ATLS POST TEST EXAM (2 VERSIONS) 2024
QUESTIONS & CORRECT ANSWERS
GRADED A+
Version 1
1. A 20-year-old athlete is involved in a motorcycle crash after having ridden for hours on a very hot
day. When he arrives in the emergency department, he shouts that he cannot move his legs. On
physical examination, there are no abnormalities of the chest, abdomen, or pelvis. The patient has no
sensation in his legs and cannot move them, but his arms are moving. The patient's respiratory rate is
22, heart rate is 88, and blood pressure is 80/60 mm Hg. He is pale and sweaty. What is the most likely
cause of his hypotension?
a. neurogenic shock *
b. cardiac tamponade
c. myocardial contusion
d. hyperthermia
e. hemorrhagic shock
2. Which one of the findings below requires a definitive airway in trauma patients?
a. facial lacerations
b. repeated vomiting
c. partial thickness facial burns, cough, and hoarseness*
d. sternal fracture
e. Glasgow Coma Scale score of 12
3. Twenty-seven patients are seriously injured in an airplane crash at a local airport. The principles of
triage include:
a. establish a triage site within the hot zone of the crush site
b. treat only the most severely injured patients first
c. immediately transport all patients to the nearest hospital
d. treat the greatest number of patients in the shortest period of time
e. produce the greatest number of survivors based on available resources*
4. Which one of the following statements is correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma.
b. Epidural hematomas are usually seen in the frontal region.
c. Subdural hematomas are caused by injury to the middle meningeal artery.
d. subdural hematomas typically have a lenticular shape on CT scan.
e. The associated brain damage is more severe in epidural hematomas. *
5. An 18-year-old male is brought to the emergency department after having been shot. He has one
bullet wound just below the right clavicle and another just below the costal margin in the right
posterior axillary line. His blood pressure is 110/60 mm Hg. heartrate is 90 beats per minute, and
respiratory rate is 34 breaths per minute. After ensuring a patent airway and inserting two large-
caliber IV lines, the next appropriate step is to:
a. obtain a portable chest x-ray *
b. administer a bolus of additional IV
c. perform a laparotomy
d. obtain an abdominal CT scan
e. perform diagnostic peritoneal lavage
6. A 47-year-old house painter is brought to the hospital after falling 6 meters (20 feet) from a ladder
and landing straddling a fence Examination of his perineum reveals extensive ecchymosis. There is
blood in the external urethral nicatus. The initial diagnostic study for evaluation of the urinary tract in
this patient should be :
a cystoscopy
b. cystography
c. intravenous pyelography
d. CT scan
e. retrograde urethrography*
,
, 7. Neurogenic shock has all of the following characteristics except which?
a. hypotension
b. vasodilation
c. bradycardia
d. neurologic deficit
e. narrowed pulse pressure*
8. Which one of the following statements is false concerning Rh isoimmunization in pregnant trauma
patients?
a. It occurs in blunt or penetrating abdominal trauma.
b. It is produced by minor degrees of fetomaternal hemorrhage.
c. Rh immunoglobulin therapy should be administered to pregnant females who have sustained a
gunshot wound to the leg. *
D. Isoimmunization is not a problem in Rh-positive pregnant patients.
E. Initiation of Rh immunoglobulin therapy does not require proof of fetomaternal hemorrhage.
Rh imunoglobulin rh (-) pada luka dimana tmnya bayi
9. An 18-year-old motorcyclist collides head-on with a pick-up truck and sustains massive facial
injuries. In the emergency department his blood pressure is 150/38mm Hg. heartrate is 88 beats per
minute and regular, and respiratory rate is 26 breaths per minute. His respirations are labored and
sonorous. His Glasgow Coma Scale score is 7. Attempts at orotracheal intubation with restriction of
cervical spinal motion are unsuccessful due to bleeding and distorted anatomy. The patient becomes
apneic. The best procedure for airway management in this situation is:
a. nasotracheal intubation
b. emergency tracheostomy
c. surgical cricothyroidotomy*
d. placement of an oropharyngeal airway
e. placement of NPA
10. A 25-year-old male is brought to the hospital after sustaining partial- and full thickness burns
involving 60% of his body surface area. General surgical services are available. His right arm and hand
are severely burned. There are obvious full thickness burns of the entire right hand and a
circumferential burn of the right arm. Pulses are absent at the right wrist and are not detected by
Doppler examination. Management should include:
a. fasciotomy
b. angiography
c. escharotomy*
d. heparinization
e. tangential excision
11. All of the following are signs of aortic rupture on chest x-ray of a patient who sustained a blunt
decelerating trauma except which one?
