1. A 22-year-old man is hypotensive and tachycardic
A) Reexamine the chest
af- ter a shotgun wound to the left shoulder.
His blood pressure is initially 80/40 mm Hg.
After initial fluid resuscitation his blood
pressure increases to 122/84 mm Hg. His
heart rate is now 100 beats per minute and his
respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for
decreased left chest breath sounds with the
return of a small amount of blood and no air
leak. After chest tube insertion, the most
appropriate next step is:
Select one:
a.
reexamine the
chest b.
perform an
aortogram c.
obtain a CT scan of the
chest d.
obtain arterial blood gas
analyses e.
perform transesophageal echocardiography
2. A construction worker falls two stories from a building e) Complete
spine x-ray
and sustains bilateral calcaneal fractures. In the emer- series
gency department, he is alert, vital signs are
normal, and he is complaining of severe pain in
both heels and his lower back. Lower extremity
pulses are strong and there is no other
deformity. The suspected diagnosis is most
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likely to be confirmed by:
Select one:
a.
angiograph
y
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b.
compartment
pressures c.
retrograde
urethrogram d.
Doppler ultrasound
studies e.
complete spine x-ray series
3. Which of the following is true regarding the b.
initial re- suscitation of a trauma patient? Evidence of improved
Select one: per- fusion after fluid
a. resusci- tation could
A patient that presents with a torso gunshot include im- provement
wound and is hypotensive should receive in Glasgow coma
crystalloid fluid re- suscitation until the blood scale score on
pressure is normal reevaluation
b.
Evidence of improved perfusion after fluid
resuscita- tion could include improvement in
Glasgow coma scale score on reevaluation
c.
Massive transfusion is defined as transfusion of
more than >10 of packed red blood cells and
plasma in 24 hours
d.
When tranexamic acid is administered by pre-
hospital providers a second dose is required
within 24 hours e.
Fluid resuscitation is far more important than
bleeding control in trauma patients
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4.
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