ATLS Pretest
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
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- Evidence of improved perfusion after fluid resuscitation could include
improvement in Glasgow Coma Scale score on reevaluation.
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- An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
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- cerebral vasoconstriction with diminished perfusion
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