Summary ATLS Test 1 EXAM 2024-2025 QUESTIONS and
ANSWERS
A patient is brought to the emergency department after a motor vehicle crash. He is conscious
and there is no obvious external trauma. His blood pressure 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?
Select one:
a.Vasoactive medications have no role in this patient's management.
b.The hypotension should be managed with volume resuscitation alone.
c.Flexion and extension views of the c-spine should be performed early.
d.Abdominal visceral injuries can be excluded as a cause of hypotension.
e.Flaccidity of the lower extremities and loss of deep tendon reflexes are expected. - ANSWER-
e.Flaccidity of the lower extremities and loss of deep tendon reflexes are expected
Which one of the following is the most effective method for initially treating frostbite?
Select one:
a.moist heat
b.early amputation
c.padding and elevation
d.vasodilators and heparin
e.topical application of silver sulfadiazine - ANSWER-a. moist heat
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he
is extricated. On arrival to the emergency department, his right lower extremity is cool,
mottled, insensate, and motionless. Despite normal vital signs, a pulse cannot be palpated
below the right femoral artery and the muscles of the lower extremity are firm and hard. During
the management of this patient, which of the following is most likely to improve the chances
for limb salvage?
Select one:
a.applying skeletal traction
b.administering anticoagulant drugs
,c.administering thrombolytic therapy
d.surgical consultation for right lower extremity fasciotomy e.
transferring the patient to the trauma center 120 km away - ANSWER-d. surgical consultation
for right lower extremity fasciotomy
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:
Select one:
a.request a CT scan
b.insert a gastric tube
c.suction the oropharynx
d.obtain a lateral cervical spine x-ray
e.ventilate the patient with a bag-mask - ANSWER-c. suction the oropharynx
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital; no surgical capabilities are available. In the emergency department, 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 blood pressure
decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute. The next step
should be to:
Select one:
a.clamp the chest tube
b.cancel the patient's transfer
c.perform an emergency department thoracotomy
d.repeat the primary survey and proceed with transfer
e.delay the transfer until the referring doctor can contact a thoracic surgeon - ANSWER-d.
repeat the primary survey and proceed with transfer
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 chest x-ray with fractures of left ribs 2 through 4, but no
pneumothorax. After initiating fluid resuscitation, his blood pressure is 110/74 mm Hg,
, heart rate is 100 beats per minute, and respiratory rate is 18 breaths per minute. He has gross
hematuria and a pelvic fracture. You decide to transfer this patient to a facility capable of
providing a higher level of care. The facility is 128 km (80 miles) away. Before transfer, you
should first:
Select one:
a.intubate the patient
b.perform diagnostic peritoneal lavage or FAST
c.insert a left chest tube
d.call the receiving hospital and speak to the surgeon on call
e.discuss the advisability of transfer with the patient's family - ANSWER- d.
call the receiving hospital and speak to the surgeon on call
Hemorrhage of 20% of the patient's blood volume is associated usually with:
Select one:
a. oliguria
b. confusion
c.hypotensio
d. tachycardia e.
blood transfusion requirement - ANSWER-d. tachycardia
Which one of the following statements concerning intraosseous infusion is TRUE?
Select one:
a.Only crystalloid solutions may be safely infused through the needle.
b.Aspiration of bone marrow confirms appropriate positioning of the needle.
c.Intraosseous infusion is the preferred route for volume resuscitation in small children.
d.Intraosseous infusion may be utilized indefinitely. e.
ANSWERS
A patient is brought to the emergency department after a motor vehicle crash. He is conscious
and there is no obvious external trauma. His blood pressure 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?
Select one:
a.Vasoactive medications have no role in this patient's management.
b.The hypotension should be managed with volume resuscitation alone.
c.Flexion and extension views of the c-spine should be performed early.
d.Abdominal visceral injuries can be excluded as a cause of hypotension.
e.Flaccidity of the lower extremities and loss of deep tendon reflexes are expected. - ANSWER-
e.Flaccidity of the lower extremities and loss of deep tendon reflexes are expected
Which one of the following is the most effective method for initially treating frostbite?
Select one:
a.moist heat
b.early amputation
c.padding and elevation
d.vasodilators and heparin
e.topical application of silver sulfadiazine - ANSWER-a. moist heat
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he
is extricated. On arrival to the emergency department, his right lower extremity is cool,
mottled, insensate, and motionless. Despite normal vital signs, a pulse cannot be palpated
below the right femoral artery and the muscles of the lower extremity are firm and hard. During
the management of this patient, which of the following is most likely to improve the chances
for limb salvage?
Select one:
a.applying skeletal traction
b.administering anticoagulant drugs
,c.administering thrombolytic therapy
d.surgical consultation for right lower extremity fasciotomy e.
transferring the patient to the trauma center 120 km away - ANSWER-d. surgical consultation
for right lower extremity fasciotomy
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:
Select one:
a.request a CT scan
b.insert a gastric tube
c.suction the oropharynx
d.obtain a lateral cervical spine x-ray
e.ventilate the patient with a bag-mask - ANSWER-c. suction the oropharynx
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital; no surgical capabilities are available. In the emergency department, 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 blood pressure
decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute. The next step
should be to:
Select one:
a.clamp the chest tube
b.cancel the patient's transfer
c.perform an emergency department thoracotomy
d.repeat the primary survey and proceed with transfer
e.delay the transfer until the referring doctor can contact a thoracic surgeon - ANSWER-d.
repeat the primary survey and proceed with transfer
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 chest x-ray with fractures of left ribs 2 through 4, but no
pneumothorax. After initiating fluid resuscitation, his blood pressure is 110/74 mm Hg,
, heart rate is 100 beats per minute, and respiratory rate is 18 breaths per minute. He has gross
hematuria and a pelvic fracture. You decide to transfer this patient to a facility capable of
providing a higher level of care. The facility is 128 km (80 miles) away. Before transfer, you
should first:
Select one:
a.intubate the patient
b.perform diagnostic peritoneal lavage or FAST
c.insert a left chest tube
d.call the receiving hospital and speak to the surgeon on call
e.discuss the advisability of transfer with the patient's family - ANSWER- d.
call the receiving hospital and speak to the surgeon on call
Hemorrhage of 20% of the patient's blood volume is associated usually with:
Select one:
a. oliguria
b. confusion
c.hypotensio
d. tachycardia e.
blood transfusion requirement - ANSWER-d. tachycardia
Which one of the following statements concerning intraosseous infusion is TRUE?
Select one:
a.Only crystalloid solutions may be safely infused through the needle.
b.Aspiration of bone marrow confirms appropriate positioning of the needle.
c.Intraosseous infusion is the preferred route for volume resuscitation in small children.
d.Intraosseous infusion may be utilized indefinitely. e.
