiatesdcardiacdtamponadedfromdtensiondpn
eumothoraxdasdthedcausedofdhisdhypotension?
- breathdsounds
20. Bronchialdintubationdofdthedrightdordleftdmainstemdbronchusdcandeasilydoccurdduringd
infantdendotrachealdintubationdbecause:
- Thedtracheadisdrelativelydshort.
