ATLS10 exam questions with answers (answers outlined!!) 2.pdf

ATLS10 2022/2023 Post-Test
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WhichnofnthenfollowingnisnthenrecommendednMethodnforntreatmentnfrostbite?
A. Vasodilators
B. Anticigulants
C. Warmn(40ndegrees)nwater
D. Paddingnandnelevation
E. Applicationnofnheatnfromnanhairdryer

Whichnofnthenfollowingnphysicalnfindingsnsuggestnancausenofnhypotensionnothernthannspinal
ncordninjury?

A. Priapism
B. Bradycardia
C. Diaphragmaticnbreathing
D. Presencenofndeepntendonnreflexes
E. Abilityntonflexnforearmsnbutnnotnextendnthem
- D..nSpinalnshocknrefersntonlossnofnmusclentoen(flaccidity)nandnlossnofnreflexes.

ThenprimarynindicationnforntransferringnAnpatientntonanhigher-levelntraumancenternis:
A. Unavailabilitynofnsurgeonnornoperatingnstaff
B. Multiplensystemninjuries,nincludingnseverenheadninjury
C. Resourcenlimitationsnasndeterminednbynthentransferringndoctor
D. Resourcenlimitationsnasndeterminednbynthenhospitalnadministration
E. Widenednmediastinumnonnchestnx-raynfollowingnbluntntrauma
- C.nResourcenlimitationsnasndeterminednbynthentransferringndoctorn(MÅnSJEKKES)

Anyoungnmannsustainsnanriflenwoundntonthenmid-
abdomen.nHenisnbroughtnpromptlyntonthenEDnbynprehospitalnpersonnel.nHisnskinnisncoolnand
ndiaphoretic,nandnhisnsystolicnbloodnpressurenisn58mmHg.nWarmedncrystalloidnfluidsnareninit

iatednwithoutnimprovementninnhisnvitalnsigns.nThennext,nmostnappropriate,nstepnisntonperfor
m:
A. anlaparotomy
B. AnnabdominalnCT-scan
C. Diagnosticnlaparoscopy
D. Abdominalnultrasonography
E. Andiagnosticnperitonealnlavage
- A.nLaparotomynbecausenofnhemodynamicnabnormality

An42-year-
oldnmannisntrappednfromnthenwaistndownnbeneathnhisnoverturnedntractornfornseveralnhoursnb
eforenmedicalnassistancenarrives.nHenisnawakenandnalertnuntilnjustnbeforenarrivingninnthenED.
nHenisnnownunconsciousnandnrespondsnonlyntonpainfulnstimulinbynmoaning.nHisnpupilsnaren3

mmninndiameternandnsymmetricallynreactiventonlight.
Prehospitalnpersonnelnindicatenthatntheynhavennotnseennthenpatientnmoveneithernofnhisnlow
ernextremities.nOnnexaminationninnthenED,nnonmovementnofnhisnlowernextremitiesnarendetec
ted,nevenninnresponsentonpainfulnstimuli.nThenmostnlikelyncausenfornthisnfindingnis:
A. Annepiduralnhematoma
B. Anpelvicnfracture

,C. Centralncordnsyndrome
D. Intracerebralnhemorrhage
E. Bilateralncompartmentnsyndrome

An6-year-
onboynisnstrucknbynannautomobilenandnbroughtntonthenED.nHenisnlethargic,nbutnwithdrawsnpu
rposefullynfromnpainfulnstimuli.nHisnbloodnpressurenisn90mmHgnsystolic,nheartnraten140nbe
atsnpernminutenandnhisnrespiratorynratenisn36nbreathsnpernminute.nThenpreferrednroutenofnve
nousnaccessninnthisnpatientnis:
A. Percutaneousnfemoralnveinncannulation
B. Cutdownnonnthensaphenousnveinnatnthenankle
C. Intraosseousncatheternplacementninnthenproximalntibia
D. Percutaneousnperipheralnveinsninnthenuppernextremities
E. Centralnvenousnaccessnvianthensubclaviannorninternalnjugularnvein

AnyoungnmannsustainsnangunshotnwoundntonthenabdomennandnisnbroughtnpromptlyntonthenE
Dnbynprehospitalnpersonnel.nHisnskinnisncoolnandndiaphoretic,nandnhenisnconfused.nHisnpuls
enisnthreadynandnhisnfemoralnpulsenisnonlynweaklynpalpable.nThendefinitiventreatmentninnma
nagingnthisnpatientnisnto:
A. AdministernO-negativenblood
B. Applynexternalnwarmingndevices
C. Controlninternalnhemorrhagenoperatively
D. Applynanpneumaticnantishockngarmentn(PASG)
E. Infusenlargenvolumesnofnintravenousncrystalloidnsolutions.

