ATLS TEST EXAM QUESTIONS WITH
COMPLETE SOLUTIONS 2023
re-examine the chest - Answer-A 22-year-old man is hypotensive and tachycardic after
a shotgun wound to the left shoulder. His BP is initially 80/40 mm Hg. After 2 liters of
crystalloid solution his BP increases to 122/84. His heart rate is now 100 BPM and his
RR is 28 breaths per minute. His breath sounds are decreased in the left hemithorax,
and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for
decreased left 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 __________.
complete spine x-rays - Answer-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 _________.
secure the airway - Answer-In managing the head-injured patient, the most important
initial step is to ________.
his systolic pressure will be decreased with a narrowed pulse pressure - Answer-A
previously healthy, 70 kg man suffers an estimated acute blood loss of 2 liters. How will
this affect his blood pressure?
increasing the volume of blood loss to produce maternal hypotension - Answer-The
physiologic hypervolemia of pregnancy has clinical significance in the management of
the severely injured, gravid woman by ____________.
adequate urinary output - Answer-The best assessment of fluid resuscitation of the adult
burn patient is __________.
evidence of inadequate organ perfusion - Answer-The diagnosis of shock must include
_________.
direct pressure on the wound - Answer-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 ________ (application of a tourniquet vs. direct pressure
on the wound).
cerebral vasoconstriction with diminished perfusion - Answer-For the patient with severe
TBI, profound hypocarbia should be avoided to prevent __________.
,exploratory laparotomy - Answer-A 25-year-old man is brought to a hospital after being
involved in a MVA. CT shows an aortic injury and splenic laceration with free abdominal
fluid. His BP falls to 70 mm Hg after CT. The next step is _______.
leakage of amniotic fluid - Answer-Abdominal trauma in a pregnant patient -->
_________ is an indication for hospital admission.
administer supplemental oxygen - Answer-What is the first maneuver to improve
oxygenation after chest injury?
9 (eyes = 2, verbal = 2, motor = 5) - Answer-A 25-year old man, injured in a MVA, is
admitted to the emergency department. His pupils react sluggishly and his eyes open to
painful stimuli. He does not follow commands, but he does moan periodically. His right
arm is deformed and does not respond to painful stimulus; however, his left hand
reaches purposefully toward the painful stimulus. Both legs are stiffly extended. His
GCS score is ________.
RR of 40 BPM - Answer-Which one of the following findings in an adult is most likely to
require immediate management during the primary survey: distended abdomen, GCS
score of 11, deforming of the right thigh, RR of 40 BPM.
placement of an occlusive dressing over the wound - Answer-The most important,
immediate step in the management of an open pneumothorax is _________.
history of neurological reaction or severe hypersensitivity to the product - Answer-The
following are contraindications for tetanus toxoid administration: history of neurological
reaction or severe hypersensitivity to the product, local side effects, muscular spasms,
pregnancy, or all of the above.
breath sounds - Answer-A 56-year-old man is thrown violently against the steering
wheel of his truck during a motor vehicle crash. On arrival in the emergency
department, he is diaphoretic and complaining of chest pain. His BP is 60/40 mm Hg
and his RR is 40 breaths per minute. Which of the following best differentiates cardiac
tamponade from tension pneumothorax as the cause of his hypotension?
the trachea is relatively short - Answer-Bronchial intubation of the right or left mainstem
bronchus can easily occur during infant ET intubation because _______.
urgently transfer the patient to the operating room - Answer-A 23-year-old man sustains
4 stab wounds to the upper right chest during an altercation and is brought by
ambulance to a hospital that has full surgical capabilities. His wounds are all above the
nipple. He is endotracheally intubated, closed tube thoracostomy is performed, and 2
liters of crystalloid solution are infused through 2 large-caliber IVs. His blood pressure is
now 60/0 mm Hg. Heart rate is 160 bpm, and RR is 14 breaths per minute (ventilated
with 100% O2). 1500 cc of blood has drained from the right chest. The most appropriate
next step in managing this patient is to ______.
, attempt orotracheal intubation using 2 people and inline stabilization of the cervical
spine - Answer-A 39-year-old man is admitted to the emergency department after an
automobile collision. He is cyanotic, has insufficient respiratory effort, and has a GCS
Score of 6. His full beard makes it difficult to fit the oxygen facemask to his face. The
most appropriate next step is to _______.
flaccidity of the lower extremities and loss of deep tendon reflexes are expected -
Answer-A patient is brought to the emergency department after a motor vehicle crash.
He is conscious and there is no obvious external trauma. He arrives at the hospital
completely immobilized on a long spine board. His BP is 60/40 mm Hg and his heart
rate is 70 beats per minute. His skin is warm. Which one of the following statements is
TRUE?
moist heat - Answer-What is the most effective method for initially treating frostbite?
suction the oropharynx - Answer-A patient arrives in the emergency department after
being beaten about the head and face with a wooden club. He is comatose and has a
palpable depressed skull fracture. His face is swollen and ecchymotic. He has gurgling
respirations and vomitus on his face and clothing. The most appropriate step after
providing supplemental oxygen and elevating his jaw is to _______.
repeat the primary survey and proceed with the transfer - Answer-A 22-year-old man
sustains a gunshot wound to the left chest and is transported to a small community
hospital at which surgical capabilities are not available. In the emergency dept, a chest
tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the
patient in transfer. Just before the patient is placed in the ambulance for transfer, his BP
decreases to 80/68 and his HR increases to 136 beats per minute. The next step should
be to ______.
call the receiving hospital and speak to the surgeon on call - Answer-A 64-year-old man
involved in a high-speed car crash is resuscitated initially in a small hospital without
surgical capabilities. He has a closed head injury with a GCS score of 13. He has a
widened mediastinum on CXR with fractures of left ribs 2-4, but no pneumothorax. After
infusing 2 liters of crystalloid solution, bis BP is 110/74, his heart rate is 100 bpm, and
his RR is 18 breaths per minute. He has gross hematuria and a pelvic fracture. You
decided to transfer this patient to a facility capable of providing a higher level of care.
The facility is 80 miles away. Before transfer, you should first _______.
tachycardia - Answer-Hemorrhage of 20% of the patient's blood volume is usually a/w
_______.
aspiration of bone marrow confirms appropriate positioning of the needle - Answer-
Which one of the following statements concerning intraosseous infusion is TRUE?
COMPLETE SOLUTIONS 2023
re-examine the chest - Answer-A 22-year-old man is hypotensive and tachycardic after
a shotgun wound to the left shoulder. His BP is initially 80/40 mm Hg. After 2 liters of
crystalloid solution his BP increases to 122/84. His heart rate is now 100 BPM and his
RR is 28 breaths per minute. His breath sounds are decreased in the left hemithorax,
and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for
decreased left 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 __________.
complete spine x-rays - Answer-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 _________.
secure the airway - Answer-In managing the head-injured patient, the most important
initial step is to ________.
his systolic pressure will be decreased with a narrowed pulse pressure - Answer-A
previously healthy, 70 kg man suffers an estimated acute blood loss of 2 liters. How will
this affect his blood pressure?
increasing the volume of blood loss to produce maternal hypotension - Answer-The
physiologic hypervolemia of pregnancy has clinical significance in the management of
the severely injured, gravid woman by ____________.
adequate urinary output - Answer-The best assessment of fluid resuscitation of the adult
burn patient is __________.
evidence of inadequate organ perfusion - Answer-The diagnosis of shock must include
_________.
direct pressure on the wound - Answer-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 ________ (application of a tourniquet vs. direct pressure
on the wound).
cerebral vasoconstriction with diminished perfusion - Answer-For the patient with severe
TBI, profound hypocarbia should be avoided to prevent __________.
,exploratory laparotomy - Answer-A 25-year-old man is brought to a hospital after being
involved in a MVA. CT shows an aortic injury and splenic laceration with free abdominal
fluid. His BP falls to 70 mm Hg after CT. The next step is _______.
leakage of amniotic fluid - Answer-Abdominal trauma in a pregnant patient -->
_________ is an indication for hospital admission.
administer supplemental oxygen - Answer-What is the first maneuver to improve
oxygenation after chest injury?
9 (eyes = 2, verbal = 2, motor = 5) - Answer-A 25-year old man, injured in a MVA, is
admitted to the emergency department. His pupils react sluggishly and his eyes open to
painful stimuli. He does not follow commands, but he does moan periodically. His right
arm is deformed and does not respond to painful stimulus; however, his left hand
reaches purposefully toward the painful stimulus. Both legs are stiffly extended. His
GCS score is ________.
