12/15/23,n5:50nPM ATLSnPREnTEST n1n-
nATLSnPREnTEST n1
ATLSnPREnTE STn1 n–
4 QUESTIONSnANDnCORRE CTn ANSWE RSn320 +n QUE ST I
n n
ONSnANDn ANSWE RS|
GRADEDn A
Whichn ofn then followingn physical n findingsn suggest n an caus en ofn hypot ensionn othern tha
nn spinal n cordn injury?
A. Prispism nB
. n Bradycardia
C. Diaphragmaticnbreathing
D. Presencen ofn deepn tendonn reflexes
E. Abilityn ton flexn forearmsn butn notn extendn themn -ANSWER -
n D. n Presencen ofn deepn tendonn reflexes. n Spinal n shockn refersn ton lossn ofn muscl en t
oen (flaccidty)n andn lossn ofn reflexes.
Then primaryn indicationn forn trans ferringn An patient n ton an highern leveln traum an cent ern is:
A. Unavailibilityn ofn surgeonn orn operatingn staff
B. Multiplen systemn injuries, n includingn severen headn injury
C. Resourcen limitationsn asn determinedn byn then transferringn doctor
D. Resourcen limitationsn asn determinedn byn then hospit al n administration
E. Widenednmediastinum nonn chestnx-raynfollowi ngnbluntnt rauman -ANS WER -
nC. n Resourcen limitations n asn determinedn byn then transferringn doctorn (MÅn SJE
KKES)
Anyoungn mann sustainsn an riflen woundn ton then mid-
abdomen. n Hen isn broughtn promptlyn ton then EDn byn prehospital n personnel. n Hisn skinn i
sn cooln andn diaphoretic, n andn hisn systolicn bloodn pressuren isn 58mm Hg. n Warm edn cry
stalloidn fluidsn aren initiatedn without n improvement n inn hisn vitaln signs. n Then next, n mo
stn appropriate, n stepn isn ton perform:
A. an laparotomy
B. Ann abdominal n CT-scan
C. Diagnosticnlaparoscopy
D. Abdominal nultrasonography
E. Andiagnosticnperitoneal nl avagen-ANS WER -
nA. nLaparotomynbecausenofn hemodynamicn abnorm ality
An 42-year-
oldn mann isn trappedn fromn then waistn downn beneathn hisn overt urnedn tract orn forn s ever
aln hoursn beforen medical n assist ancen arrives. n Hen isn awaken andn al ertn untiln justn before
n arrivingn inn then ED. n Hen isn nown unconscious n andn respondsn onlyn ton painful n stimuli
n byn moaning. n Hisn pupilsn aren 3mm n inn diametern andn symmetricallyn reactiven ton light
. n Prehospital n personneln indicaten thatn theyn haven notn seenn then pati ent n moven eithern of
n hisn lowern extremities. n Onn examinationn inn then ED, n non movem ent n ofn hisn lower
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nATLSnPREnTEST n1
extremitiesn aren detected, n evenn inn respons en ton painfuln stimuli. n Then mostn likelyn caus
en forn thisn findingn is:
A. Ann epiduraln hematoma
B. An pelvicn fracture
C. Central ncordnsyndrom enD
. n Intracerebral n hemorrhage
E. n Bilateral n compartment n syndromen -ANS WER -n MÅn SJEKKES
An 6-year-
on boyn isn struckn byn ann automobilen andn broughtn ton then ED. n Hen isn lethargic, n butn wit
hdrawsn purposefullyn fromn painfuln stimuli. n Hisn bloodn pressuren isn 90mm Hgn systol
ic, n heartn raten 140n beatsn pern minuten andn hisn res piratoryn rat en isn 36n breathsn pern min
ute. n Then preferredn routen ofn venousn accessn inn thisn patientn is:
A. Percutaneousn femoraln veinn cannul ation
B. Cutdownn onn then saphenousn veinn atn then ankle
C. Intraosseousn cathetern placem ent n inn then proxim aln tibia
D. Percutaneousn peripheral n veinsn inn then uppern ext remities
E. Central n venousn accessn vian then subclavi ann orn internal n jugularn veinn -ANSWER-
n D. n Percutaneous n peripheral n veinsn inn then uppern extremiti es
An youngn mann sustainsn an gunshotn woundn ton then abdomenn andn isn broughtn promptlyn
ton then EDn byn prehospital n personnel. n Hisn skinn isn cooln andn diaphoretic, n andn hen isn
confused. n Hisn pulsen isn threadyn andn hisn femoraln puls en isn onlyn weakl yn palpabl e. n Th
en definitiven treatment n inn managi ngn thisn patientn isn to:
A. Administern O-negativen blood
B. Applyn externaln warmingn devices
C. Controln internaln hemorrhagen operatively
D. Applyn an pneumaticn antishockn garm entn (PASG)
E. Infusenlargenvolum esnofnint ravenousn crystalloidns olutions. n-ANS WER-
nC. n Control n internal n hemorrhagen operatively
Regardingn shockn inn then child, n whichn ofn then followingn isn FALSE?
A. Vitalnsignsnarenage-relat ed
B. Childrenn haven greatern physiologicn reservesn thann don adults
C. Tachycardian isn then primaryn physiologicn res pons en ton hypovolemia
D. Then absoluten volumen ofn bloodn lossn requiredn ton producen shockn isn then samen as
n inn adults
E. Ann initial n fluidn bolusn forn resuscitationn shouldn approxim at en 20ml/kgn Ringers
Lactaten -ANSWER-
n D. nThen absoluten volumen ofn bloodn lossn requiredn ton producen shockn isn then samen as
n inn adults
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nATLSnPREnTEST n1
An33-year-
oldnmann isn struckn byn an carn travellingn atn 56km/hn (35mph). n Hen hasn obviousn fractur
esn ofn then leftn tibian nearn then knee, n painn inn then pelvicn area, n andn severen dys pnea. n Hi
sn heartn raten isn 182n beatsn pern minute, n andn hisn respi rat oryn rat en isn 48n breathsn pern m
inuten withn non breathn soundsn heardn inn then leftn chest. n An tensionn pneumot horaxn isn
relievedn byn immediaten needl en decompressionn andn tuben thoracost omy.
Subsequently, n hisn heartn raten decreasesn ton 144n beatsn pern minute, n hisn respirartoryn rat
en decreasesn ton 36n breathsn pern minuten andn hisn bloodn pressuren isn 81/53n mm Hg.
WarmednRingersnlactat en isnadminst erednint ravenously. nThennextnpri oritynshouldnb
en to:
A. Performn externaln fixationn ofn then pelvis
B. Obtainnabdominal nandnpelvicnC T-scans
C. Performn arterialn embolizationn ofn then pelvi cn vessel
D. Performn diagnosticn peritoneal n lavagen orn FAST
E. Performnanurethrogram nandncystogram n-ANS WER -
nD. nPerform ndiagnosticn peritoneal n lavagen orn FAST
An42-year-
oldn man, n injuredn inn an motorn vehiclen crash, n suffersn an cl osedn headn injury, n multipl
en palpablen leftn ribn fractures, n andn bilat eral n femurn fractures. n Hen isn intubat edn orot r
acheallynwithoutndifficulty. nInitiall y, nhisnventil ationsn arenReasilyn assistednwithn an
bag-
maskn device. n Itn becomesn moren diffi cult n ton ventilaten then pati ent n overn then nextn 5n
minutes, n andn hisn hemoglobinn oxygenn saturationn leveln decreas esn fromn 98%n ton 8
9%. n Then mostn appropriaten nextn stepn isn to:
A. Obtainn an chestn x-ray
B. Decreasen then tidaln vol
umenC. nDecreasenPEEP
D. Increasen then raten ofn assist edn ventilations
E. Performnneedlen decompressi onn ofn then leftn chest. n -ANSWER-
nA. n Obtainn an chest n x-rayn (MÅn SJEKKES)
An 30-year-
oldn mann sustainsn an severelyn comminuted, n open, n distaln rightn femurn fracturen inn an
motorcyclen crash. n Then woundn isn activelyn bleeding. n Normaln sensati onn isn present n o
vern then lateraln aspectn ofn then footn butn decreas edn overn then medi aln footn andn greatn to
e. n Normaln motionn ofn then footn isn observed. n Dorsalisn pedisn andn posteri orn tibialn puls
esn aren easilyn palpablen onn then l eft, n butn heardn onl yn byn Doppl ern onn then right.
