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ATLS Post Test 2025-2026 Verified Questions and Answers with Detailed Rationales
(Advanced Trauma Life Support)
A | 22 |year |old |male |is |brought |by |ambulance |to |a |small |community |hospital |after |falling |from |the |top | of |an | 8 |foot |ladder. |Initially, |he |was |found |to |have |a |large |right |pneumothorax. |A |chest |tube |was | inserted |and |connected |to |an |underwater |seal |drainage |collection |system |with |negative |pressure. |A | repeat |CXR |demonstrates |a |residual, |large |right |pneumothorax. |After |transferring |the |patient |to |a | verified |trauma |center, |a |third |chest |x-ray |reveals |a |persistent |right |pneumothorax. |The |chest |tube | appears |to |be |functioning |and |in |good |position. |He |remains |hemodynamically |normal |with |no |signs |of |respiratory |distress. |The |most |likely |cause |for |the |persistent |right |pneumothorax |is: A. |Flail |chest B. |Diaphragmatic |injury C. |Pulmonary |contusion D. |Esophageal |perforation E. |Tracheobronchial |injury |- |answersE. |Tracheobronchial |injury Which |of |the |following |is |LEAST |reliable |for |diagnosing |ESOPHAGEAL |intubation? A. |symmetrical |chest |wall |movement B. |end-tidal |CO C. |bilateral |breath |sounds D. |oxygen |saturation |>92% E. |ETT |above |carina |on |chest |x-ray |- |answersD. |oxygen |saturation |>92% -> |if |it |says |ESOPHAGEAL, |go |with |this |answer Which |of |the |following |signs |necessitates |the |need |for |a |definitive |airway |in |severe |trauma |patient? A. |facial |lacerations B. |repeated |vomiting C. |severe |maxillofacial |trauma D. |sternal |fracture E. |GCS | 12 |- |answersC. |Severe |maxillofacial |trauma Twenty |seven |people |are |severely |injured |in |an |aircraft |crash |at |a |local |airport. |The |principles |of | triage |include:
A. |establish |a |triage |site |within |the |internal |perimeter |of |the |crash |site B. |treat |only |the |most |severely |injured |patients |first C. |immediately |transport |all |patients |to |the |nearest |hospital D. |treat |the |greatest |number |of |patients |in |the |shortest |period |of |time E. |produce |the |greatest |number |of |survivors |based |on |available |resources |- |answersE. |Produce |the | greatest |number |of |survivors |based |on |available |resources Which |of |the |following |statements |are |correct? A. |Cerebral |contusions |may |coalesce |to |form |an |intracerebral |hematoma B. |Epidural |hematomas |are |usually |seen |in |the |frontal |region C. |Subdural |hematomas |are |caused |by |injury |to |the |middle |meningeal |artery D. |Subdural |hematomas |typically |have |a |lenticular |shape |on |CT E. |The |associated |brain |damage |is |more |severe |in |epidural |hematomas |- |answersA. |Cerebral | contusions |may |coalesce |to |form |an |intracerebral |hematoma EM: |Epidural, |middle |meningeal SuB: |Subdural, |Bridging |veins An | 18 |year |old |male |is |brought |to |the |ED |after |being |shot. |He |has |one |bullet |wound |just |below |the | right |clavicle |and |another |just |below |the |costal |margin |in |the |right |posterior |axillary |line. |His |blood | pressure |is |110/60, |heart |rate |of |90, |and |respiratory |rate |of |34. |After |ensuring |a |patent |airway |and | inserting | 2 |large |caliber |IV |lines, |the |next |most |appropriate |step |is |to: A. |Obtain |a |portable |chest |x-ray B. |Administer |a |bolus |of |additional |IV |fluid C. |Perform |a |laparatomy D. |Obtain |an |abdominal |CT |scan E. |Perform |diagnostic |peritoneal |lavage |- |answersA. |Obtain |a |portable |chest |x-ray need |more |info |on |chest, |not |abdomen Which |of |the |following |should |be |performed |FIRST |in |any |patient |whose |injuries |may |include |multiple |closed |extremity |fractures? A. |A |thorough |assessment |of |four |limb |perfusion B. |Manuevers |to |prevent |necrosis |of |the |skin C. |Extremity |compartment |syndrome |release D. |Ensuring |adequate |oxygenation |and |ventilation
