ATLS POST-TEST EXAM|| ACTUAL EXAM ALL QUESTIONS
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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 2 liters of crystalloid
solution 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. His breath sounds
are decreased in the left hemithorax, and after initial IV fluid resuscitation, a closed
tube thoracostomy is performed for decreased left 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:
a) reexamine the chest.
b) perform an aortogram.
c) obtain a CT scan of the chest.
d) obtain arterial blood gas analyses - ANSWER: a) reexamine the chest
Which one of the following physical findings suggests a cause of hypotension other
than spinal cord injury?
a) priapism.
b) bradycardia.
c) diaphragmatic breathing.
d) presence of deep tendon reflexes. - ANSWER: d) presence of deep tendon
reflexes.
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A construction worker falls two stories from a building and sustains bilateral calcaneal
fractures. In the emergency 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 likely to
be confirmed by:
a) compartment pressures
b) retrograde urethrogram
c) Doppler-ultrasound studies
d) complete spine x-ray series - ANSWER: d) complete spine x-ray series
In managing the head-injured patient, the most important initial step is to:
a) obtain c-spine film.
b) secure the airway.
c) support the circulation.
d) control scalp hemorrhage. - ANSWER: b) secure the airway.
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2
liters. Which one of the following statements applies to this patient?
a) His pulse pressure will be widened.
b) His urinary output will be at the lower limits of normal.
c) He will have tachycardia, but no change in his systolic blood pressure.
d) His systolic blood pressure will be decreased with a narrowed pulse
pressure. - ANSWER: d) His systolic blood pressure will be decreased with a
narrowed pulse pressure.
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The physiologic hypervolemia of pregnancy has clinical significance in the management
of the severely injured, gravid woman by:
a) reducing the need for blood transfusion.
b) increasing the risk of pulmonary edema.
c) increasing the volume of blood loss to produce maternal hypotension.
d) complicating the mangement of closed head injury. - ANSWER: c)
increasing the volume of blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the burn patient is:
a) adequate urinary output.
b) reversal of systemic acidosis.
c) normalization of the heart rate.
d) a normal central venous pressure. - ANSWER: a) adequate urinary output.
The diagnosis of shock must include:
a) increased vascular resistance.
b) evidence of inadequate organ perfusion.
c) acidosis.
d) hypoxemia. - ANSWER: b) evidence of inadequate organ perfusion.
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:
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a) application of a tourniquet.
b) direct pressure on the wound.
c) packing the wound with gauze.
d) direct pressure on the femoral artery at the groin. - ANSWER: b) direct
pressure on the wound.
For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent:
a) respiratory acidosis.
b) metabolic acidosis.
c) cerebral vasoconstriction with diminished perfusion.
d) neurogenic pulmonary edema. - ANSWER: c) cerebral vasoconstriction with
diminished perfusion.
A 25-year-old man is brought to a hospital with a general surgeon after being
involved in a motor vehicle crash. Computed tomography shows an aortic injury and
splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after
CT. The next step is:
a) contrast angiography.
b) transfer to a higher level trauma center.
c) exploratory laparotomy.
d) infuse additional crystalloids. - ANSWER: c) exploratory laparotomy.
Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE?