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
f f f f f f f f f f f f f
shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his
f f f f f f f f f f f f f f
blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and
f f f f f f f f f f f f f f f f f
his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for
f f f f f f f f f f f f f f
decreased left chest breath sounds with the return of a small amount of blood and no air
f f f f f f f f f f f f f f f f f
leak. After chest tube insertion, the most appropriate next step is: - answer-re-examine the
f f f f f f f f f f f f f f
chest
f
A construction worker falls two stories from a building and sustains bilateral calcaneal
f f f f f f f f f f f f
fractures. In the emergency department, he is alert, vital signs are normal, and he is
f f f f f f f f f f f f f f f
complaining of severe pain in both heels and his lower back. Lower extremity pulses are
f f f f f f f f f f f f f f f
strong and there is no other deformity. The suspected diagnosis is most likely to be
f f f f f f f f f f f f f f f
confirmed by: - answer-complete spine x-ray series
f f f f f f f
Which of the following is true regarding the initial resuscitation of a trauma patient? -
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answer-Evidence of improved perfusion after fluid resuscitation could include
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improvement in Glasgow Coma Scale score on reevaluation.
f f f f f f f f
In managing a patient with a severe traumatic brain injury, the most important initial step is
f f f f f f f f f f f f f f f
to: - answer-secure the airway
f f f f f
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2
f f f f f f f f f f f f f
liters. Which one of the following statements applies to this patient? - answer-An ABG
f f f f f f f f f f f f f f
would demonstrate a base deficit between -6 and -10 mEq/L.
f f f f f f f f f f
The physiological hypervolemia of pregnancy has clinical significance in the management
f f f f f f f f f f
of the severely injured, gravid woman by: - answer-increasing the volume of blood loss to
f f f f f f f f f f f f f f f
produce maternal hypotension
f f f
The best assessment of fluid resuscitation of the adult burn patient is: - answer-urinary
f f f f f f f f f f f f f
output of 0.5 mL/kg/hr
f f f f
The diagnosis of shock must include: - answer-evidence of inadequate organ perfusion
f f f f f f f f f f f
,A 7-year-old boy is brought to the emergency department by his parents several minutes
f f f f f f f f f f f f f
after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial
f f f f f f f f f f f f f f f f f
right thigh. Immediate management of the wound should consist of: - answer-direct
f f f f f f f f f f f f
pressure on the wound
f f f f
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided
f f f f f f f f f f f f
to prevent: - answer-cerebral vasoconstriction with diminished perfusion
f f f f f f f f
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
f f f f f f f f f f f f f f f
that has surgery capabilities available.. Computed tomography of the chest and abdomen
f f f f f f f f f f f f
shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure
f f f f f f f f f f f f f f
falls to 70 mm Hg after CT. The next step is: - answer-perform an exploratory laparotomy
f f f f f f f f f f f f f f f f
Which one of the following statements regarding abdominal trauma in the pregnant patient
f f f f f f f f f f f f
is TRUE? - answer-Leakage of amniotic fluid is an indication for hospital admission.
f f f f f f f f f f f f f
The first maneuver to improve oxygenation after chest injury is: - answer-administer
f f f f f f f f f f f
supplemental oxygen
f f
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
f f f f f f f f f f f f f
department. His pupils react sluggishly and his eyes open to pressure. He does not follow
f f f f f f f f f f f f f f f
commands, but he does moan periodically. His right arm is deformed and does not
f f f f f f f f f f f f f f
respond to pressure; however, his left hand reaches purposefully toward the stimulus.
f f f f f f f f f f f f
Both legs are stiffly extended. His GCS score is: - answer-9
f f f f f f f f f f f
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In
f f f f f f f f f f f f f f f f
the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
f f f f f f f f f f f f f f f
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest.