E. |Excluding |hemorrhage |as |a |cause |of |shock |- |answersD. |Applying |oxygen |and |maintaining |airway First |= |ABCs Signs |and |symptoms |of |airway |compromise |include |all |of |the |following |except: A. |Change |in |voice B. |Stridor C. |Tachypea D. |Dyspnea |and |agitation E. |Decreased |pulse |pressure |- |answersE. |Decreased |pulse |pressure A | 47 |year |old |house |painter |is |brought |to |the |hospital |after |falling | 20 |feet |from |a |ladder |and |landing | straddled |on |a |fence. |Examination |of |his |perineum |reveals |extensive |ecchymosis. |There |is |blood |in | the |external |urethral |meatus. |The |initial |diagnostic |study |for |the |evaluation |of |the |urinary |tract | should |be: A. |cystoscopy B. |cystography C. |intravenous |pyelography D. |CT |scan E. |retrograde |urethrography |- |answersE. |retrograde |urethrography -> |any |ecchymosis, |needs |to |be |done |before |catheter! A | 30 |year |old |male |presents |after |a |MVC. |Vitals |are |RR |18, |HR |88, |BP |130/72, |GCS |13. |Laparatomy |is | indicated |when: A. |There |is |a |distinct |seat |belt |sign |over |the |abdomen B. |The |CT |demonstrates |a |grade | 4 |hepatic |injury C. |There |is |evidence |of |extraperitoneal |bladder |injury D. |CT |demonstrates |retroperitoneal |air E. |The |abdomen |is |distended |with |localized |rihgt |upper |quadrant |tenderness |- |answersD. |CT | demonstrates |retroperitoneal |air -> |air, |peritonitis |(tenderness, |rigidity), |unstable |vital |signs A | 20 |year |old |male |is |brought |to |the |hospital |approximately | 30 |minutes |after |being |stabbed |in |the | chest. |There |is | 3 |cm |wound |just |medial |to |the |left |nipple. |BP |is |70/33 |and |HR |is |140. |Neck |and |arm | veins |are |distended. |Breath |sounds |are |normal. |Heart |sounds |are |diminished, |IV |access |is |established | and |warm |crystalloid |is |infusing. |The |next |most |important |aspect |of |immediate |management |is: A. |CT |Chest
B. |EKG
C. |Left |tube |thoracostomy D. |RBC |infusion E. |FAST |exam |- |answersE. |FAST |exam Tamponade: |muffled |heart |sounds, |JVD, |and |hypotension |-> |FAST |cardiac |exam Will |require |pericardiocentesis Neurogenic |shock |has |all |of |the |following |characteristics |except |which |one? A. |hypotension B. |vasodilation C. |bradycardia D. |neurologic |deficit E. |narrowed |pulse |pressure |- |answersE. |narrowed |pulse |pressure always |the |answer |:) A | 30 |year |old |male |sustains |a |gunshot |wound |to |the |right |lower |chest, |midway |between |the |nipple | and |the |costal |margin. |He |is |brought |by |ambulance |to |a |hospital |with |full |surgical |capabilities. |In |the | ED, |he |is |endotracheally |intubated, | 2 |L |of |crystalloid |is |infused |rapidly, |and |a |closed |tube | thoracostomy |is |performed |with |the |return |of | 200 |mL |of |blood. |A |CXR |reveals |correct |placement |of | the |chest |tube |and |a |small |residual |hemothorax. |His |BP |is |now |70/50 |and |HR |140. |The |most | appropriate |next |step |is: A. |Insert |a |second |chest |tube B. |Obtain |CT |Abd C. |Perform |a |thoracotomy |in |the |ED D. |Perform |a |laporotomy |in |the |OR E. |Perform |a |FAST |exam |- |answersE. |Perform |a |FAST |exam -> |needs |more |CHEST |exploration |not |abdomen, |so |FAST |of |chest Which |of |the |following |is |true |regarding |a |PREGNANT |patient |who |presents |following |blunt |trauma? A. |Early |gastric |decompression |is |important B. |A |hemoglobin |level |of | 10 |indicates |recent |blood |loss C. |The |CVP |response |to |volume |resuscitation |is |blunted |in |pregnant |patients D. |A |lap |belt |is |the |best |form |of |restraint |due |to |the |size |of |the |gravid |uterus
