ATLS PRACTICE TEST
(*)Degree of burn that is characterized by bone involvement - ANS-Fourth
37-yr-vintage guy is struck on the aspect of the pinnacle however is aware and talkative after
the damage. No evidence of cranium fracture. Several days later, he will become an
increasing number of lethargic, quite harassed, and not able to move his proper aspect.
Which kind of event has maximum probable passed off?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion - ANS-A. Subdural hematoma
7-12 months-old lady is found at the bottom of a swimming pool. Initially she turned into in
complete arrest but after 5 mins she confirmed sinus tachycardia but no breathing attempt.
Intubation was achieved within the field and cervical collar positioned. After transport to the
emergency branch she become unresponsive with a blood stress of a hundred/60 mmHg,
pulse a hundred and five, temperature 34.3C, and oxygen saturation one hundred%. The
pupils were 3 mm and sluggishly responsive to mild. There isn't any response to pain. The
lungs show wheezing at the left and coarse breath sounds bilaterally. The display shows
sinus tachycardia. There is no rectal tone. Which of the subsequent should be the next step
in control?
A. Cervical backbone movies and CT of the pinnacle B. Portable chest radiograph
C. Arterial blood fuel
D. Right and left decubitus chest radiographs - ANS-A. Cervical spine movies and CT of the
pinnacle
A thirteen year vintage boy fell whilst driving his bicycle and hit his head. He was
unconscious for four or five minutes. He vomited two times. He has no reminiscence of the
event or a headache. His exam is entirely regular. Glasgow coma rating is 15. Select the
following step in control.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull movies
D. Admit for observation - ANS-B. CT of the top
A 17-12 months-old male is hit on the head with a baseball bat. He withdraws and opens his
eyes in response to deep painful stimuli. He also mumbles incomprehensibly. What is his
Glasgow coma scale rating? - ANS-eight
A 18-yr-antique male sustains a right femur fracture and a cerebral concussion in a motor
vehicle coincidence. His initial blood strain is seventy five/50 mmHg with a pulse of ninety
beats in keeping with minute. After giving him 2 liters of Ringer lactate he stabilizes, however
the blood pressure falls whilst he's seen in the ER. Which of the following will be the motive
of suspected hypotension in this patient?
,A. Subdural hematoma
B. Undiagnosed facial fracture
C. Ruptured spleen
D. 10% pneumothorax - ANS-C. Ruptured spleen
A 20-12 months-vintage woman who's at 32 weeks gestation, is stabbed within the higher
proper chest. In the emergency department, her blood pressure is 80/60 mm Hg. She is
gasping for breath, extraordinarily anxious, and yelling for assist. Breath sounds are
dwindled within the proper chest. The most appropriate first step is to: - ANS-carry out
needle or finger decompression of the right chest
A 22-year-vintage female athlete is stabbed in her left chest at the 0.33 interspace inside the
anterior axillary line. On admission to the emergency department and 15 minutes after the
incident, she is awake and alert. Her heart charge is 100 beats according to minute, blood
pressure 80/60 mm Hg, and respiratory rate 20 breaths in line with minute. A chest x-ray
famous a massive left hemothorax. A left chest tube is placed with an immediate go back of
1600 mL of blood. The next management step for this affected person is: - ANS-put together
for an exploratory thoracotomy
A 22-12 months-old guy is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His blood strain is to begin with eighty/forty mm Hg. After preliminary fluid
resuscitation his blood pressure increases to 122/eighty four mm Hg. His coronary heart
charge is now 100 beats in keeping with minute and his breathing fee is 28 breaths in line
with minute. A tube thoracostomy is achieved 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
suitable next step is: - ANS-re-look at the chest
A 22-12 months-old guy sustains a gunshot wound to the stomach and gives with surprise.
He requires more than one devices of packed crimson blood cells during resuscitation. Later
he complains of numbness round his mouth. Physical examination exhibits carpopedal
spasm and a fine Chvostek signal. An electrocardiogram demonstrates a prolonged QT c
language. Which of the following is the maximum appropriate treatment?
