POSTEST ATLS 2022 QUESTIONS ANSWERS GRADED
1. 8. An 8-year-old girl is an unrestrained passenger in a vehicle struck from behind. In the
emergency department, her blood pressure is 80/60 mm Hg, heart rate is 80 beats per minute, and
respiratory rate is 16 breaths per minute. Her GCS score is 14. She complains that her legs feel
"funny and won't move right;" however, her spine x-rays do not show a fracture or dislocation. A
spinal cord injury in this child Correct Answer: * d. may exist in the absence of objective
findings on x-ray studies.
1. 2. Which one of the following statements regarding patients with thoracic spine injuries is
TRUE? Correct Answer: * d. Hyperflexion fractures in the upper thoracic spine are inherently
unstable.
1. 3. Absence of breath sounds and dullness to percussion over the left hemithorax are findings
best explained by Correct Answer: * a. Left hemothorax.
1. 4. A young man sustains a gunshot wound to the abdomen and is brought promptly to the
emergency department by prehospital personnel. His skin is cool and diaphoretic, and he is
confused. His pulse is thready and his femoral pulse is only weakly palpable. The defmitive
treatment in managing this patient is to Correct Answer: * c. Control internal hemorrhage
operatively
1. 5. To establish a diagnosis of shock, Correct Answer: * e. clinical evidence of inadequate
organ perfusion must be present.
1. 6. A 23-year-old man is brought immediately to the emergency department from the hospital' s
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 unconscious and has no detectable blood
pressure. Optimal immediate management is to Correct Answer: * d. transfer the patient to the
operating room, while initiating fluid therapy.
1. 7. An electrician is electrocuted 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 emergency department, his
vital signs are normal and no dysrhythmia 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 dip stick but no RBCs
are seen microscopically. Initial management should include Correct Answer: * b. aggressive
fluid infusion.
1. 9. Immediate chest tube insertion is indicated for which of the following conditions? Correct
Answer: * c. Massive hemothorax
1. 10. A 32-year-old man is brought to the hospital unconscious with severe facial injuries and
noisy respirations after an automobile collision. In the emergency department, 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 airway should
consist of Correct Answer: * c. performing a surgical cricothyroidotomy.
1. 11. The primary indication for transferring a patient to a higher level trauma center is Correct
Answer: * b. multiple system injuries, including severe head injury.
1. 12. A young man sustains a ritle wound to the mid-abdomen. He is brought promptly to the
emergency department by prehospital personnel. His skin is cool and diaphoretic, and his
systolic blood pressure is 58 rnm Hg. Warmed crystalloid fluids are initiated without
improvement in his vital signs. The next, most appropriate step is to perform Correct Answer: *
a. celiotomy.
1. 13. A teen-aged bicycle rider is hit by a truck traveling at a high rate of speed. In the
emergency department, 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 mm Hg, 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 Correct Answer: * d. perform endotracheal intubation and
ventilation.
1. 14. An 8-year-old boy falls 4.5 meters (15 feet) from a tree and is brought to the emergency
department 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 Correct Answer: * c. transfer the patient to a trauma
center.
1. 15. 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 140/90 mm Hg, 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 Correct Answer: * a. air splints.
1. 16. Which of the following statements regarding injury to the central nervous system in
children is TRUE? Correct Answer: * a. Children suffer spinal cord injury without x-ray
abnormality more commonly than adults.
1. 17. During an altercation, a 32-year-old man sustains a gunshot wound to the right upper
hemithorax, above the nipple line with an exit wound posteriorly above the scapula on the right.
He is transported by ambulance to a community hospital. He is endotracheally intubated, closed
tube thoracostomy is performed, and 2 liters of Ringer's lactate solution are infused through 2
large-caliber IVs. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% 02). The most appropriate next
step in managing this patient is Correct Answer: * a. celiotomy.
