ATLS EXAM UPDATED ACTUAL Exam
Questions and CORRECT Answers
True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults. -
CORRECT ANSWER -True
In the elderly population, what is decreased physiological reserve? - CORRECT
ANSWER -aging is characterized by impaired adaptive and homeostatic mechanisms that
caused an increased susceptibility to the stress of injury. Insults tolerated by the younger
population can lead to devastating results in elderly patients.
Pre-existing conditions that affect morbidity and mortality include: - CORRECT
ANSWER -cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - CORRECT ANSWER -
Fall. Nonfatal falls are common in women and fractures are common in women who fall. Falls
are the most common cause of TBI.
In the elderly population, what are risk factors for falls? - CORRECT ANSWER -
advanced age, physical impairment, history of previous fall, medication use, dementia, unsteady
gait, and visual, cognitive impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve
other vehicles. Why? - CORRECT ANSWER -Older people drive on more familiar roads
and at lower speeds and tend to drive during the day. Older people have slower reaction time, a
larger blind spot, limited cervical mobility, decreased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older adults remains
high - CORRECT ANSWER -True
,Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an adequate
number of hair follicles, will result in a full thickness burn in older patients. - CORRECT
ANSWER -this is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are not
obstructing the airway, leave them in place for what? - CORRECT ANSWER -bag mask
ventilation, as it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other sedatives
should be reduced to what percentage to minimize the risk of cardiovascular depression? -
CORRECT ANSWER -20-40%
Functional changes in cardiac system include declining function, decreased sensitivity to
catecholamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
blockers) - CORRECT ANSWER -this results in lack of classic response to hypovolemia,
risk for cardiac ischemia, elevated BP at baseline, and increased risk of dysrythmias.
Functional changes in pulmonary system include decreased elastic recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex - CORRECT ANSWER -
thus they are at increased risk for respiratory failure, increased risk for pneumonia, and poor
tolerance to rib fractures
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased
sensitivity to ADH and aldosterone - CORRECT ANSWER -resulting in drug dosing for
renal insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow
may be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat -
CORRECT ANSWER -resulting in increased risk for fractures, decreased mobility,
difficulty for oral intubation, risk of skin injury, increased risk for hypothermia, challenges in
rehabiliation
, Functional changes in Endocrine system include decreased production and response to thyroxin
and decreased dehydroepiandrosterone (DHEA) - CORRECT ANSWER -resulting in
occult hypothyroidism, relative hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have multilevel
degenerative changes affecting disk spaces and posterior elements associated with severe central
canal stenosis, cord compression, and myelomalacia - CORRECT ANSWER -true
In elderly population, due to their changes in pulmonary system, placing a gauze between gums
and cheek to achieve seal when using bag valve mask ventilation is okay. In addition, because
aging causes a suppressed heart rate response to hypoxia...... - CORRECT ANSWER -
respiratory failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at significant
risk for being inaccurately categorized as hemodynamically stable. - CORRECT
ANSWER -Elderly patients have a fixed heart rate and fixed cardiac output, thus, their
response to hypovolemia will involve increasing their systemic vascular resistance. Furthermore,
since older patients have HTN, an acceptable BP may truly reflect a hypotensive state. A systolic
BP of 110 is to be utilized as the threshold for identifying hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients - CORRECT ANSWER -BP in
older patients may look normal due to the medications they are on. Use lactate and base deficit to
evaluate for evidence of shock
what 2 factors place elderly patients at risk for intracranial hemorrhage? - CORRECT
ANSWER -aging causes dura to become more adherent to the skull increasing risk of
injury and older patients are on anticoagulant and antiplatelet medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly
patients as risk for hypothermia and complications for immobility. - CORRECT
ANSWER -Rapid evaluation and when possible early liberation from spine boards and
cervical collars will minimize complications.
