ATLS practice Questions and Answers A+ Graded 100% Verified

ATLS practice Questions and Answers A+ Graded 100% Verified Assessed first in trauma patient ANSWER: Airway (*)Degree of burn that is characterized by bone involvement ANSWER: Fourth Complications of head trauma ANSWER: Intracerebral hematoma Extradural hematoma Brain abscess Most common cause of laryngotracheal stenosis ANSWER: Trauma Intervention that can help prevent development of acute renal failure ANSWER: Infusion of normal saline A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was complicated by a fractured pelvis. A few hours later, the patient becomes febrile, hypotensive with a normal CVP, and oliguric. Upon examination, the patient is found to be bleeding from the NG tube and IV sites. Which of the following is the most likely diagnosis? A. Hemorrhagic shock B. Acute adrenal insufficiency C. Fat embolism syndrome D. Transfusion reaction ANSWER: D. Transfusion reaction Skin antiseptic ANSWER: -Ethanol 70% is an effective skin antiseptic -Acetic acid can be used to treat Gram- skin infections -Salicylic acid is used to treat certain skin yeast infections Class IV hemorrhage indicates what % blood loss ANSWER: 55% How does shivering affect body temperature ANSWER: Increases body temperature Class III hemorrhage indicates what % of blood loss ANSWER: 35% Management of a stable patient with kidney contusion ANSWER: Observation Associated with hypovolemic shock ANSWER: -Inadequate tissue perfusion with resultant tissue hypoxia -Blood shunting to vital organs -Decreased circulating blood volume and decreased venous return -Low cardiac output -Loss of less than 20% of the blood volume is usually without symptom except for mild tachycardia -Patients become orthostatic with losses between 20 and 40% -Shock is evidenced by tachycardia, hypotension, oliguria, flat neck veins The most effective method of monitoring the success of resuscitation during CPR? ANSWER: Reactivity of pupils to light Used to ensure correct placement of endotracheal tube ANSWER: -Ultrasound -Bilateral breath sounds -Sustained end-tidal CO2 Total body surface area involved in a burn in an adult to the anterior chest and abdomen ANSWER: 18% What is often caused by carotid massage? ANSWER: Bradycardia Step in a patient diagnosed with tension pneumothorax ANSWER: 1. Needle decompression/ thoracotomy 2. Chest tube True statements regarding diaphragmatic injuries ANSWER: -Blunt diaphragmatic injuries are usually associated with skeletal trauma -Penetrating diaphragmatic injuries may be missed -Repair of traumatic diaphragmatic injuries usually does not require prosthetic material First priority in the treatment of an unconscious patient ANSWER: Checking the pulse A patient involved in a road accident is brought to the emergency department in an unconscious state. On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold, shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain. On physical examination, she has no obvious sign of external bleeding. Which of the following cannot be the cause of hypotension in this patient? A. Pelvic fracture B. Fracture of femur C. Intracranial hemorrhage D. Hemothorax ANSWER: C. Intracranial hemorrhage A patient suffered a slash to his right neck. The wound is over the mid-portion of the sternocleidomastoid. There is a large hematoma and brisk bleeding when uncovered. He is stable. What is the next step in management? A. Get an angiogram B. Close the wound in the ER C. Take him to the operating room D. CT scan to evaluate neck structure ANSWER: C. Take him to the OR After abdominal injury, which of the following urinalysis findings would be an indication for further testing? A. 0-5 casts/HPF B. 5-10 WBC/HPF C. 10-20 RBC/HPF D. Gross hematuria ANSWER: D. Gross hematuria A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at its midpoint would cause bleeding from which structure? ANSWER: External jugular vein Clinical features associated with tension pneumothorax ANSWER: Unilateral decrease in breath sounds Hyperresonance Respiratory distress Tachycardia