ATLS Pre-test Exam.

ATLS Pre-test Exam. 1. A 22-year-old man is hypotensive and tachycardic after 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 per- formed 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 appro- priate next step is: - *Re-examine the chest* - Perform an aortogram - Obtain a CT scan of the chest - Obtain ABG analysis - Transesophageal echocardiography 2. A construction worker falls two stories - complete spine x-ray series from a building and sustains bilateral calcaneal fractures. In the emergency department, he is alert, vital signs are normal, and he is complaining of se- vere pain in both heels and his low- er back. Lower extremity pulses are strong and there is no other defor- mity. The suspected diagnosis is most likely to be confirmed by: 3. Which of the following is true regard- - A patient with a torso gunshot wound and hy- ing the initial resuscitation of a trauma potension should receive crystalloid fluid resusci- patient? tation until the blood pressure is normal -* Evidence of improved perfusion after fluid re- suscitation could include improvement in Glasgow Coma Scale score on reevaluation* 4. In managing a patient with a severe traumatic brain injury, the most im- portant initial step is to: 5. A previously healthy, 70-kg - Massive transfusion is defined as transfusion of more than 10 units of packed red blood cells and plasma within 24 hours - When tranexamic acid is administered by pre-hospital providers, a second dose is required within 24 hours - Fluid resuscitation is far more important than bleeding control in trauma patient - Secure the airway - His pulse pressure will be widened. (154-pound) man suffers an estimated - His urinary output will be at the lower limits of acute blood loss of 2 liters. Which one normal. xxx of the following statements applies to this patient? 6. The physiological hypervolemia of pregnancy has clinical significance in the management of the severely in- jured, gravid woman by: 7. The best assessment of fluid resusci- tation of the adult burn patient is: - He will have tachycardia, but no change in his systolic blood pressure. - *An ABG would demonstrate a base deficit be- tween -6 and -10 mEq/L.* - His systolic blood pressure will be maintained with an elevated diastolic pressure. - increasing the volume of blood loss to produce maternal hypotension. - urinary output of 0.5 mL/kg/hr 8. The diagnosis of shock must include: - evidence of inadequate organ perfusion 9. 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 from a 6-cm wound of his medial right thigh. Immediate management of the wound should consist of: 10. For the patient with severe traumat- ic brain injury, profound hypocarbia should be avoided to prevent: - direct pressure on the wound