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MAP CERTIFICATION TEST LATEST REAL EXAM 180 QUESTIONS AND
CORRECT ANSWERS|ALREADY GRADED A+||BRAND NEW 2025/2026
A 22-year-old male sustains a shotgun wound to the left shoulder and chest at close range.
His BP is 80/40mmHg and his HR is 130bpm. After 2 liters of crystalloid solution are rapidly
infused, his BP increases to 122/84, and HR decreases to 100bpm. He is tachypneic with
RR of 28. On physical examination, his breath sounds are decreased at the left upper chest
with dullness on percussion. A large caliber (36 French) tube thoracostomy is inserted in
the fifth intercostal space with the return of 200ml of blood and no air leak. The most
appropriate next step is to:
A. insert a foley catheter
B. Begin to transfuse o-negative blood
C. Perform thoracotomy
D. Obtain a CT-scan of chest and abdomen
E. Repeat the physical examination of the chest - ......ANSWER........E. Repeat the physical
examination of the chest
A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
awake and alert. Her heart rate is 100 beats per minute, BP 80/60mmHg, and respiratory
rate is 20 breaths per minute. A chest x-ray reveals a large left hemithorax. A left chest tube
is placed with an immediate return of 1600ml of blood. The next management step for this
patient is:
A. perform a thoracoscopy
B. Perform an arch aortogram
C. Insert a second left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ......ANSWER........D. Prepare for an exploratory thoracotomy
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A 22-year-old man is brought to the hospital after crashing his motorcycle into a telephone
pole. He is unconscious and in profound shock. He has no open wounds or obvious
fractures. The cause of his shock is MOST LIKELY caused by:
A. A subdural hematoma
B. An epidural hematoma
C. A transected lumbar spinal cord
D. A basilar skull fracture
E. Hemorrhage into the chest or abdomen - ......ANSWER........E. Hemorrhage into the
chest or abdomen
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is initially 80/40mmHg. After 2 liters of crystalloid solution his blood
pressure increases to 122/84mmHg. His heart rate is now 100 beats per minute, and his
respiratory rate is 28 breaths per minute. His breath sounds are decreased in the left
hemithorax, and after initial IV fluid resuscitation, a closed tube thoracostomy is
performed for decreased left breath sound with the return of small amount of blood and no
air leak. After chest tube insertion, the most appropriate next step is to:
A. Reexamine the chest
B. Perform an aortogram
C. Obtain a CT-scan of the chest
D. Obtain arterial blood gas analyses
E. Perform transesophageal echocardiography - ......ANSWER........A. Reexamine the chest
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital at which surgical capabilities are not available. In the ED, a chest tube
is inserted and 700ml of blood is evacuated. The trauma center accepts the patient in
transfer. Just before the patient is placed in an ambulance for transfer, his blood pressure
decreases to 80/68mmHg, and his heart rate increases to 136 beats per minute. The next
step should be to:
A. Clamp the chest tube
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B. Cancel the patients transfer
C. Perform an ED thoracotomy
D. Repeat the primary survey and proceed with transfer
E. Delay the transfer until the referring doctor can contact a thoracic surgeon.
- ......ANSWER........D. Repeat the primary survey and proceed with transfer
A 23-year-old construction worker is brought to the ED after falling more than 9 meters
from scaffolding. He is complaining bitterly of lower abdominal and lower limb pain and
has obvious deformity of both lower legs with bilateral open tibial fractures. Which one of
the following statements concerning this patient is true?
A. Pelvic injury can be ruled out based on the mechanism of injury
B. Blood loss from the lower limb is most likely because of his hypotension
C. Spinal cord injury is the most likely because of his hypotension
D. X-ray of the chest and pelvis are important adjuncts in his assessment
E. Aortic injury is the most likely because of his tachycardia. - ......ANSWER........D. X-ray of
the chest and pelvis are important adjuncts in his assessment
A 23-year-old man is brought immediately to the ED from the hospitals parking lot where
he was shot in the lower abdomen. Examination reveals a single bullet wound. He is
breathing and has a thready pulse. However, he is unconscious and has no detectable
blood pressure. Optimal immediate management is to:
A. Perform a diagnostic peritoneal lavage
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - ......ANSWER........D.
