QUESTIONS & VERIFIED ANSWERS|A+ GRADED|BRAND NEW
A construction worker falls two stories from a building and sustains bilateral calcaneal frac-
tures. 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:
A) Angiography
B) Compartment pressures
C) Retrograde urethrogram
D) Doppler ultrasound studies
E) Complete spine x-ray series
ANSWER
E
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoul-
der. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood
pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his res-
piratory 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:
A) Reexamine the chest
B) Aortogram
C) Chest CT
D) ABG
E) TOE
ANSWER
A
1
,Which of the following is true regarding the initial resuscitation of a trauma patient?
A) A patient that presents with a torso gunshot wound and is hypotensive should receive
crystalloid fluid resuscitation until the blood pressure is normal
B) Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow coma scale score on reevaluation
C) Massive transfusion is defined as transfusion of more than >10 of packed red blood cells
and plasma in 24 hours
D) When tranexamic acid is administered by pre-hospital providers a second dose is required
within 24 hours
E) Fluid resuscitation is far more important than bleeding control in trauma patients
ANSWER
B
In managing a patient with a severe traumatic brain injury, the most important initial step is
to:
A) Secure the airway
B) Obtain a c-spine film
C) Support the circulation
D) Control scalp hemorrhage
E) Determine the GCS score
ANSWER
A
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 li-
ters.
Which one of the following statements applies to this patient?
A) His pulse pressure will be widened.
B) His urinary output will be at the lower limits of normal.
2
, C) He will have tachycardia, but no change in his systolic blood pressure.
D) An ABG would demonstrate a base deficit between -6 and -10 mEq/L
E) His systolic blood pressure will be maintained with an elevated diastolic pressure.
ANSWER
D
The physiologic hypervolemia of pregnancy has clinical significance in the management of
the severely injured, gravid woman by:
A) Reducing the need for blood transfusion
B) Resulting in an elevated hematocrit
C) Complicating the management of closed head injury
D) Reducing the volume of crystalloid required for resuscitation
E) Increasing the volume of blood loss to produce maternal hypotension
ANSWER
E
The diagnosis of shock must include:
A) Hypoxemia
B) Acidosis
C) Hypotension
D) Increased vascular resistance
E) Evidence of inadequate organ perfusion
ANSWER
E
The best assessment of fluid resuscitation of the adult burn patient is:
A) Urine output of 0.5 mL/kg/hr
B) Normalization of blood pressure
3
A construction worker falls two stories from a building and sustains bilateral calcaneal frac-
tures. 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:
A) Angiography
B) Compartment pressures
C) Retrograde urethrogram
D) Doppler ultrasound studies
E) Complete spine x-ray series
ANSWER
E
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoul-
der. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood
pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his res-
piratory 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:
A) Reexamine the chest
B) Aortogram
C) Chest CT
D) ABG
E) TOE
ANSWER
A
1
,Which of the following is true regarding the initial resuscitation of a trauma patient?
A) A patient that presents with a torso gunshot wound and is hypotensive should receive
crystalloid fluid resuscitation until the blood pressure is normal
B) Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow coma scale score on reevaluation
C) Massive transfusion is defined as transfusion of more than >10 of packed red blood cells
and plasma in 24 hours
D) When tranexamic acid is administered by pre-hospital providers a second dose is required
within 24 hours
E) Fluid resuscitation is far more important than bleeding control in trauma patients
ANSWER
B
In managing a patient with a severe traumatic brain injury, the most important initial step is
to:
A) Secure the airway
B) Obtain a c-spine film
C) Support the circulation
D) Control scalp hemorrhage
E) Determine the GCS score
ANSWER
A
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 li-
ters.
Which one of the following statements applies to this patient?
A) His pulse pressure will be widened.
B) His urinary output will be at the lower limits of normal.
2
, C) He will have tachycardia, but no change in his systolic blood pressure.
D) An ABG would demonstrate a base deficit between -6 and -10 mEq/L
E) His systolic blood pressure will be maintained with an elevated diastolic pressure.
ANSWER
D
The physiologic hypervolemia of pregnancy has clinical significance in the management of
the severely injured, gravid woman by:
A) Reducing the need for blood transfusion
B) Resulting in an elevated hematocrit
C) Complicating the management of closed head injury
D) Reducing the volume of crystalloid required for resuscitation
E) Increasing the volume of blood loss to produce maternal hypotension
ANSWER
E
The diagnosis of shock must include:
A) Hypoxemia
B) Acidosis
C) Hypotension
D) Increased vascular resistance
E) Evidence of inadequate organ perfusion
ANSWER
E
The best assessment of fluid resuscitation of the adult burn patient is:
A) Urine output of 0.5 mL/kg/hr
B) Normalization of blood pressure
3