Questions and CORRECT Answers
True or false? Although the mechanism of injury may be similar to those for the younger
population, data shows increased mortality with similar severity of injury in older adults. -
CORRECT ANSWER -True
In the elderly population, what is decreased physiological reserve? - CORRECT
ANSWER -aging is characterized by impaired adaptive and homeostatic mechanisms that
caused an increased susceptibility to the stress of injury. Insults tolerated by the younger
population can lead to devastating results in elderly patients.
Pre-existing conditions that affect morbidity and mortality include: - CORRECT
ANSWER -cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - CORRECT ANSWER -
Fall. Nonfatal falls are common in women and fractures are common in women who fall. Falls
are the most common cause of TBI.
In the elderly population, what are risk factors for falls? - CORRECT ANSWER -
advanced age, physical impairment, history of previous fall, medication use, dementia, unsteady
gait, and visual, cognitive impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve
other vehicles. Why? - CORRECT ANSWER -Older people drive on more familiar roads
and at lower speeds and tend to drive during the day. Older people have slower reaction time, a
larger blind spot, limited cervical mobility, decreased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older adults remains
high - CORRECT ANSWER -True
,Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an adequate
number of hair follicles, will result in a full thickness burn in older patients. - CORRECT
ANSWER -this is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are not
obstructing the airway, leave them in place for what? - CORRECT ANSWER -bag mask
ventilation, as it improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other sedatives
should be reduced to what percentage to minimize the risk of cardiovascular depression? -
CORRECT ANSWER -20-40%
Functional changes in cardiac system include declining function, decreased sensitivity to
catecholamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta
blockers) - CORRECT ANSWER -this results in lack of classic response to hypovolemia,
risk for cardiac ischemia, elevated BP at baseline, and increased risk of dysrythmias.
Functional changes in pulmonary system include decreased elastic recoil, reduced residual
capacity, decreased gas exchange and decreased cough reflex - CORRECT ANSWER -
thus they are at increased risk for respiratory failure, increased risk for pneumonia, and poor
tolerance to rib fractures
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased
sensitivity to ADH and aldosterone - CORRECT ANSWER -resulting in drug dosing for
renal insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow
may be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and
cartilage, c spine degenerative changes and loss of skin elastin and subcutaneous fat -
CORRECT ANSWER -resulting in increased risk for fractures, decreased mobility,
difficulty for oral intubation, risk of skin injury, increased risk for hypothermia, challenges in
rehabiliation
, Functional changes in Endocrine system include decreased production and response to thyroxin
and decreased dehydroepiandrosterone (DHEA) - CORRECT ANSWER -resulting in
occult hypothyroidism, relative hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have multilevel
degenerative changes affecting disk spaces and posterior elements associated with severe central
canal stenosis, cord compression, and myelomalacia - CORRECT ANSWER -true
In elderly population, due to their changes in pulmonary system, placing a gauze between gums
and cheek to achieve seal when using bag valve mask ventilation is okay. In addition, because
aging causes a suppressed heart rate response to hypoxia...... - CORRECT ANSWER -
respiratory failure may present insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at significant
risk for being inaccurately categorized as hemodynamically stable. - CORRECT
ANSWER -Elderly patients have a fixed heart rate and fixed cardiac output, thus, their
response to hypovolemia will involve increasing their systemic vascular resistance. Furthermore,
since older patients have HTN, an acceptable BP may truly reflect a hypotensive state. A systolic
BP of 110 is to be utilized as the threshold for identifying hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients - CORRECT ANSWER -BP in
older patients may look normal due to the medications they are on. Use lactate and base deficit to
evaluate for evidence of shock
what 2 factors place elderly patients at risk for intracranial hemorrhage? - CORRECT
ANSWER -aging causes dura to become more adherent to the skull increasing risk of
injury and older patients are on anticoagulant and antiplatelet medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly
patients as risk for hypothermia and complications for immobility. - CORRECT
ANSWER -Rapid evaluation and when possible early liberation from spine boards and
cervical collars will minimize complications.