f f f f f f f f f f f f f f
The most appropriate first step is to: - answer-perform needle or finger decompression of
f f f f f f f f f f f f f f
the right chest
f f f
Which one of the following findings in an adult is most likely to require immediate
f f f f f f f f f f f f f f
management during the primary survey? - answer-respiratory rate of 40 breaths per
f f f f f f f f f f f f
minute
f
The most important, immediate step in the management of an open pneumothorax is: -
f f f f f f f f f f f f f
answer-placement of an occlusive dressing over the wound
f f f f f f f f
The following are contraindications for tetanus toxoid administration: - answer-history of
f f f f f f f f f f
neurological reaction or severe hypersensitivity to the product
f f f f f f f f
A 56-year-old man is thrown violently against the steering wheel of his truck during a motor
f f f f f f f f f f f f f f f
vehicle crash. On arrival in the emergency department he is diaphoretic and complaining
f f f f f f f f f f f f f
of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per
f f f f f f f f f f f f f f f f f f
,minute. Which of the following best differentiates cardiac tamponade from tension
f f f f f f f f f f f
pneumothorax as the cause of his hypotension? - answer-breath sounds
f f f f f f f f f f
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
f f f f f f f f f f f f f
endotracheal intubation because: - answer-The trachea is relatively short.
f f f f f f f f f
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
f f f f f f f f f f f f f f
and is brought by ambulance to a hospital that has full surgical capabilities. His wounds are
f f f f f f f f f f f f f f f f
all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
f f f f f f f f f f f f
performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does not
f f f f f f f f f f f f f
reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160
f f f f f f f f f f f f f f f
beats per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% O2).
f f f f f f f f f f f f f f f
1500 mL of blood has drained from the right chest. The most appropriate next step in
f f f f f f f f f f f f f f f f
managing this patient is to: - answer-urgently transfer the patient to the operating room
f f f f f f f f f f f f f f
A 39-year-old man is admitted to the emergency department after an automobile collision.
f f f f f f f f f f f f
He is cyanotic, has insufficient respiratory effort, and has a GCS score of 6. His full beard
f f f f f f f f f f f f f f f f f
makes it difficult to fit the oxygen facemask to his face. The most appropriate next step is
f f f f f f f f f f f f f f f f f
to: - answer-restrict cervical motion and attempt orotracheal intubation using 2 people
f f f f f f f f f f f f
A patient is brought to the emergency department after a motor vehicle crash. He is
f f f f f f f f f f f f f f
conscious and there is no obvious external trauma. He arrives at the hospital completely
f f f f f f f f f f f f f f
immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart rate is
f f f f f f f f f f f f f f f f f f
70 beats per minute. His skin is warm. Which one of the following statements is TRUE? -
f f f f f f f f f f f f f f f f f
answer-Flaccidity of the lower extremities and loss of deep tendon reflexes are expected.
f f f f f f f f f f f f f
Which one of the following is the most effective method for initially treating frostbite? -
f f f f f f f f f f f f f f
answer-moist heat
f f
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours
f f f f f f f f f f f f f f
before he is extricated. On arrival in the emergency department, his right lower extremity is
f f f f f f f f f f f f f f f
cool, mottled, insensate, and motionless. Despite normal vital signs, pulses cannot be
f f f f f f f f f f f f
palpated below the right femoral artery and the muscles of the lower extremity are firm and
f f f f f f f f f f f f f f f f
hard. During the management of this patient, which of the following is most likely to
f f f f f f f f f f f f f f f
improve the chances for limb salvage? - answer-surgical consultation for right lower
f f f f f f f f f f f f
extremity fasciotomy
f f
A patient arrives in the emergency department after being beaten about the head and face
f f f f f f f f f f f f f f
with a wooden club. He is comatose and has a palpable depressed skull fracture. His face
f f f f f f f f f f f f f f f f
is swollen and ecchymotic. He has gurgling respirations and vomitus on his face and
f f f f f f f f f f f f f f
clothing. The most appropriate step after providing supplemental oxygen and elevating his
f f f f f f f f f f f f
jaw is to: - answer-suction the oropharynx
f f f f f f f
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
f f f f f f f f f f f f f f f f
community hospital no surgical capabilities are available. In the emergency department, a
f f f f f f f f f f f f
chest tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the
f f f f f f f f f f f f f f f f
, patient in transfer. Just before the patient is placed in the ambulance for transfer, his blood
f f f f f f f f f f f f f f f f
pressure decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute.
f f f f f f f f f f f f f f f f
The next step should be to: - answer-repeat the primary survey and proceed with transfer
f f f f f f f f f f f f f f f
A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small
f f f f f f f f f f f f f f
hospital without surgical capabilities. He has a closed head injury with a GCS score of 13.