A. IV bicarbonate
B. IV furosemide
C. IV calcium
D. IV insulin - ANS-C. IV calcium
A 22-12 months-old man sustains a gunshot wound to the left chest and is transported to a
small community health center no surgical abilities are available. In the emergency
department, a chest tube is inserted and seven-hundred mL of blood is evacuated. The
trauma center accepts the affected person in switch. Just before the affected person is
positioned in the ambulance for switch, his blood stress decreases to eighty/68 mm Hg and
his coronary heart rate will increase to 136 beats in keeping with minute. The next step
should be to: - ANS-repeat the primary survey and continue with transfer
A 23-12 months-old guy sustains four stab wounds to the upper proper chest at some stage
in an altercation and is added by ambulance to a sanatorium that has complete surgical
competencies. His wounds are all above the nipple. He is endotracheally intubated, closed
,tube thoracostomy is done, fluid resuscitation is initiated via 2 large-caliber IVs. FAST
examination does no longer reveal intraabdominal injuries. His blood strain now is 60/0 mm
Hg, heart price is a hundred and sixty beats in keeping with minute, and breathing price is 14
breaths according to minute (ventilated with 100% O2). 1500 mL of blood has tired from the
proper chest. The maximum appropriate next step in managing this patient is to: -
ANS-urgently transfer the affected person to the working room
A 25-12 months-antique man, injured in a motor vehicular crash, is admitted to the
emergency department. His scholars react sluggishly and his eyes open to stress. He does
not observe instructions, but he does moan periodically. His proper arm is deformed and
does now not reply to pressure; however, his left hand reaches purposefully closer to the
stimulus. Both legs are stiffly prolonged. His GCS score is: - ANS-nine
A 26-12 months-antique male is resuscitated with blood transfusion after a motor vehicle
collision that turned into complex by means of a fractured pelvis. A few hours later, the
affected person turns into febrile, hypotensive with a regular CVP, and oliguric. Upon exam,
the patient is found to be bleeding from the NG tube and IV websites. Which of the
subsequent is the maximum probably prognosis?
A. Hemorrhagic surprise
B. Acute adrenal insufficiency
C. Fat embolism syndrome
D. Transfusion reaction - ANS-D. Transfusion response
A 28-12 months-antique male changed into worried in a motor car coincidence. He is stable.
When he's asked to sit up, the umbilicus moves up closer to the neck location. What kind of
damage can this indicate?
A. Rectus hematoma
B. Diastasis recti
C. T6-T10 spinal twine harm
D. Muscle spasms - ANS-C. T6-T10 spinal twine damage
A 32-yr-vintage guy's right leg is trapped under his overturned vehicle for nearly 2 hours
earlier than he is extricated. On arrival in the emergency department, his proper decrease
extremity is cool, mottled, insensate, and motionless. Despite regular critical symptoms,
pulses can't be palpated underneath the right femoral artery and the muscle tissues of the
lower extremity are corporation and hard. During the control of this affected person, which of
the subsequent is maximum probable to enhance the probabilities for limb salvage? -
ANS-surgical consultation for proper decrease extremity fasciotomy
A 33-year-antique woman is involved in a head-on motor automobile crash. It took 30
minutes to extricate her from the auto. Upon arrival in the emergency branch, her heart fee is
a hundred and twenty beats in step with minute, BP is 90/70 mm Hg, respiratory price is
sixteen breaths in line with minute, and her GCS rating is 15. Examination reveals bilaterally
identical breath sounds, anterior chest wall ecchymosis, and distended neck veins. Her
stomach is flat, gentle, and no longer tender. Her pelvis is solid. Palpable distal pulses are
discovered in all four extremities. Of the following, the maximum possibly diagnosis is: -
ANS-cardiac tamponade
, A 34-year-vintage with intense head trauma and increased intracranial pressures is
intubated. Which of the subsequent have to be the target for mechanical air flow? - ANS-Set
PaCO2 between 30-35
A 39-year-vintage guy is admitted to the emergency department after an vehicle collision. He
is cyanotic, has inadequate respiratory effort, and has a GCS rating of 6. His full beard
makes it hard to suit the oxygen facemask to his face. The maximum suitable next step is to:
- ANS-restriction cervical movement and try orotracheal intubation the usage of 2 people
A 40-yr-old lady who changed into a constrained motive force in a motor car crash is
evaluated in the emergency branch. She is hemodynamically ordinary and located to be
paraplegic at the level of T10. Which of the following are real concerning her evaluation and
management? - ANS-Log rolling the use of four people is a secure approach to restriction
spinal motion while shifting her.
