ATLS Post Test Questions with All correct Answers (Advanced trauma life support)

ATLS Post Test Questions with All correct Answers (Advanced trauma life support). Cardiac tamponade after trauma a. is seldom life-threatening b. can be excluded by an upr ight, AP chest x-ray c. can be confused with a tension pneumothorax d. causes a fall in systolic pressure of > 15 mm Hg with expiration e. most common ly occurs after blunt injury to the anterior chest wall 2. Which one of the following statements regarding patients with thoracic spine injuries is TRUE? a. Log-rolling may be d estabilizing to fractures from T-12 to L-1. b. Adequate immobilization can be accomplished with the scoop stretcher. c. Spinal cord injury below T-10 usu ally spares bowel and b ladder f unction. d. Hyperflexion fractures in the upper thoracic spine are inherently unstable. e. These patients rarely present with spinal shock in association with cord injury. 3. Absence of breath sounds and du llness to percussion over the l eft hemithorax are fmdings best explained by a. Left hemothorax. b. cardiac contusion c. left simple pneumothorax d. left diaphragmatic rupture tension pneumothorax. 4. A young man sus tains a gunshot wound to the abdomen and is brough t promptly to the emergency department by pr ehospital personnel. His skin is cool and d iaphoretic, and he is confused. His pu lse is thready and h is femoral pulse is only weakly palpable. The defmitive treatment in managing this patient is to a. administer 0-negative blood b. applyextemal warming devices. c. Control internal hemorrhage operativ ely d. apply the pn eumatic antishock garment e. infuse large volumes of intravenous crystalloid solution. 5. To establish a diagnosis of shock, a. systolic blood pressure must be below 90 mm Hg. 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 in travenous fluid infusion. e. clinical evidence of inadequate organ perfusion must be present. 6. A 23-year-old man is brought imm ediately 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 unconsc ious and has no d etectable blood pressure. Optimal immediate management is to a. perform diagnostic peritoneal lavage. b. in itiate 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 normo tensive 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, h is vital signs are normal and no dysrhythm ia 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 shou ld include a. immediate angiography. b. aggressiv e fluid infusion. c. intravenouspyleography. d. d ebridement of necrotic muscle. e. admission to the intensive care unit for observation. 8. An 8-year-old girl is an unrestrained passenger in a veh icle struck from behind. In the emergency department, her b lood pressure is 80/60 mm Hg, heart rate is 80 beats per m inute, and respiratory rate is 16 breaths per minute. Her GCS score is 14. She comp lains that her legs feel "funny and won't move r ight;" however, her sp ine x-rays do not show a fracture or dislocation. A spinal cord injury in this child a. is most likely a central cord syndrom e. b. must be d iagnosed by magnetic resonance imaging. c. can be excluded by obtaining a CT of the entire spine. d. may exist in the absence of objectiv e findings on x-ray studies. e. is unlikely because of the incomplete calcification of the vertebral bodies. 9. Immediate chest tube ins ertion is indicated for which of the following conditions? a. Pneumothorax b. Pneumomediastinum c. Massive hemothorax d. Diaphragmatic rupture e. Subcutaneous emphysema 10.A 32-year-old man is brought to the hosp ital unconscious with severe facial injuries and no isy 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 r eveals a large hematoma of the pharynx with loss of normal anatomic landmarks. Initial management of his airway should consist of a. inserting an oroph aryngealairvvay. b. ins erting a nasopharyngeal airway. c. performing a surgical cricothyroidotomy. d. p erformingfiberoptic-guided nasotracheal intubation. e. performingorotracheal intubation after obtaining a lateral c-spine x-ray. 11.The primary indication for transferring a patient to a h igher level trauma center is a. unavailability of a surgeon or operating room staff. b. multiple system injuries, including severe head injury. c. resource limitations as determined by the transferring doctor. d. resource limitations as determined by the hospital administration. e. widened m ediastinum on chest x-ray following blunt thoracic trauma. 12.A young man sus tains a ritle wound to the mid-abdomen. He is brought promptly to the emergency department by pr ehospital personnel. His skin is cool and d iaphoretic, and h is systolic blood pressure is 58 rnm Hg. Warmed crystalloid fluids are initiated without improvem ent in his vital signs. The next, most appropriate step is to perform a. celiotomy. b. an abdominal CT scan. c. diagnostic laparoscopy. d. abdominal ultrasonography. e. a diagnostic peritoneal lavage. 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 l egs, and has abrasions on her chest and abdominal wall. Her blood pressure is 80/50 mm Hg, heart rate is 140 beats per m inute, respiratory rate is 8 breaths per m inute, and GCS score is 6. The first step in m anaging this patient is to a. obtain a lateral cervical spine x-ray. b. insert a central venous pressure line. c. administer 2 liters of crystalloid solution. d. perform endotracheal intubation and ventilation. e. apply the PASG and inflate the l eg compartments. 14.An 8-year-old boy falls 4.5 meters (15 feet) from a tree and is brought to the emergency department by h is family. His vital signs are normal, but h e complains of left upper quadrant p ain. An abdominal CT scan r eveals a moderately severe laceration of the sp leen. The receiving institution does not have 24-hour-a-day op erating room capabilities . The most appropriate management of this patient would be to a. type and crossmatch for blood. b. request consu ltation 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 d ay.