QUESTIONS & VERIFIED ANSWERS|A+ GRADED|BRAND NEW
The highest priority in managing a patient whose injuries include closed extremity fractures
is:
A. Assessing limb perfusion
B. Preventing necrosis of the skin
C. Decompressing compartment syndrome
D. Addressing respiratory insufficiency
E. Identifying crush syndrome
ANSWER
D
A 24 year old male pedestrian, struck by an automobile, is admitted to the emergency de-
partment 1 hour after injury. His blood pressure is 80/60 mmHg, heart rate 140 beats per
minute and respiratory rate is 36 per minute. He is lethargic. Oxygen is delivered via face
mask, and two large-caliber IVs are initiated. Arterial blood gases are obtained. His PaO2 is
118 mmHg, PaCO2 is 30 mmHg, and pH is 7.21. The treatment of his acid-base disorder is
best accomplished by:
A. Hyperventilation
B. Restoration of normal perfusion
C. Initiation of low-dose dopamine
D. Administration of sodium bicarbonate
E. Initiation of phenylepinephrine infusion
ANSWER
B
A 30-year-old male sustains a gunshot wound to the right lower chest, midway between the
nipple and the costal margin. He is brought by ambulance to a hospital that has full surgical
1
,capabilities. In the emergency department he is endotracheally intubated, fluid resuscitation
is initiated through two large-caliber IV lines, and a closed tube thoracostomy is performed,
with the return of 200 ml of blood. A chest x- ray reveals correct placement of the chest tube
and a small residual hemothorax. His blood pressure is now 70/0 mmHg, and his heart rate
is 140 beats per minute. His hypotension is most likely due to:
A. Tension pneumothorax
B. Massive hemothorax
C. Pericardial tamponade
D. Intraabdominal bleeding
E. Insufficient isotonic crystalloid infusion
ANSWER
D
A 34-year-old female is involved in a motor vehicle crash is brought to the emergency de-
partment. She is talking, but her voice is hoarse and on exposure she has diagonal bruising
of the chest and anterior neck. What is the next step?
A. Direct laryngoscopy to exclude laryngeal trauma
B. Oxygen by non-rebreathing mask
C. Protecting the spine by making her lie down
D. Palpation of the anterior neck
E. Attaching a pulse oximeter to her finger
ANSWER
B
A 20-year-old athlete is involved in a motorcycle crash after having ridden for hours on a
very hot day. When he arrives in the emergency department, he shouts that he cannot move
his legs. On physical examination, there are no abnormalities of the chest, abdomen, or pel-
vis. The patient has no sensation in his legs and cannot move them, but his arms are moving.
The patient's respiratory rate is 22, heart rate is 88, and blood pressure is 80/60 mmHg. He is
pale and sweaty. What is the most likely cause of his hypotension?
A. Neurogenic shock
2
, B. Cardiac tamponade
C. Myocardial contusion
D. Hyperthermia
E. Hemorrhagic shock
ANSWER
E
Compared with adults, children have:
A. A longer, wider, funnel-shaped airway
B. A less pliable, calcified skeleton
C. Greater mobility of mediastinal structures
D. A relatively smaller head and larger jaw
E. Anterior displacement of C5 on C6
ANSWER
C
Which one of the findings below requires a definitive airway in trauma patients?
A. Facial lacerations
B. Repeated vomiting
C. Partial thickness facial burns, cough, and hoarseness
D. Sternal fracture
E. Glasgow Coma Scale score of 12
ANSWER
C
A 22-year-old woman falls while skiing. She is evaluated at a small community hospital that
does not have neurological services. Spinal motion is restricted, supplemental oxygen by
mask is administered, and two antecubital IVs are placed. Her Glascow Coma Scale score is
3
The highest priority in managing a patient whose injuries include closed extremity fractures
is:
A. Assessing limb perfusion
B. Preventing necrosis of the skin
C. Decompressing compartment syndrome
D. Addressing respiratory insufficiency
E. Identifying crush syndrome
ANSWER
D
A 24 year old male pedestrian, struck by an automobile, is admitted to the emergency de-
partment 1 hour after injury. His blood pressure is 80/60 mmHg, heart rate 140 beats per
minute and respiratory rate is 36 per minute. He is lethargic. Oxygen is delivered via face
mask, and two large-caliber IVs are initiated. Arterial blood gases are obtained. His PaO2 is
118 mmHg, PaCO2 is 30 mmHg, and pH is 7.21. The treatment of his acid-base disorder is
best accomplished by:
A. Hyperventilation
B. Restoration of normal perfusion
C. Initiation of low-dose dopamine
D. Administration of sodium bicarbonate
E. Initiation of phenylepinephrine infusion
ANSWER
B
A 30-year-old male sustains a gunshot wound to the right lower chest, midway between the
nipple and the costal margin. He is brought by ambulance to a hospital that has full surgical
1
,capabilities. In the emergency department he is endotracheally intubated, fluid resuscitation
is initiated through two large-caliber IV lines, and a closed tube thoracostomy is performed,
with the return of 200 ml of blood. A chest x- ray reveals correct placement of the chest tube
and a small residual hemothorax. His blood pressure is now 70/0 mmHg, and his heart rate
is 140 beats per minute. His hypotension is most likely due to:
A. Tension pneumothorax
B. Massive hemothorax
C. Pericardial tamponade
D. Intraabdominal bleeding
E. Insufficient isotonic crystalloid infusion
ANSWER
D
A 34-year-old female is involved in a motor vehicle crash is brought to the emergency de-
partment. She is talking, but her voice is hoarse and on exposure she has diagonal bruising
of the chest and anterior neck. What is the next step?
A. Direct laryngoscopy to exclude laryngeal trauma
B. Oxygen by non-rebreathing mask
C. Protecting the spine by making her lie down
D. Palpation of the anterior neck
E. Attaching a pulse oximeter to her finger
ANSWER
B
A 20-year-old athlete is involved in a motorcycle crash after having ridden for hours on a
very hot day. When he arrives in the emergency department, he shouts that he cannot move
his legs. On physical examination, there are no abnormalities of the chest, abdomen, or pel-
vis. The patient has no sensation in his legs and cannot move them, but his arms are moving.
The patient's respiratory rate is 22, heart rate is 88, and blood pressure is 80/60 mmHg. He is
pale and sweaty. What is the most likely cause of his hypotension?
A. Neurogenic shock
2
, B. Cardiac tamponade
C. Myocardial contusion
D. Hyperthermia
E. Hemorrhagic shock
ANSWER
E
Compared with adults, children have:
A. A longer, wider, funnel-shaped airway
B. A less pliable, calcified skeleton
C. Greater mobility of mediastinal structures
D. A relatively smaller head and larger jaw
E. Anterior displacement of C5 on C6
ANSWER
C
Which one of the findings below requires a definitive airway in trauma patients?
A. Facial lacerations
B. Repeated vomiting
C. Partial thickness facial burns, cough, and hoarseness
D. Sternal fracture
E. Glasgow Coma Scale score of 12
ANSWER
C
A 22-year-old woman falls while skiing. She is evaluated at a small community hospital that
does not have neurological services. Spinal motion is restricted, supplemental oxygen by
mask is administered, and two antecubital IVs are placed. Her Glascow Coma Scale score is
3
