ATLS Pretest
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The
most appropriate first step is to: - ANS-perform needle or finger decompression of the right
chest
\A 22-year-old female athlete is stabbed in her left chest at the third interspace in the anterior
axillary line. On admission to the emergency department and 15 minutes after the incident, she
is awake and alert. Her heart rate is 100 beats per minute, blood pressure 80/60 mm Hg, and
respiratory rate 20 breaths per minute. A chest x-ray reveals a large left hemothorax. A left
chest tube is placed with an immediate return of 1600 mL of blood. The next management step
for this patient is: - ANS-prepare for an exploratory thoracotomy
\A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure
increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate
is 28 breaths per minute. A tube thoracostomy is performed for decreased left chest breath
sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the
most appropriate next step is: - ANS-re-examine the chest
\A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital no surgical capabilities are available. In the emergency department, a chest
tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the patient in
transfer. Just before the patient is placed in the ambulance for transfer, his blood pressure
decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute. The next step
should be to: - ANS-repeat the primary survey and proceed with transfer
\A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation and is
brought by ambulance to a hospital that has full surgical capabilities. His wounds are all above
the nipple. He is endotracheally intubated, closed tube thoracostomy is performed, fluid
resuscitation is initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal
injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% O2). 1500 mL of blood has
drained from the right chest. The most appropriate next step in managing this patient is to: -
ANS-urgently transfer the patient to the operating room
\A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
department. His pupils react sluggishly and his eyes open to pressure. He does not follow
commands, but he does moan periodically. His right arm is deformed and does not respond to
pressure; however, his left hand reaches purposefully toward the stimulus. Both legs are stiffly
extended. His GCS score is: - ANS-9
\A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he
is extricated. On arrival in the emergency department, his right lower extremity is cool, mottled,
insensate, and motionless. Despite normal vital signs, pulses cannot be palpated below the right
femoral artery and the muscles of the lower extremity are firm and hard. During the
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The
most appropriate first step is to: - ANS-perform needle or finger decompression of the right
chest
\A 22-year-old female athlete is stabbed in her left chest at the third interspace in the anterior
axillary line. On admission to the emergency department and 15 minutes after the incident, she
is awake and alert. Her heart rate is 100 beats per minute, blood pressure 80/60 mm Hg, and
respiratory rate 20 breaths per minute. A chest x-ray reveals a large left hemothorax. A left
chest tube is placed with an immediate return of 1600 mL of blood. The next management step
for this patient is: - ANS-prepare for an exploratory thoracotomy
\A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure
increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate
is 28 breaths per minute. A tube thoracostomy is performed for decreased left chest breath
sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the
most appropriate next step is: - ANS-re-examine the chest
\A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital no surgical capabilities are available. In the emergency department, a chest
tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the patient in
transfer. Just before the patient is placed in the ambulance for transfer, his blood pressure
decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute. The next step
should be to: - ANS-repeat the primary survey and proceed with transfer
\A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation and is
brought by ambulance to a hospital that has full surgical capabilities. His wounds are all above
the nipple. He is endotracheally intubated, closed tube thoracostomy is performed, fluid
resuscitation is initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal
injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% O2). 1500 mL of blood has
drained from the right chest. The most appropriate next step in managing this patient is to: -
ANS-urgently transfer the patient to the operating room
\A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
department. His pupils react sluggishly and his eyes open to pressure. He does not follow
commands, but he does moan periodically. His right arm is deformed and does not respond to
pressure; however, his left hand reaches purposefully toward the stimulus. Both legs are stiffly
extended. His GCS score is: - ANS-9
\A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he
is extricated. On arrival in the emergency department, his right lower extremity is cool, mottled,
insensate, and motionless. Despite normal vital signs, pulses cannot be palpated below the right
femoral artery and the muscles of the lower extremity are firm and hard. During the
