ATLS Pretest & ALL Modules
1. re-examine the chest: 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:
2. complete spine x-ray series: 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:
3. Evidence of improved perfusion after fluid resuscitation could include im-
provement in Glasgow Coma Scale score on reevaluation.: Which of the following is true
regarding the initial resuscitation of a trauma patient?
4. secure the airway: In managing a patient with a severe traumatic brain injury, the most important initial step is
to:
5. An ABG would demonstrate a base deficit between -6 and -10 mEq/L.: A
previously healthy, 70-kg (154-pound) man sutters an estimated acute blood loss of 2 liters. Which one of the following
statements applies to this patient?
6. increasing the volume of blood loss to produce maternal hypotension: The
physiological hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid
, ATLS Pretest & ALL Modules
woman by:
7. urinary output of 0.5 mL/kg/hr: The best assessment of fluid resuscitation of the adult burn patient
is:
8. evidence of inadequate organ perfusion: The diagnosis of shock must include:
9. direct pressure on the wound: 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:
10. cerebral vasoconstriction with diminished perfusion: For the patient with severe trau-
matic brain injury, profound hypocarbia should be avoided to prevent:
11. perform an exploratory laparotomy: After being involved in a motor vehicle crash, a 25-year-old
man is brought to a hospital that has surgery capabilities available.. Computed tomography of the chest and abdomen
shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT.
The next step is:
, ATLS Pretest & ALL Modules
12. Leakage of amniotic fluid is an indication for hospital admission.: Which one of
the following statements regarding abdominal trauma in the pregnant patient is TRUE?
13. administer supplemental oxygen: The first maneuver to improve oxygenation after chest injury is:
14. 9: 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:
15. perform needle or finger decompression of the right chest: 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:
16. respiratory rate of 40 breaths per minute: Which one of the following findings in an adult is
most likely to require immediate management during the primary survey?
17. placement of an occlusive dressing over the wound: The most important, immediate step
in the management of an open pneumothorax is:
18. history of neurological reaction or severe hypersensitivity to the product: The
following are contraindications for tetanus toxoid administration:
19. breath sounds: A 56-year-old man is thrown violently against the steering wheel of his truck during a motor
vehicle crash. On arrival in the emergency department he is diaphoretic and complaining of chest pain. His blood
, ATLS Pretest & ALL Modules
pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per minute. Which of the following best ditterentiates
cardiac tamponade from tension pneumothorax as the cause of his hypotension?
20. The trachea is relatively short.: Bronchial intubation of the right or left mainstem bronchus can easily
occur during infant endotracheal intubation because:
21. urgently transfer the patient to the operating room: 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 nex
step in managing this patient is to:
22. restrict cervical motion and attempt orotracheal intubation using 2 people: A
39-year-old man is admitted to the emergency department after an automobile collision. He is cyanotic, has insuflcient
1. re-examine the chest: 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:
2. complete spine x-ray series: 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:
3. Evidence of improved perfusion after fluid resuscitation could include im-
provement in Glasgow Coma Scale score on reevaluation.: Which of the following is true
regarding the initial resuscitation of a trauma patient?
4. secure the airway: In managing a patient with a severe traumatic brain injury, the most important initial step is
to:
5. An ABG would demonstrate a base deficit between -6 and -10 mEq/L.: A
previously healthy, 70-kg (154-pound) man sutters an estimated acute blood loss of 2 liters. Which one of the following
statements applies to this patient?
6. increasing the volume of blood loss to produce maternal hypotension: The
physiological hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid
, ATLS Pretest & ALL Modules
woman by:
7. urinary output of 0.5 mL/kg/hr: The best assessment of fluid resuscitation of the adult burn patient
is:
8. evidence of inadequate organ perfusion: The diagnosis of shock must include:
9. direct pressure on the wound: 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:
10. cerebral vasoconstriction with diminished perfusion: For the patient with severe trau-
matic brain injury, profound hypocarbia should be avoided to prevent:
11. perform an exploratory laparotomy: After being involved in a motor vehicle crash, a 25-year-old
man is brought to a hospital that has surgery capabilities available.. Computed tomography of the chest and abdomen
shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT.
The next step is:
, ATLS Pretest & ALL Modules
12. Leakage of amniotic fluid is an indication for hospital admission.: Which one of
the following statements regarding abdominal trauma in the pregnant patient is TRUE?
13. administer supplemental oxygen: The first maneuver to improve oxygenation after chest injury is:
14. 9: 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:
15. perform needle or finger decompression of the right chest: 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:
16. respiratory rate of 40 breaths per minute: Which one of the following findings in an adult is
most likely to require immediate management during the primary survey?
17. placement of an occlusive dressing over the wound: The most important, immediate step
in the management of an open pneumothorax is:
18. history of neurological reaction or severe hypersensitivity to the product: The
following are contraindications for tetanus toxoid administration:
19. breath sounds: A 56-year-old man is thrown violently against the steering wheel of his truck during a motor
vehicle crash. On arrival in the emergency department he is diaphoretic and complaining of chest pain. His blood
, ATLS Pretest & ALL Modules
pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per minute. Which of the following best ditterentiates
cardiac tamponade from tension pneumothorax as the cause of his hypotension?
20. The trachea is relatively short.: Bronchial intubation of the right or left mainstem bronchus can easily
occur during infant endotracheal intubation because:
21. urgently transfer the patient to the operating room: 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 nex
step in managing this patient is to:
22. restrict cervical motion and attempt orotracheal intubation using 2 people: A
39-year-old man is admitted to the emergency department after an automobile collision. He is cyanotic, has insuflcient
