ATLS 10th Edition Post Test 2 Updated Questions
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A 22-year-old male is brought by ambulance to a small community hospital after falling
from the top of an 8-foot ladder. Initially, he was found to have a large right pneumothorax.
A chest tube was inserted and connected to an underwater seal drainage collection system
with negative pressure. A repeat CXR demonstrates a residual, large right pneumothorax.
After transferring the patient to a verified trauma center, a third chest x-ray reveals a
persistent right pneumothorax. The chest tube appears to be functioning and in good
position. He remains hemodynamically normal with no signs of respiratory distress. The
most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury
Ans: E. Tracheobronchial injury
Quiz Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
,C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray
Ans: D. oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Quiz Which of the following signs necessitates the need for a definitive airway in severe
trauma patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12
Ans: C. Severe maxillofacial trauma
Quiz Twenty seven people are severely injured in an aircraft crash at a local airport. The
principles of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources
,Ans: E. Produce the greatest number of survivors based on available resources
Quiz 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
Quiz 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
, Quiz 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)
Quiz 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
and Verified Answers () 100%
Guarantee Pass
A 22-year-old male is brought by ambulance to a small community hospital after falling
from the top of an 8-foot ladder. Initially, he was found to have a large right pneumothorax.
A chest tube was inserted and connected to an underwater seal drainage collection system
with negative pressure. A repeat CXR demonstrates a residual, large right pneumothorax.
After transferring the patient to a verified trauma center, a third chest x-ray reveals a
persistent right pneumothorax. The chest tube appears to be functioning and in good
position. He remains hemodynamically normal with no signs of respiratory distress. The
most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury
Ans: E. Tracheobronchial injury
Quiz Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
,C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray
Ans: D. oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Quiz Which of the following signs necessitates the need for a definitive airway in severe
trauma patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12
Ans: C. Severe maxillofacial trauma
Quiz Twenty seven people are severely injured in an aircraft crash at a local airport. The
principles of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources
,Ans: E. Produce the greatest number of survivors based on available resources
Quiz 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
Quiz 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
, Quiz 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)
Quiz 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
