ATLS PRACTICE QUESTIONS
• First priority in the treatment of an unconscious patient
Answer: Checking the pulse
• A patient involved in a road accident is brought to the emergency department in
an unconscious state. On arrival, her vitals show a temperature of 96.4degrees
Fahrenheit, a respiration rate of 24 breaths per minute, a heart rate of 140 beats per
minute, and a blood pressure of 80/40 mm Hg. She is cold, shivering, and perspiring
profusely. She has bilateral reactive pupils but shedoes not respond to pain. On
physical examination, she has no obvious sign ofexternal bleeding. Which of the
following cannot be the cause of hypotensionin this patient?
A. Pelvic fracture
B. Fracture of femur
C. Intracranial hemorrhage
D. Hemothorax
Answer: C. Intracranial hemorrhage
• A patient suffered a slash to his right neck. The wound is over the mid-portion of
the sternocleidomastoid. There is a large hematoma and brisk bleeding when
uncovered. He is stable. What is the next step in management?
A. Get an angiogram
B. Close the wound in the ER
C. Take him to the operating room
D. CT scan to evaluate neck structure
Answer: C. Take him to the OR
• After abdominal injury, which of the following urinalysis findings would bean
indication for further testing?
A. 0-5 casts/HPF
B. 5-10 WBC/HPF
C. 10-20 RBC/HPF
D. Gross hematuria
,Answer: D. Gross hematuria
• A laceration of the neck superficial to the deep cervical fascia along the
sternocleidomastoid muscle at its midpoint would cause bleeding from which
structure?
Answer: External jugular vein
• Clinical features associated with tension pneumothorax
Answer:
Unilateral de-crease in breath sounds
Hyperresonance Respiratory distressTachycardia Tracheal shift Desatruation
Decreased breath sounds Decreased compliance Asymmetric chest movement
NOT hypertension, audible bronchial sounds
• Not recommended as a mode of ventilation for a patient with a diaphrag-matic
hernia
A. Bag and mask
B. LMA
C. Endotracheal intubation
D. Jet ventilation
Answer: A. Bag and mask
• What is the next step in the assessment of a traumatic patient after airwayis
established?
Answer: Breathing
• Blood group that is considered a universal donor
Answer: O
• A provider is examining a patient who sustained a severe traumatic headinjury.
He documents no Doll's eyes. What does this signify?
Answer: Brainstem injury
• Which of the following is the least preferred method of administering IVfluids?
A. Cubital veins
B. Cephalic veins
C. Subclavian veins
D. Saphenous vein
,Answer: Subclavian veins
• Dermatome level for nipple sensationDermatome level for umbilicus
Answer:
T4
T10
• At which temperature would a hypothermic patient stop shivering?
Answer: 88degrees F
• What is the energy recommendation for the first defibrillation in an adult(*)
Answer: 300 J
• Pharmacologic effects of Morphine
Answer:
Behavioral changes
Analgesia
Respiratory depression
NOT diarrhea
• A patient with which condition should be triaged to receive medical atten-tion
first?
A. Choking
B. Dizziness
C. Leg cramp
D. Vomiting
Answer: A. Choking
• Assessed first in trauma patient
Answer: Airway
• (*)Degree of burn that is characterized by bone involvement
Answer: Fourth
• Complications of head trauma
Answer:
Intracerebral hematoma
Extradural hematoma
, Brain abscess
• Most common cause of laryngotracheal stenosis
Answer: Trauma
• Intervention that can help prevent development of acute renal failure
Answer: Infusion of normal saline
• A 26-year-old male is resuscitated with blood transfusion after a motor vehicle
collision that was complicated by a fractured pelvis. A few hours later,the patient
becomes febrile, hypotensive with a normal CVP, and oliguric. Upon examination,
the patient is found to be bleeding from the NG tube and IV sites. Which of the
following is the most likely diagnosis?
A. Hemorrhagic shock
B. Acute adrenal insufficiency
C. Fat embolism syndrome
D. Transfusion reaction
Answer: D. Transfusion reaction
• Skin antiseptic
Answer:
-Ethanol 70% is an effective skin antiseptic
-Acetic acid can be used to treat Gram- skin infections
-Salicylic acid is used to treat certain skin yeast infections
• Class IV hemorrhage indicates what % blood loss
Answer: 55%
• How does shivering affect body temperature
Answer: Increases body temperature
• Class III hemorrhage indicates what % of blood loss
Answer: 35%
• Management of a stable patient with kidney contusion
Answer: Observation
• Associated with hypovolemic shock
Answer:
-Inadequate tissue perfusion with resultant tissue hypoxia
-Blood shunting to vital organs
-Decreased circulating blood volume and decreased venous return
• First priority in the treatment of an unconscious patient
Answer: Checking the pulse
• A patient involved in a road accident is brought to the emergency department in
an unconscious state. On arrival, her vitals show a temperature of 96.4degrees
Fahrenheit, a respiration rate of 24 breaths per minute, a heart rate of 140 beats per
minute, and a blood pressure of 80/40 mm Hg. She is cold, shivering, and perspiring
profusely. She has bilateral reactive pupils but shedoes not respond to pain. On
physical examination, she has no obvious sign ofexternal bleeding. Which of the
following cannot be the cause of hypotensionin this patient?
