ATLS test questions with complete solutions

A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His BP is initially 80/40 mm Hg. After 2 liters of crystalloid solution his BP increases to 122/84. His heart rate is now 100 BPM and his RR 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 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 ANSWERS: re-examine the chest 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 ANSWERS: complete spine x-rays In managing the head-injured patient, the most important initial step is to ________. CORRECT ANSWERS: secure the airway A previously healthy, 70 kg man suffers an estimated acute blood loss of 2 liters. How will this affect his blood pressure? CORRECT ANSWERS: his systolic pressure will be decreased with a narrowed pulse pressure The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by ____________. CORRECT ANSWERS: increasing the volume of blood loss to produce maternal hypotension The best assessment of fluid resuscitation of the adult burn patient is __________. CORRECT ANSWERS: adequate urinary output The diagnosis of shock must include _________. CORRECT ANSWERS: 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 ________ (application of a tourniquet vs. direct pressure on the wound). CORRECT ANSWERS: direct pressure on the wound For the patient with severe TBI, profound hypocarbia should be avoided to prevent __________. CORRECT ANSWERS: cerebral vasoconstriction with diminished perfusion