ATLS Pre-test Questions & Answers
1.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 initia
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
ANS - *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
2.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
ANS - complete spine x-ray series
3.Which of the following is true regarding the initial resuscitation of a
trauma patient?
1/
15
, - A patient with a torso gunshot wound and hypotension should receive
crystalloid fluid resuscitation until the blood pressure is normal
-* ANS Evidence of improved perfusion after fluid resuscitation could
include improve- ment 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 traum
patient
4.In managing a patient with a severe traumatic brain injury, the most
impor- tant initial step is to
ANS - Secure the airway
5.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?
- 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.
- * ANS 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.
2/
15
1.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 initia
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
ANS - *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
2.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
ANS - complete spine x-ray series
3.Which of the following is true regarding the initial resuscitation of a
trauma patient?
1/
15
, - A patient with a torso gunshot wound and hypotension should receive
crystalloid fluid resuscitation until the blood pressure is normal
-* ANS Evidence of improved perfusion after fluid resuscitation could
include improve- ment 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 traum
patient
4.In managing a patient with a severe traumatic brain injury, the most
impor- tant initial step is to
ANS - Secure the airway
5.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?
- 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.
- * ANS 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.
2/
15
