ATLS Post Test QUESTIONS AND ANSWERS
1. Theprimaryindicationfortransferrin 4. Which one of the following
ga statementsregardingpatientswiththoracicspi
patienttoahigherleveltraumacenteris neinj uriesisTRUE?
: Log-rollingmaybedestabilizingto
fracturesfromT-12toL-1.
Adequateimmobilizationcanbe
unavailabilityofasurgeonoroperatingroom accomplishedwiththescoopstretcher.
staff.mult SpinalcordinjurybelowT-10usuallyspares
iplesysteminjuries,includingsevere bowelandbladderfunction.
headinjury. Hyperflexionfracturesintheupper
resourcelimitationsasdeterminedbythe thoracicspineareinherentlyunstable.
transferringdoctor. Thesepatientsrarelypresentwithspinal
resourcelimitationsasdeterminedbythe shockinassociationwithcordinjury.
hospitaladministration.widen
edmediastinumonchestx-ray
followingbluntthoracictrauma. 5. young man sustains a ritle wound to the
mid- abdomen. He is brought promptly to
theemergencydepartmentbyprehospital
2. teen-aged bicycle rider is hit by a
personnel.Hisskiniscoolanddiaphoretic,andh
trucktraveling at a high rate of speed. In
issy stolicbloodpressureis58rnmHg.
theemergencydepartment,sheisactivelyble
Warmed crystalloid fluids are
edin gfrom open fractures of her legs, and
initiated
hasabrasionsonherchestandabdominalwall
withoutimprovementinhisvitalsigns.Thenext,
.Her
bloodpressureis80/50mmHg,heartrateis14 mostappropriatestepistoperform:
0beat sperminute,respiratoryrateis8 aceliotomy.
anabdominalCTscan.
breaths per minute, and GCS score is
6.Thefirststepinmanagingthispatientisto: diagnosticlaparoscopy.
abdominalultrasonography.
obtainalateralcervicalspinex-ray.
adiagnosticperitoneallavage.
insertacentralvenouspressureline.
administer2litersofcrystalloidsolution. 6. young woman sustains a severe head
performendotrachealintubationand injuryas the result of a motor vehicular
ventilation. crash. In
applythePASGandinflatetheleg theemergencydepartment,herGCSscoreis6
compartments. .Her blood pressure is 140/90 mm Hg and
her
3. Contraindication to nasogastric heartrateis80beatsperminute.Sheisintubate
intubation isthepresenceofa: dand
gastricperforation. isbeingmechanicallyventilated.Herpupilsar
diaphragmaticrupture. e3m minsizeandequallyreactivetolight.
opendepressedskullfracture. Thereisnootherapparentinjury.Themostimp
orta nt principle to follow in the
fractureofthecervicalspine.
earlymanagementofherheadinjuryisto:
fracture of the cribriformplate.
administeranosmoticdiuretic.
preventsecondarybraininjury.
, aggressivelytreatsystemichypertension. 9.8-year-
reducemetabolicrequirementsofthe
oldgirlisanunrestrainedpassengerinavehiclest
brain.dis
tinguishbetweenintracranialhematoma ruc kfrombehind.Intheemergency
andcerebraledema. department, herblood pressure
is80/60mmHg,heartrateis80beatsperminute,a
nd respiratory rate is16 breaths per minute.
7. 22-year-old man is brought to the
Her GCS score is 14. She complains that
hospitalaftercrashinghismotorcycleintoateleph
herlegs feel "funny and won't move
one
right;"however, her spine x-rays do not
pole.Heisunconsciousandinprofoundshock
show
.He hasnoopenwoundsorobviousfractures.
afractureordislocation.Aspinalcordinjuryinthi
ThecauseofhisshockisMOSTLIKELYcaus
sc hild:
ed by:
ismostlikelyacentralcordsyndrome.
mustbediagnosedbymagneticresonance
asubduralhematoma. imaging.
an epidural hematoma. a canbeexcludedbyobtainingaCTofthe
transected lumbar spinal cord. entirespine.
atransectedcervicalspinalcor d. mayexistintheabsenceofobjective
hemorrhageintothechestorabdomen. findingsonx-raystudies.
isunlikelybecauseoftheincomplete
calcificationofthevertebralbodies.
