160 QUESTIONS AND CORRECT ANSWERS GRADE
A PASS 2024-2025
A 23-year-old man is brought immediately to the ED from the hospitals parking lot where
he was shot in the lower abdomen. Examination reveals a single bullet wound. He is
breathing and has a thready pulse. However, he is unconsious and has no detectable
blood pressure. Optimale immediate management is to:
A. Perform a FAST
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - D. Transfer the
patient to the operating room, while initiating fluid therapy
A 22 year old male present following a motorcycle crash. He complains of the inability to
move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99%
on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are
normal. His management should be:
A: 1L of iv . crystalloid and two units of pRBCs
B. 1L of iv. crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
D. Vasopressors and laparotomy
E. 1 L of cystalloid and vasopressors if blood pressure does not respond - E. 1 L of
cystalloid and vasopressors if blood pressure does not respond
Which of the following is MOST RELIABLE to confirm endotracheal intubation? a.
presence of breath sounds bilaterally
b. absence of borborygmi in the epigatrium on ascultation
c. presence of CO2 in exhaled air via capnography
d. appearance of fog in the endotracheal tube
e. chest xray with endotracheal tube tip appearing above the carina - e. chest xray with
endotracheal tube tip appearing above the carina
A 6 month old infant, being held in her mothers arms, is ejected on impact from a
vehicle that is struck head on by an oncoming car traveling at 64kph. The infant arrives
in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress.
Respiratory support is not effective using a bag mask device, and her oxygen saturation
is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most
appropriate procedure to perform next is: A.Administer heliox and racemic epinephrine
B. Perform nasotracheal intubation
, C.Perform surgical cricothyroidotomy
D.Repeat orotracheal intubation
E. Perform needle cricothyroidotomy with jet insufflation - E. Perform needle
cricothyroidotomy with jet insufflation
A 28 year olf male is brought to the ED. He was involved in a fight, during which he was
beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear,
resp rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the
following should be performed during the primary survey a. glasgow coma
b. tetanus status
c. cervical spine xray
d. blood alcohol level
e. rectal exam - a. glasgow coma
A 15 year old is brought to the ED after being involved in a MVA. He was intubated by
emergency medical personnal with subsequent bilateral breath sounds per their
report. Upon arrival to the ED the patients O2 saat is 92%, heart 96, and blood
pressure 150/85. Breath sounds are decreased in the left side of the thorax. The next
step is a. immediate needle cricothyroidotomy
b. immediate needle thoracentesis
c. chest tube insertion
d. reassess the position of the endotracheal tube
e. obtain a chest CT - d. reassess the position of the endotracheal tube
an 18yo male is brought to the emergency department after being dumped by a large
wave while surfing. He landed head first on the firm beach sand. His vital signs are
blood pressure 85/60 mmHg, heart rate 60, and respiratory rate 18; he is unable to
move his lower extremities. He appears calm and asks if he will ever walk again. The
most appropriate next step is to:
a. reassure patient that he will walk again
b. proceed to a more detailed neuro exam
c. obtain c spin xrays
d. begin infusion of vasopressors
e. begin bolus of warm IV crystalloid - e. begin bolus of warm IV crystalloid
Whic one of the following statements is true regarding access in pediatric resuscitation?
a. intraosseous access should be considered only after 5 percutaneous attempts
b. cutdown at teh ankle is the preferred initial access technique