ATLS POST
TEST 2023
QUESTIONS
&
ANSWERS
,ATLS POST TEST 2023 QUESTIONS & ANSWERS
1. The primary indication for transferring a 4. Which one of the following statements
patient to a higher level trauma center is: regarding patients with thoracic spine injuries is
TRUE?
unavailability of a surgeon or operating room Log-rolling may be destabilizing to
staff. fractures from T-12 to L-1.
multiple system injuries, including severe Adequate immobilization can be
head injury. accomplished with the scoop stretcher.
resource limitations as determined by the Spinal cord injury below T-10 usually spares
transferring doctor. bowel and bladder function.
resource limitations as determined by the Hyperflexion fractures in the upper
hospital administration. thoracic spine are inherently unstable.
widened mediastinum on chest x-ray These patients rarely present with spinal
following blunt thoracic trauma. shock in association with cord injury.
2. teen-aged bicycle rider is hit by a truck 5. young man sustains a ritle wound to the mid-
traveling at a high rate of speed. In the abdomen. He is brought promptly to the
emergency department, she is actively bleeding emergency department by prehospital
from open fractures of her legs, and has personnel. His skin is cool and diaphoretic, and
abrasions on her chest and abdominal wall. Her his systolic blood pressure is 58 rnm Hg.
blood pressure is 80/50 mm Hg, heart rate is Warmed crystalloid fluids are initiated without
140 beats per minute, respiratory rate is 8 improvement in his vital signs. The next, most
breaths per minute, and GCS score is 6. appropriate step is to perform:
The first step in managing this patient is to: a celiotomy.
an abdominal CT scan.
obtain a lateral cervical spine x-ray. diagnostic laparoscopy.
insert a central venous pressure line. abdominal ultrasonography.
administer 2 liters of crystalloid solution. a diagnostic peritoneal lavage.
perform endotracheal intubation and
ventilation.
apply the PASG and inflate the leg
6. young woman sustains a severe head injury
compartments. as the result of a motor vehicular crash. In the
emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She is intubated and
the presence of a: is being mechanically ventilated. Her pupils are
gastric perforation. 3 mm in size and equally reactive to light.
diaphragmatic rupture. There is no other apparent injury. The most
open depressed skull fracture. important principle to follow in the early
fracture of the cervical spine. management of her head injury is to:
fracture of the cribriform plate.
administer an osmotic diuretic.
prevent secondary brain injury.
1
, aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrained passenger
reduce metabolic requirements of the in a vehicle struck from behind. In the
brain. emergency department, her blood pressure is
distinguish between intracranial hematoma 80/60 mm Hg, heart rate is 80 beats per minute,
and cerebral edema. and respiratory rate is 16 breaths per minute.
Her GCS score is 14. She complains that her
legs feel "funny and won't move right;"
7. 22-year-old man is brought to the hospital
however, her spine x-rays do not show a
after crashing his motorcycle into a telephone
fracture or dislocation. A spinal cord injury in
pole. He is unconscious and in profound shock.
this child:
He has no open wounds or obvious fractures.
is most likely a central cord syndrome.
The cause of his shock is MOST LIKELY
must be diagnosed by magnetic resonance
caused by:
imaging.
a subdural hematoma.
can be excluded by obtaining a CT of the
an epidural hematoma.
entire spine.
a transected lumbar spinal cord.
may exist in the absence of objective
a transected cervical spinal cord. findings on x-ray studies.
hemorrhage into the chest or abdomen.
is unlikely because of the incomplete
calcification of the vertebral bodies.
8. 30-year-old man is struck by a car traveling
at 56 kph (35 mph). He has obvious fractures of 10. Immediate chest tube insertion is indicated
the left tibia near the knee, pain in the pelvic for which of the following conditions?
area, and severe dyspnea. His heart rate is 180 Pneumothorax
beats per minute, and his respiratory rate is 48 Pneumomediastinum
breaths per minute with no breath sounds heard Massive hemothorax
in the left chest. A tension pneumothorax is Diaphragmatic rupture
relieved by immediate needle decompression Subcutaneous emphysema
and tube thoracostomy. Subsequently, his heart
rate decreases to 140 beats per minute, his
respiratory rate decreases to 36 breaths per 11. 18-year-old, helmeted motorcyclist is
minute, and his blood pressure is 80/50 inm Hg. brought by ambulance to the emergency
Warmed Ringer's lactate is administered department following a high-speed crash.
intravenously. The next priority should be to: Prehospital persormel report that he was thrown
perform a urethrogram and cystogram. 15 meters (50 feet) off his bfice. He has a
perform external fixation of the pelvis. history of hypotension prior to arrival in the
obtain abdominal and pelvic CT scans. emergency department, but is now awake, alert,
perform arterial embolization of the pelvic and conversational. Which of the following
vessels. statements is TRUE?
perform diagnostic peritoneal lavage or Cerebral perfiision is intacto
abdominal ultrasound. Intravascular volume status is normal.
The patient has sensitive vasomotor
reflexes.
2
TEST 2023
QUESTIONS
&
ANSWERS
,ATLS POST TEST 2023 QUESTIONS & ANSWERS
1. The primary indication for transferring a 4. Which one of the following statements
patient to a higher level trauma center is: regarding patients with thoracic spine injuries is
TRUE?
unavailability of a surgeon or operating room Log-rolling may be destabilizing to
staff. fractures from T-12 to L-1.
multiple system injuries, including severe Adequate immobilization can be
head injury. accomplished with the scoop stretcher.
resource limitations as determined by the Spinal cord injury below T-10 usually spares
transferring doctor. bowel and bladder function.
resource limitations as determined by the Hyperflexion fractures in the upper
hospital administration. thoracic spine are inherently unstable.
widened mediastinum on chest x-ray These patients rarely present with spinal
following blunt thoracic trauma. shock in association with cord injury.
2. teen-aged bicycle rider is hit by a truck 5. young man sustains a ritle wound to the mid-
traveling at a high rate of speed. In the abdomen. He is brought promptly to the
emergency department, she is actively bleeding emergency department by prehospital
from open fractures of her legs, and has personnel. His skin is cool and diaphoretic, and
abrasions on her chest and abdominal wall. Her his systolic blood pressure is 58 rnm Hg.
blood pressure is 80/50 mm Hg, heart rate is Warmed crystalloid fluids are initiated without
140 beats per minute, respiratory rate is 8 improvement in his vital signs. The next, most
breaths per minute, and GCS score is 6. appropriate step is to perform:
The first step in managing this patient is to: a celiotomy.
an abdominal CT scan.
obtain a lateral cervical spine x-ray. diagnostic laparoscopy.
insert a central venous pressure line. abdominal ultrasonography.
administer 2 liters of crystalloid solution. a diagnostic peritoneal lavage.
perform endotracheal intubation and
ventilation.
apply the PASG and inflate the leg
6. young woman sustains a severe head injury
compartments. as the result of a motor vehicular crash. In the
emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart
3. Contraindication to nasogastric intubation is rate is 80 beats per minute. She is intubated and
the presence of a: is being mechanically ventilated. Her pupils are
gastric perforation. 3 mm in size and equally reactive to light.
diaphragmatic rupture. There is no other apparent injury. The most
open depressed skull fracture. important principle to follow in the early
fracture of the cervical spine. management of her head injury is to:
fracture of the cribriform plate.
administer an osmotic diuretic.
prevent secondary brain injury.
1
, aggressively treat systemic hypertension. 9. 8-year-old girl is an unrestrained passenger
reduce metabolic requirements of the in a vehicle struck from behind. In the
brain. emergency department, her blood pressure is
distinguish between intracranial hematoma 80/60 mm Hg, heart rate is 80 beats per minute,
and cerebral edema. and respiratory rate is 16 breaths per minute.
Her GCS score is 14. She complains that her
legs feel "funny and won't move right;"
7. 22-year-old man is brought to the hospital
however, her spine x-rays do not show a
after crashing his motorcycle into a telephone
fracture or dislocation. A spinal cord injury in
pole. He is unconscious and in profound shock.
this child:
He has no open wounds or obvious fractures.
is most likely a central cord syndrome.
The cause of his shock is MOST LIKELY
must be diagnosed by magnetic resonance
caused by:
imaging.
a subdural hematoma.
can be excluded by obtaining a CT of the
an epidural hematoma.
entire spine.
a transected lumbar spinal cord.
may exist in the absence of objective
a transected cervical spinal cord. findings on x-ray studies.
hemorrhage into the chest or abdomen.
is unlikely because of the incomplete
calcification of the vertebral bodies.
8. 30-year-old man is struck by a car traveling
at 56 kph (35 mph). He has obvious fractures of 10. Immediate chest tube insertion is indicated
the left tibia near the knee, pain in the pelvic for which of the following conditions?
area, and severe dyspnea. His heart rate is 180 Pneumothorax
beats per minute, and his respiratory rate is 48 Pneumomediastinum
breaths per minute with no breath sounds heard Massive hemothorax
in the left chest. A tension pneumothorax is Diaphragmatic rupture
relieved by immediate needle decompression Subcutaneous emphysema
and tube thoracostomy. Subsequently, his heart
rate decreases to 140 beats per minute, his
respiratory rate decreases to 36 breaths per 11. 18-year-old, helmeted motorcyclist is
minute, and his blood pressure is 80/50 inm Hg. brought by ambulance to the emergency
Warmed Ringer's lactate is administered department following a high-speed crash.
intravenously. The next priority should be to: Prehospital persormel report that he was thrown
perform a urethrogram and cystogram. 15 meters (50 feet) off his bfice. He has a
perform external fixation of the pelvis. history of hypotension prior to arrival in the
obtain abdominal and pelvic CT scans. emergency department, but is now awake, alert,
perform arterial embolization of the pelvic and conversational. Which of the following
vessels. statements is TRUE?
perform diagnostic peritoneal lavage or Cerebral perfiision is intacto
abdominal ultrasound. Intravascular volume status is normal.
The patient has sensitive vasomotor
reflexes.
2
