ATLS Quiz Test Bank Question and Answers Approved 2023
and GRADED A+
Which of the following is the recommended Method for trestemt frostbite?
A. Vasodilators
B. Anticigulants
C. Warm (40 degrees) water
D. Padding and elevation
E. Application of heat from a hairdryer correct answers C. Warm (40 degrees) water
Which of the following physical findings suggest a cause of hypotension other than spinal cord injury?
A. Prispism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them correct answers D. Presence of deep tendon reflexes.
Spinal shock refers to loss of muscle toe (flaccidty) and loss of reflexes.
The primary indication for transferring A patient to a higher level trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma correct answers C. Resource limitations
as determined by the transferring doctor (MÅ SJEKKES)
A young man sustains a rifle wound to the mid-abdomen. He is brought promptly to the ED by
prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58mmHg.
Warmed crystalloid fluids are initiated without improvement in his vital signs. The next, most
appropriate, step is to perform:
A. a laparotomy
,B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage correct answers A. Laparotomy because of hemodynamic abnormality
A 42-year-old man is trapped from the waist down beneath his overturned tractor for several hours
before medical assistance arrives. He is awake and alert until just before arriving in the ED. He is now
unconscious and responds only to painful stimuli by moaning. His pupils are 3mm in diameter and
symmetrically reactive to light. Prehospital personnel indicate that they have not seen the patient move
either of his lower extremities. On examination in the ED, no movement of his lower extremities are
detected, even in response to painful stimuli. The most likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome correct answers MÅ SJEKKES
A 6-year-o boy is struck by an automobile and brought to the ED. He is lethargic, but withdraws
purposefully from painful stimuli. His blood pressure is 90mmHg systolic, heart rate 140 beats per
minute and his respiratory rate is 36 breaths per minute. The preferred route of venous access in this
patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein correct answers D. Percutaneous
peripheral veins in the upper extremities
A young man sustains a gunshot wound to the abdomen and is brought promptly to the ED by
prehospital personnel. His skin is cool and diaphoretic, and he is confused. His pulse is thready and his
femoral pulse is only weakly palpable. The definitive treatment in managing this patient is to:
A. Administer O-negative blood
B. Apply external warming devices
,C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions. correct answers C. Control internal
hemorrhage operatively
Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the same as in adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg Ringers Lactate correct answers D.
The absolute volume of blood loss required to produce shock is the same as in adults
A 33-year-old man is struck by a car travelling at 56km/h (35mph). He has obvious fractures of the left
tibia near the knee, pain in the pelvic area, and severe dyspnea. His heart rate is 182 beats per minute,
and his respiratory rate is 48 breaths per minute with no breath sounds heard in the left chest. A tension
pneumothorax is relieved by immediate needle decompression and tube thoracostomy. Subsequently,
his heart rate decreases to 144 beats per minute, his respirartory rate decreases to 36 breaths per
minute and his blood pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered intravenously.
The next priority should be to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
C. Perform arterial embolization of the pelvic vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram correct answers D. Perform diagnostic peritoneal lavage or
FAST
A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury, multiple palpable left
rib fractures, and bilateral femur fractures. He is intubated orotracheally without difficulty. Initially, his
ventilations are easily assisted with a bag-mask device. It becomes more difficult to ventilate the patient
over the next 5 minutes, and his hemoglobin oxygen saturation level decreases from 98% to 89%. The
most appropriate next step is to:
A. Obtain a chest x-ray
, B. Decrease the tidal volume
C. Decrease PEEP
D. Increase the rate of assisted ventilations
E. Perform needle decompression of the left chest. correct answers A. Obtain a chest x-ray (MÅ SJEKKES)
A 30-year-old man sustains a severely comminuted, open, distal right femur fracture in a motorcycle
crash. The wound is actively bleeding. Normal sensation is present over the lateral aspect of the foot but
decreased over the medial foot and great toe. Normal motion of the foot is observed. Dorsalis pedis and
posterior tibial pulses are easily palpable on the left, but heard only by Doppler on the right. Immediate
efforts to improve circulation to the injured extremity should involve:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
E. Fasciotomy of all four compartments in the lower extremity correct answers B. Tamponade of the
wound with a pressure dressing
An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the ED following a crash. He had
decreased level of consciousness at the scene, but then was alert and conversational during
transportation. Now his GCS is only 11. Which of the following statements is TRUE?
A. Cerebral perfusion is intact
B. Intravascular volume status is normal
C. The patient is in a postictal state
D. Intra-abdominal visceral injury is unlikely
E. The patient probably has an acute epidural hematoma correct answers E. The patient probably has an
acute epidural hematoma
A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss of two liters. Which
one of the following statements apply 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 systolic blood pressure
and GRADED A+
Which of the following is the recommended Method for trestemt frostbite?
