ATLS POST TEST 2023 QUESTIONS AND ANSWERS

ATLS POST TEST 2023 QUESTIONS AND
ANSWERS

1. Theprimaryindicationfortransferringas 4. Which one of the following st
s s s s s


patienttoahigherleveltraumacenteris: gpatientswiththoracicspineinjur s



Log-rollingmaybedestabili
unavailabilityofasurgeonoroperatingroom fracturesfromT-
staff.mult Adequateimmobilizatio
iplesysteminjuries,includingsevere accomplishedwiththescoops
SpinalcordinjurybelowT-10usuallys
headinjury.s
bowelandbladder
resourcelimitationsasdeterminedbythe
Hyperflexionfracturesinth
transferringdoctor. thoracicspineareinherently
resourcelimitationsasdeterminedbythe
Thesepatientsrarelypresentwit
hospitaladministration.widens
shockinassociationwithcor
edmediastinumonchestx-ray
followingbluntthoracictrauma.
5. youngsmanssustainssasritleswou
sabdomen. He is brought prompt
s s s s
2.teen-
cydepartmentbyprehospital pers s
aged bicycle rider is hit by a trucktraveling at a hi
s s s s s s s s s s

coolanddiaphoretic,andhissysto s
gh rate of speed. In theemergencydepartment,sh
s s s s s

is58rnmHg.
eisactivelybleedin gfrom open fractures of her le s s s s s s

Warmed crystalloid fluids
gs, and hasabrasionsonherchestandabdominalw
s s


all.Her bloodpressureis80/50mmHg,heartrateis
s
initiatedwithoutimpro s




140beatsperminute,respiratoryrateis8
s
alsigns.Thenext, mostappropriate s




breaths per minute, and GCS score is 6.Thefirsts
s s s s s s s
m:
tepinmanagingthispatientisto: ac
anabd

obtainalateralcervicalspinex-ray. s diagnost

insertacentralvenouspressureline.
s abdominalultraso
s


adiagnosticperitonea
ss administer2litersofcrystalloidsolution.

s performendotrachealintubationand
ventilation.sap 6. youngswomans sustainss assever
plythePASGandinflatetheleg the result of a motor vehicular cr
s s s s s s

compartments. gencydepartment,herGCSscore
essure is 140/90 mm Hg and her
s s s s s s s


3.Contraindication to nasogastric intubationi s s s s
atsperminute.Sheisintubatedand
sthepresenceofa: icallyventilated.Herpupilsare3m
gastricperforation. allyreactivetolight. Thereisnoot s

diaphragmaticrupture. ry.Themostimportant principle t s s s



opendepressedskullfracture.
s
arlymanagementofherheadinjur

, aggressivelytreatsystemichypertension. 9.8-year-
reducemetabolicrequirementsofthe
brain.diss soldgirlisanunrestrainedpassenge
tinguishbetweenintracranialhematoma kfrombehind.Intheemergency de s


andcerebraledema. lood pressure is80/60mmHg,hea
s s


perminute,andrespiratory rate is s s s



7. 22-year- minute.
old man is brought to the hospitalaftercrashing
s s s s s s
Her GCS score is 14. She compla
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hismotorcycleintoateleph one pole.Heisuncons s s
feel "funny and won't move righ
s s s s s



ciousandinprofoundshock.Hehasnoopenwou s
sspine x- s



ndsorobviousfractures. Thecauseofhisshockis s
rays do not show afractureordis
s s s s



