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1. A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the
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left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid
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resuscitation his blood pressure increases to 122/84 mm Hg. His heart rate is now
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100 beats per minute and his respiratory rate is 28 breaths per minute. A tube
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thoracostomy is performed for decreased left chest breath sounds with the
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return of a small amount of blood and no air leak. Afterchesttube insertion, the most
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appropriate next step is:
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Select one: gy
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reexaminethechest y
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b.
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performanaortogram c. y
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obtaina CTscanofthe chest d.
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obtainarterialbloodgasanalyses e.
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performtransesophagealechocardiography
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,:A)Reexaminethechest
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2. Aconstructionworkerfallstwostoriesfromabuildingandsustainsbilateral
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calcaneal fractures. In the emergency department, he is alert, vital signs are
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normal, and he is complaining of severe pain in both heels and his lower back.
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Lower extremity pulses are strong and there is no other deformity.The
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suspected diagnosis is most likely to be confirmed by:
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Select one: gy
a.
angiograph
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compartmentpressures y
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c.
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retrogradeurethrogram y
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d.
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Dopplerultrasoundstudies y
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e.
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complete spine x-ray series gy gy gy
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:e) Complete spine x-ray series
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3. Whichofthefollowingistrueregardingtheinitialresuscitationofatrauma
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patient?
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Select one: gy
a.
Apatientthatpresentswithatorsogunshotwoundandishypotensiveshould
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, receive crystalloid fluid resuscitation until the blood pressure is normal b.
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Evidenceofimproved perfusionafterfluidresuscitationcouldinclude im- gy gy gy gy gy gy gy gy gy
provement in Glasgow coma scale score on reevaluation
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c.
Massivetransfusionisdefinedastransfusionofmorethan>10ofpackedred blood
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cells and plasma in 24 hours
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d.
Whentranexamicacidis administeredbypre-hospitalprovidersasecond dose is
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required within 24 hours
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e.
Fluid resuscitation is far more important than bleeding control in trauma patients
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Evidenceofimprovedperfusionafterfluidresuscitationcouldincludeimprovement in
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Glasgow coma scale score on reevaluation
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4. Inmanaging a patientwith a severetraumaticbrain injury,themostimpor- tant
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initial step is to:
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a.
Securetheairway b. y
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obtainac-spinefilm c. y
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supportthecirculation y
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d.
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controlscalphemorrhage e. y
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, determinetheGCSscore y
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Feedback
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:a. Secure the airway
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5. Apreviouslyhealthy,70-kg(154-pound)mansuffersanestimatedacute
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blood loss of 2 liters.
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Whichone ofthe following statementsapplies tothis patient? Select
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one:
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a.
Hispulsepressurewillbe widened. b.
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His urinary output will be at the lower limits of normal.
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