C. |Nasopharyngeal |airway D. |Oxygen E. |Laryngeal |mask |airway |- |answersA. |Gum |elastic |bougie When |glottis |is |not |visualized, |it |is |passed |blindly |behind |the |epiglottis A | 79 |year |old |female |is |involved |in |a |motor |vehicle |crash |and |presents |to |the |ED. |She |is |on |Coumadin |and |a |beta |blocker. |Which |of |the |folowing |statements |is |true |concerning |her |management? A. |The |risk |of |subdural |hemorrhage |is |decreased B. |Absence |of |tachycardia |indicates |that |the |patient |is |hemodynamically |normal C. |Non-operative |management |of |abdominal |injuries |is |more |likely |to |be |successful |in |older |adults | than |in |younger |patients D. |Vigorous |fluid |resuscitation |may |be |assocaited |with |cardiorespiratory |failure E. |Epinephrine |should |be |infused |immediately |for |hypotension |- |answersD. |Vigorous |fluid | resuscitation |may |be |assocaited |with |cardiorespiratory |failure The |primary |indication |for |transferring |a |patient |to |a |higher |level |trauma |center |is: |- |answersResource |limitations |as |determined |by |the |transferring |doctor -> |DO |NOT |obtain |things |unless |they |are |necessary |at |current |hospital! A |teenaged |bicycle |rider |is |hit |by |a |truck |traveling |at |high |speed. |In |the |emergency |department, |she | is |actively |bleeding |from |open |fractures |of |her |legs, |and |has |abrasions |on |her |chest |and |abdominal | wall. |Her |blood |pressure |is |80/50 |mm |Hg, |heart |rate |is | 140 |beats |per |minute, |respiratory |rate |is | 8 | breaths |per |minute, |and |GCS |score |is |6. |The |first |step |in |managing |this |patient |is |to: a) |obtain |a |lateral |cervical |spine |xray. b) |administer | 2 |liters |of |crystalloid |solution. c) |insert |a |central |venous |pressure |line. d) |perform |endotracheal |intubation |and |ventilation. |- |answersD. |Perform |endotracheal |intubation |and |ventilation GCS | 8 |or |less |-> |intubate Contraindication |to |nasogastric |intubation |is |the |presence |of |a: |- |answersFracture |of |the |cribiform | plate Which |of |the |following |statements |regarding |patients |with |thoracic |spine |injuries |is |true? |- | answersLog |rolling |may |be |destabilizing |to |fractures |from |T12-L 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. |a |laparotomy B. |An |abdominal |CT-scan C. |Diagnostic |laparoscopy D. |Abdominal |ultrasonography E. |A |diagnostic |peritoneal |lavage |- |answersA. |a |laparotomy unstable |vitals |+ |wound |to |mid-abdomen |-> |laparotomy Young |women |sustains |a |severe |head |injury |as |the |result |of |a |motor |vehicle |crash. |In |the |emergency | department |her |GCS |is |6. |Her |BP |is |140/90 |mmHg |and |her |HR |is |80. |She |is |intubated |and |is |being | mechanically |ventilated. |Her |pupils |are | 3 |mm |in |size |and |equally |reactive |to |light. |There |is |no |other | apparent |injury. |The |more |important |principle |to |follow |in |the |early |management |of |her |head |injury | is |to: |- |answersPrevent |secondary |brain |injury 22 |year |old |man |is |brought |to |the |hospital |after |crashing |his |motorcycle |into |a |telephone |pole. |He |is | unconscious |and |in |profound |shock. |He |has |no |open |wounds |or |obvious |fractures. |The |cause |of |his | shocks |is |most |likely |caused |by: |- |answersHemorrhage |into |the |chest |or |abdomen nothing |visible |-> |think |chest |or |abdomen 30 |year |old |man |is |struck |by |a |car |traveling |35mph. |He |has |obvious |fractures |of |the |left |tibia |near |the |knee, |pain |in |the |pelvis |area, |and |severe |dyspnea. |His |HR |is |180, |RR | 48 |bpm |with |no |breath |sounds | heard |in |the |left |chest. |A |tension |PTX |is |relieved |by |immediate |needle |decompression |and |tube | thoracostomy. |Subsequently |his |HR |decreased |to |140, |his |RR |decreased |to | 36 |bpm, |and |BP |80/50 | mmHg. |Warmed |LR |is |administered |intravenously. |The |next |priority |should |be |to: |- |answersPerform | external |fixation |of |the |pelvis 8 |year |old |girl |is |an |unrestrained |passenger |in |a |vehicle |struck |from |behind. |In |the |ED, |her |blood | pressure |is |80/60, |heart |rate |is | 80 |bpm, |and |respiratory |rate |is | 16 |breaths |per |minute. |Her |GCS |score |is |14. |She |complains |that |her |legs |"feel |funny |and |won't |move |right", |however, |her |spine |x-rays |do | not |show |a |fracture |dislocation. |A |spinal |injury |in |this |child: |- |answersCan |be |excluded |by |obtaining |a | CT |of |the |entire |spine Immediately |chest |tube |insertion |is |indicated |for |which |of |the |following |conditions? |- |answersMassive |hemothorax 18 |year |old |helmeted |motorcyclist |is |brought |by |ambulance |to |the |emergency |department |following | a |high |speed |crash. |Pre-hospital |personnel |report |that |he |was |thrown | 50 |feet |off |his |bike. |He |has |a | history |of |hypotension |prior |to |arrival |in |the |ED, |but |is |now |awake, |alert, |and |conversational. |Which | of |the |following |statements |is |true? |- |answersThe |patient |probably |has |an |acute |epidural |hematoma | (lucid |interval)
E. |Infuse |large |volumes |of |intravenous |crystalloid |solutions. |- |answersC. |Control |internal |hemorrhage | operatively Hemorrhage: |STOP |the |bleeding! A | 30 |year |old |male |is |brought |to |the |hospital |after |falling | 20 |feet. |Inspection |reveals |an |obvious |flail | chest |on |the |right. |The |patient |is |tachypenic. |Breath |sounds |are |present |and |symmetric. |There |is |no | significant |hyperresonance |or |dullness. |ABG |obtained |while |the |patient |receives |oxygen |by |face |mask | are: |PaO2 |of |45, |PaCO2 |of |28, |and |pH |of |7.47. |The |component |of |injury |that |is |most |likely | responsible |for |abnormalities |in |the |patient's |blood |gases |is: A. |Hypoventilation B. |Pulmonary |contusion C. |Hypovolemia D. |Small |pneumothorax E. |Flail |chest |- |answersA. |Hypoventilation retaining |CO2, |respiratory |alkalosis A | 14 |year |old |female |is |brought |to |the |ED |after |falling |from |a |horse. |She |is |immoblized |on |a |long | spine |board |with |a |hard |collar |and |blocks. |Cervical |spine |x-ray: |- |answers?? The |first |priority |in |management |of |a |long |bone |fracture |is: A. |Reduction |of |pain B. |Prevention |of |infection |in |case |of |an |open |fracture C. |Prevention |of |further |soft |tissue |injury D. |Improve |long |term |function E. |Control |of |hemorrhage |- |answersE. |Control |of |hemorrhage stop |the |bleeding! The |most |SPECIFIC |test |to |evaluate |for |injuries |of |solid |abdominal |organs |is: A. |Abdominal |x-ray B. |Abdominal |ultrasound C. |Diagnostic |peritoneal |lavage D. |Frequent |abdominal |examination
E. |CT |Abd/Pelvis |- |answersE. |CT |Abd/Pelvis To |establish |a |diagnosis |of |shock, A. |Systolic |blood |pressure |must |be |below |90mmHg B. |The |presence |of |a |closed |head |injury |should |be |excluded C. |Acidosis |should |be |present |by |arterial |blood |gas |analysis D. |The |patient |must |fail |to |respond |to |intravenous |fluid |infusion E. |Clinical |evidence |of |inadequate |organ |perfusion |must |be |present. |- |answersE. |Clinical |evidence |of | inadequate |organ |perfusion |must |be |present. A | 29 |year |old |female |arrives |in |the |ED |after |being |involved |in |a |motor |vehicle |crash. |She |is | 30 |weeks | pregnant. |She |was |restrained |with |a |lap |and |shoulder |belt, |and |an |airbag |deployed. |Which |one |of |the |following |statements |best |describes |the |risk |of |injury? A. |The |deployment |of |the |airbag |increased |the |risk |of |fetal |loss B. |The |risk |of |premature |fetal |delivery |and |death |is |reduced |by |the |use |of |restraints C. |The |use |of |seatbelts |is |associated |with |increased |risk |of |maternal |death D. |The |mechanism |of |injury |suggests |the |need |for |emergency |C |section |due |to |the |risk |of |impending | abruptio |placentae E. |The |deployment |of |the |airbag |increases |the |risk |of |maternal |abdominal |injury |- |answersB. |The |risk | of |premature |fetal |delivery |and |death |is |reduced |by |the |use |of |restraints The |most |important |consequence |of |inadequate |organ |perfusion |is: A. |Vasodilation B. |Multiple |organ |failure C. |Decreased |base |deficit D. |Acute |glomerulonephritis E. |Increased |cellular |ATP |production |- |answersB. |Multiple |organ |failure The |most |common |acid-base |disturbance |encountered |in |injured |pediatric |patients |is |caused |by: A. |Hemorrhage B. |Changes |in |ventilation C. |Renal |failure D. |Injudicious |bicarbonate |administration E. |Insufficient |sodium |chloride |administration |- |answersB. |Changes |in |ventilation
Which |of |the |following |statements |regarding |injury |to |the |central |nervous |system |in |children |is |true? |- |answersChildren |suffer |spinal |cord |injury |without |an |XR |abnormality |more |commonly |than |adults Which |of |the |following |physical |findings |does |NOT |suggest |spinal |cord |injury |as |the |cause |of | hypotension? A. |Priapism B. |Bradycardia C. |Distended |neck |veins D. |Diaphragmatic |breathing E. |Ability |to |flex |forearms |but |inability |to |extend |them |- |answers?? 5 |year |old |boy |is |struck |by |an |automobile |and |brought |to |the |emergency |department. |He |is |lethargic, |but |withdraws |purposefully |from |painfully |stimuli. |His |blood |pressure |is | 90 |mmHg, |HR | 140 |BPM, |and | RR |is | 36 |bpm. |The |preferred |route |of |venous |access |in |this |patient |is: |- |answersPertained |veins |in |the |upper |extremities The |response |to |catecholamines |in |an |injured, |hypovolemic |pregnant |woman |can |be |expected |to | result |in: A. |Placental |abruption B. |Fetal |hypoxia |and |distress C. |Fetal/maternal |dysrhytmia D. |Improved |uterine |blood |flow E. |Increased |maternal |renal |blood |flow |- |answersB. |Fetal |hypoxia |and |distress A |construction |worker |falls |from |a |scaffold |and |is |transferred |to |the |ED. |His |HR |is | 124 |bpm |and |his | BP |is |85/60. |He |complains |of |lower |abdominal |pain. |After |assessing |the |airway |and |chest, | immobilizing |the |C |spine |and |initiating |fluid |resuscitation, |the |next |step |is |to |perform: A. |FAST |exam B. |Detailed |neurological |exam C. |Rectal |exam D. |Cervical |spine |x-ray E. |Urethral |catheterization |- |answersA. |FAST |exam Cardiac |tamponade |after |trauma: |- |answersCan |be |confused |with |a |tension |pneumothorax Cardic |tamponade: A. |Requires |surgical |intervention B. |Is |definitively |managed |by |needle |pericardiocentesis
C. |Is |easily |diagnosed |by |Beck's |triad D. |Is |indicated |by |Kussmaul |breathing E. |Is |most |common |with |blunt |thoracic |trauma |and |anterior |rib |fractures |- |answers?? 