ATLS POST TEST 4 LATEST VERSIONS REAL EXAM
160 QUESTIONS AND CORRECT ANSWERS |AGRADE
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is initially 80/40 mm Hg. After 2 liters of crystalloid solution his BP
increases to 122/84. His heart rate is now 100 BPM and his RR 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 __________. - ANSWER✔✔re-examine the chest
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 _________. - ANSWER✔✔complete spine x-rays
In managing the head-injured patient, the most important initial step is to ________. -
ANSWER✔✔secure the airway
A previously healthy, 70 kg man suffers an estimated acute blood loss of 2 liters. How
will this affect his blood pressure? - ANSWER✔✔his systolic pressure will be decreased
with a narrowed pulse pressure
,The physiologic hypervolemia of pregnancy has clinical significance in the management
of the severely injured, gravid woman by ____________. - ANSWER✔✔increasing the
volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is __________. -
ANSWER✔✔adequate urinary output
The diagnosis of shock must include _________. - ANSWER✔✔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 ________
(application of a tourniquet vs. direct pressure on the wound). - ANSWER✔✔direct
pressure on the wound
For the patient with severe TBI, profound hypocarbia should be avoided to prevent
__________. - ANSWER✔✔cerebral vasoconstriction with diminished perfusion
A 25-year-old man is brought to a hospital after being involved in a MVA. CT shows an
aortic injury and splenic laceration with free abdominal fluid. His BP falls to 70 mm Hg
after CT. The next step is _______. - ANSWER✔✔exploratory laparotomy
Abdominal trauma in a pregnant patient --> _________ is an indication for hospital
admission. - ANSWER✔✔leakage of amniotic fluid
,What is the first maneuver to improve oxygenation after chest injury? -
ANSWER✔✔administer supplemental oxygen
A 25-year old man, injured in a MVA, is admitted to the emergency department. His
pupils react sluggishly and his eyes open to painful stimuli. He does not follow
commands, but he does moan periodically. His right arm is deformed and does not
respond to painful stimulus; however, his left hand reaches purposefully toward the
painful stimulus. Both legs are stiffly extended. His GCS score is ________. -
ANSWER✔✔9 (eyes = 2, verbal = 2, motor = 5)
Which one of the following findings in an adult is most likely to require immediate
management during the primary survey: distended abdomen, GCS score of 11,
deforming of the right thigh, RR of 40 BPM. - ANSWER✔✔RR of 40 BPM
The most important, immediate step in the management of an open pneumothorax is
_________. - ANSWER✔✔placement of an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration: history of
neurological reaction or severe hypersensitivity to the product, local side effects,
muscular spasms, pregnancy, or all of the above. - ANSWER✔✔history of neurological
reaction or severe hypersensitivity to the product
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, he is diaphoretic and
complaining of chest pain. His BP is 60/40 mm Hg and his RR is 40 breaths per minute.
, Which of the following best differentiates cardiac tamponade from tension
pneumothorax as the cause of his hypotension? - ANSWER✔✔breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
ET intubation because _______. - ANSWER✔✔the trachea is relatively short
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
and is brought by ambulance to a hospital that has full surgical capabilities. His wounds
are all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
performed, and 2 liters of crystalloid solution are infused through 2 large-caliber IVs. His
blood pressure is now 60/0 mm Hg. Heart rate is 160 bpm, and RR is 14 breaths per
minute (ventilated with 100% O2). 1500 cc of blood has drained from the right chest.
The most appropriate next step in managing this patient is to ______. -
ANSWER✔✔urgently transfer the patient to the operating room
A 39-year-old man is admitted to the emergency department after an automobile
collision. He is cyanotic, has insufficient respiratory effort, and has a GCS Score of 6.
