ATLS
ATLS POST TEST EXAM QUESTIONS AND ANSWERS
A 22 year old male is brought by ambulance to a small community
hospital after falling from the top of an 8 foot ladder. Initially, he was
found to have a large right pneumothorax. A chest tube was inserted
and connected to an underwater seal drainage collection system with
negative pressure. A repeat CXR demonstrates a residual, large right
pneumothorax. After transferring the patient to a verified trauma
center, a third chest x-ray reveals a persistent right pneumothorax. The
chest tube appears to be functioning and in good position. He remains
hemodynamically normal with no signs of respiratory distress. The most
likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury - correct answer E. Tracheobronchial injury
,ATLS
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL
intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray - correct answer D. oxygen saturation
>92%
-> if it says ESOPHAGEAL, go with this answer
Which of the following signs necessitates the need for a definitive
airway in severe trauma patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12 - correct answer C. Severe maxillofacial trauma
Twenty seven people are severely injured in an aircraft crash at a local
airport. The principles of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
,ATLS
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available
resources - correct answer E. Produce the greatest number of survivors
based on available resources
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral
hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal
artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas -
correct answer A. Cerebral contusions may coalesce to form an
intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He has one
bullet wound just below the right clavicle and another just below the
costal margin in the right posterior axillary line. His blood pressure is
110/60, heart rate of 90, and respiratory rate of 34. After ensuring a
patent airway and inserting 2 large caliber IV lines, the next most
appropriate step is to:
, ATLS
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage - correct answer A. Obtain a
portable chest x-ray
need more info on chest, not abdomen
Which of the following should be performed FIRST in any patient whose
injuries may include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - correct answer D. Ensuring
adequate oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest
at close range. His BP is 80/40 and HR 130. After 2 L of crystalloid
solution are rapidly infused, his BP increases to 122/84 and HR
decreases to 100. He is tachypneic with RR of 28. On PE, his breath
sounds are decreased at the left upper chest with dullness on
percussion. A large caliber tube thoracostomy is inserted into the fifth
ATLS POST TEST EXAM QUESTIONS AND ANSWERS
A 22 year old male is brought by ambulance to a small community
hospital after falling from the top of an 8 foot ladder. Initially, he was
found to have a large right pneumothorax. A chest tube was inserted
and connected to an underwater seal drainage collection system with
negative pressure. A repeat CXR demonstrates a residual, large right
pneumothorax. After transferring the patient to a verified trauma
center, a third chest x-ray reveals a persistent right pneumothorax. The
chest tube appears to be functioning and in good position. He remains
hemodynamically normal with no signs of respiratory distress. The most
likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury - correct answer E. Tracheobronchial injury
,ATLS
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL
intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray - correct answer D. oxygen saturation
>92%
-> if it says ESOPHAGEAL, go with this answer
Which of the following signs necessitates the need for a definitive
airway in severe trauma patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12 - correct answer C. Severe maxillofacial trauma
Twenty seven people are severely injured in an aircraft crash at a local
airport. The principles of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
,ATLS
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available
resources - correct answer E. Produce the greatest number of survivors
based on available resources
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral
hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal
artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas -
correct answer A. Cerebral contusions may coalesce to form an
intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He has one
bullet wound just below the right clavicle and another just below the
costal margin in the right posterior axillary line. His blood pressure is
110/60, heart rate of 90, and respiratory rate of 34. After ensuring a
patent airway and inserting 2 large caliber IV lines, the next most
appropriate step is to:
, ATLS
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage - correct answer A. Obtain a
portable chest x-ray
need more info on chest, not abdomen
Which of the following should be performed FIRST in any patient whose
injuries may include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - correct answer D. Ensuring
adequate oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest
at close range. His BP is 80/40 and HR 130. After 2 L of crystalloid
solution are rapidly infused, his BP increases to 122/84 and HR
decreases to 100. He is tachypneic with RR of 28. On PE, his breath
sounds are decreased at the left upper chest with dullness on
percussion. A large caliber tube thoracostomy is inserted into the fifth
