ATLS Practice questions with correct answers A+ graded 100% verified

ATLS Practice questions with correct answers A+ graded 100% verified Definitive control of the airway is achieved by ____________ ANS: Endotracheal intubation How do you treat hypothermia in the ED? ANS: crystalloid fluids at 102.2 degrees F and warmed treatment area What does definitive hemorrhage control refer to? (3) ANS: 1) Possible surgery 2) Stabilizing of pelvis 3) Angioembolization What are rates of fluid administration measured by? ANS: Size and length of catheter Minimum flow rate of oxygen reservoir mask ANS: 11 L/min MCC of shock in trauma pt ANS: Hypovolemia due to hemorrhage Describe the 3 for 1 rule ANS: Replace each mL of blood loss with 3 ml of crystalloid solution What metabolic state can result from continued hemorrhage or decreased perfusion? ANS: Metabolic acidosis In what survey, primary or secondary, are these identified? 1) Simple PTX 2) Pulmonary contusion 3) Traumatic aortic disruption ANS: Secondary Via thorough PE, CXR, pulse ox, ECG and ABG What imaging study is preferred for penetrating abdominal trauma? ANS: CT What can FAST rapidly diagnose? ANS: Abdominal hemorrhage When is a laparotomy indicated? ANS: Fascial penetration with intraperitoneal bleeding or peritonitis What does the Monro Kellie doctrine describe? ANS: The relationship between IC volume and pressure Normal resting ICP ANS: 10 mm Hg How do you reduce elevated ICP? ANS: Mannitol in a 20% solution How do you temporarily control pelvic hemorrhage and instability? ANS: Internal traction and external counter-pressure How do you initially manage major arterial injury? ANS: Direct pressure and fluid resuscitation Full thickness burn ANS: Third degree burn What is used to estimate the size and depth of burns? ANS: Rule of 9's Head= 9% Each arm=9% Front Trunk= 18% Back Trunk= 18% Upper leg= 9% Lower leg= 9% What type of burns appear wet and blistered? ANS: Partial thickness burns (second degree) How do you treat CO exposed pt? ANS: 100% oxygen flow through non re-breather mask What is a reliable measure of circulating blood volumes in burn patients? ANS: Hourly urine output *Goal= 0.5-1.0 ml/kg body weight* Hospital admission criteria for burn pt (8) ANS: 1) Partial-thickness burns greater than 10% total BSA (TBSA) 2) Full-thickness burns greater than 2% TBSA 3) Burns involving the face, hands, genitalia, perineum, or major joints 4) Circumferential extremity burns 5) All high-voltage electrical burns, including lightning injury--Admission of low-voltage electrical burns is selective 6) Chemical burns 7) Inhalation injury 8) Burn injuries in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality (eg, diabetes, immunosuppression) Parkland Formula for Fluid Resuscitation in Burn pt ANS: 3-4 mL Ringer lactate X weight (kg) X %TBSA burned (second-degree and third degree); *half administered over the first 8 hours* (from time of injury),* remaining half administered over the next 16 hours* What injuries may necessitate inter-hospital transfer? (3) ANS: 1) Head or spinal cord trauma 2) Pulmonary contusions 3) Severe burns *consider time between injury and definitive care as well as resources available at local facilities* A 34 year old man is injured in a motor vehicle collision. Physical examination is normal except for diffuse abdominal tenderness. He is conscious and vital signs obtained enroute to the hospital are respirations 20 per ,minute, pulse rate is 120 per minute blood pressure 100/60; How should this patient be managed in the field? A. Intravenous fluid at a "keep open" rate B. Intravenous fluid at 20 ml/kg bolus C. Fentanyl 100 mcg intravenous D. Insert an oropharyngeal airway and assist ventilation ANS: A. Intravenous fluid at a "keep open" rate What is Sellick's maneuver? A. A method allowing the rescuer to hold a mask on the face with both hands B. A system used to calculate minute volume C. Another name for Mallampati D. Posteriorly directed pressure applied to the cricoid cartilage ANS: D. Posteriorly directed pressure applied to the cricoid cartilage A 16 year old girl is rescued from a burning house. She has 25% partial thickness burns, and the burned areas are hot to the touch. What is the appropriate treatment? A. Apply ice to burned areas until cool to touch B. Apply clean water to burned areas for up to 1-2 minutes C. Apply iced water to burned