8. 30-year-old man is struck by a car
travelingat56kph(35mph).Hehasobviousfra 10. Immediatechesttubeinsertionisindicatedf
ctur esofthe left tibia near the knee, pain in or whichofthefollowingconditions?
the Pneumothorax
pelvicarea,andseveredyspnea.Hisheartratei
s18 0 Pneumomediastinum
beatsperminute,andhisrespiratoryrateis48 Massivehemothorax
breaths per minute with no breath sounds
heardintheleftchest.Atensionpneumothoraxisr Diaphragmaticrupture
eli
Subcutaneousemphysema
evedbyimmediateneedledecompressionand
tube thoracostomy. Subsequently, his
heartrate decreases to 140 beats perminute, 11. 18-year-
hisrespiratory rate decreases to 36 breaths old,helmetedmotorcyclistis brought
perminute,andhisbloodpressureis80/50inmHg by ambulance to the
.W armed Ringer's lactateis emergencydepartment following a high-
administeredintravenously.Thenextprioritysho speed
uld beto: crash.Prehospitalpersormelreportthathewasth
performaurethrogramandcystogram. ro wn15 meters (50 feet) off his bfice. He
has ahistory of hypotension prior to arrival in
performexternalfixationofthepelvis.
theemergency department, but is now
obtainabdominalandpelvicCTscans. awake, alert,and conversational. Which of
the followingstatementsisTRUE?
performarterialembolizationofthepelvic
vessels.
performdiagnosticperitoneallavageor
abdominalultrasound.
Cerebral perfiision is
intacto Intravascular volume status is
normal. Thepatienthassensitivevasomo
tor
, reflexes.
1. Theprimaryindicationfortransferrin 4. Which one of the following
ga statementsregardingpatientswiththoracicspi
patienttoahigherleveltraumacenteris neinj uriesisTRUE?
: Log-rollingmaybedestabilizingto
fracturesfromT-12toL-1.
Adequateimmobilizationcanbe
unavailabilityofasurgeonoroperatingroom accomplishedwiththescoopstretcher.
staff.mult SpinalcordinjurybelowT-10usuallyspares
iplesysteminjuries,includingsevere bowelandbladderfunction.
headinjury. Hyperflexionfracturesintheupper
resourcelimitationsasdeterminedbythe thoracicspineareinherentlyunstable.
transferringdoctor. Thesepatientsrarelypresentwithspinal
resourcelimitationsasdeterminedbythe shockinassociationwithcordinjury.
hospitaladministration.widen
edmediastinumonchestx-ray
followingbluntthoracictrauma. 5. young man sustains a ritle wound to the
mid- abdomen. He is brought promptly to
theemergencydepartmentbyprehospital
2. teen-aged bicycle rider is hit by a
personnel.Hisskiniscoolanddiaphoretic,andh
trucktraveling at a high rate of speed. In
issy stolicbloodpressureis58rnmHg.
theemergencydepartment,sheisactivelyble
Warmed crystalloid fluids are
edin gfrom open fractures of her legs, and
initiated
hasabrasionsonherchestandabdominalwall
withoutimprovementinhisvitalsigns.Thenext,
.Her
bloodpressureis80/50mmHg,heartrateis14 mostappropriatestepistoperform:
0beat sperminute,respiratoryrateis8 aceliotomy.
anabdominalCTscan.
breaths per minute, and GCS score is
6.Thefirststepinmanagingthispatientisto: diagnosticlaparoscopy.
abdominalultrasonography.
obtainalateralcervicalspinex-ray.
adiagnosticperitoneallavage.
