ANSWERS 2025/26
AK22-year-
old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood pressure is
initially 80/40Kmm Hg. After initial fluid resuscitation his blood pressure increases to 122/84 mm Hg. His
heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. A tube thoraco
stomy is performed for decreased left chest breath sounds with the return of a small amount of blood a
nd no air leak. After chest tube insertion, the most appropriate next step is: - correct answer-- *Re-
examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
A construction worker falls two storiesKfrom a building and sustains bilateral calcaneal fractures. In the e
mergency department, he is alert, vital signs are normal, and he isKcomplaining of severe pain in both he
els and his lower back. Lower extremity pulses are strong and there is no other deformity. The suspected
diagnosis is most likely to be confirmed by: - correct answer-- complete spine x-ray series
Which of the following is true regardingKthe initial resuscitation of a trauma patient? - correct answer--
A patient with a torso gunshot wound and hypotension should receive crystalloid fluid resuscitation unti
l the blood pressure is normal
-
* Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow Coma
Scale score on reevaluation*
-
Massive transfusion is defined as transfusion of more than 10 units of packed red blood cells and plasm
a within 24 hours
- When tranexamic acid is administered by pre-
hospital providers, a second dose is required within 24 hours
- Fluid resuscitation is far more important than bleeding control in trauma patient
In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
correct answer-- Secure the airway
, AKpreviously healthy, 70-kg (154-
pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following statements app
lies to this patient? - correct answer-- His pulse pressure will be widened.
- His urinary output will be at the lower limits of normal. xxx
- He will have tachycardia, but no change in his systolic blood pressure.
- *An ABG would demonstrate a base deficit between -6 and -10 mEq/L.*
- His systolic blood pressure will be maintained with an elevated diastolic pressure.
The physiological hypervolemia of pregnancy has clinical significance in the management of the severely
injured, gravid woman by: -Kcorrect answer--
increasing the volume of blood loss to produce maternal hypotension.
The best assessment of fluid resuscitation of the adult burn patient is: - correct answer--
urinary output of 0.5 mL/kg/hr
The diagnosis of shock must include: - correct answer-- evidence of inadequate organ perfusion
A 7-year-
old boy is brought to the emergency department by his parents several minutes after he fell through a w
indow. He is bleeding profusely from a 6-
cm wound of his medial right thigh. Immediate management of the wound should consistKof: -
correct answer-- direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: -
correct answer-- respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
After being involved in a motor vehicle crash, a 25-year-
old man is brought to a hospital that has surgery capabilities available. Computed tomography of the ch