ATLS POST TEST 4 LATEST VERSIONS REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS
Which of the following is the recommended Method for trestemt
frostbite?
A. Vasodilators
B. Anticoagulants C. Warm (40 degrees) water
C. Warm (40 degrees) water
D. Padding and elevation
E. Application of heat from a hairdryer
Which of the following physical findings suggest a cause of hy-
potension other than spinal cord injury?
A. Priapism
D. Presence of deep tendon reflexes. Spinal shock refers to loss
B. Bradycardia
of muscle toe (flaccidity) and loss of reflexes.
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them
The primary indication for transferring A patient to a higher-level
trauma center is:
A. Unavailability of surgeon or operating staff
B. Multiple system injuries, including severe head injury C. Resource limitations as determined by the transferring doctor
C. Resource limitations as determined by the transferring doctor (MÅ SJEKKES)
D. Resource limitations as determined by the hospital administra-
tion
E. Widened mediastinum on chest x-ray following blunt trauma
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. Laparotomy because of hemodynamic abnormality
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage
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 MÅ SJEKKES
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
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 D. Percutaneous peripheral veins in the upper extremities
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
, ATLS POST TEST 4 LATEST VERSIONS REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS
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:
C. Control internal hemorrhage operatively
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.
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 hypov-
D. The absolute volume of blood loss required to produce shock is
olemia
the same as in adults
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
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 thora-
costomy. Subsequently, his heart rate decreases to 144 beats per
minute, his respirartory rate decreases to 36 breaths per minute D. Perform diagnostic peritoneal lavage or FAST
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
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. Ini-
tially, 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
A. Obtain a chest x-ray (MÅ SJEKKES)
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.
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 B. Tamponade of the wound with a pressure dressing
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
, ATLS POST TEST 4 LATEST VERSIONS REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS
An 18-yeard-old, unhelmeted motorcyclist is brought by ambu-
lance 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?
E. The patient probably has an acute epidural hematoma
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
A previously healthy, 70kg (175 pound) man suffers an estimated
acute blood loss of two liters. Which one of the following state-
ments apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
E. His systolic blood pressure will be maintained with an elevated
C. He will have tachycardia, but no change in systolic blood
diastolic pressure.
pressure
D. His systolic blood pressure will be decreased with a narrowed,
pulse pressure
E. His systolic blood pressure will be maintained with an elevated
diastolic pressure.
The physioclogic hypervolemia of pregnancy has clinical signifi-
cance in the management of the severely injured gravid woman
by
A. Reducing the need for blood transfusion
B. Increasing the risk of pulmonary edema D. Increasing the volume of blood loss to produce shock
C. Complicating the management of closed head injury
D. Increasing the volume of blood loss to produce shock/maternal
hypotension
E. Reducing the volume of crystalloid required for resuscitation
A 17-year-old helmeted motorcyclist loses consciousness when
he is struck broad side by an automobile at an intersection. He
arrives in the ED with a blood pressure of 140/92, pulse rate 88
beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient should
include a semi-rigid cervical collar and: B. A long spine board
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment
During an altercation, a 36-year-old man sustains a gunshot
wound above the nipple line on the right, with an exit wound
posteriorly above the scapula on the right. He is transported by
ambulance to a community hospital. He is endotracheally intu-
bated, close tube thoracostomy is performed, and 2 liters Ringers
lactate solution are infused via 2 large-caliber IV´s. His blood
pressure now is 60/0mmHg, heart rate is 160 beats per minute,
E. Chest X-ray to confirm tube placement
and respiratory rate is 14 breaths per minute (ventilated with 100%
O2). The most appropriate next step in managin this patient is:
A. Laparotomy
B. Diagnostic peritoneal lavage
C. Arterial blood gas determination
D. Administer packed red blood cells
E. Chest X-ray to confirm tube placement
Abscence of breath sounds and dullness to percussion over the
left hemithorax are findings best explained by:
A. Left hemothorax A. Left hemothorax
B. Cardiac contusion
QUESTIONS AND CORRECT ANSWERS
Which of the following is the recommended Method for trestemt
frostbite?
