ATLS: Pretests
1. Thoracic trauma. Chest tube insertion.
A 22 year old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood after initial IV fluid resuscitation, a closed tube thoracostomy is performed for
decreased left breath sounds
a) reexamine the chest
b) perform an aortogram
c) obtain a CT scan of the chest
d) obtain arterial blood gas analyses
e) perform tranesohageal echocardiography
answer: a.
info: chest tube insertion, p. 108.
2. Musculoskeletal trauma. Extremity trauma.
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) angiography
b) compartment pressures
c) retrograde urethrogram
d) Doppler-ultrasound studies
e) complete spine x-ray series
answer: e.
3. Trauma in women.
During the third trimester of pregnancy, all of the following changes occur normally EXCEPT
a
a) decrease in PaCO2
b) decrease in leukocyte count
c) reduced gastric emptying rate
d) diminished residual lung volume
e) diminished elvic ligament tension
answer: b.
info: p. 261.
1
, 4. Head Trauma.
In managing the head injured patient, the most important initial step is to
a) secure the airway
b) obtain c-spine film
c) support circulation
c) control scalp hemorrhage
e) determine the GCS score
answer: a.
info: p. 154.
5. Shock.
A previously healthy, 70kg (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 ressure (true)
e) his systolic blood pressure will be maintained with an elevated diastolic pressure
answer: d.
info: p. 61.
6. Trauma in Women.
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) complicating the management of closed head injury
d) reducing the volume of crystalloid required for resuscitation
e) increasing the volume of blood loss to
produce maternal hypotension
answer: e.
info: p. 261.
7. Thermal Injuries. Injury Due to Burn and Cold.
The best guide for adequate fluid resuscitation of the burn patient is
2
1. Thoracic trauma. Chest tube insertion.
A 22 year old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood after initial IV fluid resuscitation, a closed tube thoracostomy is performed for
decreased left breath sounds
a) reexamine the chest
b) perform an aortogram
c) obtain a CT scan of the chest
d) obtain arterial blood gas analyses
e) perform tranesohageal echocardiography
answer: a.
info: chest tube insertion, p. 108.
2. Musculoskeletal trauma. Extremity trauma.
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) angiography
b) compartment pressures
c) retrograde urethrogram
d) Doppler-ultrasound studies
e) complete spine x-ray series
answer: e.
3. Trauma in women.
During the third trimester of pregnancy, all of the following changes occur normally EXCEPT
a
a) decrease in PaCO2
b) decrease in leukocyte count
c) reduced gastric emptying rate
d) diminished residual lung volume
e) diminished elvic ligament tension
answer: b.
info: p. 261.
1
, 4. Head Trauma.
In managing the head injured patient, the most important initial step is to
a) secure the airway
b) obtain c-spine film
c) support circulation
c) control scalp hemorrhage
e) determine the GCS score
answer: a.
info: p. 154.
5. Shock.
A previously healthy, 70kg (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 ressure (true)
e) his systolic blood pressure will be maintained with an elevated diastolic pressure
answer: d.
info: p. 61.
6. Trauma in Women.
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) complicating the management of closed head injury
d) reducing the volume of crystalloid required for resuscitation
e) increasing the volume of blood loss to
produce maternal hypotension
answer: e.
info: p. 261.
7. Thermal Injuries. Injury Due to Burn and Cold.
The best guide for adequate fluid resuscitation of the burn patient is
2