Tracheal shift Desatruation Decreased breath sounds Decreased compliance Asymmetric chest movement NOT hypertension, audible bronchial sounds Not recommended as a mode of ventilation for a patient with a diaphragmatic hernia A. Bag and mask B. LMA C. Endotracheal intubation D. Jet ventilation ANSWER: A. Bag and mask What is the next step in the assessment of a traumatic patient after airway is established? ANSWER: Breathing Blood group that is considered a universal donor ANSWER: O A provider is examining a patient who sustained a severe traumatic head injury. He documents no Doll's eyes. What does this signify? ANSWER: Brainstem injury Which of the following is the least preferred method of administering IV fluids? A. Cubital veins B. Cephalic veins C. Subclavian veins D. Saphenous vein ANSWER: Subclavian veins Dermatome level for nipple sensation Dermatome level for umbilicus ANSWER: T4 T10 At which temperature would a hypothermic patient stop shivering? ANSWER: 88 degrees F What is the energy recommendation for the first defibrillation in an adult (*) ANSWER: 300 J Pharmacologic effects of Morphine ANSWER: Behavioral changes Analgesia Respiratory depression NOT diarrhea A patient with which condition should be triaged to receive medical attention first? A. Choking B. Dizziness C. Leg cramp D. Vomiting ANSWER: A. Choking For pediatric patients, what volume of fluid resuscitation should be given initially in the setting of shock? A. 750 mL of saline uniformly B. 1 liter of saline C. 20 mL/kg of 0.45% NaCl with 5% glucose D. 10 to 20 mL/kg of Ringers lactate ANSWER: D. 10 to 20 mL/kg of Ringers lactate A patient is found unconscious after a fire in his bedroom. He is found to have severe burns around his face. What is the first aspect of treatment? A. Tetanus toxoid B. Cover the wound C. Airway D. Obtain blood work ANSWER: C. Airway Basilar skull fracture ANSWER: PE: raccoon eyes, battle sign, CSF ottorrhea (rhinorrhea), loculated pneumoencephalocele Bone MC involved = Temporal A patient with von Willebrand disease is bleeding after sustaining a knife wound. Which of the following is most appropriate for the treatment of this patient? A. Vitamin K B. Cryoprecipitate C. Protamine D. DDAVP ANSWER: D. DDAVP What is the total body surface area involved in a burn to both lower extremities? ANSWER: 36% Which injury is most common in rear end motor vehicle accidents? A. Cervical fractures B. Hypextension-hyperflexion neck injuries C. Forearm fractures D. Rotational neck injuries ANSWER: B. Hypextension-hyperflexion neck injuries What is true about an unrestrained pregnant driver? A. She is at increased risk of placenta previa B. She is at increased risk of placental abruption C. At 33 weeks, her fetus is well protected by an amniotic fluid cushion and thus the pregnancy is not at risk D. If the mother's vital signs are stable, complications are unlikely ANSWER: B. She is at increased risk of placental abruption In adults, an aspirated foreign body is most likely to get stuck in the: A. Left main bronchus B. Carina C. Right main bronchus D. Esophagus ANSWER: C. Right main bronchus Skin finding characteristic of second-degree burns ANSWER: Blisters Which is true regarding cervical spine fractures? A. Seen most commonly in elderly females B. Athletic activities are the most common cause C. Falls are the most common cause D. Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours ANSWER: D. Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours In which patients can an oropharyngeal airway be used? ANSWER: Non-gag reflex If a trauma patient has clear fluid draining from the nose the provider should do which of the following? A. Tilt the head back B. Apply pressure C. Collect the fluid D. Insert nasal tampons ANSWER: C. Collect the fluid What is the estimated time a person's brain can be anoxic from cardiopulmonary failure and not develop permanent brain damage? A. 10 minutes B. 5 minutes C. 2 minutes D. 20 minutes ANSWER: B. 5 minutes The laryngeal mask airway is contraindicated in patients with what condition? A. Spine injury B. Head