A. Pelvic fracture
B. Fracture of femur
C. Intracranial hemorrhage
D. Hemothorax
Answer: C. Intracranial hemorrhage
• A patient suffered a slash to his right neck. The wound is over the mid-portion of
the sternocleidomastoid. There is a large hematoma and brisk bleeding when
uncovered. He is stable. What is the next step in management?
A. Get an angiogram
B. Close the wound in the ER
C. Take him to the operating room
D. CT scan to evaluate neck structure
Answer: C. Take him to the OR
• After abdominal injury, which of the following urinalysis findings would bean
indication for further testing?
A. 0-5 casts/HPF
B. 5-10 WBC/HPF
C. 10-20 RBC/HPF
D. Gross hematuria
,Answer: D. Gross hematuria
• A laceration of the neck superficial to the deep cervical fascia along the
sternocleidomastoid muscle at its midpoint would cause bleeding from which
structure?
Answer: External jugular vein
• Clinical features associated with tension pneumothorax
Answer:
Unilateral de-crease in breath sounds
Hyperresonance Respiratory distressTachycardia Tracheal shift Desatruation
Decreased breath sounds Decreased compliance Asymmetric chest movement
NOT hypertension, audible bronchial sounds
• Not recommended as a mode of ventilation for a patient with a diaphrag-matic
hernia
A. Bag and mask
B. LMA
C. Endotracheal intubation
D. Jet ventilation
Answer: A. Bag and mask
• What is the next step in the assessment of a traumatic patient after airwayis
established?
Answer: Breathing
• Blood group that is considered a universal donor
Answer: O
• A provider is examining a patient who sustained a severe traumatic headinjury.
He documents no Doll's eyes. What does this signify?
Answer: Brainstem injury
• Which of the following is the least preferred method of administering IVfluids?
A. Cubital veins
B. Cephalic veins
C. Subclavian veins
D. Saphenous vein
,Answer: Subclavian veins
• Dermatome level for nipple sensationDermatome level for umbilicus
Answer:
T4
T10
• At which temperature would a hypothermic patient stop shivering?
Answer: 88degrees F
• What is the energy recommendation for the first defibrillation in an adult(*)
Answer: 300 J
• Pharmacologic effects of Morphine
Answer:
Behavioral changes
Analgesia
Respiratory depression
NOT diarrhea
• A patient with which condition should be triaged to receive medical atten-tion
first?
A. Choking
B. Dizziness
C. Leg cramp
D. Vomiting
Answer: A. Choking
• Assessed first in trauma patient
Answer: Airway
• (*)Degree of burn that is characterized by bone involvement
Answer: Fourth
• Complications of head trauma
Answer:
Intracerebral hematoma
Extradural hematoma
, Brain abscess
• Most common cause of laryngotracheal stenosis
Answer: Trauma
• Intervention that can help prevent development of acute renal failure
Answer: Infusion of normal saline
• A 26-year-old male is resuscitated with blood transfusion after a motor vehicle
collision that was complicated by a fractured pelvis. A few hours later,the patient
becomes febrile, hypotensive with a normal CVP, and oliguric. Upon examination,
the patient is found to be bleeding from the NG tube and IV sites. Which of the
following is the most likely diagnosis?
A. Hemorrhagic shock
B. Acute adrenal insufficiency
C. Fat embolism syndrome
D. Transfusion reaction
Answer: D. Transfusion reaction
• Skin antiseptic
Answer:
-Ethanol 70% is an effective skin antiseptic
-Acetic acid can be used to treat Gram- skin infections
-Salicylic acid is used to treat certain skin yeast infections
• Class IV hemorrhage indicates what % blood loss
Answer: 55%
• How does shivering affect body temperature
Answer: Increases body temperature
• Class III hemorrhage indicates what % of blood loss
Answer: 35%
• Management of a stable patient with kidney contusion
Answer: Observation
• Associated with hypovolemic shock
Answer:
-Inadequate tissue perfusion with resultant tissue hypoxia
-Blood shunting to vital organs
-Decreased circulating blood volume and decreased venous return
