ATLS Pre-test UPDATED ACTUAL Exam
Questions and CORRECT Answers
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: - CORRECT ANSWER -- *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
A construction worker falls two stories from a building and sustains bilateral calcaneal fractures.
In the emergency department, he is alert, vital signs are normal, and he is complaining of severe
pain in both heels and his lower back. Lower extremity pulses are strong and there is no other
deformity. The suspected diagnosis is most likely to be confirmed by: - CORRECT
ANSWER -- complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? -
CORRECT ANSWER -- A patient with a torso gunshot wound and hypotension should
receive crystalloid fluid resuscitation until the blood pressure is normal
-* Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation*
- Massive transfusion is defined as transfusion of more than 10 units of packed red blood cells
and plasma within 24 hours
- When tranexamic acid is administered by pre-hospital providers, a second dose is required
within 24 hours
- Fluid resuscitation is far more important than bleeding control in trauma patient
In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
CORRECT ANSWER -- Secure the airway
, A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters.
Which one of the following statements applies to this patient? - CORRECT ANSWER --
His pulse pressure will be widened.
- His urinary output will be at the lower limits of normal. xxx
- He will have tachycardia, but no change in his systolic blood pressure.
- *An ABG would demonstrate a base deficit between -6 and -10 mEq/L.*
- His systolic blood pressure will be maintained with an elevated diastolic pressure.
The physiological hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by: - CORRECT ANSWER -- increasing the volume of
blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the adult burn patient is: - CORRECT
ANSWER -- urinary output of 0.5 mL/kg/hr
The diagnosis of shock must include: - CORRECT ANSWER -- evidence of inadequate
organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he
fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh.
Immediate management of the wound should consist of: - CORRECT ANSWER -- direct
pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to
prevent: - CORRECT ANSWER -- respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
Questions and CORRECT Answers
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: - CORRECT ANSWER -- *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
A construction worker falls two stories from a building and sustains bilateral calcaneal fractures.
In the emergency department, he is alert, vital signs are normal, and he is complaining of severe
pain in both heels and his lower back. Lower extremity pulses are strong and there is no other
deformity. The suspected diagnosis is most likely to be confirmed by: - CORRECT
ANSWER -- complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? -
CORRECT ANSWER -- A patient with a torso gunshot wound and hypotension should
receive crystalloid fluid resuscitation until the blood pressure is normal
-* Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation*
- Massive transfusion is defined as transfusion of more than 10 units of packed red blood cells
and plasma within 24 hours
- When tranexamic acid is administered by pre-hospital providers, a second dose is required
within 24 hours
- Fluid resuscitation is far more important than bleeding control in trauma patient
In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
CORRECT ANSWER -- Secure the airway
, A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters.
Which one of the following statements applies to this patient? - CORRECT ANSWER --
His pulse pressure will be widened.
- His urinary output will be at the lower limits of normal. xxx
- He will have tachycardia, but no change in his systolic blood pressure.
- *An ABG would demonstrate a base deficit between -6 and -10 mEq/L.*
- His systolic blood pressure will be maintained with an elevated diastolic pressure.
The physiological hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by: - CORRECT ANSWER -- increasing the volume of
blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the adult burn patient is: - CORRECT
ANSWER -- urinary output of 0.5 mL/kg/hr
The diagnosis of shock must include: - CORRECT ANSWER -- evidence of inadequate
organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he
fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh.
Immediate management of the wound should consist of: - CORRECT ANSWER -- direct
pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to
prevent: - CORRECT ANSWER -- respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
