POST TEST ATLS LATEST
QUESTIONS ANSWERS GRADED A+ AND
VERIFIED ANSWERS
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His blood pressure is initially 80/40 mm Hg. After 2 liters of crystalloid solution
his blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per
minute and his respiratory rate 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:
a) reexamine the chest.
b) perform an aortogram.
c) obtain a CT scan of the chest.
d) obtain arterial blood gas analyses - ANSWER>>a) reexamine the chest
Which one of the following physical findings suggests a cause of hypotension other than
spinal cord injury?
a) priapism.
b) bradycardia.
c) diaphragmatic breathing.
d) presence of deep tendon reflexes. - ANSWER>>d) presence of deep tendon
reflexes.
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:
a) compartment pressures
b) retrograde urethrogram
c) Doppler-ultrasound studies
d) complete spine x-ray series - ANSWER>>d) complete spine x-ray series
In managing the head-injured patient, the most important initial step is to:
a) obtain c-spine film.
b) secure the airway.
c) support the circulation.
d) control scalp hemorrhage. - ANSWER>>b) 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?
a) His pulse pressure will be widened.
b) His urinary output will be at the lower limits of normal.
c) He will have tachycardia, but no change in his systolic blood pressure.
d) His systolic blood pressure will be decreased with a narrowed pulse pressure. -
ANSWER>>d) His systolic blood 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:
a) reducing the need for blood transfusion.
b) increasing the risk of pulmonary edema.
c) increasing the volume of blood loss to produce maternal hypotension.
d) complicating the mangement of closed head injury. - ANSWER>>c) increasing the
volume of blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the burn patient is:
a) adequate urinary output.
b) reversal of systemic acidosis.
c) normalization of the heart rate.
d) a normal central venous pressure. - ANSWER>>a) adequate urinary output.
The diagnosis of shock must include:
a) increased vascular resistance.
b) evidence of inadequate organ perfusion.
c) acidosis.
d) hypoxemia. - ANSWER>>b) 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:
a) application of a tourniquet.
b) direct pressure on the wound.
c) packing the wound with gauze.
d) direct pressure on the femoral artery at the groin. - ANSWER>>b) direct pressure on
the wound.
For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent:
,a) respiratory acidosis.
b) metabolic acidosis.
c) cerebral vasoconstriction with diminished perfusion.
d) neurogenic pulmonary edema. - ANSWER>>c) cerebral vasoconstriction with
diminished perfusion.
A 25-year-old man is brought to a hospital with a general surgeon after being involved in
a motor vehicle crash. Computed tomography 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:
a) contrast angiography.
b) transfer to a higher level trauma center.
c) exploratory laparotomy.
d) infuse additional crystalloids. - ANSWER>>c) exploratory laparotomy.
Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE?
a) The fetus is in jeopardy only with major abdominal trauma.
b) Leakage of amniotic fluid is an indication for hospital admission.
c) Indications for peritoneal lavage are different from those in the nonpregnant patient.
d) Penetration of an abdominal hollow viscus is more common in late than in early
pregnancy. - ANSWER>>b) Leakage of amniotic fluid is an indication for hospital
admission.
The first maneuver to improve oxygenation after chest injury is:
a) intubate the patient.
b) assess arterial blood gases.
c) administer supplemental oxygen.
d) ascertain the need for a chest tube. - ANSWER>>c) 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 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:
a) 2
b) 4
c) 6
d) 9 - ANSWER>>d) 9
, A 20-year-old woman, 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:
a) perform tracheal intubation.
b) perform needle decompression of the right chest.
c) manually displace the gravid uterus to the left side of the abdomen.
d) insert an oropharyngeal airway. - ANSWER>>b) perform needle 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?
a) Distended abdomen.
b) Glasgow Coma Scale Score of 11.
c) Temperature of 36.5°C (97.8°F).
d) Respiratory rate of 40 breaths per minute. - ANSWER>>d) Respiratory rate of 40
breaths per minute.
The most important, immediate step in the management of an open pneumothorax is:
a) endotracheal intubation.
b) operation to close the wound.
c) placing a chest tube through the chest wound.
d) placement of an occlusive dressing over the wound. - ANSWER>>d) placement of an
occlusive dressing over the wound.
The following are contraindications for tetanus toxoid administration:
a) History of neurological reaction or severe hypersensitivity to the product.
b) Local side effects.
c) Muscular spasms.
d) Pregnancy. - ANSWER>>a) 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?
a) Tachycardia.
b) Pulse volume.
c) Breath sounds.
d) Pulse pressure. - ANSWER>>c) Breath sounds.
