ATLS PRACTICE TEST 2024-2025
ACTUAL EXAM 250 REAL QUESTIONS
AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED
ANSWERS) |
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
c c c c c c c c c c c c c
shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his
c c c c c c c c c c c c c c
blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute
c c c c c c c c c c c c c c c c
and his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for
c c c c c c c c c c c c c c c
decreased left chest breath sounds with the return of a small amount of blood and no air
c c c c c c c c c c c c c c c c c
leak. After chest tube insertion, the most appropriate next step is: - answer-re-examine
c c c c c c c c c c c c c
the chest
c c
A construction worker falls two stories from a building and sustains bilateral calcaneal
c c c c c c c c c c c c
fractures. In the emergency department, he is alert, vital signs are normal, and he is
c c c c c c c c c c c c c c c
complaining of severe pain in both heels and his lower back. Lower extremity pulses are
c c c c c c c c c c c c c c c
strong and there is no other deformity. The suspected diagnosis is most likely to be
c c c c c c c c c c c c c c c
confirmed by: - answer-complete spine x-ray series
c c c c c c c
Which of the following is true regarding the initial resuscitation of a trauma patient? -
c c c c c c c c c c c c c c
answer-Evidence of improved perfusion after fluid resuscitation could include
c c c c c c c c c
improvement in Glasgow Coma Scale score on reevaluation.
c c c c c c c c
In managing a patient with a severe traumatic brain injury, the most important initial step
c c c c c c c c c c c c c c
cis to: - answer-secure the airway
c c c c c
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2
c c c c c c c c c c c c c
liters. Which one of the following statements applies to this patient? - answer-An ABG
c c c c c c c c c c c c c c
would demonstrate a base deficit between -6 and -10 mEq/L.
c c c c c c c c c c
The physiological hypervolemia of pregnancy has clinical significance in the
c c c c c c c c c
management of the severely injured, gravid woman by: - answer-increasing the volume
c c c c c c c c c c c c
of blood loss to produce maternal hypotension
c c c c c c c
The best assessment of fluid resuscitation of the adult burn patient is: - answer-urinary
c c c c c c c c c c c c c
output of 0.5 mL/kg/hr
c c c c
,The diagnosis of shock must include: - answer-evidence of inadequate organ perfusion
c c c c c c c c c c c
A 7-year-old boy is brought to the emergency department by his parents several minutes
c c c c c c c c c c c c c
after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial
c c c c c c c c c c c c c c c c c
right thigh. Immediate management of the wound should consist of: - answer-direct
c c c c c c c c c c c c
pressure on the wound
c c c c
For the patient with severe traumatic brain injury, profound hypocarbia should be
c c c c c c c c c c c
avoided to prevent: - answer-cerebral vasoconstriction with diminished perfusion
c c c c c c c c c
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
c c c c c c c c c c c c c c c
that has surgery capabilities available.. Computed tomography of the chest and
c c c c c c c c c c c
abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His
c c c c c c c c c c c c c
blood pressure falls to 70 mm Hg after CT. The next step is: - answer-perform an
c c c c c c c c c c c c c c c c
exploratory laparotomy
c c
Which one of the following statements regarding abdominal trauma in the pregnant
c c c c c c c c c c c
patient is TRUE? - answer-Leakage of amniotic fluid is an indication for hospital
c c c c c c c c c c c c c
admission.
c
The first maneuver to improve oxygenation after chest injury is: - answer-administer
c c c c c c c c c c c
supplemental oxygen
c c
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
c c c c c c c c c c c c c
department. His pupils react sluggishly and his eyes open to pressure. He does not
c c c c c c c c c c c c c c
follow commands, but he does moan periodically. His right arm is deformed and does
c c c c c c c c c c c c c c
not respond to pressure; however, his left hand reaches purposefully toward the
c c c c c c c c c c c c
stimulus. Both legs are stiffly extended. His GCS score is: - answer-9
c c c c c c c c c c c c
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest.
