ATLS Pre-test Questions & Answers: Guaranteed A+ Guide

A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. 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 respiratory 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: (Ans – - *Re-examine the chest* - Perform an aortogram - Obtain a CT scan of the chest - Obtain ABG analysis - Transesophageal echocardiography A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. 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: (Ans – - complete spine x-ray series Which of the following is true regarding the initial resuscitation of a trauma patient? (Ans – - A patient with a torso gunshot wound and hypotension should receive crystalloid fluid resuscitation until the blood pressure is normal -* Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow Coma Scale score on reevaluation* - Massive transfusion is defined as transfusion of more than 10 units of packed red blood cells and plasma within 24 hours - When tranexamic acid is administered by pre-hospital providers, a second dose is required within 24 hours - Fluid resuscitation is far more important than bleeding control in trauma patient In managing a patient with a severe traumatic brain injury, the most important initial step is to: (Ans – - Secure the airway A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following statements applies to this patient? (Ans – - His pulse pressure will be widened. - His urinary output will be at the lower limits of normal. xxx - He will have tachycardia, but no change in his systolic blood pressure. - *An ABG would demonstrate a base deficit between -6 and -10 mEq/L.* - His systolic blood pressure will be maintained with an elevated diastolic pressure. The physiological hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by: (Ans – - increasing the volume of blood loss to produce maternal hypotension. The best assessment of fluid resuscitation of the adult burn patient is: (Ans – - urinary output of 0.5 mL/kg/hr The diagnosis of shock must include: (Ans – - evidence of inadequate organ perfusion A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate management of the wound should consist of: (Ans – - direct pressure on the wound For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: (Ans – - respiratory acidosis xxx - metabolic acidosis - *Cerebral vasoconstriction with diminished perfusion* - neurogenic pulmonary edema - shift of the oxyhemoglobin dissociation curve