areas until cool to touch D. Do not apply anything to burned areas other than clean sheets ANS: B. Apply clean water to burned areas for up to 1-2 minutes What treatment is NOT indicated in the routine management of the patient with a head injury? A. Administration of 100% oxygen B. Fluid resuscitation to a BP of 110-120 systolic if the patient is hypotensive C. Hyperventilating to obtain an EtCO2 of less than 30 D. Stabilization of the cervical spine ANS: C. Hyperventilating to obtain an EtCO2 of less than 30 Which of the following sets of vital signs is most compatible with a diagnosis of isolated head injury with increasing intracranial pressure? A. BP 170/100, pulse 50/min B. BP 80/60, pulse 130/min C. BP 80/60, pulse 50/min D. BP 170/100, pulse 130/min ANS: A. BP 170/100, pulse 50/min Which one of the following is a reason to interrupt the initial assessment? A. Cardiac arrest B. Multiple open (compound) fractures C. Severe head injury with brain tissue visible D. Severe shock ANS: A. Cardiac arrest What site is the first choice for intraosseous infusion? A. Proximal tibia B. Distal humerus C. Proximal femur D. Distal fibula ANS: A. Proximal tibia A 34 year old man has a gunshot wound to the right groin area. Arterial bleeding, which cannot be controlled with direct pressure, is coming from the wound. The patient appears confused, diaphoretic, and has weak peripheral pulses. What is the appropriate fluid resuscitation for this patient? A. Intravenous fluid at a "keep open" rate B. Apply a hemostatic agent and gain intravenous access given enough fluid to maintain peripheral pulses C. Intravenous fluid at a wide open rate; give at least tw ANS: B. Apply a hemostatic agent and gain intravenous access given enough fluid to maintain peripheral pulses Which one of the following is typically associated with, post-traumatic hemorrhage, EARLY shock? A. Ventricular dysrhythmias B. Hypotension C. Loss of 30% to 45% of blood volume D. Narrowed pulse pressure ANS: D. Narrowed pulse pressure Among the following, what is the most common cause of preventable trauma death in the injured adult patient? A. Airway obstruction B. Cardiac tamponade C. Hemorrhagic shock D. Spinal injury ANS: C. Hemorrhagic shock Which of the following is most typical of early, neurogenic shock? A. Increased pulse, clammy skin B. Increased pulse, warm and dry skin C. Decreased pulse, clammy skin D. Decreased pulse, warm and dry skin ANS: D. Decreased pulse, warm and dry skin (skin is warm due to vasodilation) Which of the following is an acceptable location to insert a needle when decompressing a tension pneumothorax? A. Directly under the bottom of the second rib, midclavicular line B. Directly under the bottom of the third rib, midclavicular line C. Directly over the top of the fourth rib, midaxillary line D. Directly over the top of the third rib, midclavicular line ANS: D. Directly over the top of the third rib, midclavicular line What is the most common cause of cardiopulmonary arrest in the trauma patient? A. Brain injury B. Hypoxemia C. Myocardial contusion D. Ventricular arrhythmia ANS: B. Hypoxemia A 49 year old man is involved in a motor vehicle collision. First responders are doing CPR. Findings include a distended abdomen and obviously deformed pelvis and a quick look at the monitor shows asystole. Which of the following is the most appropriate act? A. Establish intravenous access and administer a 20mL/kg bolus B. Establish intravenous access and administer a 1 liter bolus C. Establish intravenous access and administer a 2-4 liter bolus D. Resuscitative efforts should not be started and ANS: D. Resuscitative efforts should not be started and the patient pronounced dead Which of the following statements concerning treatment of shock in the pregnant, burn patient is TRUE? A. Oxygen should be used sparingly so as to avoid oxygen toxicity to the fetus B. Pressor agents such as dopamine should be used to improve circulation to the fetus C. Volume replacement should be given earlier and in larger amounts to the pregnant, burn patient D. Volume replacement should be given more slowly so as to avoid fluid overloading the fetus ANS: C. Volume replacement should be given earlier and in larger amounts to the pregnant, burn patient Which area of the spine is most susceptible to injury in a rear-impact motor vehicle crash? A. Cervical B. Thoracic C. Lumbar