Immediaten effortsn ton improven circul ationn ton then injuredn ext remit yn shouldn involve:
A. Immediatenangiography
B. Tamponaden ofn then woundn withn an pressuren dressing
C. Woundn explorationn andn removal n ofn bonyn fragments
D. Realignment n ofn then fracturen segm entsn withn an tracti onn splint
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nATLSnPREnTEST n1
E. Fasciotomyn ofn alln fourn compartmentsn inn then lowern extremityn -ANS WER-
n B. n Tamponaden ofn then woundn withn an pressuren dressing
Ann 18-yeard-
old, n unhelmetedn motorcyclist n isn broughtn byn ambul ancen ton then EDn followingn an c
rash. n Hen hadn decreasedn leveln ofn cons ciousnessn atn then scene, n butn thenn wasn al ertn a
ndn conversational n duringn transport ation. n Nown hisn GCS n isn onlyn 11.
Whichn ofn then followingn statementsn isn TRUE?
A. Cerebraln perfusionn isn intact
B. Intravascularn volumen statusn isn normal
C. Then patient n isn inn an postictal n state
D. Intra-abdominal n visceral n injuryn isn unlikely
E. Then patient n probablyn hasn ann acuten epidural n hem atom an -ANS WER-
n E. nThen patient n probablyn hasn ann acuten epidural n hem atom a
An previouslyn healthy, n 70kgn (175n pound)n mann suffersn ann estim atedn acut en bloodn lo
ssn ofn twon liters. n Whichn onen ofn then followingn statem entsn applyn ton thisn patient?
A. Hisn pulsen pressuren willn ben widened
B. Hisn urinaryn outputn willn ben atn then lowern limitsn ofn normal
C. Hen willn haven tachycardia, n butn non changen inn systolicn bloodn pressure
D. Hisn systolicn bloodn pressuren willn ben decreas edn withn an narrowed, n pulse
n pressuren E. n Hisn systolicn bloodn pressuren will n ben maintainedn withn ann elev
atedn diastolicn pressure. n -ANSWER-
n E. n Hisn systolicn bloodn pressuren will n ben maintainedn withn ann el evat edn di as
tolicn pressure.
Thenphysioclogicnhypervol emi anofn pregnancynhasn clinical nsigni ficanceninnthen man
agementn ofn then severel yn injuredn gravidn womann by
A. Reducingn then needn forn bloodn transfusion
B. Increasingn then riskn ofn pulmonaryn edema
C. Complicatingn then management n ofn clos edn headn injury
D. Increasingn then volumen ofn bloodn lossn ton producen shock/m aternal n hypotensi onn
E. n Reducingn then volumen ofn crystalloidn requiredn forn resus citationn -ANS WER -
n D. n Increasingn then volumen ofn bloodn lossn ton producen shock
An 17-year-
oldn helmetedn motorcyclist n losesn consciousnessn whenn hen isn struckn broadn siden byn
ann automobilen atn ann intersection. n Hen arrivesn inn then EDn withn an bloodn pressuren o
fn 140/92, n pulsen raten 88n beatsn pern minute, n an respiratoryn rat en ofn 18n breathsn pern mi
nue, n andn an GCS n ofn 7. n Appropriaten initialn immobilizationn ofn thisn pati entn shouldn
includen an semi-rigidn cervi caln collarn and:
A. nAnscoopn stretcher
B. An longn spinen board
about:blank 4/75
nATLSnPREnTEST n1
ATLSnPREnTE STn1 n–
4 QUESTIONSnANDnCORRE CTn ANSWE RSn320 +n QUE ST I
n n
ONSnANDn ANSWE RS|
GRADEDn A
Whichn ofn then followingn physical n findingsn suggest n an caus en ofn hypot ensionn othern tha
nn spinal n cordn injury?
