ATLS PRETEST + MODULES
Questions & Answers
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 initia
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
ANS re-examine the chest
2.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
ANS complete spine x-ray series
3.Which of the following is true regarding the initial resuscitation of a
trauma patient?
ANS Evidence of improved perfusion after fluid resuscitation could
include improvement in Glasgow Coma Scale score on reevaluation.
,4.In managing a patient with a severe traumatic brain injury, the most
impor- tant initial step is to
ANS secure the airway
5.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?
ANS An ABG would demonstrate a base deficit between -6 and -10
mEq/L.
6.The physiological hypervolemia of pregnancy has clinical significance
in the management of the severely injured, gravid woman by
ANS increasing the volume of blood loss to produce maternal
hypotension
7.The best assessment of fluid resuscitation of the adult burn patient is
ANS uri- nary output of 0.5 mL/kg/hr
8.The diagnosis of shock must include
ANS 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
,ANS direct pressure on the wound
10.For the patient with severe traumatic brain injury, profound hypocarbia
should be avoided to prevent
ANS cerebral vasoconstriction with diminished perfusion
11.After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available.. Computed
tomography of the chest and abdomen 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
ANS perform an exploratory laparotomy
12.Which one of the following statements regarding abdominal trauma in
the pregnant patient is TRUE?
ANS Leakage of amniotic fluid is an indication for hospital admission.
13.The first maneuver to improve oxygenation after chest injury is
ANS administer supplemental oxygen
14.A 25-year-old man, injured in a motor vehicular crash, is admitted to the
emergency department. His pupils react sluggishly and his eyes open to
pressure. He does not follow commands, but he does moan periodically. His
right arm is deformed and does not respond to pressure; however, his left
, hand reaches purposefully toward the stimulus. Both legs are stiffly
extended. His GCS score is
ANS 9
15.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
ANS perform needle or finger decompression of the right chest
16.Which one of the following findings in an adult is most likely to require
im- mediate management during the primary survey?
ANS respiratory rate of 40 breaths per minute
17.The most important, immediate step in the management of an open
pneu- mothorax is
ANS placement of an occlusive dressing over the wound
18.The following are contraindications for tetanus toxoid administration
ANS his- tory of neurological reaction or severe hypersensitivity to the
product
19.A 56-year-old man is thrown violently against the steering wheel of his
truck during a motor vehicle crash. On arrival in the emergency department
Questions & Answers
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 initia
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
ANS re-examine the chest
2.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
ANS complete spine x-ray series
3.Which of the following is true regarding the initial resuscitation of a
trauma patient?
ANS Evidence of improved perfusion after fluid resuscitation could
include improvement in Glasgow Coma Scale score on reevaluation.
,4.In managing a patient with a severe traumatic brain injury, the most
impor- tant initial step is to
ANS secure the airway
5.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?
ANS An ABG would demonstrate a base deficit between -6 and -10
mEq/L.
6.The physiological hypervolemia of pregnancy has clinical significance
in the management of the severely injured, gravid woman by
ANS increasing the volume of blood loss to produce maternal
hypotension
7.The best assessment of fluid resuscitation of the adult burn patient is
ANS uri- nary output of 0.5 mL/kg/hr
8.The diagnosis of shock must include
ANS 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
,ANS direct pressure on the wound
10.For the patient with severe traumatic brain injury, profound hypocarbia
should be avoided to prevent
ANS cerebral vasoconstriction with diminished perfusion
11.After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available.. Computed
tomography of the chest and abdomen 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
ANS perform an exploratory laparotomy
12.Which one of the following statements regarding abdominal trauma in
the pregnant patient is TRUE?
ANS Leakage of amniotic fluid is an indication for hospital admission.
13.The first maneuver to improve oxygenation after chest injury is
ANS administer supplemental oxygen
14.A 25-year-old man, injured in a motor vehicular crash, is admitted to the
emergency department. His pupils react sluggishly and his eyes open to
pressure. He does not follow commands, but he does moan periodically. His
right arm is deformed and does not respond to pressure; however, his left
, hand reaches purposefully toward the stimulus. Both legs are stiffly
extended. His GCS score is
ANS 9
15.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
ANS perform needle or finger decompression of the right chest
16.Which one of the following findings in an adult is most likely to require
im- mediate management during the primary survey?
ANS respiratory rate of 40 breaths per minute
17.The most important, immediate step in the management of an open
pneu- mothorax is
ANS placement of an occlusive dressing over the wound
18.The following are contraindications for tetanus toxoid administration
ANS his- tory of neurological reaction or severe hypersensitivity to the
product
19.A 56-year-old man is thrown violently against the steering wheel of his
truck during a motor vehicle crash. On arrival in the emergency department