QUESTIONS ANSWERS GRADED A+ AND
VERIFIED ANSWERS
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His blood pressure is initially 80/40 mm Hg. After 2 liters of crystalloid solution
his blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per
minute and his respiratory rate 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:
a) reexamine the chest.
b) perform an aortogram.
c) obtain a CT scan of the chest.
d) obtain arterial blood gas analyses - ANSWER>>a) reexamine the chest
Which one of the following physical findings suggests a cause of hypotension other than
spinal cord injury?
a) priapism.
b) bradycardia.
c) diaphragmatic breathing.
d) presence of deep tendon reflexes. - ANSWER>>d) presence of deep tendon
reflexes.
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:
a) compartment pressures
b) retrograde urethrogram
c) Doppler-ultrasound studies
d) complete spine x-ray series - ANSWER>>d) complete spine x-ray series
In managing the head-injured patient, the most important initial step is to:
a) obtain c-spine film.
b) secure the airway.
c) support the circulation.
d) control scalp hemorrhage. - ANSWER>>b) 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?
a) His pulse pressure will be widened.
b) His urinary output will be at the lower limits of normal.
c) He will have tachycardia, but no change in his systolic blood pressure.
d) His systolic blood pressure will be decreased with a narrowed pulse pressure. -
ANSWER>>d) His systolic blood 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:
a) reducing the need for blood transfusion.
b) increasing the risk of pulmonary edema.
c) increasing the volume of blood loss to produce maternal hypotension.
d) complicating the mangement of closed head injury. - ANSWER>>c) increasing the
volume of blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the burn patient is:
a) adequate urinary output.
b) reversal of systemic acidosis.
c) normalization of the heart rate.
d) a normal central venous pressure. - ANSWER>>a) adequate urinary output.
The diagnosis of shock must include:
a) increased vascular resistance.
b) evidence of inadequate organ perfusion.
c) acidosis.
d) hypoxemia. - ANSWER>>b) 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:
a) application of a tourniquet.
b) direct pressure on the wound.
c) packing the wound with gauze.
d) direct pressure on the femoral artery at the groin. - ANSWER>>b) direct pressure on
the wound.
For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent:
,a) respiratory acidosis.
b) metabolic acidosis.
c) cerebral vasoconstriction with diminished perfusion.
d) neurogenic pulmonary edema. - ANSWER>>c) cerebral vasoconstriction with
diminished perfusion.
A 25-year-old man is brought to a hospital with a general surgeon after being involved in
a motor vehicle crash. Computed tomography 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:
a) contrast angiography.
b) transfer to a higher level trauma center.
c) exploratory laparotomy.
d) infuse additional crystalloids. - ANSWER>>c) exploratory laparotomy.
Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE?
a) The fetus is in jeopardy only with major abdominal trauma.
b) Leakage of amniotic fluid is an indication for hospital admission.
c) Indications for peritoneal lavage are different from those in the nonpregnant patient.
d) Penetration of an abdominal hollow viscus is more common in late than in early
pregnancy. - ANSWER>>b) Leakage of amniotic fluid is an indication for hospital
admission.
The first maneuver to improve oxygenation after chest injury is:
a) intubate the patient.
b) assess arterial blood gases.
c) administer supplemental oxygen.
d) ascertain the need for a chest tube. - ANSWER>>c) 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 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:
a) 2
b) 4
c) 6
d) 9 - ANSWER>>d) 9
, A 20-year-old woman, 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:
a) perform tracheal intubation.
b) perform needle decompression of the right chest.
c) manually displace the gravid uterus to the left side of the abdomen.
d) insert an oropharyngeal airway. - ANSWER>>b) perform needle 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?
a) Distended abdomen.
b) Glasgow Coma Scale Score of 11.
c) Temperature of 36.5°C (97.8°F).
d) Respiratory rate of 40 breaths per minute. - ANSWER>>d) Respiratory rate of 40
breaths per minute.
The most important, immediate step in the management of an open pneumothorax is:
a) endotracheal intubation.
b) operation to close the wound.
c) placing a chest tube through the chest wound.
d) placement of an occlusive dressing over the wound. - ANSWER>>d) placement of an
occlusive dressing over the wound.
The following are contraindications for tetanus toxoid administration:
a) History of neurological reaction or severe hypersensitivity to the product.
b) Local side effects.
c) Muscular spasms.
d) Pregnancy. - ANSWER>>a) 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?
a) Tachycardia.
b) Pulse volume.
c) Breath sounds.
d) Pulse pressure. - ANSWER>>c) Breath sounds.