A fifty six-year-vintage man is thrown violently against the steerage wheel of his truck in the
course of a motor automobile crash. On arrival in the emergency branch he's diaphoretic and
complaining of chest pain. His blood strain is 60/40 mm Hg and his breathing charge is 40
breaths according to minute. Which of the following first-class differentiates cardiac
tamponade from tension pneumothorax because the purpose of his hypotension?
A. Tachycardia
B. Pulse extent
C. Breath sounds
D. Pulse strain
E. Jugular venous stress - ANS-C. Breath sounds
A fifty six-12 months-antique guy is thrown violently towards the steering wheel of his truck in
the course of a motor vehicle crash. On arrival within the emergency branch he's diaphoretic
and complaining of chest pain. His blood stress is 60/40 mm Hg and his respiration fee is
forty breaths in line with minute. Which of the subsequent excellent differentiates cardiac
tamponade from anxiety pneumothorax as the reason of his hypotension? - ANS-breath
sounds
A 6-year-vintage boy walking across the road is struck by way of the the front bumper of a
sports activities application automobile journeying at 32 kph (20 mph). Which one of the
following statements is TRUE about this patient? - ANS-A pulmonary contusion can be gift
inside the absence of rib fractures.
A sixty four-yr-vintage man involved in a high-pace car crash, is resuscitated first of all in a
small medical institution with out surgical competencies. He has a closed head damage with
a GCS score of thirteen. He has a widened mediastinum on chest x-ray with fractures of left
ribs 2 thru four, however no pneumothorax. After initiating fluid resuscitation, his blood
pressure is one hundred ten/seventy four mm Hg, coronary heart fee is a hundred beats in
line with minute, and respiration fee is eighteen breaths per minute. He has gross hematuria
and a pelvic fracture. You decide to switch this affected person to a facility capable of
presenting a better degree of care. The facility is 128 km (80 miles) away. Before transfer,
you must first: - ANS-name the receiving hospital and talk to the health practitioner on call
(*)Degree of burn that is characterized by bone involvement - ANS-Fourth
37-yr-vintage guy is struck on the aspect of the pinnacle however is aware and talkative after
the damage. No evidence of cranium fracture. Several days later, he will become an
increasing number of lethargic, quite harassed, and not able to move his proper aspect.
Which kind of event has maximum probable passed off?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion - ANS-A. Subdural hematoma
7-12 months-old lady is found at the bottom of a swimming pool. Initially she turned into in
complete arrest but after 5 mins she confirmed sinus tachycardia but no breathing attempt.
Intubation was achieved within the field and cervical collar positioned. After transport to the
emergency branch she become unresponsive with a blood stress of a hundred/60 mmHg,
pulse a hundred and five, temperature 34.3C, and oxygen saturation one hundred%. The
pupils were 3 mm and sluggishly responsive to mild. There isn't any response to pain. The
lungs show wheezing at the left and coarse breath sounds bilaterally. The display shows
sinus tachycardia. There is no rectal tone. Which of the subsequent should be the next step
in control?
A. Cervical backbone movies and CT of the pinnacle B. Portable chest radiograph
C. Arterial blood fuel
D. Right and left decubitus chest radiographs - ANS-A. Cervical spine movies and CT of the
pinnacle
A thirteen year vintage boy fell whilst driving his bicycle and hit his head. He was
unconscious for four or five minutes. He vomited two times. He has no reminiscence of the
event or a headache. His exam is entirely regular. Glasgow coma rating is 15. Select the
following step in control.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull movies
D. Admit for observation - ANS-B. CT of the top
A 17-12 months-old male is hit on the head with a baseball bat. He withdraws and opens his
eyes in response to deep painful stimuli. He also mumbles incomprehensibly. What is his
Glasgow coma scale rating? - ANS-eight
A 18-yr-antique male sustains a right femur fracture and a cerebral concussion in a motor
vehicle coincidence. His initial blood strain is seventy five/50 mmHg with a pulse of ninety
beats in keeping with minute. After giving him 2 liters of Ringer lactate he stabilizes, however
the blood pressure falls whilst he's seen in the ER. Which of the following will be the motive
of suspected hypotension in this patient?
