ATLS POST TEST 2023 QUESTIONS & ANSWERS

ATLS POST
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TEST 2023
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QUESTION
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S
&
ANSWERS

, ATLS POST TEST 2023 QUESTIONS & ANSWERS v v v v v v




1. The primary indication for transferring a
v v v v v 4. Which one of the following statements
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patient to a higher level trauma center is:
v v v v v v v v regarding patients with thoracic spine injuries is
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TRUE?
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unavailability of a surgeon or operating room v v v v v v v v  Log-rolling may be destabilizing to v v v v 


staff. fractures from T-12 to L-1. v v v v



v multiple system injuries, including severe
v v v v v  Adequate immobilization can be v v v 


head injury. v accomplished with the scoop stretcher. v v v v



resource limitations as determined by the
v v v v v v  Spinal cord injury below T-10 usually spares
v v v v v v 


transferring doctor. v bowel and bladder function. v v v



resource limitations as determined by the v v v v v v v  Hyperflexion fractures in the upper v v v v 


hospital administration. v thoracic spine are inherently unstable. v v v v



v widened mediastinum on chest x-ray v v v v v  These patients rarely present with spinal
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following blunt thoracic trauma. v v v shock in association with cord injury.
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2. teen-aged bicycle rider is hit by a truck v v v v v v v 5. young man sustains a ritle wound to the mid-
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traveling at a high rate of speed. In the
v v v v v v v v v abdomen. He is brought promptly to the
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emergency department, she is actively bleeding
v v v v v v emergency department by prehospital
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from open fractures of her legs, and has
v v v v v v v v personnel. His skin is cool and diaphoretic, and
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abrasions on her chest and abdominal wall.
v v v v v v v his systolic blood pressure is 58 rnm Hg.
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Her blood pressure is 80/50 mm Hg, heart
v v v v v v v v Warmed crystalloid fluids are initiated without
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rate is 140 beats per minute, respiratory rate
v v v v v v v v improvement in his vital signs. The next, most
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is 8 breaths per minute, and GCS score is 6.
v v v v v v v v v v appropriate step is to perform:
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The first step in managing this patient is to:
v v v v v v v v a celiotomy.
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v an abdominal CT scan. 
v v v



obtain a lateral cervical spine x-ray. 
v v v v v v diagnostic laparoscopy. v 


v insert a central venous pressure line.
v v v v v  v abdominal ultrasonography. v 


v administer 2 liters of crystalloid solution. v v v v v a diagnostic peritoneal lavage.
v v v 

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v perform endotracheal intubation and v v v 


ventilation. 6. young woman sustains a severe head injury
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apply the PASG and inflate the leg
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as the result of a motor vehicular crash. In the
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compartments. emergency department, her GCS score is 6.
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Her blood pressure is 140/90 mm Hg and her
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heart rate is 80 beats per minute. She is
3. Contraindication to nasogastric intubation is
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intubated and is being mechanically ventilated.
the presence of a:
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Her pupils are 3 mm in size and equally
gastric perforation.
v v v v v v v v v
v 

reactive to light. There is no other apparent
diaphragmatic rupture. 
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injury. The most important principle to follow
open depressed skull fracture.
v v v v v v v
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in the early management of her head injury is
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v fracture of the cervical spine. v v v v 

to:
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v fracture of the cribriform plate. v v v v 


administer an osmotic diuretic. v v v 


prevent secondary brain injury. v v v 




1

, aggressively treat systemic hypertension. v v v  9. 8-year-old girl is an unrestrained passenger
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reduce metabolic requirements of the v v v v  in a vehicle struck from behind. In the
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brain. emergency department, her blood pressure is
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v distinguish between intracranial hematoma  v v v 80/60 mm Hg, heart rate is 80 beats per
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and cerebral edema. v v minute, and respiratory rate is 16 breaths per
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minute. Her GCS score is 14. She complains
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that her legs feel "funny and won't move
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7. 22-year-old man is brought to the hospital
right;" however, her spine x-rays do not
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v v v v v v v

after crashing his motorcycle into a telephone
show a fracture or dislocation. A spinal cord
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pole. He is unconscious and in profound
injury in this child:
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v v v v

shock. He has no open wounds or obvious
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is most likely a central cord syndrome.
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fractures. The cause of his shock is MOST
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must be diagnosed by magnetic resonance
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LIKELY caused by:
imaging.
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a subdural hematoma.
v v v v v 
can be excluded by obtaining a CT of the
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an epidural hematoma.
v v v
entire spine. v


a transected lumbar spinal cord. 
may exist in the absence of objective
v v v v v v
v v v v v v 

a transected cervical spinal cord. findings on x-ray studies.
v v v v v v
v v v
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hemorrhage into the chest or abdomen. v v v v v  is unlikely because of the incomplete
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calcification of the vertebral bodies. v v v v




8. 30-year-old man is struck by a car
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vtraveling at 56 kph (35 mph). He has obviousv v v v v v v v
10. Immediate chest tube insertion is indicated v v v v v




fractures of the left tibia near the knee, pain in
v v v v v v v v v v
for which of the following conditions?
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the pelvic area, and severe dyspnea. His heart
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Pneumothorax 



rate is 180 beats per minute, and his
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v Pneumomediastinum 
respiratory rate is 48 breaths per minute with
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v Massive hemothorax v 
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no breath sounds heard in the left chest. A
v v v v v v v v v v Diaphragmatic rupture v 



tension pneumothorax is relieved by immediate
v v v v v v v Subcutaneous emphysema v 



needle decompression and tube thoracostomy.
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Subsequently, his heart rate decreases to 140
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11. 18-year-old, helmeted motorcyclist is
beats per minute, his respiratory rate
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brought by ambulance to the emergency
decreases to 36 breaths per minute, and his
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v v v v v v v v

department following a high-speed crash.
blood pressure is 80/50 inm Hg. Warmed
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v v v v v v v

Prehospital persormel report that he was
Ringer's lactate is administered intravenously.
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thrown 15 meters (50 feet) off his bfice. He
The next priority should be to:
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has a history of hypotension prior to arrival in
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perform a urethrogram and cystogram. v v v v 

the emergency department, but is now awake,
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v perform external fixation of the pelvis. v v v v v 

alert, and conversational. Which of the
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v obtain abdominal and pelvic CT scans.  v v v v v

following statements is TRUE?
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v perform arterial embolization of the pelvic
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vessels.
perform diagnostic peritoneal lavage or v v v v  Cerebral perfiision is intacto v v v 


abdominal ultrasound. v v Intravascular volume status is normal. v v v v




v The patient has sensitive vasomotor
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reflexes.



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