c c c c c c c c c c c c c c c
In the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for
c c c c c c c c c c c c c c c
breath, extremely anxious, and yelling for help. Breath sounds are diminished in the
c c c c c c c c c c c c c
right chest. The most appropriate first step is to: - answer-perform needle or finger
c c c c c c c c c c c c c c
decompression of the right chest
c c c c c
Which one of the following findings in an adult is most likely to require immediate
c c c c c c c c c c c c c c
management during the primary survey? - answer-respiratory rate of 40 breaths per
c c c c c c c c c c c c
minute
c
The most important, immediate step in the management of an open pneumothorax is: -
c c c c c c c c c c c c c
answer-placement of an occlusive dressing over the wound
c c c c c c c c
The following are contraindications for tetanus toxoid administration: - answer-history of
c c c c c c c c c c
neurological reaction or severe hypersensitivity to the product
c c c c c c c c
,A 56-year-old man is thrown violently against the steering wheel of his truck during a
c c c c c c c c c c c c c c
motor vehicle crash. On arrival in the emergency department he is diaphoretic and
c c c c c c c c c c c c c
complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is
c c c c c c c c c c c c c c c c
40 breaths per minute. Which of the following best differentiates cardiac tamponade
c c c c c c c c c c c c
from tension pneumothorax as the cause of his hypotension? - answer-breath sounds
c c c c c c c c c c c c
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
c c c c c c c c c c c c c
endotracheal intubation because: - answer-The trachea is relatively short.
c c c c c c c c c
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
c c c c c c c c c c c c c c
and is brought by ambulance to a hospital that has full surgical capabilities. His wounds
c c c c c c c c c c c c c c c
are all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
c c c c c c c c c c c c c
performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does
c c c c c c c c c c c c
not reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is
c c c c c c c c c c c c c c c
160 beats per minute, and respiratory rate is 14 breaths per minute (ventilated with
c c c c c c c c c c c c c c
100% O2). 1500 mL of blood has drained from the right chest. The most appropriate
c c c c c c c c c c c c c c c
next step in managing this patient is to: - answer-urgently transfer the patient to the
c c c c c c c c c c c c c c c
operating room
c c
A 39-year-old man is admitted to the emergency department after an automobile
c c c c c c c c c c c
collision. He is cyanotic, has insufficient respiratory effort, and has a GCS score of 6.
c c c c c c c c c c c c c c c
His full beard makes it difficult to fit the oxygen facemask to his face. The most
c c c c c c c c c c c c c c c c
appropriate next step is to: - answer-restrict cervical motion and attempt orotracheal
c c c c c c c c c c c c
intubation using 2 people
c c c c
A patient is brought to the emergency department after a motor vehicle crash. He is
c c c c c c c c c c c c c c
conscious and there is no obvious external trauma. He arrives at the hospital completely
c c c c c c c c c c c c c c
immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart
c c c c c c c c c c c c c c c c
rate is 70 beats per minute. His skin is warm. Which one of the following statements is
c c c c c c c c c c c c c c c c c
TRUE? - answer-Flaccidity of the lower extremities and loss of deep tendon reflexes are
c c c c c c c c c c c c c c
expected.
c
Which one of the following is the most effective method for initially treating frostbite? -
c c c c c c c c c c c c c c
answer-moist heat
c c
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours
c c c c c c c c c c c c c c
before he is extricated. On arrival in the emergency department, his right lower extremity
c c c c c c c c c c c c c c
is cool, mottled, insensate, and motionless. Despite normal vital signs, pulses cannot be
c c c c c c c c c c c c c
palpated below the right femoral artery and the muscles of the lower extremity are firm
c c c c c c c c c c c c c c c
and hard. During the management of this patient, which of the following is most likely to
c c c c c c c c c c c c c c c c
improve the chances for limb salvage? - answer-surgical consultation for right lower
c c c c c c c c c c c c
extremity fasciotomy
c c
A patient arrives in the emergency department after being beaten about the head and
c c c c c c c c c c c c c
face with a wooden club. He is comatose and has a palpable depressed skull fracture.
c c c c c c c c c c c c c c c
His face is swollen and ecchymotic. He has gurgling respirations and vomitus on his
c c c c c c c c c c c c c c
, cface and clothing. The most appropriate step after providing supplemental oxygen and
c c c c c c c c c c c
celevating his jaw is to: - answer-suction the oropharynx
c c c c c c c c
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a
c c c c c c c c c c c c c c c
small community hospital no surgical capabilities are available. In the emergency
c c c c c c c c c c c
department, a chest tube is inserted and 700 mL of blood is evacuated. The trauma
c c c c c c c c c c c c c c c
center accepts the patient in transfer. Just before the patient is placed in the ambulance
c c c c c c c c c c c c c c c
for transfer, his blood pressure decreases to 80/68 mm Hg and his heart rate increases
c c c c c c c c c c c c c c c
to 136 beats per minute. The next step should be to: - answer-repeat the primary survey
c c c c c c c c c c c c c c c c
and proceed with transfer
c c c c
A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small
c c c c c c c c c c c c c c
hospital without surgical capabilities. He has a closed head injury with a GCS score of
c c c c c c c c c c c c c c c
13. He has a widened mediastinum on chest x-ray with fractures of left ribs 2 through 4,
c c c c c c c c c c c c c c c c c
but no pneumothorax. After initiating fluid resuscitation, his blood pressure is 110/74
c c c c c c c c c c c c
mm Hg, heart rate is 100 beats per minute, and respiratory rate is 18 breaths per
c c c c c c c c c c c c c c c c
minute. He has gross hematuria and a pelvic fracture. You decide to transfer this patient
c c c c c c c c c c c c c c c
to a facility capable of providing a higher level of care. The facility is 128 km (80 miles)
c c c c c c c c c c c c c c c c c c
away. Before transfer, you should first: - answer-call the receiving hospital and speak to
c c c c c c c c c c c c c c
the surgeon on call
c c c c
Hemorrhage of 20% of the patient's blood volume is associated usually with: - answer-
c c c c c c c c c c c c c
tachycardia
Which one of the following statements concerning intraosseous infusion is TRUE? -
c c c c c c c c c c c
answer-Aspiration of bone marrow confirms appropriate positioning of the needle.