MOSTLIKELYcaused by: ss
cordinjuryinthischild: s



ismostlikelyacentralcordsynd
mustbediagnosedbymagneticres
asubduralhematoma.
anssepiduralsshematoma. sast
canbeexcludedbyobtainingaCTo
ransectedssssslumbarsssssspinalscord. satr
en
ansectedcervicalspinalcorsd.
yexistintheabsenceofobjec
hemorrhageintothechestorabdomen.
findingsonx-ra
isunlikelybecauseoftheinco
calcificationofthevertebra
8. 30-year-
old man is struck by a car travelingat56kph(35m
s s s s s s s
10. Immediatechesttubeinsertion
ph).Hehasobviousfracturesofthe left tibia near t s s s s s
whichofthefollowingconditions?
he knee, pain in the pelvicarea,andseveredyspn
Pn
s s s s s


ea.Hisheartrateis180 s


beatsperminute,andhisrespiratoryrateis48 breat s
ss Pneumo
hs per minute with no breath sounds heardinthele
s s s s s s s
s Massive
ftchest.Atensionpneumothoraxisrelievedbyimme s


diateneedledecompressionand tubethoracostom s s
s Diaphrag

y. Subsequently, his heartrate decreases to 140 be
s s s s s s s
s Subcutaneous
ats perminute, hisrespiratoryrate decreases to 36
s s s s s s s


breaths perminute,andhisbloodpressureis80/50i
s


nmHg.Warmed Ringer's lactateis administeredint
s s s s
11. 18-year-
ravenously.Thenextpriorityshouldbeto: s
old,helmetedmotorcyclistisbroug s



performaurethrogramandcystogram. ambulance to the s s


emergencydepartment followin s

sss performexternalfixationofthepelvis.
speedcrash.Prehospitalpersorm
s


s obtainabdominalandpelvicCTscans. asthrown15 meters (50 feet) off
s s s s s


s ahistory of hypotension prior t
s s s s s
s performarterialembolizationofthepelvic
mergency department, but is now s s s s
vessels.sper
nd conversational. Which of the
s s s s
formdiagnosticperitoneallavageor

, Intraabdominalvisceralinjuriesare defmitivetreatmentinmanagingt
unlikely.
Thepatientprobablyhasanacute administer0-
epiduralhematoma. negativeblood. sapply
warming
devices. scontrolinternalhemo
12. crosstable,slateralsx- atively. sapplythepneumatican
ray of thecervicalspine:
s s s
ent.
infuselargevolumesofintr
mustprecedeendotrachealintubation. sexc
crystalloid
ludesssserioussscervicalssspinessinjury. sis
an essential part of the primary
survey. sisnotnecessaryforunconsciouspaties 16. Toestablishadiagnosisofshock
nts systolicbloodpressuremustbebelo
withpenetratingcervicalinjuries. sis
unacceptableunless7cervicalvertebraes presenceofaclosedheadinjurysho
andtheC-7toT-1relationshipare be
excluded.acidosisshouldbepresent
visualized.
od
\ga
patientmustfailtorespond
13. Duringsresuscitation,swhichsonesofsthef intravenousfluidi
ollowingisthemostreliableasaguidetovolu s clinicalevidenceofinadequ
mereplacement? perfusionmustb
Pulserate
Hematocrit s 17. Absenceofbreathsoundsandd
Bloodsss pressure s rcussionoverthelefthemithoraxa
Urinarysoutput
stexplainedby:
Jugularvenouspressure lefthem
cardiacs
eft
14. Whichsonesofsthesfollowingsisstherecom
pneumothorax. sle
s
mendedmethodforinitiallytreatingfrostbit s
aticsssssssssssss rupture. sr
e? neumothsorax.
Vasodilators

s Anticoagulants 18. 17-year-
Warm(40°C)waters sP
s
oldhelmetedmotorcyclistisstruc
addingandelevation nautomobileatanintersection.He
sTopicalapplicatio tthescenewithablood pressureof s

nofsilvasulphadiazine heartrateof90 beatsperminute,an
s


eof22
15. youngsmanssustainssasgunshotswoundstosthe breaths per minute. His respirati
s s s s



abdomen and is brought promptly to theemerg
s s s s s s
and deep. His GCS score is 6.Im
s s s s s s





encydepartmentbyprehospital personnel.Hiss s
he entire patient mayincludetheu
s s s