,A. Subdural hematoma
B. Undiagnosed facial fracture
C. Ruptured spleen
D. 10% pneumothorax - ANS-C. Ruptured spleen
A 20-12 months-vintage woman who's at 32 weeks gestation, is stabbed within the higher
proper chest. In the emergency department, her blood pressure is 80/60 mm Hg. She is
gasping for breath, extraordinarily anxious, and yelling for assist. Breath sounds are
dwindled within the proper chest. The most appropriate first step is to: - ANS-carry out
needle or finger decompression of the right chest
A 22-year-vintage female athlete is stabbed in her left chest at the 0.33 interspace inside the
anterior axillary line. On admission to the emergency department and 15 minutes after the
incident, she is awake and alert. Her heart charge is 100 beats according to minute, blood
pressure 80/60 mm Hg, and respiratory rate 20 breaths in line with minute. A chest x-ray
famous a massive left hemothorax. A left chest tube is placed with an immediate go back of
1600 mL of blood. The next management step for this affected person is: - ANS-put together
for an exploratory thoracotomy
A 22-12 months-old guy is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His blood strain is to begin with eighty/forty mm Hg. After preliminary fluid
resuscitation his blood pressure increases to 122/eighty four mm Hg. His coronary heart
charge is now 100 beats in keeping with minute and his breathing fee is 28 breaths in line
with minute. A tube thoracostomy is achieved 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
suitable next step is: - ANS-re-look at the chest
A 22-12 months-old guy sustains a gunshot wound to the stomach and gives with surprise.
He requires more than one devices of packed crimson blood cells during resuscitation. Later
he complains of numbness round his mouth. Physical examination exhibits carpopedal
spasm and a fine Chvostek signal. An electrocardiogram demonstrates a prolonged QT c
language. Which of the following is the maximum appropriate treatment?
A. IV bicarbonate
B. IV furosemide
C. IV calcium
D. IV insulin - ANS-C. IV calcium
A 22-12 months-old man sustains a gunshot wound to the left chest and is transported to a
small community health center no surgical abilities are available. In the emergency
department, a chest tube is inserted and seven-hundred mL of blood is evacuated. The
trauma center accepts the affected person in switch. Just before the affected person is
positioned in the ambulance for switch, his blood stress decreases to eighty/68 mm Hg and
his coronary heart rate will increase to 136 beats in keeping with minute. The next step
should be to: - ANS-repeat the primary survey and continue with transfer
A 23-12 months-old guy sustains four stab wounds to the upper proper chest at some stage
in an altercation and is added by ambulance to a sanatorium that has complete surgical
competencies. His wounds are all above the nipple. He is endotracheally intubated, closed
,tube thoracostomy is done, fluid resuscitation is initiated via 2 large-caliber IVs. FAST
examination does no longer reveal intraabdominal injuries. His blood strain now is 60/0 mm
Hg, heart price is a hundred and sixty beats in keeping with minute, and breathing price is 14
breaths according to minute (ventilated with 100% O2). 1500 mL of blood has tired from the
proper chest. The maximum appropriate next step in managing this patient is to: -
ANS-urgently transfer the affected person to the working room
A 25-12 months-antique man, injured in a motor vehicular crash, is admitted to the
emergency department. His scholars react sluggishly and his eyes open to stress. He does
not observe instructions, but he does moan periodically. His proper arm is deformed and
does now not reply to pressure; however, his left hand reaches purposefully closer to the
stimulus. Both legs are stiffly prolonged. His GCS score is: - ANS-nine
A 26-12 months-antique male is resuscitated with blood transfusion after a motor vehicle
collision that turned into complex by means of a fractured pelvis. A few hours later, the
affected person turns into febrile, hypotensive with a regular CVP, and oliguric. Upon exam,
the patient is found to be bleeding from the NG tube and IV websites. Which of the
subsequent is the maximum probably prognosis?
A. Hemorrhagic surprise
B. Acute adrenal insufficiency
C. Fat embolism syndrome
D. Transfusion reaction - ANS-D. Transfusion response
A 28-12 months-antique male changed into worried in a motor car coincidence. He is stable.