c c c c c c c c c c
A young woman sustains a severe head injury as the result of a motor vehicle crash. In
c c c c c c c c c c c c c c c c
the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her
c c c c c c c c c c c c c c c c
heart rate is 80 beats per minute. She is intubated and mechanically ventilated. Her
c c c c c c c c c c c c c c
pupils are 3 mm in size and equally reactive to light. There is no other apparent injury.
c c c c c c c c c c c c c c c c c
The most important principle to follow in the early management of her head injury is to: -
c c c c c c c c c c c c c c c c c
answer-avoid hypotension
c c
A 33-year-old woman is involved in a head-on motor vehicle crash. It took 30 minutes to
c c c c c c c c c c c c c c c
extricate her from the car. Upon arrival in the emergency department, her heart rate is
c c c c c c c c c c c c c c c
120 beats per minute, BP is 90/70 mm Hg, respiratory rate is 16 breaths per minute, and
c c c c c c c c c c c c c c c c c
her GCS score is 15. Examination reveals bilaterally equal breath sounds, anterior chest
c c c c c c c c c c c c c
wall ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not tender.
c c c c c c c c c c c c c c
Her pelvis is stable. Palpable distal pulses are found in all 4 extremities. Of the
c c c c c c c c c c c c c c c
following, the most likely diagnosis is: - answer-cardiac tamponade
c c c c c c c c c
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade
c c c c c c c c c c c
III (moderately severe) splenic injury has been confirmed by computed tomography
c c c c c c c c c c c
(CT). Which of the following mandates prompt celiotomy (laparotomy)? - answer-
c c c c c c c c c c c
development of peritonitis on physical exam c c c c c
ACTUAL EXAM 250 REAL QUESTIONS
AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED
ANSWERS) |
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
c c c c c c c c c c c c c
shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his
c c c c c c c c c c c c c c
blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute
c c c c c c c c c c c c c c c c
and his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for
c c c c c c c c c c c c c c c
decreased left chest breath sounds with the return of a small amount of blood and no air
c c c c c c c c c c c c c c c c c
leak. After chest tube insertion, the most appropriate next step is: - answer-re-examine
c c c c c c c c c c c c c
the chest
c c
A construction worker falls two stories from a building and sustains bilateral calcaneal
c c c c c c c c c c c c
fractures. In the emergency department, he is alert, vital signs are normal, and he is
c c c c c c c c c c c c c c c
complaining of severe pain in both heels and his lower back. Lower extremity pulses are
c c c c c c c c c c c c c c c
strong and there is no other deformity. The suspected diagnosis is most likely to be
c c c c c c c c c c c c c c c
confirmed by: - answer-complete spine x-ray series
c c c c c c c
Which of the following is true regarding the initial resuscitation of a trauma patient? -
c c c c c c c c c c c c c c
answer-Evidence of improved perfusion after fluid resuscitation could include
c c c c c c c c c
improvement in Glasgow Coma Scale score on reevaluation.
c c c c c c c c
In managing a patient with a severe traumatic brain injury, the most important initial step
c c c c c c c c c c c c c c
cis to: - answer-secure the airway
c c c c c
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2
c c c c c c c c c c c c c
liters. Which one of the following statements applies to this patient? - answer-An ABG
c c c c c c c c c c c c c c
would demonstrate a base deficit between -6 and -10 mEq/L.