1. 18. A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury, multiple
palpable left rib fractures, and bilateral femur fractures. He is intubated orotracheally without
1. 8. An 8-year-old girl is an unrestrained passenger in a vehicle struck from behind. In the
emergency department, her blood pressure is 80/60 mm Hg, heart rate is 80 beats per minute, and
respiratory rate is 16 breaths per minute. Her GCS score is 14. She complains that her legs feel
"funny and won't move right;" however, her spine x-rays do not show a fracture or dislocation. A
spinal cord injury in this child Correct Answer: * d. may exist in the absence of objective
findings on x-ray studies.
1. 2. Which one of the following statements regarding patients with thoracic spine injuries is
TRUE? Correct Answer: * d. Hyperflexion fractures in the upper thoracic spine are inherently
unstable.
1. 3. Absence of breath sounds and dullness to percussion over the left hemithorax are findings
best explained by Correct Answer: * a. Left hemothorax.
1. 4. A young man sustains a gunshot wound to the abdomen and is brought promptly to the
emergency department by prehospital personnel. His skin is cool and diaphoretic, and he is
confused. His pulse is thready and his femoral pulse is only weakly palpable. The defmitive
treatment in managing this patient is to Correct Answer: * c. Control internal hemorrhage
operatively
1. 5. To establish a diagnosis of shock, Correct Answer: * e. clinical evidence of inadequate
organ perfusion must be present.
1. 6. A 23-year-old man is brought immediately to the emergency department from the hospital' s
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 unconscious and has no detectable blood
pressure. Optimal immediate management is to Correct Answer: * d. transfer the patient to the
operating room, while initiating fluid therapy.
1. 7. An electrician is electrocuted 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 emergency department, his
vital signs are normal and no dysrhythmia 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 dip stick but no RBCs
are seen microscopically. Initial management should include Correct Answer: * b. aggressive
fluid infusion.
1. 9. Immediate chest tube insertion is indicated for which of the following conditions? Correct
Answer: * c. Massive hemothorax
1. 10. A 32-year-old man is brought to the hospital unconscious with severe facial injuries and
noisy respirations after an automobile collision. In the emergency department, 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 airway should
consist of Correct Answer: * c. performing a surgical cricothyroidotomy.
1. 11. The primary indication for transferring a patient to a higher level trauma center is Correct
Answer: * b. multiple system injuries, including severe head injury.
1. 12. A young man sustains a ritle wound to the mid-abdomen. He is brought promptly to the
emergency department by prehospital personnel. His skin is cool and diaphoretic, and his
systolic blood pressure is 58 rnm Hg. Warmed crystalloid fluids are initiated without
improvement in his vital signs. The next, most appropriate step is to perform Correct Answer: *
a. celiotomy.
1. 13. A teen-aged bicycle rider is hit by a truck traveling at a high rate of speed. In the
emergency department, 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 mm Hg, 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 Correct Answer: * d. perform endotracheal intubation and
ventilation.
1. 14. An 8-year-old boy falls 4.5 meters (15 feet) from a tree and is brought to the emergency
department 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 Correct Answer: * c. transfer the patient to a trauma
center.
1. 15. 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 140/90 mm Hg, 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 Correct Answer: * a. air splints.
1. 16. Which of the following statements regarding injury to the central nervous system in
children is TRUE? Correct Answer: * a. Children suffer spinal cord injury without x-ray
abnormality more commonly than adults.
1. 17. During an altercation, a 32-year-old man sustains a gunshot wound to the right upper
hemithorax, above the nipple line with an exit wound posteriorly above the scapula on the right.
He is transported by ambulance to a community hospital. He is endotracheally intubated, closed
tube thoracostomy is performed, and 2 liters of Ringer's lactate solution are infused through 2
large-caliber IVs. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% 02). The most appropriate next
step in managing this patient is Correct Answer: * a. celiotomy.
1. 18. A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury, multiple
palpable left rib fractures, and bilateral femur fractures. He is intubated orotracheally without