a. mediastinal emphysema*
b. presence of a pleural cap
c. obliteration of the aortic knob
d. deviation of the trachea to the
e. depression of the left mainstem bronchus
12. A 30-year-old female is brought to the hospital after a fall from her bicycle.
She was initially unconscious and then regained consciousness en route to the hospital. Thirty minutes
after admission to the emergency department, her Glasgow Coma Scale score decreases to 6. Her
right pupil is larger than the left. She most likely has sustained:
a. a subdural hemorrhage
b. an epidural hemorrhage *
c. an occipital hemorrhage
d. a subarachnoid hemorrhage
QUESTIONS & CORRECT ANSWERS
GRADED A+
Version 1
1. A 20-year-old athlete is involved in a motorcycle crash after having ridden for hours on a very hot
day. When he arrives in the emergency department, he shouts that he cannot move his legs. On
physical examination, there are no abnormalities of the chest, abdomen, or pelvis. The patient has no
sensation in his legs and cannot move them, but his arms are moving. The patient's respiratory rate is
22, heart rate is 88, and blood pressure is 80/60 mm Hg. He is pale and sweaty. What is the most likely
cause of his hypotension?
a. neurogenic shock *
b. cardiac tamponade
c. myocardial contusion
d. hyperthermia
e. hemorrhagic shock
2. Which one of the findings below requires a definitive airway in trauma patients?
a. facial lacerations
b. repeated vomiting
c. partial thickness facial burns, cough, and hoarseness*
d. sternal fracture
e. Glasgow Coma Scale score of 12
3. Twenty-seven patients are seriously injured in an airplane crash at a local airport. The principles of
triage include:
a. establish a triage site within the hot zone of the crush site
b. treat only the most severely injured patients first
c. immediately transport all patients to the nearest hospital
d. treat the greatest number of patients in the shortest period of time
e. produce the greatest number of survivors based on available resources*
4. Which one of the following statements is correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma.
b. Epidural hematomas are usually seen in the frontal region.
c. Subdural hematomas are caused by injury to the middle meningeal artery.
d. subdural hematomas typically have a lenticular shape on CT scan.
e. The associated brain damage is more severe in epidural hematomas. *
5. An 18-year-old male is brought to the emergency department after having been shot. He has one
bullet wound just below the right clavicle and another just below the costal margin in the right
posterior axillary line. His blood pressure is 110/60 mm Hg. heartrate is 90 beats per minute, and
respiratory rate is 34 breaths per minute. After ensuring a patent airway and inserting two large-
caliber IV lines, the next appropriate step is to:
a. obtain a portable chest x-ray *
b. administer a bolus of additional IV
c. perform a laparotomy
d. obtain an abdominal CT scan
e. perform diagnostic peritoneal lavage
6. A 47-year-old house painter is brought to the hospital after falling 6 meters (20 feet) from a ladder
and landing straddling a fence Examination of his perineum reveals extensive ecchymosis. There is
blood in the external urethral nicatus. The initial diagnostic study for evaluation of the urinary tract in
this patient should be :
a cystoscopy
b. cystography
c. intravenous pyelography
d. CT scan
e. retrograde urethrography*
,
, 7. Neurogenic shock has all of the following characteristics except which?
a. hypotension
b. vasodilation
c. bradycardia
d. neurologic deficit
e. narrowed pulse pressure*
8. Which one of the following statements is false concerning Rh isoimmunization in pregnant trauma
patients?
a. It occurs in blunt or penetrating abdominal trauma.
b. It is produced by minor degrees of fetomaternal hemorrhage.
c. Rh immunoglobulin therapy should be administered to pregnant females who have sustained a
gunshot wound to the leg. *
D. Isoimmunization is not a problem in Rh-positive pregnant patients.
E. Initiation of Rh immunoglobulin therapy does not require proof of fetomaternal hemorrhage.
Rh imunoglobulin rh (-) pada luka dimana tmnya bayi
9. An 18-year-old motorcyclist collides head-on with a pick-up truck and sustains massive facial
injuries. In the emergency department his blood pressure is 150/38mm Hg. heartrate is 88 beats per
minute and regular, and respiratory rate is 26 breaths per minute. His respirations are labored and
sonorous. His Glasgow Coma Scale score is 7. Attempts at orotracheal intubation with restriction of
cervical spinal motion are unsuccessful due to bleeding and distorted anatomy. The patient becomes
apneic. The best procedure for airway management in this situation is:
a. nasotracheal intubation
b. emergency tracheostomy
c. surgical cricothyroidotomy*
d. placement of an oropharyngeal airway
e. placement of NPA
10. A 25-year-old male is brought to the hospital after sustaining partial- and full thickness burns
involving 60% of his body surface area. General surgical services are available. His right arm and hand
are severely burned. There are obvious full thickness burns of the entire right hand and a
circumferential burn of the right arm. Pulses are absent at the right wrist and are not detected by
Doppler examination. Management should include:
a. fasciotomy
b. angiography
c. escharotomy*
d. heparinization
e. tangential excision
11. All of the following are signs of aortic rupture on chest x-ray of a patient who sustained a blunt
decelerating trauma except which one?
a. mediastinal emphysema*
b. presence of a pleural cap
c. obliteration of the aortic knob
d. deviation of the trachea to the
e. depression of the left mainstem bronchus
12. A 30-year-old female is brought to the hospital after a fall from her bicycle.
She was initially unconscious and then regained consciousness en route to the hospital. Thirty minutes
after admission to the emergency department, her Glasgow Coma Scale score decreases to 6. Her
right pupil is larger than the left. She most likely has sustained:
a. a subdural hemorrhage
b. an epidural hemorrhage *
c. an occipital hemorrhage
d. a subarachnoid hemorrhage