A. Vasodilators
B. Anticigulants
C. Warm (40 degrees) water
D. Padding and elevation
E. Application of heat from a hairdryer correct answers C. Warm (40 degrees) water
Which of the following physical findings suggest a cause of hypotension other than spinal cord injury?
A. Prispism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them correct answers D. Presence of deep tendon reflexes.
Spinal shock refers to loss of muscle toe (flaccidty) and loss of reflexes.
The primary indication for transferring A patient to a higher level trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma correct answers C. Resource limitations
as determined by the transferring doctor (MÅ SJEKKES)
A young man sustains a rifle wound to the mid-abdomen. He is brought promptly to the ED by
prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58mmHg.
Warmed crystalloid fluids are initiated without improvement in his vital signs. The next, most
appropriate, step is to perform:
A. a laparotomy
,B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage correct answers A. Laparotomy because of hemodynamic abnormality
A 42-year-old man is trapped from the waist down beneath his overturned tractor for several hours
before medical assistance arrives. He is awake and alert until just before arriving in the ED. He is now
unconscious and responds only to painful stimuli by moaning. His pupils are 3mm in diameter and
symmetrically reactive to light. Prehospital personnel indicate that they have not seen the patient move
either of his lower extremities. On examination in the ED, no movement of his lower extremities are
detected, even in response to painful stimuli. The most likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome correct answers MÅ SJEKKES
A 6-year-o boy is struck by an automobile and brought to the ED. He is lethargic, but withdraws
purposefully from painful stimuli. His blood pressure is 90mmHg systolic, heart rate 140 beats per
minute and his respiratory rate is 36 breaths per minute. The preferred route of venous access in this
patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein correct answers D. Percutaneous
peripheral veins in the upper extremities
A young man sustains a gunshot wound to the abdomen and is brought promptly to the ED by
prehospital personnel. His skin is cool and diaphoretic, and he is confused. His pulse is thready and his
femoral pulse is only weakly palpable. The definitive treatment in managing this patient is to:
A. Administer O-negative blood
B. Apply external warming devices
,C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions. correct answers C. Control internal
hemorrhage operatively
Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the same as in adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg Ringers Lactate correct answers D.
The absolute volume of blood loss required to produce shock is the same as in adults
A 33-year-old man is struck by a car travelling at 56km/h (35mph). He has obvious fractures of the left
tibia near the knee, pain in the pelvic area, and severe dyspnea. His heart rate is 182 beats per minute,
and his respiratory rate is 48 breaths per minute with no breath sounds heard in the left chest. A tension
pneumothorax is relieved by immediate needle decompression and tube thoracostomy. Subsequently,
his heart rate decreases to 144 beats per minute, his respirartory rate decreases to 36 breaths per
minute and his blood pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered intravenously.
The next priority should be to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
C. Perform arterial embolization of the pelvic vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram correct answers D. Perform diagnostic peritoneal lavage or
FAST
A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury, multiple palpable left
rib fractures, and bilateral femur fractures. He is intubated orotracheally without difficulty. Initially, his
ventilations are easily assisted with a bag-mask device. It becomes more difficult to ventilate the patient
over the next 5 minutes, and his hemoglobin oxygen saturation level decreases from 98% to 89%. The
most appropriate next step is to:
A. Obtain a chest x-ray
, B. Decrease the tidal volume
C. Decrease PEEP
D. Increase the rate of assisted ventilations
E. Perform needle decompression of the left chest. correct answers A. Obtain a chest x-ray (MÅ SJEKKES)
A 30-year-old man sustains a severely comminuted, open, distal right femur fracture in a motorcycle
crash. The wound is actively bleeding. Normal sensation is present over the lateral aspect of the foot but
decreased over the medial foot and great toe. Normal motion of the foot is observed. Dorsalis pedis and
posterior tibial pulses are easily palpable on the left, but heard only by Doppler on the right. Immediate
efforts to improve circulation to the injured extremity should involve:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
E. Fasciotomy of all four compartments in the lower extremity correct answers B. Tamponade of the
wound with a pressure dressing
An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the ED following a crash. He had
decreased level of consciousness at the scene, but then was alert and conversational during
transportation. Now his GCS is only 11. Which of the following statements is TRUE?
A. Cerebral perfusion is intact
B. Intravascular volume status is normal
C. The patient is in a postictal state
D. Intra-abdominal visceral injury is unlikely
E. The patient probably has an acute epidural hematoma correct answers E. The patient probably has an
acute epidural hematoma
A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss of two liters. Which
one of the following statements apply 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 systolic blood pressure