Transfer the patient to the operating room, while initiating fluid therapy
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A 23-year-old man sustains three 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 intubates, closed tube
thoracostomy is performed, and 2 liters of crystalloid solution are infused through 2 large-
caliber IVs. His BP I 60/0mmHg, heart rate is 160 beats per minute, and respiratory rate is
14 breaths per minute (ventilated with 100% O2). 1500ml of blood has drained from the
right chest. The most appropriate next step in managing this patient is to:
A. Perform FAST
B. Obtain a CT of the chest
C. Perform angiography
D. Urgently transfer the patient to the operating room
E. Immediately transfer the patient to a trauma center. - ......ANSWER........D. Urgently
transfer the patient to the operating room
A 24-year-old man sustains multiple fractured ribs bilaterally because of being crushed in
a press at a plywood factory. Examination in the ED reveals a flail segment of the patient's
thorax. Primary resuscitation includes high-flow oxygen administration via a
nonrebreathing mask, and initiation of Ringers lactate solution. The patient exhibits
progressive confusion, cyanosis and tachypnea. Management at this time should consist
of:
A. Intravenous sedation
B. External stabilization of the chest wall
C. Increasing the FIO2 in the inspired gas
D. Intercostal nerve blocks for pain relief
E. Endotracheal intubation and mechanical ventilation. - ......ANSWER........E.
Endotracheal intubation and mechanical ventilation
A 24-year-old woman passenger in an automobile strikes the wind screen with her face
during a head-on collision. In the ED, she is talking and has marked facial edema and
crepitus. The highest priority should be given to:
A. Lateral c-spine x-ray
MAP CERTIFICATION TEST LATEST REAL EXAM 180 QUESTIONS AND
CORRECT ANSWERS|ALREADY GRADED A+||BRAND NEW 2025/2026
A 22-year-old male sustains a shotgun wound to the left shoulder and chest at close range.
His BP is 80/40mmHg and his HR is 130bpm. After 2 liters of crystalloid solution are rapidly
infused, his BP increases to 122/84, and HR decreases to 100bpm. He is tachypneic with
RR of 28. On physical examination, his breath sounds are decreased at the left upper chest
with dullness on percussion. A large caliber (36 French) tube thoracostomy is inserted in
the fifth intercostal space with the return of 200ml of blood and no air leak. The most
appropriate next step is to:
A. insert a foley catheter
B. Begin to transfuse o-negative blood
C. Perform thoracotomy
D. Obtain a CT-scan of chest and abdomen
E. Repeat the physical examination of the chest - ......ANSWER........E. Repeat the physical
examination of the chest
A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
awake and alert. Her heart rate is 100 beats per minute, BP 80/60mmHg, and respiratory
rate is 20 breaths per minute. A chest x-ray reveals a large left hemithorax. A left chest tube
is placed with an immediate return of 1600ml of blood. The next management step for this
patient is:
A. perform a thoracoscopy
B. Perform an arch aortogram
C. Insert a second left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ......ANSWER........D. Prepare for an exploratory thoracotomy
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A 22-year-old man is brought to the hospital after crashing his motorcycle into a telephone
pole. He is unconscious and in profound shock. He has no open wounds or obvious
fractures. The cause of his shock is MOST LIKELY caused by:
A. A subdural hematoma
B. An epidural hematoma
C. A transected lumbar spinal cord
D. A basilar skull fracture
E. Hemorrhage into the chest or abdomen - ......ANSWER........E. Hemorrhage into the
chest or abdomen
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is initially 80/40mmHg. After 2 liters of crystalloid solution his blood
pressure increases to 122/84mmHg. His heart rate is now 100 beats per minute, and his
respiratory rate is 28 breaths per minute. His breath sounds are decreased in the left
hemithorax, and after initial IV fluid resuscitation, a closed tube thoracostomy is
