ATLS Pre-test 2023 exam questions and
answers
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: - Answer-- *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: - Answer-- complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? -
Answer-- 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: - Answer-- 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? - Answer-- 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: - Answer-- increasing the
volume of blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the adult burn patient is: - Answer-- urinary
output of 0.5 mL/kg/hr
The diagnosis of shock must include: - Answer-- 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: -
Answer-- direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent: - Answer-- respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
that has surgery capabilities available. Computed tomography of the chest and
abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His
blood pressure falls to 70 mm Hg after CT. The next step is: - Answer-- perform an
exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE? - Answer-- The fetus is in jeopardy only with major abdominal trauma.
- *Leakage of amniotic fluid is an indication for hospital admission.*
- Indications for peritoneal lavage are different from those in the nonpregnant patient.
- With penetrating trauma, injury to the mother's abdominal hollow viscus is more
common in late than in early pregnancy.
- The secondary survey follows a different pattern from that of the nonpregnant patient.
The first maneuver to improve oxygenation after chest injury is: - Answer-- *Administer
supplemental oxygen*
- intubate the patient
- assess arterial blood gases
- ascertain the need for a chest tube
- obtain a chest x-ray
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
department. His pupils react sluggishly and his eyes open to pressure. He does not
follow commands, but he does moan periodically. His right arm is deformed and does
answers
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: - Answer-- *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: - Answer-- complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? -
Answer-- 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: - Answer-- 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? - Answer-- 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: - Answer-- increasing the
volume of blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the adult burn patient is: - Answer-- urinary
output of 0.5 mL/kg/hr
The diagnosis of shock must include: - Answer-- 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: -
Answer-- direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent: - Answer-- respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
that has surgery capabilities available. Computed tomography of the chest and
abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His
blood pressure falls to 70 mm Hg after CT. The next step is: - Answer-- perform an
exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE? - Answer-- The fetus is in jeopardy only with major abdominal trauma.
- *Leakage of amniotic fluid is an indication for hospital admission.*
- Indications for peritoneal lavage are different from those in the nonpregnant patient.
- With penetrating trauma, injury to the mother's abdominal hollow viscus is more
common in late than in early pregnancy.
- The secondary survey follows a different pattern from that of the nonpregnant patient.
The first maneuver to improve oxygenation after chest injury is: - Answer-- *Administer
supplemental oxygen*
- intubate the patient
- assess arterial blood gases
- ascertain the need for a chest tube
- obtain a chest x-ray
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
department. His pupils react sluggishly and his eyes open to pressure. He does not
follow commands, but he does moan periodically. His right arm is deformed and does