Regardingnshockninnthenchild,nwhichnofnthenfollowingnisnFALSE?
A. Vitalnsignsnarenage-related
B. Childrennhavengreaternphysiologicnreservesnthanndonadults
C. Tachycardianisnthenprimarynphysiologicnresponsentonhypovolemia
D. Thenabsolutenvolumenofnbloodnlossnrequiredntonproducenshocknisnthensamenasninna
dults
E. Anninitialnfluidnbolusnfornresuscitationnshouldnapproximaten20ml/kgnRingersnLactate

An33-year-
oldnmannisnstrucknbynancarntravellingnatn56km/hn(35mph).nHenhasnobviousnfracturesnofnthenl
eftntibiannearnthenknee,npainninnthenpelvicnarea,nandnseverendyspnea.nHisnheartnratenisn182n
beatsnpernminute,nandnhisnrespiratorynratenisn48nbreathsnpernminutenwithnnonbreathnsoundsn
heardninnthenleftnchest.nAntensionnpneumothoraxnisnrelievednbynimmediatenneedlendecomp
ressionnandntubenthoracostomy.nSubsequently,nhisnheartnratendecreasesnton144nbeatsnpern
minute,nhisnrespiratorynratendecreasesnton36nbreathsnpernminutenandnhisnbloodnpressurenisn
81/53nmmHg.nWarmednRingersnlactatenisnadministerednintravenously.nThennextnprioritynsh
ouldnbento:
A. Performnexternalnfixationnofnthenpelvis
B. ObtainnabdominalnandnpelvicnCT-scans
C. Performnarterialnembolizationnofnthenpelvicnvessel
D. PerformndiagnosticnperitonealnlavagenornFAST
E. Performnanurethrogramnandncystogram

,An42-year-
oldnman,ninjuredninnanmotornvehiclencrash,nsuffersnanclosednheadninjury,nmultiplenpalpablenl
eftnribnfractures,nandnbilateralnfemurnfractures.nHenisnintubatednorotracheallynwithoutndifficu
lty.nInitially,nhisnventilationsnareneasilynassistednwithnanbag-
nmaskndevice.nItnbecomesnmorendifficultntonventilatenthenpatientnovernthennextn5nminutes,nan

dnhisnhemoglobinnoxygennsaturationnlevelndecreasesnfromn98%nton89%.nThenmostnapprop
riatennextnstepnisnto:
A. Obtainnanchestnx-ray
B. Decreasenthentidalnvolume
C. DecreasenPEEP
D. Increasenthenratenofnassistednventilations
E. Performnneedlendecompressionnofnthenleftnchest.

An30-year-
oldnmannsustainsnanseverelyncomminuted,nopen,ndistalnrightnfemurnfractureninn anmotorcycl
encrash.nThenwoundnisnactivelynbleeding.nNormalnsensationnisnpresentnovernthenlateralnasp
ectnofnthenfootnbutndecreasednovernthenmedialnfootnandngreatntoe.nNormalnmotionnofnthenfoot
nisnobserved.nDorsalisnpedisnandnposteriorntibialnpulsesnareneasilynpalpablenonnthenleft,nbutn

heardnonlynbynDopplernonnthenright.nImmediateneffortsntonimprovencirculationntontheninjuredn
extremitynshouldninvolve:
A. Immediatenangiography
B. Tamponadenofnthenwoundnwithnanpressurendressing
C. Woundnexplorationnandnremovalnofnbonynfragments
D. Realignmentnofnthenfracturensegmentsnwithnantractionnsplint
E. Fasciotomynofnallnfourncompartmentsninnthenlowernextremity

Ann18-yeard-
old,nunhelmetnmotorcyclistnisnbroughtnbynambulancentonthenEDnfollowingnancrash.nHenhadnd
ecreasednlevelnofnconsciousnessnatnthenscene,nbutnthennwasnalertnandnconversationalnduri
ngntransportation.nNownhisnGCSnisnonlyn11.nWhichnofnthenfollowingnstatementsnisnTRUE?
A. Cerebralnperfusionnisnintact
B. Intravascularnvolumenstatusnisnnormal
C. Thenpatientnisninnanpostictalnstate
D. Intra-abdominalnvisceralninjurynisnunlikely
E. Thenpatientnprobablynhasnannacutenepiduralnhematoma

