ATLS POST TEST
1. The diagnosis of shock must include:Select one:
a. hypoxemia
b. acidosis
c.
hypotension
d.
increased vascular resistance
e.
evidence of inadequate organ perfusion
Answer: e.evidence of inadequate organ perfusion
2. 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 froma 6-cm wound
of his medial right thigh. Immediate management of the woundshould consist of:
Select one:
a.
application of a tourniquet
b.
direct pressure on the wound
c.
packing the wound with gauze
d.
direct pressure on the femoral artery at the groin
e.
debridement of devitalized tissue
Answer: b.direct pressure on the wound
3. For the patient with severe traumatic brain injury, profound hypocarbiashould
be avoided to prevent:
Select one:
a.
respiratory acidosis
b.
metabolic acidosis
c.
cerebral vasoconstriction with diminished perfusion
d.
neurogenic pulmonary edema
e.
shift of the oxyhemoglobin dissociation curve
Answer: c.cerebral vasoconstriction with diminished perfusion
,4. After being involved in a motor vehicle crash, a 25-year-old man is broughtto a
hospital that has surgery capabilities available.. Computed tomography of the chest
and abdomen shows an aortic injury and splenic laceration withfree abdominal
fluid. His blood pressure falls to 70 mm Hg after CT. The nextstep is:
Select one:
a.
obtain contrast angiography
b.
transfer to a higher level trauma center
c.
perform an exploratory laparotomy
d.
infuse additional crystalloid fluids
e.
Obtain transesophageal echocardiography
Answer: c.perform an exploratory laparotomy
5. Which one of the following statements regarding abdominal trauma in the
pregnant patient is TRUE?
Select one:
a.
The fetus is in jeopardy only with major maternal abdominal trauma.
b.
Leakage of amniotic fluid is an indication for hospital admission.
c.
Indications for peritoneal lavage are different from those in the nonpregnantpatient.
d.
With penetrating trauma, injury to the mother's abdominal hollow viscus ismore
common in late than in early pregnancy.
e.
The secondary survey follows a different pattern from that of the nonpregnantpatient.
Answer: b.
Leakage of amniotic fluid is an indication for hospital admission.
6. The first maneuver to improve oxygenation after chest injury is to:Select one:
a.
intubate the patient
b.
assess arterial blood gases
c.
administer supplemental oxygen
d.
ascertain the need for a chest tube
e.
obtain a chest x-ray
, Answer: c. administer supplemental oxygen
7. 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. Hisright arm is
deformed and does not respond to pressure; however, his left hand reaches
purposefully toward the stimulus. Both legs are stiffly extended.His GCS score is:
Select one:
a: 2
b: 4
c: 6
d: 9
e: 12
Answer: d: 9
8. Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?
Select one:
a.
distended abdomen
b.
Glasgow Coma Scale score of 11
c.
temperature of 36.5°C (97.8°F)
d.
deformity of the right thigh
e.
respiratory rate of 40 breaths per minute
Answer: e.respiratory rate of 40 breaths per minute
9. A 20-year-old woman that is 32 weeks gestation , is stabbed in the upper right
chest. In the emergency department, her blood pressure is 80/60 mm Hg. She is
gasping for breath, extremely anxious, and yelling for help. Breathsounds are
diminished in the right chest.The most appropriate first step is to:Select one:
a.
perform tracheal intubation
b.
insert an oropharyngeal airway
c.
perform needle or finger decompression of the right chest
d.
manually displace the gravid uterus to the left side of the abdomen
e.
initiate 2, large-caliber peripheral IV lines and crystalloid infusion
Answer: c.perform needle or finger decompression of the right chest
1. The diagnosis of shock must include:Select one:
a. hypoxemia
b. acidosis
c.
hypotension
d.
increased vascular resistance
e.
evidence of inadequate organ perfusion
Answer: e.evidence of inadequate organ perfusion
2. 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 froma 6-cm wound
of his medial right thigh. Immediate management of the woundshould consist of:
Select one:
a.
application of a tourniquet
b.
direct pressure on the wound
c.
packing the wound with gauze
d.
direct pressure on the femoral artery at the groin
e.
debridement of devitalized tissue
Answer: b.direct pressure on the wound
3. For the patient with severe traumatic brain injury, profound hypocarbiashould
be avoided to prevent:
Select one:
a.
respiratory acidosis
b.
metabolic acidosis
c.
cerebral vasoconstriction with diminished perfusion
d.
neurogenic pulmonary edema
e.
shift of the oxyhemoglobin dissociation curve
Answer: c.cerebral vasoconstriction with diminished perfusion
,4. After being involved in a motor vehicle crash, a 25-year-old man is broughtto a
hospital that has surgery capabilities available.. Computed tomography of the chest
and abdomen shows an aortic injury and splenic laceration withfree abdominal
fluid. His blood pressure falls to 70 mm Hg after CT. The nextstep is:
Select one:
a.
obtain contrast angiography
b.
transfer to a higher level trauma center
c.
perform an exploratory laparotomy
d.
infuse additional crystalloid fluids
e.
Obtain transesophageal echocardiography
Answer: c.perform an exploratory laparotomy
5. Which one of the following statements regarding abdominal trauma in the
pregnant patient is TRUE?
Select one:
a.
The fetus is in jeopardy only with major maternal abdominal trauma.
b.
Leakage of amniotic fluid is an indication for hospital admission.
c.
Indications for peritoneal lavage are different from those in the nonpregnantpatient.
d.
With penetrating trauma, injury to the mother's abdominal hollow viscus ismore
common in late than in early pregnancy.
e.
The secondary survey follows a different pattern from that of the nonpregnantpatient.
Answer: b.
Leakage of amniotic fluid is an indication for hospital admission.
6. The first maneuver to improve oxygenation after chest injury is to:Select one:
a.
intubate the patient
b.
assess arterial blood gases
c.
administer supplemental oxygen
d.
ascertain the need for a chest tube
e.
obtain a chest x-ray
, Answer: c. administer supplemental oxygen
7. 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. Hisright arm is
deformed and does not respond to pressure; however, his left hand reaches
purposefully toward the stimulus. Both legs are stiffly extended.His GCS score is:
Select one:
a: 2
b: 4
c: 6
d: 9
e: 12
Answer: d: 9
8. Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?
Select one:
a.
distended abdomen
b.
Glasgow Coma Scale score of 11
c.
temperature of 36.5°C (97.8°F)
d.
deformity of the right thigh
e.
respiratory rate of 40 breaths per minute
Answer: e.respiratory rate of 40 breaths per minute
9. A 20-year-old woman that is 32 weeks gestation , is stabbed in the upper right
chest. In the emergency department, her blood pressure is 80/60 mm Hg. She is
gasping for breath, extremely anxious, and yelling for help. Breathsounds are
diminished in the right chest.The most appropriate first step is to:Select one:
a.
perform tracheal intubation
b.
insert an oropharyngeal airway
c.
perform needle or finger decompression of the right chest
d.
manually displace the gravid uterus to the left side of the abdomen
e.
initiate 2, large-caliber peripheral IV lines and crystalloid infusion
Answer: c.perform needle or finger decompression of the right chest
