ATLS POST TEST ALL QUESTIONS AND ANSWERS
SURE A+
✔✔A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss
of two liters. Which one of the following statements apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
C. He will have tachycardia, but no change in systolic blood pressure
D. His systolic blood pressure will be decreased with a narrowed, pulse pressure
E. His systolic blood pressure will be maintained with an elevated diastolic pressure. -
✔✔E. His systolic blood pressure will be maintained with an elevated diastolic pressure.
✔✔The physioclogic hypervolemia of pregnancy has clinical significance in the
management of the severely injured gravid woman by
A. Reducing the need for blood transfusion
B. Increasing the risk of pulmonary edema
C. Complicating the management of closed head injury
D. Increasing the volume of blood loss to produce shock/maternal hypotension
E. Reducing the volume of crystalloid required for resuscitation - ✔✔D. Increasing the
volume of blood loss to produce shock
✔✔A 17-year-old helmeted motorcyclist loses consciousness when he is struck broad
side by an automobile at an intersection. He arrives in the ED with a blood pressure of
140/92, pulse rate 88 beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient should include a semi-rigid
cervical collar and:
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment - ✔✔B. A long spine board
,✔✔During an altercation, a 36-year-old man sustains a gunshot wound above the nipple
line on the right, with an exit wound posteriorly above the scapula on the right. He is
transported by ambulance to a community hospital. He is endotracheally intubated,
close tube thoracostomy is performed, and 2 liters Ringers lactate solution are infused
via 2 large-caliber IV´s. His blood pressure now is 60/0mmHg, heart rate is 160 beats
per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% O2). The
most appropriate next step in managin this patient is:
A. Laparotomy
B. Diagnostic peritoneal lavage
C. Arterial blood gas determination
D. Administer packed red blood cells
E. Chest X-ray to confirm tube placement - ✔✔E. Chest X-ray to confirm tube
placement
✔✔Abscence of breath sounds and dullness to percussion over the left hemithorax are
findings best explained by:
A. Left hemothorax
B. Cardiac contusion
C. Left simple pneumothorax
D. Left diaphragmatic rupture
E. Right tension pneumothorax - ✔✔A. Left hemothorax
✔✔A 23-year-old man is brought immediately to the ED from the hospitals parking lot
where he was shot in the lower abdomen. Examination reveals a single bullet wound.
He is breathing and has a thready pulse. However, he is unconsious and has no
detectable blood pressure. Optimale immediate management is to:
A. Perform a diagnostic peritoneal lavage
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - ✔✔D. Transfer the
patient to the operating room, while initiating fluid therapy
✔✔A teen-aged bicycle rider is hit by a truck traveling at high speed. In the ED, she is
actively bleeding from open fractures of her legs, and has abrasions on her chest and
abdominal wall. Her blood pressure is 80/50 mmHg, heart rate is 140 beats per minute,
respiratory rate is 8 breaths per minute, and GCS score is 6. The first step in managing
this patient is to:
A. Obtain a lateral cervical spine x-ray
B. Insert av central venous pressure line
C. Adminster 2 liters of crystalloid solution
D. Perform endotracheal intubation and ventilation
E. Apply a pneumatic antishock garment (PASG) and inflate the leg compartments. -
✔✔D. Perform endotracheal intubation and ventilation
,✔✔An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is brought to the ED by
his family. His vital signs are normal, but he complains of left upper quadrant pain. An
abdominal CT-scan reveals a moderately severe laceration of the spleen. The receiving
institution does not have 24-hour-a-day operating room capabilities. The most
appropriate management of this patient would be to
A. Type and crossmatch for blood
B. Request consultation of a pediatrician
C. Transfer the patient to a trauma center
D. Admit the patient to the intensive care unit
E. Prepare the patient for surgery the next day - ✔✔D. Admit the patient to the intensive
care unit
✔✔Which of the following statements regarding injury to the central nervous system in
children is TRUE?
A. Children suffer spinal cord injury without x-ray abnormality more commonly than
adults.
B. An infant with a traumatic brain injury may become hypotensive from cerebral edema
C. Initial therapy for the child with traumatic brain injury includes the administration of
methylprednisolone intravenously
D. Children have more focal mass lesions as a result for traumatic brain injury when
compared to adults.
E. Young children are less tolerant of expanding intracranial mass lesions than adults -
✔✔A. Children suffer spinal cord injury without x-ray abnormality more commonly than
adults.
✔✔A 17-year-old helmeted motorcyclist is struck broadside by an automobile at an
intersection. He is unconscious at the scene with a blood pressure of 140/90mmHg,
heart rate of 90 beats per minute, and respiratory rate of 22 breaths per minute. His
respirations are sonorous and deep. His GCS score is 6. Immobilization of the entire
patient may include the use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar - ✔✔A. Air splints
✔✔Twenty-seven patients are seriously injured in an aircraft accident at a local airport.