c c c c c c c c c c
The physiological hypervolemia of pregnancy has clinical significance in the
c c c c c c c c c
management of the severely injured, gravid woman by: - answer-increasing the volume
c c c c c c c c c c c c
of blood loss to produce maternal hypotension
c c c c c c c
The best assessment of fluid resuscitation of the adult burn patient is: - answer-urinary
c c c c c c c c c c c c c
output of 0.5 mL/kg/hr
c c c c
,The diagnosis of shock must include: - answer-evidence of inadequate organ perfusion
c c c c c c c c c c c
A 7-year-old boy is brought to the emergency department by his parents several minutes
c c c c c c c c c c c c c
after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial
c c c c c c c c c c c c c c c c c
right thigh. Immediate management of the wound should consist of: - answer-direct
c c c c c c c c c c c c
pressure on the wound
c c c c
For the patient with severe traumatic brain injury, profound hypocarbia should be
c c c c c c c c c c c
avoided to prevent: - answer-cerebral vasoconstriction with diminished perfusion
c c c c c c c c c
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
c c c c c c c c c c c c c c c
that has surgery capabilities available.. Computed tomography of the chest and
c c c c c c c c c c c
abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His
c c c c c c c c c c c c c
blood pressure falls to 70 mm Hg after CT. The next step is: - answer-perform an
c c c c c c c c c c c c c c c c
exploratory laparotomy
c c
Which one of the following statements regarding abdominal trauma in the pregnant
c c c c c c c c c c c
patient is TRUE? - answer-Leakage of amniotic fluid is an indication for hospital
c c c c c c c c c c c c c
admission.
c
The first maneuver to improve oxygenation after chest injury is: - answer-administer
c c c c c c c c c c c
supplemental oxygen
c c
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
c c c c c c c c c c c c c
department. His pupils react sluggishly and his eyes open to pressure. He does not
c c c c c c c c c c c c c c
follow commands, but he does moan periodically. His right arm is deformed and does
c c c c c c c c c c c c c c
not respond to pressure; however, his left hand reaches purposefully toward the
c c c c c c c c c c c c
stimulus. Both legs are stiffly extended. His GCS score is: - answer-9
c c c c c c c c c c c c
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest.
c c c c c c c c c c c c c c c
In the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for
c c c c c c c c c c c c c c c
breath, extremely anxious, and yelling for help. Breath sounds are diminished in the
c c c c c c c c c c c c c
right chest. The most appropriate first step is to: - answer-perform needle or finger
c c c c c c c c c c c c c c
decompression of the right chest
c c c c c
Which one of the following findings in an adult is most likely to require immediate
c c c c c c c c c c c c c c
management during the primary survey? - answer-respiratory rate of 40 breaths per
c c c c c c c c c c c c
minute
c
The most important, immediate step in the management of an open pneumothorax is: -
c c c c c c c c c c c c c
answer-placement of an occlusive dressing over the wound
c c c c c c c c
The following are contraindications for tetanus toxoid administration: - answer-history of
c c c c c c c c c c
neurological reaction or severe hypersensitivity to the product
c c c c c c c c
,A 56-year-old man is thrown violently against the steering wheel of his truck during a
c c c c c c c c c c c c c c
motor vehicle crash. On arrival in the emergency department he is diaphoretic and
c c c c c c c c c c c c c
complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is
c c c c c c c c c c c c c c c c
40 breaths per minute. Which of the following best differentiates cardiac tamponade
c c c c c c c c c c c c
from tension pneumothorax as the cause of his hypotension? - answer-breath sounds
c c c c c c c c c c c c
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
c c c c c c c c c c c c c
endotracheal intubation because: - answer-The trachea is relatively short.
c c c c c c c c c
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
c c c c c c c c c c c c c c
and is brought by ambulance to a hospital that has full surgical capabilities. His wounds
c c c c c c c c c c c c c c c
are all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
c c c c c c c c c c c c c
performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does
c c c c c c c c c c c c
not reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is
c c c c c c c c c c c c c c c
160 beats per minute, and respiratory rate is 14 breaths per minute (ventilated with
c c c c c c c c c c c c c c
100% O2). 1500 mL of blood has drained from the right chest. The most appropriate
c c c c c c c c c c c c c c c
next step in managing this patient is to: - answer-urgently transfer the patient to the
c c c c c c c c c c c c c c c
operating room
c c
A 39-year-old man is admitted to the emergency department after an automobile
c c c c c c c c c c c
collision. He is cyanotic, has insufficient respiratory effort, and has a GCS score of 6.