30 |year |old |man |sustains |a |severely, |communities, |open |distal |right |femur |fracture |in |a |motorcycle | crash. |The |wound |is |actively |bleeding. |DP |and |PT |are |easily |palpable |on |the |left, |but |heard |only |by | Doppler |on |the |right. |Immediate |effort |to |improve |circulation |the |injured |extremity |should |involve: |- | answersTamponade |of |the |wound |with |a |pressure |dressing 24 |year |old |male |sustains |multiple |fractured |ribs |bilaterally |as |a |result |of |being |crushed |in |a |press |at | plywood |factory. |Examination |in |the |ED |revealed |a |foil |segment |on |the |patient's |thorax. |Primary | resuscitation |includes |high |flow, |oxygen |administration |via |a |non-breathing |mask, |and |initiation |of | ringers |lactate |solution. |The |patient |exhibits |progressive |confusion, |cyanosis, |and |kidney. | Management |at |this |time |she |consist |of: |- |answersEndotracheal |intubation |and |mechanical |ventilation 23 |year |old |man |is |brought |immediately |to |the |emergency |department |from |the |hospital |parking |lot | where |he |was |shot |in |the |lower |abdomen. |Examination |reveals |a |single |bullet |wound. |He |is |breathing |and |has |a |thrash |pulse. |However, |he |is |unconscious |and |has |no |detectable |blood |pressure. |Optimal | immediate |management |is |to: |- |answersTransfer |the |patient |to |the |operating |room |while |initiating | fluid |therapy Compared |with |adults, |children |have: A. |A |longer, |wide, |funnel |shaped |airway B. |A |less |pliable, |calcified |skeleton C. |Lower |incidence |of |bony |injury |with |neurogenic |shock D. |A |relatively |smaller |head |and |larger |jaw E. |Anterior |displacement |of |C5 |and |C6 |- |answersC. |Lower |incidence |of |bony |injury |with |neurogenic | shock 25 |year |old |woman |is |brought |to |the |emergency |department |after |a |motor |vehicle |crash. |She |was | initially |lucid |at |the |scene |and |then |developed |the |dilated |people |in |contralateral |externally | weakness. |In |the |emergency |department, |she's |unconscious |and |has |a |GCS |score |of |6. |The |initial | management |step |for |this |patient |should |be |to: |- |answersPerform |endotracheal |intubation A | 22 |year |old |female |is | 6 |months |pregnant |presents |following |a |motor |vehicle |crash. |Paramedics | report |vaginal |bleeding. |What |is |the |initial |step |in |her |treatment? A. |Assess |fetal |heart |sounds B. |Check |for |fetal |movement C. |Perform |inspection |of |the |cervix D. |Ask |the |patient |what |her |name |is |
Early |central |venous |pressure |monitoring |during |fluid |resusciation |in |the |ED |has |the |greatest |utility |in |a: A. |Patient |with |a |splenic |laceration B. |Patient |with |a |inhalation |injury C. | 6 |year-old |child |with |a |pelvic |fracture D. |Patient |with |a |severe |cardiac |contusion E. |24-year-old |man |with |a |massive |hemothorax |- |answersD. |Patient |with |a |severe |cardiac |contusion 32 |year |old |male |is |brought |to |the |hospital |unconscious |with |severe |facial |injuries |and |noisy | respirations |after |an |automobile |collision. |In |the |emergency |department, |he |has |no |apparent |injury |to |the |anterior |aspect |of |his |neck. |He |suddenly |becomes |apneic, |and |alternative |ventilation |with |a |face | mask |is |unsuccessful. |Examination |of |his |mouth |reveals |a |large |hematoma |of |the |fairing |with |loss |of | normal |atomic |landmarks. |Initial |management |of |his |airway |should |consist |of: A. |Nasotracheal |intubation B. |Emergency |tracheostomy C. |Surgical |cricothyroidotomy D. |Placement |of |an |oropharyngeal |airway E. |Placement |of |an |nasopharyngeal |airway |- |answersC. |Surgical |cricothyroidotomy 42 |year |old |man |injured |in |a |motor |vehicle |crash, |suffers |a |closed, |head |injury, |multiple |palpable |left | roof |fracture, |bilateral |femur |fracture. |He |is |intubated |orotracheally |without |difficulty. |Initially, |has | ventilations |are |easily |assisted |with |a |bag |device. |It |becomes |more |difficult |to |ventilate |the |patient | over |the |next |five |minutes, |and |his |hemoglobin |oxygen |saturation |level |decreases |from |90% |to |89%. | The |most |appropriate |next |step |is |to: |- |answersAuscultate |the |patient's |chest 42 |year |olds |man |is |trapped |from |the |waist |down |beneath |his |overturned |tractor |for |several |hours | before |Medical |systemized. |He |is |awake |and |alert |until |just |before |arriving |in |emergency |department. |He |is |now |unconscious |in |response |only |to |painful |stimulate |by |moaning. |His |pupils |are | 3 |mm |in | diameter |and |symmetrically |reactive |delight. |Prehospital |personnel |indicate |that |they |have |not |seen | the |patient |move |either |of |his |lower |extremities.: |- |answersA |pelvic |fracture An |electrician |is |eletrocuted |by |a |downed |power |line |after |a |thunderstorm. |He |apparently |made | contact |with |the |wire |at |the |level |of |the |right |mid |thigh. |In |the |ED, |his |vital |signs |are |normal |and |no | dysrythmia |is |noted |on |ECG. |On |examination, |there |is |an |exit |wound |on |the |bottom |of |the |right |foot. |His |urine |is |positive |for |blood |by |dipstick |but |not |RBCs |are |seen |microscopically. |Initial |management | should |include: A. |Immediate |angiography B. |Aggressive |fluid |infusion C. |Intravenous |pyelography
D. |Debridement |of |necrotic |muscle E. |Admission |to |the |ICU |for |observation |- |answersB. |Aggressive |fluid |infusion |- |suspected | rhabdomyolyse Which |one |of |the |following |physical |findings |suggest |the |causes |of |hypertension, |other |than |spinal | cord |injury? |- |answersPresence |of |deep |tendon |and |reflexes Hypertension |following |a |head |injury: A. |Should |be |treated |to |reduce |intracranial |pressure B. |Indicates |pre-existing |hypertension C. |May |indicate |imminent |hernation |from |critically |high |intracranial |pressure D. |Mandates |prompt |administration |of |Mannitol E. |Should |prompt |burr |hole |drainage |of |potential |subdural |hematomas |- |answersA. |Should |be |treated |to |reduce |intracranial |pressure 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 |hypovolemia 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 |- |answersD. |The | absolute |volume |of |blood |loss |required |to |produce |shock |is |the |same |as |in |adults All |the |following |signs |on |chest |x-ray |of |a |blunt |injury |victim |may |suggest |aortic |rupture |except: A. |Mediastinal |emphysema B. |Presence |of |a |pleural |cap C. |Obliteration |of |the |aortic |knob D. |Devitation |of |the |trachea |to |the |right E. |Depression |of |the |left |mainstem |bronchus |- |answersA. |Mediastinal |emphysema An | 8 |year |old |boy |falls | 15 |feet |from |a |tree |in |a |sprout |to |the |emergency |department |by |his |family. | His |vital |signs |are |normal, |but |he |complains |of |leftover |quad |pain. |And |abdominal |CT |reveals |a | moderately |severe |laceration |of |the |spleen. |The |receiving |institution |does |not |have | 24 |hour |a |day | operating |room |capabilities. |The |most |appropriate |management |of |this |patient |would |be |to: A. |Type |and |crossmatch |for |blood B. |Request |consultation |of |a |pediatrician
Initial |resuscitation |in |an |adult |patient |should: A. |Be |with |1-2 |L |of |crystalloid, |monitoring |the |patient's |response B. |Use |crystalloid |to |normalize |BP C. |Use |permissive |hypotension |in |patients |with |head |injury D. |Be |with |a |non-blood |colloid |solution E. |Be |a |minimum |of | 2 |L |of |crystalloid |in |all |trauma |patients |prior |to |administering |blood |- |answersA. | Be |with |1-2 |L |of |crystalloid, |monitoring |the |patient's |response A | 15 |year |old |male |presents |following |a |motorcycle |crash. |Initial |exam |reveals |normal |vital |signs. | There |is |a |large |bruise |over |his |epigastrium |that |extends |to |the |left |flank. |He |has |no |other |apparent | injuries. |A |CT |scan |of |the |abdomen |demonstrates |a |ruptured |spleen |surrounded |by |a |large |hematoma |and |fluid |in |the |pelvis. |The |next |best |step |in |the |patient's |management |is: A. |Splenic |artery |embolization B. |Pneumococcal |vaccine C. |Urgent |laporotomy D. |Surgical |consultation E. |Transfer |to |a |pediatrician |- |answersD. |Surgical |consultation vs. |peritonitis |or |abnormal |vital |signs |--> |urgent |laporotomy A | 6 |months |old |infant |being |held |in |her |mother's |arms, |is |ejected |on |impact |from |a |vehicle |that | struck |head |on |by |an |oncoming |car |traveling |at | 64 |km/h. |The |infinite |arrives |in |the |ER |with |multiple | facial |injuries, |lethargic, |and |in |severe |respiratory |distress. |Respiratory |support |is |not |effective |using |a |bag |mast |device. |Oxygen |saturation |is |swelling. |Repeated |attempts |at |or |a |tracheal |intubation |or | unsuccessful. |The |most |appropriate |procedure |to |perform |next |is: |- |answersPerform |needle | cricothyrotomy |with |jet |in |insufflations 28 |year |old |male |is |brought |to |ER. |He |was |involved |in |a |fight |in |which |she |was |beaten |with |a | wooden |stick. |His |chest |has |multiple |severe |bruises. |Airways |clear, |respiratory |rate |22, |heart |rate |is | 126, |and |systemic |blood |pressure |is |90. |Which |of |the |following |should |be |performed |during |the | primary |survey? A. |GCS B. |Cervical |spine |XR C. |TT |administration D. |Blood |alcohol |level E. |Rectal |exam |- |answersA. |GCS
Which |of |the |following |statements |is |true |regarding |access |in |pediatric |resuscitation? |- |answersGood | chance |you |can |be |delivered |through |interosseous |access A | 6 |month |old |infant |is |ejected |on |impact |from |a |vehicle |that |is |struck |head |on |by |an |oncoming |car | traveling | 40 |mph. |The |infant |arrives |in |the |ED |with |multiple |facial |injuries, |is |lethargic, |and |in |severe | respiratory |distress. |Respiratory |support |is |not |effective |using |a |bag |mask |device, |and |her |oxygen | saturation |is |failing. |Repeated |attempts |at |orotracheal |intubation |are |unsuccessful. |The |most | appropriate |procedure |to |form |next |is: A. |Needle |cricothyroidotomy |with |jet |insufflation B. |Administer |heliox |and |racemic |epinephrine C. |Perform |nasotracheal |intubation D. |Perform |surgical |cricothyroidotomy E. |Repeat |orotracheal |intubation |- |answersA. |Needle |cricothyroidotomy |with |jet |insufflation A |35-year-old |female |sustained |multiple |injuries |in |a |motor |vehicle |vehicle |crash |and |is |transported |to |a |small |hospital |in |full |spinal |protection. |She |has |a |GCS |of | 4 |and |is |being |mechanically |ventilated. |IV | access |is |established |and |warm |crystalloid |is |infuse. |She |remains |hemodynamically |normal |and |full | spinal |protection |is |maintained. |Preparations |are |made |to |transfer |to |another |facility |for |definitive | neurosurgical |care. |Prior |to |transport, |which |of |the |following |test |or |treatments |is |mandatory? A. |FAST |exam B. |Lateral |cervical |spine |x-ray C. |Chest |x-ray D. |Administration |of |methylprednisolone E. |CT |of |the |Abd |- |answersC. |Chest |x-ray ?? Which |of |the |following |injuries |is |addressed |in |the |secondary |survey? A. |Bilateral |femur |fractures |with |obvious |deformity B. |Open |fracture |with |bleeding C. |Mid-thigh |amputation D. |Unstable |pelvic |fracture E. |Forearm |fracture |- |answersE. |Forearm |fracture Which |of |the |following |statements |is |false? A. |Hypotonic |fluids |should |be |used |to |limit |brain |edema |in |patients |with |severe |head |injury B. |Elevated |intracranial |pressure |will |not |affect |cerebral |perfusion
