EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (100% VERIFIED ANSWERS)
Quiz_________________?
(*)Degree of burn that is characterized by bone involvement -
Answer✅
Fourth
Quiz_________________?
37-year-old man is struck on the side of the head but is conscious and talkative after the
injury. No evidence of skull fracture. Several days later, he becomes increasingly lethargic,
somewhat confused, and unable to move his right side. Which type of event has most likely
occurred?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion -
Answer✅
A. Subdural hematoma
1
, Quiz_________________?
7-year-old girl is found at the bottom of a swimming pool. Initially she was in full arrest but
after 5 minutes she showed sinus tachycardia but no respiratory effort. Intubation was done
in the field and cervical collar placed. After transport to the emergency department she was
unresponsive with a blood pressure of 100/60 mmHg, pulse 105, temperature 34.3C, and
oxygen saturation 100%. The pupils were 3 mm and sluggishly responsive to light. There is
no response to pain. The lungs show wheezing on the left and coarse breath sounds
bilaterally. The monitor shows sinus tachycardia. There is no rectal tone. Which of the
following should be the next step in management?
A. Cervical spine films and CT of the head B. Portable chest radiograph
C. Arterial blood gas
D. Right and left decubitus chest radiographs -
Answer✅
A. Cervical spine films and CT of the head
Quiz_________________?
A 13 year old boy fell while riding his bicycle and hit his head. He was unconscious for 4 or
5 minutes. He vomited twice. He has no memory of the event or a headache. His exam is
entirely normal. Glasgow coma score is 15. Select the next step in management.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation -
Answer✅
B. CT of the head
Quiz_________________?
A 17-year-old male is hit on the head with a baseball bat. He withdraws and opens his eyes
in response to deep painful stimuli. He also mumbles incomprehensibly. What is his Glasgow
coma scale score? -
Answer✅
2
, 8
Quiz_________________?
A 18-year-old male sustains a right femur fracture and a cerebral concussion in a motor
vehicle accident. His initial blood pressure is 75/50 mmHg with a pulse of 90 beats per
minute. After giving him 2 liters of Ringer lactate he stabilizes, but the blood pressure falls
when he is seen in the ER. Which of the following would be the cause of suspected
hypotension in this patient?
A. Subdural hematoma
B. Undiagnosed facial fracture
C. Ruptured spleen
D. 10% pneumothorax -
Answer✅
C. Ruptured spleen
Quiz_________________?
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In
the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The
most appropriate first step is to: -
Answer✅
perform needle or finger decompression of the right chest
Quiz_________________?
A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the emergency department and 15 minutes after the
incident, she is awake and alert. Her heart rate is 100 beats per minute, blood pressure
80/60 mm Hg, and respiratory rate 20 breaths per minute. A chest x-ray reveals a large left
hemothorax. A left chest tube is placed with an immediate return of 1600 mL of blood. The
next management step for this patient is: -
Answer✅
prepare for an exploratory thoracotomy
3
, Quiz_________________?
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 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: -
Answer✅
re-examine the chest
Quiz_________________?
A 22-year-old man sustains a gunshot wound to the abdomen and presents with shock. He
requires multiple units of packed red blood cells during resuscitation. Later he complains of
numbness around his mouth. Physical exam reveals carpopedal spasm and a positive
Chvostek sign. An electrocardiogram demonstrates a prolonged QT interval. Which of the
following is the most appropriate treatment?
A. IV bicarbonate
B. IV furosemide
C. IV calcium
D. IV insulin -
Answer✅
C. IV calcium
Quiz_________________?
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital no surgical capabilities are available. In the emergency department, a
chest tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the
patient in transfer. Just before the patient is placed in the ambulance for transfer, his blood
pressure decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute.
The next step should be to: -
Answer✅
repeat the primary survey and proceed with transfer
4
CORRECT DETAILED ANSWERS WITH
RATIONALES (100% VERIFIED ANSWERS)
Quiz_________________?
(*)Degree of burn that is characterized by bone involvement -
Answer✅
Fourth
Quiz_________________?
37-year-old man is struck on the side of the head but is conscious and talkative after the
injury. No evidence of skull fracture. Several days later, he becomes increasingly lethargic,
somewhat confused, and unable to move his right side. Which type of event has most likely
occurred?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion -
Answer✅
A. Subdural hematoma
1
, Quiz_________________?
7-year-old girl is found at the bottom of a swimming pool. Initially she was in full arrest but
after 5 minutes she showed sinus tachycardia but no respiratory effort. Intubation was done
in the field and cervical collar placed. After transport to the emergency department she was
unresponsive with a blood pressure of 100/60 mmHg, pulse 105, temperature 34.3C, and
oxygen saturation 100%. The pupils were 3 mm and sluggishly responsive to light. There is
no response to pain. The lungs show wheezing on the left and coarse breath sounds
bilaterally. The monitor shows sinus tachycardia. There is no rectal tone. Which of the
following should be the next step in management?
A. Cervical spine films and CT of the head B. Portable chest radiograph
C. Arterial blood gas
D. Right and left decubitus chest radiographs -
Answer✅
A. Cervical spine films and CT of the head
Quiz_________________?
A 13 year old boy fell while riding his bicycle and hit his head. He was unconscious for 4 or
5 minutes. He vomited twice. He has no memory of the event or a headache. His exam is
entirely normal. Glasgow coma score is 15. Select the next step in management.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation -
Answer✅
B. CT of the head
Quiz_________________?
A 17-year-old male is hit on the head with a baseball bat. He withdraws and opens his eyes
in response to deep painful stimuli. He also mumbles incomprehensibly. What is his Glasgow
coma scale score? -
Answer✅
2
, 8
Quiz_________________?
A 18-year-old male sustains a right femur fracture and a cerebral concussion in a motor
vehicle accident. His initial blood pressure is 75/50 mmHg with a pulse of 90 beats per
minute. After giving him 2 liters of Ringer lactate he stabilizes, but the blood pressure falls
when he is seen in the ER. Which of the following would be the cause of suspected
hypotension in this patient?
A. Subdural hematoma
B. Undiagnosed facial fracture
C. Ruptured spleen
D. 10% pneumothorax -
Answer✅
C. Ruptured spleen
Quiz_________________?
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In
the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The
most appropriate first step is to: -
Answer✅
perform needle or finger decompression of the right chest
Quiz_________________?
A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the emergency department and 15 minutes after the
incident, she is awake and alert. Her heart rate is 100 beats per minute, blood pressure
80/60 mm Hg, and respiratory rate 20 breaths per minute. A chest x-ray reveals a large left
hemothorax. A left chest tube is placed with an immediate return of 1600 mL of blood. The
next management step for this patient is: -
Answer✅
prepare for an exploratory thoracotomy
3
, Quiz_________________?
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 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: -
Answer✅
re-examine the chest
Quiz_________________?
A 22-year-old man sustains a gunshot wound to the abdomen and presents with shock. He
requires multiple units of packed red blood cells during resuscitation. Later he complains of
numbness around his mouth. Physical exam reveals carpopedal spasm and a positive
Chvostek sign. An electrocardiogram demonstrates a prolonged QT interval. Which of the
following is the most appropriate treatment?
A. IV bicarbonate
B. IV furosemide
C. IV calcium
D. IV insulin -
Answer✅
C. IV calcium
Quiz_________________?
A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small
community hospital no surgical capabilities are available. In the emergency department, a
chest tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the
patient in transfer. Just before the patient is placed in the ambulance for transfer, his blood
pressure decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute.
The next step should be to: -
Answer✅
repeat the primary survey and proceed with transfer
4
