ATLS PRACTICE EXAM SERIES 2021 TESTS ONE
TWO THREE FOUR FULL STUDY GUIDE
◉ 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-ray series
◉ Which of the following is true regarding the initial resuscitation of a
trauma patient? Answer: Evidence of improved perfusion after fluid
resuscitation could include improvement in Glasgow Coma Scale score
on reevaluation.
◉ In managing a patient with a severe traumatic brain injury, the most
important initial step is to: Answer: secure the airway
◉ 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? Answer: An ABG would demonstrate a base
deficit between -6 and -10 mEq/L.
◉ The physiological 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: urinary output of 0.5 mL/kg/hr
◉ 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: Answer: direct pressure on
the wound
◉ For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent: Answer: cerebral
vasoconstriction with diminished perfusion
◉ 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: Answer: perform an exploratory
laparotomy
,◉ Which one of the following statements regarding abdominal trauma in
the pregnant patient is TRUE? Answer: Leakage of amniotic fluid is an
indication for hospital admission.
◉ The first maneuver to improve oxygenation after chest injury is:
Answer: administer supplemental oxygen
◉ 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: Answer: 9
◉ 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: Answer: perform needle or finger
decompression of the right chest
◉ Which one of the following findings in an adult is most likely to
require immediate management during the primary survey? Answer:
respiratory rate of 40 breaths per minute
, ◉ 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:
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 blood
pressure is 60/40 mm Hg and his respiratory rate 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 endotracheal 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, fluid
resuscitation is initiated through 2 large-caliber IVs. FAST exam does
not reveal intraabdominal injuries. His blood pressure now is 60/0 mm
Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths
TWO THREE FOUR FULL STUDY GUIDE
◉ 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-ray series
◉ Which of the following is true regarding the initial resuscitation of a
trauma patient? Answer: Evidence of improved perfusion after fluid
resuscitation could include improvement in Glasgow Coma Scale score
on reevaluation.
◉ In managing a patient with a severe traumatic brain injury, the most
important initial step is to: Answer: secure the airway
◉ 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? Answer: An ABG would demonstrate a base
deficit between -6 and -10 mEq/L.
◉ The physiological 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: urinary output of 0.5 mL/kg/hr
◉ 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: Answer: direct pressure on
the wound
◉ For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent: Answer: cerebral
vasoconstriction with diminished perfusion
◉ 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: Answer: perform an exploratory
laparotomy
,◉ Which one of the following statements regarding abdominal trauma in
the pregnant patient is TRUE? Answer: Leakage of amniotic fluid is an
indication for hospital admission.
◉ The first maneuver to improve oxygenation after chest injury is:
Answer: administer supplemental oxygen
◉ 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: Answer: 9
◉ 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: Answer: perform needle or finger
decompression of the right chest
◉ Which one of the following findings in an adult is most likely to
require immediate management during the primary survey? Answer:
respiratory rate of 40 breaths per minute
, ◉ 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:
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 blood
pressure is 60/40 mm Hg and his respiratory rate 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 endotracheal 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, fluid
resuscitation is initiated through 2 large-caliber IVs. FAST exam does
not reveal intraabdominal injuries. His blood pressure now is 60/0 mm
Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths
