ATLS post test 2023 QUESTIONS AND ANSWERS

1. The primary indication for transferring a1. The primary indication for transferring a patient to a higher level trauma center is: patient to a higher level trauma center is:unavailability of a surgeon or operating roomunavailability of a surgeon or operating .multiple system injuries, including severemultiple system injuries, including severehead injury.resource limitations as determined by theresource limitations as determined by thetransferring ferring doctor.resource limitations as determined by theresource limitations as determined by thehospital tal administration.widened mediastinum on chest x-raywidened mediastinum on chest x-rayfollowing blunt thoracic wing blunt thoracic trauma.2. teen-aged bicycle rider is hit b2. teen-aged bicycle rider is hit by a trucky a trucktraveling at a high rate of speed. traveling at a high rate of speed. In theIn theemergency department, she is actively bleedingemergency department, she is actively bleedingfrom open fractures of her legs, and hasfrom open fractures of her legs, and hasabrasions on her chest and abdominal abrasions on her chest and abdominal wall. Herwall. Her blood pressure is 80/50 mm Hg, heart rate is blood pressure is 80/50 mm Hg, heart rate is140 beats per minute, respiratory rate is 8140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6. breaths per minute, and GCS score is 6.The first step in managing this patient is to:The first step in managing this patient is to:obtain a lateral cervical spine n a lateral cervical spine x-ray.insert a central venous pressure t a central venous pressure line.administer 2 liters of crystalloid ister 2 liters of crystalloid solution.perform endotracheal intubation andperform endotracheal intubation lation.apply the PASG and inflate the legapply the PASG and inflate the rtments.3. Contraindication to nasogastric intubation is3. Contraindication to nasogastric intubation isthe presence of a:the presence of a:gastric ic perforation.diaphragmatic ragmatic rupture.open depressed skull depressed skull fracture.fracture of the cervical ure of the cervical spine.fracture of the cribriform ure of the cribriform plate.4. Which one of the following statements4. Which one of the following statementsregarding patients with thoracic spine injuries isregarding patients with thoracic spine injuries isTRUE?TRUE?Log-rolling may be Log-rolling may be destabilizing todestabilizing tofractures from T-12 to L-ures from T-12 to L-1.Adequate immobilization can beAdequate immobilization can beaccomplished with the scoop plished with the scoop stretcher.Spinal cord injury below T-10 usually sparesSpinal cord injury below T-10 usually sparesbowel and bladder and bladder function.Hyperflexion fractures in the upperHyperflexion fractures in the upperthoracic spine are inherently cic spine are inherently unstable.These patients rarely present with spinalThese patients rarely present with spinalshock in association with cord in association with cord injury.5. young man sustains a ritle wound to the mid-5. young man sustains a ritle wound to the mid-abdomen. He is brought promptly to theabdomen. He is brought promptly to theemergency department by prehospitalemergency department by prehospital personnel. His skin is cool and diaphoretic, and personnel. His skin is cool and diaphoretic, andhis systolic blood pressure is 58 rnm H systolic blood pressure is 58 rnm Hg.WWarmed crystalloid fluids are armed crystalloid fluids are initiated withoutinitiated withoutimprovement in his vital signs. The next, mostimprovement in his vital signs. The next, mostappropriate step is to perform:appropriate step is to perform:a celiotomy.a celiotomy.an abdominal CT abdominal CT scan.diagnostic ostic laparoscopy.abdominal inal ultrasonography.a diagnostic peritoneal lavage.a diagnostic peritoneal lavage.6. young woman sustains a severe he6. young woman sustains a severe head injuryad injuryas the result of a motor vehicular crash. In theas the result of a motor vehicular crash. In theemergency department, her GCS score is 6. Heremergency department, her GCS score is 6. Her blood pressure is 140/90 mm Hg and her heart blood pressure is 140/90 mm Hg and her heartrate is 80 beats per minute. She rate is 80 beats per minute. She is intubated andis intubated andis being mechanically ventilated. Her pupils areis being mechanically ventilated. Her pupils are3 mm in size and equall3 mm in size and equally reactive to light.y reactive to light.There is no other There is no other apparent injury. The mostapparent injury. The mostimportant principle to follow in the earlyimportant principle to follow in the earlymanagement of her head injury is to:management of her head injury is to:administer an osmotic ister an osmotic diuretic.prevent secondary brain nt secondary brain injury