c c c c c c c c c c c c c c c
His full beard makes it difficult to fit the oxygen facemask to his face. The most
c c c c c c c c c c c c c c c c
appropriate next step is to: - answer-restrict cervical motion and attempt orotracheal
c c c c c c c c c c c c
intubation using 2 people
c c c c
A patient is brought to the emergency department after a motor vehicle crash. He is
c c c c c c c c c c c c c c
conscious and there is no obvious external trauma. He arrives at the hospital completely
c c c c c c c c c c c c c c
immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart
c c c c c c c c c c c c c c c c
rate is 70 beats per minute. His skin is warm. Which one of the following statements is
c c c c c c c c c c c c c c c c c
TRUE? - answer-Flaccidity of the lower extremities and loss of deep tendon reflexes are
c c c c c c c c c c c c c c
expected.
c
Which one of the following is the most effective method for initially treating frostbite? -
c c c c c c c c c c c c c c
answer-moist heat
c c
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours
c c c c c c c c c c c c c c
before he is extricated. On arrival in the emergency department, his right lower extremity
c c c c c c c c c c c c c c
is cool, mottled, insensate, and motionless. Despite normal vital signs, pulses cannot be
c c c c c c c c c c c c c
palpated below the right femoral artery and the muscles of the lower extremity are firm
c c c c c c c c c c c c c c c
and hard. During the management of this patient, which of the following is most likely to
c c c c c c c c c c c c c c c c
improve the chances for limb salvage? - answer-surgical consultation for right lower
c c c c c c c c c c c c
extremity fasciotomy
c c
A patient arrives in the emergency department after being beaten about the head and
c c c c c c c c c c c c c
face with a wooden club. He is comatose and has a palpable depressed skull fracture.
c c c c c c c c c c c c c c c
His face is swollen and ecchymotic. He has gurgling respirations and vomitus on his
c c c c c c c c c c c c c c
, cface and clothing. The most appropriate step after providing supplemental oxygen and
c c c c c c c c c c c
celevating his jaw is to: - answer-suction the oropharynx
c c c c c c c c
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a
c c c c c c c c c c c c c c c
small community hospital no surgical capabilities are available. In the emergency
c c c c c c c c c c c
department, a chest tube is inserted and 700 mL of blood is evacuated. The trauma
c c c c c c c c c c c c c c c
center accepts the patient in transfer. Just before the patient is placed in the ambulance
c c c c c c c c c c c c c c c
for transfer, his blood pressure decreases to 80/68 mm Hg and his heart rate increases
c c c c c c c c c c c c c c c
to 136 beats per minute. The next step should be to: - answer-repeat the primary survey
c c c c c c c c c c c c c c c c
and proceed with transfer
c c c c
A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small
c c c c c c c c c c c c c c
hospital without surgical capabilities. He has a closed head injury with a GCS score of
c c c c c c c c c c c c c c c
13. He has a widened mediastinum on chest x-ray with fractures of left ribs 2 through 4,
c c c c c c c c c c c c c c c c c
but no pneumothorax. After initiating fluid resuscitation, his blood pressure is 110/74
c c c c c c c c c c c c
mm Hg, heart rate is 100 beats per minute, and respiratory rate is 18 breaths per
c c c c c c c c c c c c c c c c
minute. He has gross hematuria and a pelvic fracture. You decide to transfer this patient
c c c c c c c c c c c c c c c
to a facility capable of providing a higher level of care. The facility is 128 km (80 miles)
c c c c c c c c c c c c c c c c c c
away. Before transfer, you should first: - answer-call the receiving hospital and speak to
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the surgeon on call
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Hemorrhage of 20% of the patient's blood volume is associated usually with: - answer-
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tachycardia
Which one of the following statements concerning intraosseous infusion is TRUE? -
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answer-Aspiration of bone marrow confirms appropriate positioning of the needle.
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A young woman sustains a severe head injury as the result of a motor vehicle crash. In
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the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her
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heart rate is 80 beats per minute. She is intubated and mechanically ventilated. Her
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pupils are 3 mm in size and equally reactive to light. There is no other apparent injury.
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The most important principle to follow in the early management of her head injury is to: -
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answer-avoid hypotension
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A 33-year-old woman is involved in a head-on motor vehicle crash. It took 30 minutes to
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extricate her from the car. Upon arrival in the emergency department, her heart rate is
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120 beats per minute, BP is 90/70 mm Hg, respiratory rate is 16 breaths per minute, and
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her GCS score is 15. Examination reveals bilaterally equal breath sounds, anterior chest
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wall ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not tender.
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Her pelvis is stable. Palpable distal pulses are found in all 4 extremities. Of the
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following, the most likely diagnosis is: - answer-cardiac tamponade
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A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade
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III (moderately severe) splenic injury has been confirmed by computed tomography
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(CT). Which of the following mandates prompt celiotomy (laparotomy)? - answer-
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development of peritonitis on physical exam c c c c c