trauma C. Giving birth D. Propensity to aspirate ANSWER: D. Propensity to aspirate A patient sustains blunt trauma to the back and left leg. Vital signs in the emergency department show temperature 36 degrees C, BP 120/80 mm Hg, heart rate 92, respirations 19, GCS 15. There is bilateral lower extremity paraplegia, T12 sensory level, and decreased rectal tone. Hemoglobin is 14.2 and the same in one hour. Which of the following tests is best for diagnosing an intraperitoneal bleed? A. Abdominal ultrasound B. Laparotomy C. KUB D. Diagnostic peritoneal lavage ANSWER: A. Abdominal ultrasound Why is tracheostomy generally not performed at the first cartilage ring A. The trachea is too narrow B. A high chance of subglottic stenosis C. A high chance of tracheo-innominate artery fistula D. Inability to access the area ANSWER: B. A high chance of subglottic stenosis What does a carotid pulse indicate? A. A functioning pump for blood flow B. The circulating blood volume is reaching end organs C. Diastolic blood pressure D. None of the above ANSWER: B. The circulating blood volume is reaching end organs Which of the following generally causes hemorrhage associated with pelvic fractures? A. Obturator artery injury B. Superior gluteal artery C. Lateral sacral artery injury D. Venous bleeding ANSWER: D. Venous bleeding Hemothorax facts ANSWER: -Must have at least 500 cc of blood to make a diagnosis on chest x-rayin an adult -Incomplete evacuation of hemothorax can lead to empyema -Initial treatment of hemothorax is always a chest tube In a 66 year old intubated, comatose patient, what is one of the most important information that one needs to obtain? A. Organ donation status B. Power of attorney C. Lawyer D. Driver's license ANSWER: B. Power of attorney A patient is hit by a car and has severe injuries to his extremities. He is immediately brought to the emergency room by EMS. Evaluation reveals that he has multiple organ injuries. He has an open, gaping wound which measures 2 x 2 centimeters, just below the right knee. The leg appears dislocated and ecchymotic. However, pulses are present in the distal extremity. He does not complain of any paresthesias. X-ray reveals that there is a fracture of the tibia. The trauma team is called. As their arrival is awaited, which of the following should NOT be done to help manage this patient? A. Obtain culture and close wound using a sterile technique B. Don't reduce the dislocation C. Give tetanus toxoid/booster shot D. Give antibiotics ANSWER: A. Obtain culture and close wound using a sterile technique During resuscitation, your intubated patient's intravenous fluid infiltrates. You know that you may deliver the following drugs via the endotracheal tube: ANSWER: Lidocaine Atropine Naloxone Epinephrine Prior to tracheobronchial suctioning, the patient should receive: A. 5cc normal saline lavage B. Be placed on NPO status C. 100% oxygen prior to suctioning D. Versed 1 mg/mL ANSWER: C. 100% oxygen prior to suctioning In a patient with a pneumothorax following a stab wound, the chest tube is best inserted at which level? ANSWER: Between the 4th and 5th intercostal spaces, just anterior to the mid axillary line Indications for a CT scan of the head in trauma patients ANSWER: -Glasgow coma scale score of less than 14 -Evidence of basilar skull fracture -Amnesia lasting more than 30 minutes Most common Emergency Medical Services pediatric calls ANSWER: -Seizures -Respiratory problems -Trauma Treatments utilized in a patient with head trauma and raised intracranial pressure ANSWER: -Elevation of the head -Sedation -Use of diuretics NOT fluid restriction How deep should the provider depress the patient's sternum during CPR in adults? ANSWER: 2 to 3 inches First parameter to change in patient's with hypovolemic shock? A. Systolic blood pressure B. Pulse rate C. Respiratory rate D. Skin vasoconstriction ANSWER: B. Pulse rate A 34-year-old with severe head trauma and elevated intracranial pressures is intubated. Which of the following should be the target for mechanical ventilation? ANSWER: Set PaCO2 between 30-35