ATLS 10TH EDITION POST TEST UPDATE/ QUESTIONS AND COR
RECT VERIFIED ANSWERS (COMPLETE SOLUTIONS) ASSURED
SUCCESS/GRADED A+!!! Questions with Correct Solutions
Question:
1. A 22 year old male is brought by ambulance to a small community hospital after falling
from the top of an 8 foot ladder. Initially, he was found to have a large right pneumothorax. A
chest tube was inserted and connected to an underwater seal drainage collection system with
negative pressure. A repeat CXR demonstrates a residual, large right pneumothorax. After
transferring the patient to a verified trauma center, a third chest x-ray reveals a persistent
right pneumothorax. The chest tube appears to be functioning and in good position. He
remains hemodynamically normal with no signs of respiratory distress. The most likely cause
for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury
Answer:
E. Tracheobronchial injury
Question:
2. Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray
Answer:
D. oxygen saturation >92% -> if it says ESOPHAGEAL, go with this answer
Question:
3. Which of the following signs necessitates the need for a definitive airway in severe trauma
patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12
,Answer:
C. Severe maxillofacial trauma
Question:
4. Twenty seven people are severely injured in an aircraft crash at a local airport. The
principles of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources
Answer:
E. Produce the greatest number of survivors based on available resources
Question:
5. Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas
Answer:
A. Cerebral contusions may coalesce to form an intracerebral hematoma EM: Epidural,
middle meningeal SuB: Subdural, Bridging veins
Question:
6. An 18 year old male is brought to the ED after being shot. He has one bullet wound just
below the right clavicle and another just below the costal margin in the right posterior
axillary line. His blood pressure is 110/60, heart rate of 90, and respiratory rate of 34. After
ensuring a patent airway and inserting 2 large caliber IV lines, the next most appropriate step
is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage
Answer:
A. Obtain a portable chest x-ray need more info on chest, not abdomen
, Question:
7. Which of the following should be performed FIRST in any patient whose injuries may
include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome
Answer:
D. Ensuring adequate oxygenation and ventilation (ABC's)
Question:
8. A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His
BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases
to 122/84 and HR decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds
are decreased at the left upper chest with dullness on percussion. A large caliber tube
thoracostomy is inserted into the fifth intercostal space with the return of 200 mL of blood
and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest
Answer:
E. Repeat the physical exam of the chest decreased breath sounds w/dullness -> hemothorax,
need tube to drain vs. decreased/absent breath sounds w/hyperresonance -> tension
pneumonia, need needle decompression followed by tube
Question:
9. Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be made in
the primary survey
Answer:
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
RECT VERIFIED ANSWERS (COMPLETE SOLUTIONS) ASSURED
SUCCESS/GRADED A+!!! Questions with Correct Solutions
Question:
1. A 22 year old male is brought by ambulance to a small community hospital after falling
from the top of an 8 foot ladder. Initially, he was found to have a large right pneumothorax. A
chest tube was inserted and connected to an underwater seal drainage collection system with
negative pressure. A repeat CXR demonstrates a residual, large right pneumothorax. After
transferring the patient to a verified trauma center, a third chest x-ray reveals a persistent
right pneumothorax. The chest tube appears to be functioning and in good position. He
remains hemodynamically normal with no signs of respiratory distress. The most likely cause
for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury
Answer:
E. Tracheobronchial injury
Question:
2. Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray
Answer:
D. oxygen saturation >92% -> if it says ESOPHAGEAL, go with this answer
Question:
3. Which of the following signs necessitates the need for a definitive airway in severe trauma
patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12
,Answer:
C. Severe maxillofacial trauma
Question:
4. Twenty seven people are severely injured in an aircraft crash at a local airport. The
principles of triage include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources
Answer:
E. Produce the greatest number of survivors based on available resources
Question:
5. Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas
Answer:
A. Cerebral contusions may coalesce to form an intracerebral hematoma EM: Epidural,
middle meningeal SuB: Subdural, Bridging veins
Question:
6. An 18 year old male is brought to the ED after being shot. He has one bullet wound just
below the right clavicle and another just below the costal margin in the right posterior
axillary line. His blood pressure is 110/60, heart rate of 90, and respiratory rate of 34. After
ensuring a patent airway and inserting 2 large caliber IV lines, the next most appropriate step
is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage
Answer:
A. Obtain a portable chest x-ray need more info on chest, not abdomen
, Question:
7. Which of the following should be performed FIRST in any patient whose injuries may
include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome
Answer:
D. Ensuring adequate oxygenation and ventilation (ABC's)
Question:
8. A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His
BP is 80/40 and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases
to 122/84 and HR decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds
are decreased at the left upper chest with dullness on percussion. A large caliber tube
thoracostomy is inserted into the fifth intercostal space with the return of 200 mL of blood
and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest
Answer:
E. Repeat the physical exam of the chest decreased breath sounds w/dullness -> hemothorax,
need tube to drain vs. decreased/absent breath sounds w/hyperresonance -> tension
pneumonia, need needle decompression followed by tube
Question:
9. Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be made in
the primary survey
Answer:
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