Anpreviouslynhealthy,n70kgn(175npound)nmannsuffersnannestimatednacutenbloodnlossnofntwon
liters.nWhichnonenofnthenfollowingnstatementsnapplyntonthisnpatient?
A. Hisnpulsenpressurenwillnbenwidened
B. Hisnurinarynoutputnwillnbenatnthenlowernlimitsnofnnormal
C. Henwillnhaventachycardia,nbutnnonchangeninnsystolicnbloodnpressure
D. Hisnsystolicnbloodnpressurenwillnbendecreasednwithnannarrowed,npulsenpressure
E. Hisnsystolicnbloodnpressurenwillnbenmaintainednwithnannelevatedndiastolicnpressure.

Thenphysiologicnhypervolemianofnpregnancynhasnclinicalnsignificanceninnthenmanagementno
fnthenseverelyninjuredngravidnwomannby
A. Reducingnthenneednfornbloodntransfusion
B. Increasingnthenrisknofnpulmonarynedema

, C. Complicatingnthenmanagementnofnclosednheadninjury
D. Increasingnthenvolumenofnbloodnlossntonproducenshock/maternalnhypotension
E. Reducingnthenvolumenofncrystalloidnrequirednfornresuscitation

An17-year-
oldnhelmetednmotorcyclistnlosesnconsciousnessnwhennhenisnstrucknbroadnsidenbynannauto
mobilenatnannintersection.nHenarrivesninnthenEDnwithnanbloodnpressurenofn140/92,npulsenrat
en88nbeatsnpernminute,nanrespiratorynratenofn18nbreathsnpernminute,nandnanGCSnofn7.nAppro
priateninitialnimmobilizationnofnthisnpatientnshouldnincludenansemi-rigidncervicalncollarnand:
A. Anscoopnstretcher
B. Anlongnspinenboard
C. Anshortnspinenboard
D. Cervicalntractionntongs
E. Pneumaticnantishockngarment

Duringnannaltercation,nan36-year-
oldnmannsustainsnangunshotnwoundnaboventhennipplenlinenonnthenright,nwithnannexitnwoundnp
osteriorlynaboventhenscapulanonnthenright.nHenisntransportednbynambulancentonancommunity
nhospital.nHenisnendotracheallynintubated,nclosentubenthoracostomynisnperformed,nandn2nlit

ersnRingersnlactatensolutionnareninfusednvian2nlarge-
calibernIV´s.nHisnbloodnpressurennownisn60/0mmHg,nheartnratenisn160nbeatsnpernminute,nan
dnrespiratorynratenisn14nbreathsnpernminuten(ventilatednwithn100%nO2).nThenmostnappropria
tennextnstepninnmanagingnthisnpatientnis:
A. Laparotomy
B. Diagnosticnperitonealnlavage
C. Arterialnbloodngasndetermination
D. Administernpackednrednbloodncells
E. ChestnX-rayntonconfirmntubenplacement

Absencenofnbreathnsoundsnandndullnessntonpercussionnovernthenleftnhemithoraxnarenfinding
snbestnexplainednby:
A. Leftnhemothorax
B. Cardiacncontusion
C. Leftnsimplenpneumothorax
D. Leftndiaphragmaticnrupture
E. Rightntensionnpneumothorax

An23-year-
oldnmannisnbroughtnimmediatelyntonthenEDnfromnthenhospitalsnparkingnlotnwherenhenwasnsh
otninnthenlowernabdomen.nExaminationnrevealsnansinglenbulletnwound.nHenisnbreathingnandn
hasnanthreadynpulse.nHowever,nhenisnunconsciousnandnhasnnondetectablenbloodnpressure.
nOptimalnimmediatenmanagementnisnto:

A. Performnandiagnosticnperitonealnlavage
B. Initiateninfusionnofnpackednrednbloodncells
C. Insertnannasogastricntubenandnurinaryncatheter
D. Transfernthenpatientntonthenoperatingnroom,nwhileninitiatingnfluidntherapy
E. Initiatenfluidntherapyntonreturnnhisnbloodnpressurentonnormotensive