f f f f f f f f f f f f f f f f
He has a widened mediastinum on chest x-ray with fractures of left ribs 2 through 4, but no
f f f f f f f f f f f f f f f f f f
pneumothorax. After initiating fluid resuscitation, his blood pressure is 110/74 mm Hg,
f f f f f f f f f f f f
heart rate is 100 beats per minute, and respiratory rate is 18 breaths per minute. He has
f f f f f f f f f f f f f f f f f
gross hematuria and a pelvic fracture. You decide to transfer this patient to a facility
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capable of providing a higher level of care. The facility is 128 km (80 miles) away. Before
f f f f f f f f f f f f f f f f f
transfer, you should first: - answer-call the receiving hospital and speak to the surgeon on
f f f f f f f f f f f f f f f
call
f
Hemorrhage of 20% of the patient's blood volume is associated usually with: - answer- f f f f f f f f f f f f f
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.
f f f f f f f f f f
A young woman sustains a severe head injury as the result of a motor vehicle crash. In the
f f f f f f f f f f f f f f f f f
emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart
f f f f f f f f f f f f f f f f
rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3
f f f f f f f f f f f f f f f f
mm in size and equally reactive to light. There is no other apparent injury. The most
f f f f f f f f f f f f f f f f
important principle to follow in the early management of her head injury is to: - answer-
f f f f f f f f f f f f f f f f
avoid hypotension f
A 33-year-old woman is involved in a head-on motor vehicle crash. It took 30 minutes to
f f f f f f f f f f f f f f f
extricate her from the car. Upon arrival in the emergency department, her heart rate is 120
f f f f f f f f f f f f f f f f
beats per minute, BP is 90/70 mm Hg, respiratory rate is 16 breaths per minute, and her
f f f f f f f f f f f f f f f f f
GCS score is 15. Examination reveals bilaterally equal breath sounds, anterior chest wall
f f f f f f f f f f f f f
ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not tender. Her
f f f f f f f f f f f f f f
pelvis is stable. Palpable distal pulses are found in all 4 extremities. Of the following, the
f f f f f f f f f f f f f f f f
most likely diagnosis is: - answer-cardiac tamponade
f f f f f f f
A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III
f f f f f f f f f f f f
(moderately severe) splenic injury has been confirmed by computed tomography (CT).
f f f f f f f f f f f
Which of the following mandates prompt celiotomy (laparotomy)? - answer-development
f f f f f f f f f f
of peritonitis on physical exam
f f f f f
A 40-year-old woman who was a restrained driver in a motor vehicle crash is evaluated in
f f f f f f f f f f f f f f f
the emergency department. She is hemodynamically normal and found to be paraplegic at
f f f f f f f f f f f f f
the level of T10. Which of the following are true regarding her evaluation and
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management? - answer-Log rolling using 4 people is a safe approach to restrict spinal
f f f f f f f f f f f f f f
motion when moving her.
f f f f
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
f f f f f f f f f f f f f
shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his
f f f f f f f f f f f f f f
blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and
f f f f f f f f f f f f f f f f f
his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for
f f f f f f f f f f f f f f
decreased left chest breath sounds with the return of a small amount of blood and no air
f f f f f f f f f f f f f f f f f
leak. After chest tube insertion, the most appropriate next step is: - answer-re-examine the
f f f f f f f f f f f f f f
chest
f
A construction worker falls two stories from a building and sustains bilateral calcaneal
f f f f f f f f f f f f
fractures. In the emergency department, he is alert, vital signs are normal, and he is
f f f f f f f f f f f f f f f
complaining of severe pain in both heels and his lower back. Lower extremity pulses are
f f f f f f f f f f f f f f f
strong and there is no other deformity. The suspected diagnosis is most likely to be
f f f f f f f f f f f f f f f
confirmed by: - answer-complete spine x-ray series
f f f f f f f
Which of the following is true regarding the initial resuscitation of a trauma patient? -
f f f f f f f f f f f f f f
answer-Evidence of improved perfusion after fluid resuscitation could include
f f f f f f f f f
improvement in Glasgow Coma Scale score on reevaluation.
f f f f f f f f
In managing a patient with a severe traumatic brain injury, the most important initial step is
f f f f f f f f f f f f f f f
to: - answer-secure the airway
f f f f f
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2
f f f f f f f f f f f f f
liters. Which one of the following statements applies to this patient? - answer-An ABG
f f f f f f f f f f f f f f
would demonstrate a base deficit between -6 and -10 mEq/L.
