ATLS TEST 1/40 QUESTIONS AND ANSWERS/ LATEST WITHCOMPLETE SOLUTION

ATLS TEST 1/40 QUESTIONS AND ANSWERS/ LATEST WITHCOMPLETE SOLUTION 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 initial fluid resuscitation 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. A tube thoracostomy is performed for decreased left chest 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: Select one: a. reexamine the chestb. perform an aortogramc. obtain a CT scan of the chestd. obtain arterial blood gas analysese. perform transesophageal echocardiography Correct ans - A) Reexamine the chest 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: Select one: a. angiography b. compartment pressuresc. retrograde urethrogramd. Doppler ultrasound studiese. complete spine x-ray series Correct ans - e) Complete spine x-rayseries Which of the following is true regarding the initial resuscitation of a traumapatient? Select one:a. A patient that presents with a torso gunshot wound and is hypotensive should receive crystalloid fluid resuscitation until the blood pressure is normal b. Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow coma scale score on reevaluation c. Massive transfusion is defined as transfusion of more than 10 of packed red blood cells and plasma in 24 hours d. When tranexamic acid is administered by pre-hospital providers a second dose is required within 24 hours e. Fluid resuscitation is far more important than bleeding control in traumapatients Correct ans - b. 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 mostimportant initial step is to: Select one: a. Secure the airwayb. obtain a c-spine filmc. support the circulationd. control scalp hemorrhagee. determine the GCS score Feedback Your answer is corr Correct ans - a. Secure the airway A previously healthy, 70-kg (154-pound) man suffers an estimated acuteblood loss of 2 liters. Which one of the following statements applies to this patient?Select one: 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. An ABG would demonstrate a base deficit between -6 and -10 mEq/Le. His systolic blood pressure will be maintained with an elevated diastolic pressure. Correct ans - d. An ABG would demonstrate a base deficit between -6 and -10 mEq/L The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by: Select one: a. reducing the need for blood transfusionb. resulting in an elevated hematocritc. complicating the management of closed head injuryd. reducing the volume of crystalloid required for resuscitatione. increasing the volume of blood loss to produce maternal hypotension Correct ans - e. increasing the volume of blood loss to produce maternal hypotension The best assessment of fluid resuscitation of the adult burn patient is:Select one: a. Urine output of 0.5 mL/kg/hrb. normalization of blood pressurec. normalization of the heart rated. measuring a normal central venous pressuree. providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid Correct ans - a. Urine output of 0.5 mL/kg/hr The diagnosis of shock must include: Select one: a. hypoxemia b. acidosisc. hypotensiond. increased vascular resistancee. evidence of inadequate organ perfusion Correct ans - e. 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: Select one: a. application of a tourniquetb. direct pressure on the woundc. packing the wound with gauzed. direct pressure on the femoral artery at the groine. debridement of devitalized tissue Correct ans - b. direct pressure on the wound