insertacentralvenouspressureline.
administer2litersofcrystalloidsolution. 6. young woman sustains a severe head
performendotrachealintubationand injuryas the result of a motor vehicular
ventilation. crash. In
applythePASGandinflatetheleg theemergencydepartment,herGCSscoreis6
compartments. .Her blood pressure is 140/90 mm Hg and
her
3. Contraindication to nasogastric heartrateis80beatsperminute.Sheisintubate
intubation isthepresenceofa: dand
gastricperforation. isbeingmechanicallyventilated.Herpupilsar
diaphragmaticrupture. e3m minsizeandequallyreactivetolight.
opendepressedskullfracture. Thereisnootherapparentinjury.Themostimp
orta nt principle to follow in the
fractureofthecervicalspine.
earlymanagementofherheadinjuryisto:
fracture of the cribriformplate.
administeranosmoticdiuretic.
preventsecondarybraininjury.
, aggressivelytreatsystemichypertension. 9.8-year-
reducemetabolicrequirementsofthe
oldgirlisanunrestrainedpassengerinavehiclest
brain.dis
tinguishbetweenintracranialhematoma ruc kfrombehind.Intheemergency
andcerebraledema. department, herblood pressure
is80/60mmHg,heartrateis80beatsperminute,a
nd respiratory rate is16 breaths per minute.
7. 22-year-old man is brought to the
Her GCS score is 14. She complains that
hospitalaftercrashinghismotorcycleintoateleph
herlegs feel "funny and won't move
one
right;"however, her spine x-rays do not
pole.Heisunconsciousandinprofoundshock
show
.He hasnoopenwoundsorobviousfractures.
afractureordislocation.Aspinalcordinjuryinthi
ThecauseofhisshockisMOSTLIKELYcaus
sc hild:
ed by:
ismostlikelyacentralcordsyndrome.
mustbediagnosedbymagneticresonance
asubduralhematoma. imaging.
an epidural hematoma. a canbeexcludedbyobtainingaCTofthe
transected lumbar spinal cord. entirespine.
atransectedcervicalspinalcor d. mayexistintheabsenceofobjective
hemorrhageintothechestorabdomen. findingsonx-raystudies.
isunlikelybecauseoftheincomplete
calcificationofthevertebralbodies.
8. 30-year-old man is struck by a car
travelingat56kph(35mph).Hehasobviousfra 10. Immediatechesttubeinsertionisindicatedf
ctur esofthe left tibia near the knee, pain in or whichofthefollowingconditions?
the Pneumothorax
pelvicarea,andseveredyspnea.Hisheartratei
s18 0 Pneumomediastinum
beatsperminute,andhisrespiratoryrateis48 Massivehemothorax
breaths per minute with no breath sounds
heardintheleftchest.Atensionpneumothoraxisr Diaphragmaticrupture
eli
Subcutaneousemphysema
evedbyimmediateneedledecompressionand
tube thoracostomy. Subsequently, his
heartrate decreases to 140 beats perminute, 11. 18-year-
hisrespiratory rate decreases to 36 breaths old,helmetedmotorcyclistis brought
perminute,andhisbloodpressureis80/50inmHg by ambulance to the
.W armed Ringer's lactateis emergencydepartment following a high-
administeredintravenously.Thenextprioritysho speed
uld beto: crash.Prehospitalpersormelreportthathewasth
performaurethrogramandcystogram. ro wn15 meters (50 feet) off his bfice. He
has ahistory of hypotension prior to arrival in
performexternalfixationofthepelvis.
theemergency department, but is now
obtainabdominalandpelvicCTscans. awake, alert,and conversational. Which of
the followingstatementsisTRUE?
performarterialembolizationofthepelvic
vessels.
performdiagnosticperitoneallavageor
abdominalultrasound.
Cerebral perfiision is
intacto Intravascular volume status is
normal. Thepatienthassensitivevasomo
tor
, reflexes.