The basic principle of triage should be to:
A. Treat the most severely injured patients first
B. Establish a field triage area directed by a doctor
C. Rapidly transport all patients to the nearest appropriate 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 - ✔✔E.
Produce the greatest number of survivors based on available resources
, ✔✔An electrician is eletrocuted by a downed power line after a thunderstorm. He
apparently made contact with the wire at the level of the right mid thigh. In the ED, his
vital signs are normal and no dysrythmia is noted on ECG. On examination, there is an
exit wound on the bottom of the right foot. His urine is positive for blood by dipstick but
not RBCs are seen microscopically. Initial management should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic muscle
E. Admission to the ICU for observation - ✔✔B. Aggressive fluid infusion - suspected
rhabdomyolyse
✔✔A young woman sustains a severe head injury as the result of a motor vehicular
crash. In the ED, her GCS is 6. Her blood pressure is 140/90 mmHg and her heart rate
80 beats per minute. She is intubated and is being mechanically ventilated. Her pupils
are 3mm in size and equally reactive to light. There is no other apparent injury. The
most important principle to follow in early management of her head injury is to:
A. Administer an osmotic diuretic
B. Prevent secondary brain injury
C. Agressively treat systemic hypertension
D. Reduce meatbolic requirements of the brain
E. Distinguish between intracranial hematoma and cerebral edema. - ✔✔B. Prevent
secondary brain injury
✔✔To establish a diagnosis of shock,
A. Systolic blood pressure must be below 90mmHg
B. The presence of a closed head injury should be excluded
C. Acidosis should be present by arterial blood gas analysis
D. The patient must fail to respond to intravenous fluid infusion
E. Clinical evidence of inadequate organ perfusion must be present. - ✔✔E. Clinical
evidence of inadequate organ perfusion must be present.
✔✔A 32-year-old is brought to the hospital unconscious with severe facial injuries and
noisy respirations after an automobile collision. In the ED, he has no apparent injury to
the anterior aspect of his neck. He suddenly becomes apneic, and attempted ventilation
with a face mask is unsuccessful. Examination of his mouth reveals a large hematoma
of the pharynx with loss of normal anatomic landmarks. Initial management of his
airways should be consist of:
A. Inserting an oropharyngeal airway
B. Inserting a nasopharyngeal airway
C. Performing a surgical cricothyroidotomy
D. Performing fiberoptic-guided nasotracheal intubation
E. Performin orotracheal intubation after obtaining a lateral c-spine x-ray - ✔✔A.
Inserting an oropharyngeal airway
SURE A+
✔✔A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss
of two liters. Which one of the following statements apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
C. He will have tachycardia, but no change in systolic blood pressure
D. His systolic blood pressure will be decreased with a narrowed, pulse pressure
E. His systolic blood pressure will be maintained with an elevated diastolic pressure. -
✔✔E. His systolic blood pressure will be maintained with an elevated diastolic pressure.
✔✔The physioclogic hypervolemia of pregnancy has clinical significance in the
management of the severely injured gravid woman by
A. Reducing the need for blood transfusion
B. Increasing the risk of pulmonary edema
C. Complicating the management of closed head injury
D. Increasing the volume of blood loss to produce shock/maternal hypotension
E. Reducing the volume of crystalloid required for resuscitation - ✔✔D. Increasing the
volume of blood loss to produce shock
✔✔A 17-year-old helmeted motorcyclist loses consciousness when he is struck broad
side by an automobile at an intersection. He arrives in the ED with a blood pressure of
140/92, pulse rate 88 beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient should include a semi-rigid
cervical collar and:
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment - ✔✔B. A long spine board
,✔✔During an altercation, a 36-year-old man sustains a gunshot wound above the nipple
line on the right, with an exit wound posteriorly above the scapula on the right. He is
transported by ambulance to a community hospital. He is endotracheally intubated,
close tube thoracostomy is performed, and 2 liters Ringers lactate solution are infused
via 2 large-caliber IV´s. His blood pressure now is 60/0mmHg, heart rate is 160 beats
per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% O2). The
most appropriate next step in managin this patient is:
A. Laparotomy
B. Diagnostic peritoneal lavage
C. Arterial blood gas determination
D. Administer packed red blood cells
E. Chest X-ray to confirm tube placement - ✔✔E. Chest X-ray to confirm tube
placement
✔✔Abscence of breath sounds and dullness to percussion over the left hemithorax are
findings best explained by:
A. Left hemothorax
B. Cardiac contusion
C. Left simple pneumothorax
D. Left diaphragmatic rupture
E. Right tension pneumothorax - ✔✔A. Left hemothorax
✔✔A 23-year-old man is brought immediately to the ED from the hospitals parking lot
where he was shot in the lower abdomen. Examination reveals a single bullet wound.