f f f f f f f f f f
The physiological hypervolemia of pregnancy has clinical significance in the management
f f f f f f f f f f
of the severely injured, gravid woman by: - answer-increasing the volume of blood loss to
f f f f f f f f f f f f f f f
produce maternal hypotension
f f f
The best assessment of fluid resuscitation of the adult burn patient is: - answer-urinary
f f f f f f f f f f f f f
output of 0.5 mL/kg/hr
f f f f
The diagnosis of shock must include: - answer-evidence of inadequate organ perfusion
f f f f f f f f f f f
,A 7-year-old boy is brought to the emergency department by his parents several minutes
f f f f f f f f f f f f f
after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial
f f f f f f f f f f f f f f f f f
right thigh. Immediate management of the wound should consist of: - answer-direct
f f f f f f f f f f f f
pressure on the wound
f f f f
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided
f f f f f f f f f f f f
to prevent: - answer-cerebral vasoconstriction with diminished perfusion
f f f f f f f f
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
f f f f f f f f f f f f f f f
that has surgery capabilities available.. Computed tomography of the chest and abdomen
f f f f f f f f f f f f
shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure
f f f f f f f f f f f f f f
falls to 70 mm Hg after CT. The next step is: - answer-perform an exploratory laparotomy
f f f f f f f f f f f f f f f f
Which one of the following statements regarding abdominal trauma in the pregnant patient
f f f f f f f f f f f f
is TRUE? - answer-Leakage of amniotic fluid is an indication for hospital admission.
f f f f f f f f f f f f f
The first maneuver to improve oxygenation after chest injury is: - answer-administer
f f f f f f f f f f f
supplemental oxygen
f f
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
f f f f f f f f f f f f f
department. His pupils react sluggishly and his eyes open to pressure. He does not follow
f f f f f f f f f f f f f f f
commands, but he does moan periodically. His right arm is deformed and does not
f f f f f f f f f f f f f f
respond to pressure; however, his left hand reaches purposefully toward the stimulus.
f f f f f f f f f f f f
Both legs are stiffly extended. His GCS score is: - answer-9
f f f f f f f f f f f
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In
f f f f f f f f f f f f f f f f
the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
f f f f f f f f f f f f f f f
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest.
f f f f f f f f f f f f f f
The most appropriate first step is to: - answer-perform needle or finger decompression of
f f f f f f f f f f f f f f
the right chest
f f f
Which one of the following findings in an adult is most likely to require immediate
f f f f f f f f f f f f f f
management during the primary survey? - answer-respiratory rate of 40 breaths per
f f f f f f f f f f f f
minute
f
The most important, immediate step in the management of an open pneumothorax is: -
f f f f f f f f f f f f f
answer-placement of an occlusive dressing over the wound
f f f f f f f f
The following are contraindications for tetanus toxoid administration: - answer-history of
f f f f f f f f f f
neurological reaction or severe hypersensitivity to the product
f f f f f f f f
A 56-year-old man is thrown violently against the steering wheel of his truck during a motor
f f f f f f f f f f f f f f f
vehicle crash. On arrival in the emergency department he is diaphoretic and complaining
f f f f f f f f f f f f f
of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per
f f f f f f f f f f f f f f f f f f
,minute. Which of the following best differentiates cardiac tamponade from tension
f f f f f f f f f f f
pneumothorax as the cause of his hypotension? - answer-breath sounds
f f f f f f f f f f
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
f f f f f f f f f f f f f
endotracheal intubation because: - answer-The trachea is relatively short.
f f f f f f f f f
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
f f f f f f f f f f f f f f
and is brought by ambulance to a hospital that has full surgical capabilities. His wounds are
f f f f f f f f f f f f f f f f
all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
f f f f f f f f f f f f
performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does not
f f f f f f f f f f f f f
reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160
f f f f f f f f f f f f f f f
beats per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% O2).
f f f f f f f f f f f f f f f
1500 mL of blood has drained from the right chest. The most appropriate next step in
f f f f f f f f f f f f f f f f
managing this patient is to: - answer-urgently transfer the patient to the operating room
f f f f f f f f f f f f f f
A 39-year-old man is admitted to the emergency department after an automobile collision.