His full beard makes it difficult to fit the oxygen facemask to his face. The most
appropriate next step is to _______. - ANSWER✔✔attempt orotracheal intubation using
2 people and inline stabilization of the cervical spine
A patient is brought to the emergency department after a motor vehicle crash. He is
conscious and there is no obvious external trauma. He arrives at the hospital completely
immobilized on a long spine board. His BP is 60/40 mm Hg and his heart rate is 70
beats per minute. His skin is warm. Which one of the following statements is TRUE? -
160 QUESTIONS AND CORRECT ANSWERS |AGRADE
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His BP is initially 80/40 mm Hg. After 2 liters of crystalloid solution his BP
increases to 122/84. His heart rate is now 100 BPM and his RR 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 __________. - ANSWER✔✔re-examine the chest
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 _________. - ANSWER✔✔complete spine x-rays
In managing the head-injured patient, the most important initial step is to ________. -
ANSWER✔✔secure the airway
A previously healthy, 70 kg man suffers an estimated acute blood loss of 2 liters. How
will this affect his blood pressure? - ANSWER✔✔his systolic pressure will be decreased
with a narrowed pulse pressure
,The physiologic hypervolemia of pregnancy has clinical significance in the management
of the severely injured, gravid woman by ____________. - ANSWER✔✔increasing the
volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is __________. -
ANSWER✔✔adequate urinary output
The diagnosis of shock must include _________. - ANSWER✔✔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 ________
(application of a tourniquet vs. direct pressure on the wound). - ANSWER✔✔direct
pressure on the wound
For the patient with severe TBI, profound hypocarbia should be avoided to prevent
__________. - ANSWER✔✔cerebral vasoconstriction with diminished perfusion
A 25-year-old man is brought to a hospital after being involved in a MVA. CT shows an
aortic injury and splenic laceration with free abdominal fluid. His BP falls to 70 mm Hg
after CT. The next step is _______. - ANSWER✔✔exploratory laparotomy
Abdominal trauma in a pregnant patient --> _________ is an indication for hospital
admission. - ANSWER✔✔leakage of amniotic fluid
,What is the first maneuver to improve oxygenation after chest injury? -
ANSWER✔✔administer supplemental oxygen
A 25-year old man, injured in a MVA, is admitted to the emergency department. His
pupils react sluggishly and his eyes open to painful stimuli. He does not follow
commands, but he does moan periodically. His right arm is deformed and does not
respond to painful stimulus; however, his left hand reaches purposefully toward the
painful stimulus. Both legs are stiffly extended. His GCS score is ________. -
ANSWER✔✔9 (eyes = 2, verbal = 2, motor = 5)
Which one of the following findings in an adult is most likely to require immediate
management during the primary survey: distended abdomen, GCS score of 11,
deforming of the right thigh, RR of 40 BPM. - ANSWER✔✔RR of 40 BPM
The most important, immediate step in the management of an open pneumothorax is
_________. - ANSWER✔✔placement of an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration: history of
neurological reaction or severe hypersensitivity to the product, local side effects,
muscular spasms, pregnancy, or all of the above. - ANSWER✔✔history of neurological
reaction or severe hypersensitivity to the product
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, he is diaphoretic and
complaining of chest pain. His BP is 60/40 mm Hg and his RR is 40 breaths per minute.
, Which of the following best differentiates cardiac tamponade from tension
pneumothorax as the cause of his hypotension? - ANSWER✔✔breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
ET intubation because _______. - ANSWER✔✔the trachea is relatively short
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
and is brought by ambulance to a hospital that has full surgical capabilities. His wounds
are all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
performed, and 2 liters of crystalloid solution are infused through 2 large-caliber IVs. His
blood pressure is now 60/0 mm Hg. Heart rate is 160 bpm, and RR is 14 breaths per
minute (ventilated with 100% O2). 1500 cc of blood has drained from the right chest.
The most appropriate next step in managing this patient is to ______. -
ANSWER✔✔urgently transfer the patient to the operating room
A 39-year-old man is admitted to the emergency department after an automobile
collision. He is cyanotic, has insufficient respiratory effort, and has a GCS Score of 6.
His full beard makes it difficult to fit the oxygen facemask to his face. The most
appropriate next step is to _______. - ANSWER✔✔attempt orotracheal intubation using
2 people and inline stabilization of the cervical spine
A patient is brought to the emergency department after a motor vehicle crash. He is
conscious and there is no obvious external trauma. He arrives at the hospital completely
immobilized on a long spine board. His BP is 60/40 mm Hg and his heart rate is 70
beats per minute. His skin is warm. Which one of the following statements is TRUE? -