A. Prispism nB
. n Bradycardia
C. Diaphragmaticnbreathing
D. Presencen ofn deepn tendonn reflexes
E. Abilityn ton flexn forearmsn butn notn extendn themn -ANSWER -
n D. n Presencen ofn deepn tendonn reflexes. n Spinal n shockn refersn ton lossn ofn muscl en t
oen (flaccidty)n andn lossn ofn reflexes.
Then primaryn indicationn forn trans ferringn An patient n ton an highern leveln traum an cent ern is:
A. Unavailibilityn ofn surgeonn orn operatingn staff
B. Multiplen systemn injuries, n includingn severen headn injury
C. Resourcen limitationsn asn determinedn byn then transferringn doctor
D. Resourcen limitationsn asn determinedn byn then hospit al n administration
E. Widenednmediastinum nonn chestnx-raynfollowi ngnbluntnt rauman -ANS WER -
nC. n Resourcen limitations n asn determinedn byn then transferringn doctorn (MÅn SJE
KKES)
Anyoungn mann sustainsn an riflen woundn ton then mid-
abdomen. n Hen isn broughtn promptlyn ton then EDn byn prehospital n personnel. n Hisn skinn i
sn cooln andn diaphoretic, n andn hisn systolicn bloodn pressuren isn 58mm Hg. n Warm edn cry
stalloidn fluidsn aren initiatedn without n improvement n inn hisn vitaln signs. n Then next, n mo
stn appropriate, n stepn isn ton perform:
A. an laparotomy
B. Ann abdominal n CT-scan
C. Diagnosticnlaparoscopy
D. Abdominal nultrasonography
E. Andiagnosticnperitoneal nl avagen-ANS WER -
nA. nLaparotomynbecausenofn hemodynamicn abnorm ality
An 42-year-
oldn mann isn trappedn fromn then waistn downn beneathn hisn overt urnedn tract orn forn s ever
aln hoursn beforen medical n assist ancen arrives. n Hen isn awaken andn al ertn untiln justn before
n arrivingn inn then ED. n Hen isn nown unconscious n andn respondsn onlyn ton painful n stimuli
n byn moaning. n Hisn pupilsn aren 3mm n inn diametern andn symmetricallyn reactiven ton light
. n Prehospital n personneln indicaten thatn theyn haven notn seenn then pati ent n moven eithern of
n hisn lowern extremities. n Onn examinationn inn then ED, n non movem ent n ofn hisn lower
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nATLSnPREnTEST n1
extremitiesn aren detected, n evenn inn respons en ton painfuln stimuli. n Then mostn likelyn caus
en forn thisn findingn is:
A. Ann epiduraln hematoma
B. An pelvicn fracture
C. Central ncordnsyndrom enD
. n Intracerebral n hemorrhage
E. n Bilateral n compartment n syndromen -ANS WER -n MÅn SJEKKES
An 6-year-
on boyn isn struckn byn ann automobilen andn broughtn ton then ED. n Hen isn lethargic, n butn wit
hdrawsn purposefullyn fromn painfuln stimuli. n Hisn bloodn pressuren isn 90mm Hgn systol
ic, n heartn raten 140n beatsn pern minuten andn hisn res piratoryn rat en isn 36n breathsn pern min
ute. n Then preferredn routen ofn venousn accessn inn thisn patientn is:
A. Percutaneousn femoraln veinn cannul ation
B. Cutdownn onn then saphenousn veinn atn then ankle
C. Intraosseousn cathetern placem ent n inn then proxim aln tibia
D. Percutaneousn peripheral n veinsn inn then uppern ext remities
E. Central n venousn accessn vian then subclavi ann orn internal n jugularn veinn -ANSWER-
n D. n Percutaneous n peripheral n veinsn inn then uppern extremiti es
An youngn mann sustainsn an gunshotn woundn ton then abdomenn andn isn broughtn promptlyn
ton then EDn byn prehospital n personnel. n Hisn skinn isn cooln andn diaphoretic, n andn hen isn
confused. n Hisn pulsen isn threadyn andn hisn femoraln puls en isn onlyn weakl yn palpabl e. n Th
en definitiven treatment n inn managi ngn thisn patientn isn to:
A. Administern O-negativen blood
B. Applyn externaln warmingn devices
C. Controln internaln hemorrhagen operatively
D. Applyn an pneumaticn antishockn garm entn (PASG)
E. Infusenlargenvolum esnofnint ravenousn crystalloidns olutions. n-ANS WER-
nC. n Control n internal n hemorrhagen operatively
Regardingn shockn inn then child, n whichn ofn then followingn isn FALSE?