performed for decreased left breath sound with the return of small amount of blood and no
air leak. After chest tube insertion, the most appropriate next step is to:
A. Reexamine the chest
B. Perform an aortogram
C. Obtain a CT-scan of the chest
D. Obtain arterial blood gas analyses
E. Perform transesophageal echocardiography - ......ANSWER........A. Reexamine the chest
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital at which surgical capabilities are not available. In the ED, a chest tube
is inserted and 700ml of blood is evacuated. The trauma center accepts the patient in
transfer. Just before the patient is placed in an ambulance for transfer, his blood pressure
decreases to 80/68mmHg, and his heart rate increases to 136 beats per minute. The next
step should be to:
A. Clamp the chest tube
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B. Cancel the patients transfer
C. Perform an ED thoracotomy
D. Repeat the primary survey and proceed with transfer
E. Delay the transfer until the referring doctor can contact a thoracic surgeon.
- ......ANSWER........D. Repeat the primary survey and proceed with transfer
A 23-year-old construction worker is brought to the ED after falling more than 9 meters
from scaffolding. He is complaining bitterly of lower abdominal and lower limb pain and
has obvious deformity of both lower legs with bilateral open tibial fractures. Which one of
the following statements concerning this patient is true?
A. Pelvic injury can be ruled out based on the mechanism of injury
B. Blood loss from the lower limb is most likely because of his hypotension
C. Spinal cord injury is the most likely because of his hypotension
D. X-ray of the chest and pelvis are important adjuncts in his assessment
E. Aortic injury is the most likely because of his tachycardia. - ......ANSWER........D. X-ray of
the chest and pelvis are important adjuncts in his assessment
A 23-year-old man is brought immediately to the ED from the hospitals parking lot where
he was shot in the lower abdomen. Examination reveals a single bullet wound. He is
breathing and has a thready pulse. However, he is unconscious and has no detectable
blood pressure. Optimal immediate management is to:
A. Perform a diagnostic peritoneal lavage
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - ......ANSWER........D.
Transfer the patient to the operating room, while initiating fluid therapy
, 4 of 61
A 23-year-old man sustains three 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 intubates, closed tube
thoracostomy is performed, and 2 liters of crystalloid solution are infused through 2 large-
caliber IVs. His BP I 60/0mmHg, heart rate is 160 beats per minute, and respiratory rate is
14 breaths per minute (ventilated with 100% O2). 1500ml of blood has drained from the
right chest. The most appropriate next step in managing this patient is to:
A. Perform FAST
B. Obtain a CT of the chest
C. Perform angiography
D. Urgently transfer the patient to the operating room
E. Immediately transfer the patient to a trauma center. - ......ANSWER........D. Urgently
transfer the patient to the operating room
A 24-year-old man sustains multiple fractured ribs bilaterally because of being crushed in
a press at a plywood factory. Examination in the ED reveals a flail segment of the patient's
thorax. Primary resuscitation includes high-flow oxygen administration via a
nonrebreathing mask, and initiation of Ringers lactate solution. The patient exhibits
progressive confusion, cyanosis and tachypnea. Management at this time should consist
of:
A. Intravenous sedation
B. External stabilization of the chest wall
C. Increasing the FIO2 in the inspired gas
D. Intercostal nerve blocks for pain relief
E. Endotracheal intubation and mechanical ventilation. - ......ANSWER........E.
Endotracheal intubation and mechanical ventilation
A 24-year-old woman passenger in an automobile strikes the wind screen with her face
during a head-on collision. In the ED, she is talking and has marked facial edema and
crepitus. The highest priority should be given to:
A. Lateral c-spine x-ray
