ATI PAST TEST 4 ACTUAL LATEST
VERSION 2024/2025 REAL EXAM 160+
CORRECT QUESTIONS AND VERIFIED
ANSWERS GRADED A+
A 14 year old female is brought to the ED after falling from a horse. She is immoblized
on a long spine board with a hard collar and blocks. Cervical spine x-ray: - ANS✔✔--
??
The first priority in management of a long bone fracture is:
A. Reduction of pain
B. Prevention of infection in case of an open fracture
C. Prevention of further soft tissue injury
D. Improve long term function
E. Control of hemorrhage - ANS✔✔--E. Control of hemorrhage
stop the bleeding!
The most SPECIFIC test to evaluate for injuries of solid abdominal organs is:
A. Abdominal x-ray
B. Abdominal ultrasound
C. Diagnostic peritoneal lavage
D. Frequent abdominal examination
E. CT Abd/Pelvis - ANS✔✔--E. CT Abd/Pelvis
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas - ANS✔✔--A.
Cerebral contusions may coalesce to form an intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He has one bullet wound just
below the right clavicle and another just below the costal margin in the right posterior
axillary line. His blood pressure is 110/60, heart rate of 90, and respiratory rate of 34.
After ensuring a patent airway and inserting 2 large caliber IV lines, the next most
appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
,C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage - ANS✔✔--A. Obtain a portable chest x-ray
need more info on chest, not abdomen
Which of the following should be performed FIRST in any patient whose injuries may
include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - ANS✔✔--D. Ensuring adequate
oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range.
His BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP
increases to 122/84 and HR decreases to 100. He is tachypneic with RR of 28. On PE,
his breath sounds are decreased at the left upper chest with dullness on percussion. A
large caliber tube thoracostomy is inserted into the fifth intercostal space with the return
of 200 mL of blood and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest - ANS✔✔--E. Repeat the physical exam of
the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle
decompression followed by tube
Which one of the following statements concerning spine and spinal cord trauma is
TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine
injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be
made in the primary survey - ANS✔✔--B. A vertebral injury is unlikely in the absence
of physical findings of a cord injury
, A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is
unresponsive and found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST
step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - ANS✔✔--D. Applying oxygen and
maintaining airway
First = ABCs
Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure - ANS✔✔--E. Decreased pulse pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a ladder
and landing straddled on a fence. Examination of his perineum reveals extensive
ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study
for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography - ANS✔✔--E. retrograde urethrography
-> any ecchymosis, needs to be done before catheter!
A 30 year old male presents after a MVC. Vitals are RR 18, HR 88, BP 130/72, GCS 13.
Laparatomy is indicated when:
A. There is a distinct seat belt sign over the abdomen
B. The CT demonstrates a grade 4 hepatic injury
C. There is evidence of extraperitoneal bladder injury
D. CT demonstrates retroperitoneal air
E. The abdomen is distended with localized rihgt upper quadrant tenderness -
ANS✔✔--D. CT demonstrates retroperitoneal air
-> air, peritonitis (tenderness, rigidity), unstable vital signs
A 20 year old male is brought to the hospital approximately 30 minutes after being
stabbed in the chest. There is 3 cm wound just medial to the left nipple. BP is 70/33 and
HR is 140. Neck and arm veins are distended. Breath sounds are normal. Heart sounds
are diminished, IV access is established and warm crystalloid is infusing. The next most
important aspect of immediate management is:
A. CT Chest
B. EKG
VERSION 2024/2025 REAL EXAM 160+
CORRECT QUESTIONS AND VERIFIED
ANSWERS GRADED A+
A 14 year old female is brought to the ED after falling from a horse. She is immoblized
on a long spine board with a hard collar and blocks. Cervical spine x-ray: - ANS✔✔--
??
The first priority in management of a long bone fracture is:
A. Reduction of pain
B. Prevention of infection in case of an open fracture
C. Prevention of further soft tissue injury
D. Improve long term function
E. Control of hemorrhage - ANS✔✔--E. Control of hemorrhage
stop the bleeding!
The most SPECIFIC test to evaluate for injuries of solid abdominal organs is:
A. Abdominal x-ray
B. Abdominal ultrasound
C. Diagnostic peritoneal lavage
D. Frequent abdominal examination
E. CT Abd/Pelvis - ANS✔✔--E. CT Abd/Pelvis
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas - ANS✔✔--A.
Cerebral contusions may coalesce to form an intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He has one bullet wound just
below the right clavicle and another just below the costal margin in the right posterior
axillary line. His blood pressure is 110/60, heart rate of 90, and respiratory rate of 34.
After ensuring a patent airway and inserting 2 large caliber IV lines, the next most
appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
,C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage - ANS✔✔--A. Obtain a portable chest x-ray
need more info on chest, not abdomen
Which of the following should be performed FIRST in any patient whose injuries may
include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - ANS✔✔--D. Ensuring adequate
oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range.
His BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP
increases to 122/84 and HR decreases to 100. He is tachypneic with RR of 28. On PE,
his breath sounds are decreased at the left upper chest with dullness on percussion. A
large caliber tube thoracostomy is inserted into the fifth intercostal space with the return
of 200 mL of blood and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest - ANS✔✔--E. Repeat the physical exam of
the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle
decompression followed by tube
Which one of the following statements concerning spine and spinal cord trauma is
TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine
injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be
made in the primary survey - ANS✔✔--B. A vertebral injury is unlikely in the absence
of physical findings of a cord injury
, A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is
unresponsive and found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST
step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - ANS✔✔--D. Applying oxygen and
maintaining airway
First = ABCs
Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure - ANS✔✔--E. Decreased pulse pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a ladder
and landing straddled on a fence. Examination of his perineum reveals extensive
ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study
for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography - ANS✔✔--E. retrograde urethrography
-> any ecchymosis, needs to be done before catheter!
A 30 year old male presents after a MVC. Vitals are RR 18, HR 88, BP 130/72, GCS 13.
Laparatomy is indicated when:
A. There is a distinct seat belt sign over the abdomen
B. The CT demonstrates a grade 4 hepatic injury
C. There is evidence of extraperitoneal bladder injury
D. CT demonstrates retroperitoneal air
E. The abdomen is distended with localized rihgt upper quadrant tenderness -
ANS✔✔--D. CT demonstrates retroperitoneal air
-> air, peritonitis (tenderness, rigidity), unstable vital signs
A 20 year old male is brought to the hospital approximately 30 minutes after being
stabbed in the chest. There is 3 cm wound just medial to the left nipple. BP is 70/33 and
HR is 140. Neck and arm veins are distended. Breath sounds are normal. Heart sounds
are diminished, IV access is established and warm crystalloid is infusing. The next most
important aspect of immediate management is:
A. CT Chest
B. EKG