f f f f f f f f f f f f
He is cyanotic, has insufficient respiratory effort, and has a GCS score of 6. His full beard
f f f f f f f f f f f f f f f f f
makes it difficult to fit the oxygen facemask to his face. The most appropriate next step is
f f f f f f f f f f f f f f f f f
to: - answer-restrict cervical motion and attempt orotracheal intubation using 2 people
f f f f f f f f f f f f
A patient is brought to the emergency department after a motor vehicle crash. He is
f f f f f f f f f f f f f f
conscious and there is no obvious external trauma. He arrives at the hospital completely
f f f f f f f f f f f f f f
immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart rate is
f f f f f f f f f f f f f f f f f f
70 beats per minute. His skin is warm. Which one of the following statements is TRUE? -
f f f f f f f f f f f f f f f f f
answer-Flaccidity of the lower extremities and loss of deep tendon reflexes are expected.
f f f f f f f f f f f f f
Which one of the following is the most effective method for initially treating frostbite? -
f f f f f f f f f f f f f f
answer-moist heat
f f
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours
f f f f f f f f f f f f f f
before he is extricated. On arrival in the emergency department, his right lower extremity is
f f f f f f f f f f f f f f f
cool, mottled, insensate, and motionless. Despite normal vital signs, pulses cannot be
f f f f f f f f f f f f
palpated below the right femoral artery and the muscles of the lower extremity are firm and
f f f f f f f f f f f f f f f f
hard. During the management of this patient, which of the following is most likely to
f f f f f f f f f f f f f f f
improve the chances for limb salvage? - answer-surgical consultation for right lower
f f f f f f f f f f f f
extremity fasciotomy
f f
A patient arrives in the emergency department after being beaten about the head and face
f f f f f f f f f f f f f f
with a wooden club. He is comatose and has a palpable depressed skull fracture. His face
f f f f f f f f f f f f f f f f
is swollen and ecchymotic. He has gurgling respirations and vomitus on his face and
f f f f f f f f f f f f f f
clothing. The most appropriate step after providing supplemental oxygen and elevating his
f f f f f f f f f f f f
jaw is to: - answer-suction the oropharynx
f f f f f f f
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
f f f f f f f f f f f f f f f f
community hospital no surgical capabilities are available. In the emergency department, a
f f f f f f f f f f f f
chest tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the
f f f f f f f f f f f f f f f f
, patient in transfer. Just before the patient is placed in the ambulance for transfer, his blood
f f f f f f f f f f f f f f f f
pressure decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute.
f f f f f f f f f f f f f f f f
The next step should be to: - answer-repeat the primary survey and proceed with transfer
f f f f f f f f f f f f f f f
A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small
f f f f f f f f f f f f f f
hospital without surgical capabilities. He has a closed head injury with a GCS score of 13.
f f f f f f f f f f f f f f f f
He has a widened mediastinum on chest x-ray with fractures of left ribs 2 through 4, but no
f f f f f f f f f f f f f f f f f f
pneumothorax. After initiating fluid resuscitation, his blood pressure is 110/74 mm Hg,
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heart rate is 100 beats per minute, and respiratory rate is 18 breaths per minute. He has
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gross hematuria and a pelvic fracture. You decide to transfer this patient to a facility
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capable of providing a higher level of care. The facility is 128 km (80 miles) away. Before
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transfer, you should first: - answer-call the receiving hospital and speak to the surgeon on
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call
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Hemorrhage of 20% of the patient's blood volume is associated usually with: - answer- f f f f f f f f f f f f f
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 the
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emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart
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rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3
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mm in size and equally reactive to light. There is no other apparent injury. The most
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important principle to follow in the early management of her head injury is to: - answer-
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avoid hypotension f
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 120
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beats per minute, BP is 90/70 mm Hg, respiratory rate is 16 breaths per minute, and her
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GCS score is 15. Examination reveals bilaterally equal breath sounds, anterior chest wall
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ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not tender. Her
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pelvis is stable. Palpable distal pulses are found in all 4 extremities. Of the following, the
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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 III
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(moderately severe) splenic injury has been confirmed by computed tomography (CT).
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Which of the following mandates prompt celiotomy (laparotomy)? - answer-development
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of peritonitis on physical exam
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A 40-year-old woman who was a restrained driver in a motor vehicle crash is evaluated in
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the emergency department. She is hemodynamically normal and found to be paraplegic at
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the level of T10. Which of the following are true regarding her evaluation and
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management? - answer-Log rolling using 4 people is a safe approach to restrict spinal
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motion when moving her.
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