A. Vitalnsignsnarenage-relat ed
B. Childrenn haven greatern physiologicn reservesn thann don adults
C. Tachycardian isn then primaryn physiologicn res pons en ton hypovolemia
D. Then absoluten volumen ofn bloodn lossn requiredn ton producen shockn isn then samen as
n inn adults
E. Ann initial n fluidn bolusn forn resuscitationn shouldn approxim at en 20ml/kgn Ringers
Lactaten -ANSWER-
n D. nThen absoluten volumen ofn bloodn lossn requiredn ton producen shockn isn then samen as
n inn adults
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nATLSnPREnTEST n1
An33-year-
oldnmann isn struckn byn an carn travellingn atn 56km/hn (35mph). n Hen hasn obviousn fractur
esn ofn then leftn tibian nearn then knee, n painn inn then pelvicn area, n andn severen dys pnea. n Hi
sn heartn raten isn 182n beatsn pern minute, n andn hisn respi rat oryn rat en isn 48n breathsn pern m
inuten withn non breathn soundsn heardn inn then leftn chest. n An tensionn pneumot horaxn isn
relievedn byn immediaten needl en decompressionn andn tuben thoracost omy.
Subsequently, n hisn heartn raten decreasesn ton 144n beatsn pern minute, n hisn respirartoryn rat
en decreasesn ton 36n breathsn pern minuten andn hisn bloodn pressuren isn 81/53n mm Hg.
WarmednRingersnlactat en isnadminst erednint ravenously. nThennextnpri oritynshouldnb
en to:
A. Performn externaln fixationn ofn then pelvis
B. Obtainnabdominal nandnpelvicnC T-scans
C. Performn arterialn embolizationn ofn then pelvi cn vessel
D. Performn diagnosticn peritoneal n lavagen orn FAST
E. Performnanurethrogram nandncystogram n-ANS WER -
nD. nPerform ndiagnosticn peritoneal n lavagen orn FAST
An42-year-
oldn man, n injuredn inn an motorn vehiclen crash, n suffersn an cl osedn headn injury, n multipl
en palpablen leftn ribn fractures, n andn bilat eral n femurn fractures. n Hen isn intubat edn orot r
acheallynwithoutndifficulty. nInitiall y, nhisnventil ationsn arenReasilyn assistednwithn an
bag-
maskn device. n Itn becomesn moren diffi cult n ton ventilaten then pati ent n overn then nextn 5n
minutes, n andn hisn hemoglobinn oxygenn saturationn leveln decreas esn fromn 98%n ton 8
9%. n Then mostn appropriaten nextn stepn isn to:
A. Obtainn an chestn x-ray
B. Decreasen then tidaln vol
umenC. nDecreasenPEEP
D. Increasen then raten ofn assist edn ventilations
E. Performnneedlen decompressi onn ofn then leftn chest. n -ANSWER-
nA. n Obtainn an chest n x-rayn (MÅn SJEKKES)
An 30-year-
oldn mann sustainsn an severelyn comminuted, n open, n distaln rightn femurn fracturen inn an
motorcyclen crash. n Then woundn isn activelyn bleeding. n Normaln sensati onn isn present n o
vern then lateraln aspectn ofn then footn butn decreas edn overn then medi aln footn andn greatn to
e. n Normaln motionn ofn then footn isn observed. n Dorsalisn pedisn andn posteri orn tibialn puls
esn aren easilyn palpablen onn then l eft, n butn heardn onl yn byn Doppl ern onn then right.