A. Vasodilators
B. Anticoagulants C. Warm (40 degrees) water
C. Warm (40 degrees) water
D. Padding and elevation
E. Application of heat from a hairdryer
Which of the following physical findings suggest a cause of hy-
potension other than spinal cord injury?
A. Priapism
D. Presence of deep tendon reflexes. Spinal shock refers to loss
B. Bradycardia
of muscle toe (flaccidity) and loss of reflexes.
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them
The primary indication for transferring A patient to a higher-level
trauma center is:
A. Unavailability of surgeon or operating staff
B. Multiple system injuries, including severe head injury C. Resource limitations as determined by the transferring doctor
C. Resource limitations as determined by the transferring doctor (MÅ SJEKKES)
D. Resource limitations as determined by the hospital administra-
tion
E. Widened mediastinum on chest x-ray following blunt trauma
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. Laparotomy because of hemodynamic abnormality
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage
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 MÅ SJEKKES
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
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 D. Percutaneous peripheral veins in the upper extremities
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
, ATLS POST TEST 4 LATEST VERSIONS REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS
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:
C. Control internal hemorrhage operatively
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.
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 hypov-
D. The absolute volume of blood loss required to produce shock is
olemia
the same as in adults
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
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 thora-
costomy. Subsequently, his heart rate decreases to 144 beats per
minute, his respirartory rate decreases to 36 breaths per minute D. Perform diagnostic peritoneal lavage or FAST
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
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. Ini-
tially, 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
A. Obtain a chest x-ray (MÅ SJEKKES)
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.
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 B. Tamponade of the wound with a pressure dressing
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
, ATLS POST TEST 4 LATEST VERSIONS REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS
An 18-yeard-old, unhelmeted motorcyclist is brought by ambu-
lance 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?
E. The patient probably has an acute epidural hematoma
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
A previously healthy, 70kg (175 pound) man suffers an estimated
acute blood loss of two liters. Which one of the following state-
ments apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
E. His systolic blood pressure will be maintained with an elevated
C. He will have tachycardia, but no change in systolic blood
diastolic pressure.
pressure
D. His systolic blood pressure will be decreased with a narrowed,
pulse pressure
E. His systolic blood pressure will be maintained with an elevated
diastolic pressure.
The physioclogic hypervolemia of pregnancy has clinical signifi-
cance in the management of the severely injured gravid woman
by
A. Reducing the need for blood transfusion
B. Increasing the risk of pulmonary edema D. Increasing the volume of blood loss to produce shock
C. Complicating the management of closed head injury
D. Increasing the volume of blood loss to produce shock/maternal
hypotension
E. Reducing the volume of crystalloid required for resuscitation
A 17-year-old helmeted motorcyclist loses consciousness when
he is struck broad side by an automobile at an intersection. He
arrives in the ED with a blood pressure of 140/92, pulse rate 88
beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient should
include a semi-rigid cervical collar and: B. A long spine board
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment
During an altercation, a 36-year-old man sustains a gunshot
wound above the nipple line on the right, with an exit wound
posteriorly above the scapula on the right. He is transported by
ambulance to a community hospital. He is endotracheally intu-
bated, close tube thoracostomy is performed, and 2 liters Ringers
lactate solution are infused via 2 large-caliber IV´s. His blood
pressure now is 60/0mmHg, heart rate is 160 beats per minute,
E. Chest X-ray to confirm tube placement
and respiratory rate is 14 breaths per minute (ventilated with 100%
O2). The most appropriate next step in managin this patient is:
A. Laparotomy
B. Diagnostic peritoneal lavage
C. Arterial blood gas determination
D. Administer packed red blood cells
E. Chest X-ray to confirm tube placement
Abscence of breath sounds and dullness to percussion over the
left hemithorax are findings best explained by:
A. Left hemothorax A. Left hemothorax
B. Cardiac contusion