RR of 40 BPM - Answer-Which one of the following findings in an adult is most likely to
require immediate management during the primary survey: distended abdomen, GCS
score of 11, deforming of the right thigh, RR of 40 BPM.
placement of an occlusive dressing over the wound - Answer-The most important,
immediate step in the management of an open pneumothorax is _________.
history of neurological reaction or severe hypersensitivity to the product - Answer-The
following are contraindications for tetanus toxoid administration: history of neurological
reaction or severe hypersensitivity to the product, local side effects, muscular spasms,
pregnancy, or all of the above.
breath sounds - Answer-A 56-year-old man is thrown violently against the steering
wheel of his truck during a motor vehicle crash. On arrival in the emergency
department, he is diaphoretic and complaining of chest pain. His BP is 60/40 mm Hg
and his RR is 40 breaths per minute. Which of the following best differentiates cardiac
tamponade from tension pneumothorax as the cause of his hypotension?
the trachea is relatively short - Answer-Bronchial intubation of the right or left mainstem
bronchus can easily occur during infant ET intubation because _______.
urgently transfer the patient to the operating room - Answer-A 23-year-old man sustains
4 stab wounds to the upper right chest during an altercation and is brought by
ambulance to a hospital that has full surgical capabilities. His wounds are all above the
nipple. He is endotracheally intubated, closed tube thoracostomy is performed, and 2
liters of crystalloid solution are infused through 2 large-caliber IVs. His blood pressure is
now 60/0 mm Hg. Heart rate is 160 bpm, and RR is 14 breaths per minute (ventilated
with 100% O2). 1500 cc of blood has drained from the right chest. The most appropriate
next step in managing this patient is to ______.
, attempt orotracheal intubation using 2 people and inline stabilization of the cervical
spine - Answer-A 39-year-old man is admitted to the emergency department after an
automobile collision. He is cyanotic, has insufficient respiratory effort, and has a GCS
Score of 6. His full beard makes it difficult to fit the oxygen facemask to his face. The
most appropriate next step is to _______.
flaccidity of the lower extremities and loss of deep tendon reflexes are expected -
Answer-A patient is brought to the emergency department after a motor vehicle crash.
He is conscious and there is no obvious external trauma. He arrives at the hospital
completely immobilized on a long spine board. His BP is 60/40 mm Hg and his heart
rate is 70 beats per minute. His skin is warm. Which one of the following statements is
TRUE?
moist heat - Answer-What is the most effective method for initially treating frostbite?
suction the oropharynx - Answer-A patient arrives in the emergency department after
being beaten about the head and face with a wooden club. He is comatose and has a
palpable depressed skull fracture. His face is swollen and ecchymotic. He has gurgling
respirations and vomitus on his face and clothing. The most appropriate step after
providing supplemental oxygen and elevating his jaw is to _______.
repeat the primary survey and proceed with the transfer - Answer-A 22-year-old man
sustains a gunshot wound to the left chest and is transported to a small community
hospital at which surgical capabilities are not available. In the emergency dept, a chest
tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the
patient in transfer. Just before the patient is placed in the ambulance for transfer, his BP
decreases to 80/68 and his HR increases to 136 beats per minute. The next step should
be to ______.
call the receiving hospital and speak to the surgeon on call - Answer-A 64-year-old man
involved in a high-speed car crash is resuscitated initially in a small hospital without
surgical capabilities. He has a closed head injury with a GCS score of 13. He has a
widened mediastinum on CXR with fractures of left ribs 2-4, but no pneumothorax. After
infusing 2 liters of crystalloid solution, bis BP is 110/74, his heart rate is 100 bpm, and
his RR is 18 breaths per minute. He has gross hematuria and a pelvic fracture. You
decided to transfer this patient to a facility capable of providing a higher level of care.
The facility is 80 miles away. Before transfer, you should first _______.
tachycardia - Answer-Hemorrhage of 20% of the patient's blood volume is usually a/w
_______.
aspiration of bone marrow confirms appropriate positioning of the needle - Answer-
Which one of the following statements concerning intraosseous infusion is TRUE?