When he's asked to sit up, the umbilicus moves up closer to the neck location. What kind of
damage can this indicate?
A. Rectus hematoma
B. Diastasis recti
C. T6-T10 spinal twine harm
D. Muscle spasms - ANS-C. T6-T10 spinal twine damage
A 32-yr-vintage guy's right leg is trapped under his overturned vehicle for nearly 2 hours
earlier than he is extricated. On arrival in the emergency department, his proper decrease
extremity is cool, mottled, insensate, and motionless. Despite regular critical symptoms,
pulses can't be palpated underneath the right femoral artery and the muscle tissues of the
lower extremity are corporation and hard. During the control of this affected person, which of
the subsequent is maximum probable to enhance the probabilities for limb salvage? -
ANS-surgical consultation for proper decrease extremity fasciotomy
A 33-year-antique woman is involved in a head-on motor automobile crash. It took 30
minutes to extricate her from the auto. Upon arrival in the emergency branch, her heart fee is
a hundred and twenty beats in step with minute, BP is 90/70 mm Hg, respiratory price is
sixteen breaths in line with minute, and her GCS rating is 15. Examination reveals bilaterally
identical breath sounds, anterior chest wall ecchymosis, and distended neck veins. Her
stomach is flat, gentle, and no longer tender. Her pelvis is solid. Palpable distal pulses are
discovered in all four extremities. Of the following, the maximum possibly diagnosis is: -
ANS-cardiac tamponade
, A 34-year-vintage with intense head trauma and increased intracranial pressures is
intubated. Which of the subsequent have to be the target for mechanical air flow? - ANS-Set
PaCO2 between 30-35
A 39-year-vintage guy is admitted to the emergency department after an vehicle collision. He
is cyanotic, has inadequate respiratory effort, and has a GCS rating of 6. His full beard
makes it hard to suit the oxygen facemask to his face. The maximum suitable next step is to:
- ANS-restriction cervical movement and try orotracheal intubation the usage of 2 people
A 40-yr-old lady who changed into a constrained motive force in a motor car crash is
evaluated in the emergency branch. She is hemodynamically ordinary and located to be
paraplegic at the level of T10. Which of the following are real concerning her evaluation and
management? - ANS-Log rolling the use of four people is a secure approach to restriction
spinal motion while shifting her.
A fifty six-year-vintage man is thrown violently against the steerage wheel of his truck in the
course of a motor automobile crash. On arrival in the emergency branch he's diaphoretic and
complaining of chest pain. His blood strain is 60/40 mm Hg and his breathing charge is 40
breaths according to minute. Which of the following first-class differentiates cardiac
tamponade from tension pneumothorax because the purpose of his hypotension?
A. Tachycardia
B. Pulse extent
C. Breath sounds
D. Pulse strain
E. Jugular venous stress - ANS-C. Breath sounds
A fifty six-12 months-antique guy is thrown violently towards the steering wheel of his truck in
the course of a motor vehicle crash. On arrival within the emergency branch he's diaphoretic
and complaining of chest pain. His blood stress is 60/40 mm Hg and his respiration fee is
forty breaths in line with minute. Which of the subsequent excellent differentiates cardiac
tamponade from anxiety pneumothorax as the reason of his hypotension? - ANS-breath
sounds
A 6-year-vintage boy walking across the road is struck by way of the the front bumper of a
sports activities application automobile journeying at 32 kph (20 mph). Which one of the
following statements is TRUE about this patient? - ANS-A pulmonary contusion can be gift
inside the absence of rib fractures.
A sixty four-yr-vintage man involved in a high-pace car crash, is resuscitated first of all in a
small medical institution with out surgical competencies. He has a closed head damage with
a GCS score of thirteen. He has a widened mediastinum on chest x-ray with fractures of left
ribs 2 thru four, however no pneumothorax. After initiating fluid resuscitation, his blood
pressure is one hundred ten/seventy four mm Hg, coronary heart fee is a hundred beats in
line with minute, and respiration fee is eighteen breaths per minute. He has gross hematuria
and a pelvic fracture. You decide to switch this affected person to a facility capable of
presenting a better degree of care. The facility is 128 km (80 miles) away. Before transfer,
you must first: - ANS-name the receiving hospital and talk to the health practitioner on call
