QUESTIONS & VERIFIED ANSWERS|A+ GRADED|BRAND NEW
Which of the following signs necessitates the need for a definitive airway in severe trauma
patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12
ANSWER
C. Severe maxillofacial trauma
A 22 year old male is brought by ambulance to a small community hospital after falling from
the top of an 8 foot ladder. Initially, he was found to have a large right pneumothorax. A
chest tube was inserted and connected to an underwater seal drainage collection system
with negative pressure. A repeat CXR demonstrates a residual, large right pneumothorax. Af-
ter transferring the patient to a verified trauma center, a third chest x-ray reveals a persistent
right pneumothorax. The chest tube appears to be functioning and in good position. He re-
mains hemodynamically normal with no signs of respiratory distress. The most likely cause
for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury
ANSWER
E. Tracheobronchial injury
1
,Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray
ANSWER
D. oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Twenty seven people are severely injured in an aircraft crash at a local airport. The principles
of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources
ANSWER
E. Produce the greatest number of survivors based on available resources
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas
ANSWER
A. Cerebral contusions may coalesce to form an intracerebral hematoma
2
,EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
Which of the following should be performed FIRST in any patient whose injuries may include
multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome
ANSWER
D. Ensuring adequate oxygenation and ventilation
(ABC's)
An 18 year old male is brought to the ED after being shot. He has one bullet wound just be-
low the right clavicle and another just below the costal margin in the right posterior axillary
line. His blood pressure is 110/60, heart rate of 90, and respiratory rate of 34. After ensuring
a patent airway and inserting 2 large caliber IV lines, the next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage
ANSWER
A. Obtain a portable chest x-ray
need more info on chest, not abdomen
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His
BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases
3
, to 122/84 and HR decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds
are decreased at the left upper chest with dullness on percussion. A large caliber tube thora-
costomy is inserted into the fifth intercostal space with the return of 200 mL of blood and no
air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest
ANSWER
E. Repeat the physical exam of the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle de-
compression followed by tube
Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be made in
the primary survey
ANSWER
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is unre-
sponsive and found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST step in treat-
ment is:
4
Which of the following signs necessitates the need for a definitive airway in severe trauma
patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12
ANSWER
C. Severe maxillofacial trauma
A 22 year old male is brought by ambulance to a small community hospital after falling from
the top of an 8 foot ladder. Initially, he was found to have a large right pneumothorax. A
chest tube was inserted and connected to an underwater seal drainage collection system
with negative pressure. A repeat CXR demonstrates a residual, large right pneumothorax. Af-
ter transferring the patient to a verified trauma center, a third chest x-ray reveals a persistent
right pneumothorax. The chest tube appears to be functioning and in good position. He re-
mains hemodynamically normal with no signs of respiratory distress. The most likely cause
for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury
ANSWER
E. Tracheobronchial injury
1
,Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray
ANSWER
D. oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Twenty seven people are severely injured in an aircraft crash at a local airport. The principles
of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources
ANSWER
E. Produce the greatest number of survivors based on available resources
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas
ANSWER
A. Cerebral contusions may coalesce to form an intracerebral hematoma
2
,EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
Which of the following should be performed FIRST in any patient whose injuries may include
multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome
ANSWER
D. Ensuring adequate oxygenation and ventilation
(ABC's)
An 18 year old male is brought to the ED after being shot. He has one bullet wound just be-
low the right clavicle and another just below the costal margin in the right posterior axillary
line. His blood pressure is 110/60, heart rate of 90, and respiratory rate of 34. After ensuring
a patent airway and inserting 2 large caliber IV lines, the next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage
ANSWER
A. Obtain a portable chest x-ray
need more info on chest, not abdomen
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His
BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases
3
, to 122/84 and HR decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds
are decreased at the left upper chest with dullness on percussion. A large caliber tube thora-
costomy is inserted into the fifth intercostal space with the return of 200 mL of blood and no
air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest
ANSWER
E. Repeat the physical exam of the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle de-
compression followed by tube
Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be made in
the primary survey
ANSWER
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is unre-
sponsive and found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST step in treat-
ment is:
4