Immediaten effortsn ton improven circul ationn ton then injuredn ext remit yn shouldn involve:
A. Immediatenangiography
B. Tamponaden ofn then woundn withn an pressuren dressing
C. Woundn explorationn andn removal n ofn bonyn fragments
D. Realignment n ofn then fracturen segm entsn withn an tracti onn splint
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nATLSnPREnTEST n1
E. Fasciotomyn ofn alln fourn compartmentsn inn then lowern extremityn -ANS WER-
n B. n Tamponaden ofn then woundn withn an pressuren dressing
Ann 18-yeard-
old, n unhelmetedn motorcyclist n isn broughtn byn ambul ancen ton then EDn followingn an c
rash. n Hen hadn decreasedn leveln ofn cons ciousnessn atn then scene, n butn thenn wasn al ertn a
ndn conversational n duringn transport ation. n Nown hisn GCS n isn onlyn 11.
Whichn ofn then followingn statementsn isn TRUE?
A. Cerebraln perfusionn isn intact
B. Intravascularn volumen statusn isn normal
C. Then patient n isn inn an postictal n state
D. Intra-abdominal n visceral n injuryn isn unlikely
E. Then patient n probablyn hasn ann acuten epidural n hem atom an -ANS WER-
n E. nThen patient n probablyn hasn ann acuten epidural n hem atom a
An previouslyn healthy, n 70kgn (175n pound)n mann suffersn ann estim atedn acut en bloodn lo
ssn ofn twon liters. n Whichn onen ofn then followingn statem entsn applyn ton thisn patient?
A. Hisn pulsen pressuren willn ben widened
B. Hisn urinaryn outputn willn ben atn then lowern limitsn ofn normal
C. Hen willn haven tachycardia, n butn non changen inn systolicn bloodn pressure
D. Hisn systolicn bloodn pressuren willn ben decreas edn withn an narrowed, n pulse
n pressuren E. n Hisn systolicn bloodn pressuren will n ben maintainedn withn ann elev
atedn diastolicn pressure. n -ANSWER-
n E. n Hisn systolicn bloodn pressuren will n ben maintainedn withn ann el evat edn di as
tolicn pressure.
Thenphysioclogicnhypervol emi anofn pregnancynhasn clinical nsigni ficanceninnthen man
agementn ofn then severel yn injuredn gravidn womann by
A. Reducingn then needn forn bloodn transfusion
B. Increasingn then riskn ofn pulmonaryn edema
C. Complicatingn then management n ofn clos edn headn injury
D. Increasingn then volumen ofn bloodn lossn ton producen shock/m aternal n hypotensi onn
E. n Reducingn then volumen ofn crystalloidn requiredn forn resus citationn -ANS WER -
n D. n Increasingn then volumen ofn bloodn lossn ton producen shock
An 17-year-
oldn helmetedn motorcyclist n losesn consciousnessn whenn hen isn struckn broadn siden byn
ann automobilen atn ann intersection. n Hen arrivesn inn then EDn withn an bloodn pressuren o
fn 140/92, n pulsen raten 88n beatsn pern minute, n an respiratoryn rat en ofn 18n breathsn pern mi
nue, n andn an GCS n ofn 7. n Appropriaten initialn immobilizationn ofn thisn pati entn shouldn
includen an semi-rigidn cervi caln collarn and:
A. nAnscoopn stretcher
B. An longn spinen board
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