He is breathing and has a thready pulse. However, he is unconsious and has no
detectable blood pressure. Optimale immediate management is to:
A. Perform a diagnostic peritoneal lavage
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - ✔✔D. Transfer the
patient to the operating room, while initiating fluid therapy
✔✔A teen-aged bicycle rider is hit by a truck traveling at high speed. In the ED, she is
actively bleeding from open fractures of her legs, and has abrasions on her chest and
abdominal wall. Her blood pressure is 80/50 mmHg, heart rate is 140 beats per minute,
respiratory rate is 8 breaths per minute, and GCS score is 6. The first step in managing
this patient is to:
A. Obtain a lateral cervical spine x-ray
B. Insert av central venous pressure line
C. Adminster 2 liters of crystalloid solution
D. Perform endotracheal intubation and ventilation
E. Apply a pneumatic antishock garment (PASG) and inflate the leg compartments. -
✔✔D. Perform endotracheal intubation and ventilation
,✔✔An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is brought to the ED by
his family. His vital signs are normal, but he complains of left upper quadrant pain. An
abdominal CT-scan reveals a moderately severe laceration of the spleen. The receiving
institution does not have 24-hour-a-day operating room capabilities. The most
appropriate management of this patient would be to
A. Type and crossmatch for blood
B. Request consultation of a pediatrician
C. Transfer the patient to a trauma center
D. Admit the patient to the intensive care unit
E. Prepare the patient for surgery the next day - ✔✔D. Admit the patient to the intensive
care unit
✔✔Which of the following statements regarding injury to the central nervous system in
children is TRUE?
A. Children suffer spinal cord injury without x-ray abnormality more commonly than
adults.
B. An infant with a traumatic brain injury may become hypotensive from cerebral edema
C. Initial therapy for the child with traumatic brain injury includes the administration of
methylprednisolone intravenously
D. Children have more focal mass lesions as a result for traumatic brain injury when
compared to adults.
E. Young children are less tolerant of expanding intracranial mass lesions than adults -
✔✔A. Children suffer spinal cord injury without x-ray abnormality more commonly than
adults.
✔✔A 17-year-old helmeted motorcyclist is struck broadside by an automobile at an
intersection. He is unconscious at the scene with a blood pressure of 140/90mmHg,
heart rate of 90 beats per minute, and respiratory rate of 22 breaths per minute. His
respirations are sonorous and deep. His GCS score is 6. Immobilization of the entire
patient may include the use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar - ✔✔A. Air splints
✔✔Twenty-seven patients are seriously injured in an aircraft accident at a local airport.
The basic principle of triage should be to:
A. Treat the most severely injured patients first
B. Establish a field triage area directed by a doctor
C. Rapidly transport all patients to the nearest appropriate 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 - ✔✔E.
Produce the greatest number of survivors based on available resources
, ✔✔An electrician is eletrocuted by a downed power line after a thunderstorm. He
apparently made contact with the wire at the level of the right mid thigh. In the ED, his
vital signs are normal and no dysrythmia is noted on ECG. On examination, there is an
exit wound on the bottom of the right foot. His urine is positive for blood by dipstick but
not RBCs are seen microscopically. Initial management should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic muscle
E. Admission to the ICU for observation - ✔✔B. Aggressive fluid infusion - suspected
rhabdomyolyse
✔✔A young woman sustains a severe head injury as the result of a motor vehicular
crash. In the ED, her GCS is 6. Her blood pressure is 140/90 mmHg and her heart rate
80 beats per minute. She is intubated and is being mechanically ventilated. Her pupils
are 3mm in size and equally reactive to light. There is no other apparent injury. The
most important principle to follow in early management of her head injury is to:
A. Administer an osmotic diuretic
B. Prevent secondary brain injury
C. Agressively treat systemic hypertension
D. Reduce meatbolic requirements of the brain
E. Distinguish between intracranial hematoma and cerebral edema. - ✔✔B. Prevent
secondary brain injury
✔✔To establish a diagnosis of shock,
A. Systolic blood pressure must be below 90mmHg
B. The presence of a closed head injury should be excluded
C. Acidosis should be present by arterial blood gas analysis
D. The patient must fail to respond to intravenous fluid infusion
E. Clinical evidence of inadequate organ perfusion must be present. - ✔✔E. Clinical
evidence of inadequate organ perfusion must be present.
✔✔A 32-year-old is brought to the hospital unconscious with severe facial injuries and
noisy respirations after an automobile collision. In the ED, he has no apparent injury to
the anterior aspect of his neck. He suddenly becomes apneic, and attempted ventilation
with a face mask is unsuccessful. Examination of his mouth reveals a large hematoma
of the pharynx with loss of normal anatomic landmarks. Initial management of his
airways should be consist of:
A. Inserting an oropharyngeal airway
B. Inserting a nasopharyngeal airway
C. Performing a surgical cricothyroidotomy
D. Performing fiberoptic-guided nasotracheal intubation
E. Performin orotracheal intubation after obtaining a lateral c-spine x-ray - ✔✔A.
Inserting an oropharyngeal airway
