ATLS PRE TEST 2022

1. A 22-year-old man is hypotensive and tachycardic after a shotgun wound

to the left shoulder. His blood pressure is initially 80/40 mm 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

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minute. A tube thoracostomy is performed for decreased left chest breath

sounds with the return of a small amount of blood and no air leak. After chest

tube insertion, the most appropriate next step is:: re-examine the chest

l.c
2. A construction worker falls two stories from a building and sustains bilateral calcaneal

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fractures. In the emergency department, he is alert, vital signs

gm
are normal, and he is complaining of severe pain in both heels 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:: complete spine x-ray

series

3. Which of the following is true regarding the initial resuscitation of a trauma

patient?: Evidence of improved perfusion after fluid resuscitation could include

improvement in Glasgow Coma Scale score on reevaluation.

4. In managing a patient with a severe traumatic brain injury, the most important initial step is
sc

to:: secure the airway

5. A previously healthy, 70-kg (154-pound) man suffers an estimated acute

blood loss of 2 liters. Which one of the following statements applies to this

patient?: An ABG would demonstrate a base deficit between -6 and -10 mEq/L.

6. The physiological hypervolemia of pregnancy has clinical significance in

the management of the severely injured, gravid woman by:: increasing the

volume of blood loss to produce maternal hypotension

urinary output of 0.5 mL/kg/hr

8. The diagnosis of shock must include:: evidence of inadequate organ perfusion

9. A 7-year-old boy is brought to the emergency department by his parents

several minutes after he fell through a window. He is bleeding profusely from

a 6-cm wound of his medial right thigh. Immediate management of the wound

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should consist of:: direct pressure on the wound

10. For the patient with severe traumatic brain injury, profound hypocarbia

l.c
should be avoided to prevent:: cerebral vasoconstriction with diminished perfusion

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11. After being involved in a motor vehicle crash, a 25-year-old man is
gm
brought to a hospital that has surgery capabilities available.. Computed

tomography of the chest and abdomen shows an aortic injury and splenic
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laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg

after CT. The next step is:: perform an exploratory laparotomy

12. Which one of the following statements regarding abdominal trauma in the
72

pregnant patient is TRUE?: Leakage of amniotic fluid is an indication for hospital

admission.

13. The first maneuver to improve oxygenation after chest injury is:: administer supplemental
sc

oxygen
do

14. A 25-year-old man, injured in a motor vehicular crash, is admitted to the

emergency department. His pupils react sluggishly and his eyes open to

pressure. He does not follow commands, but he does moan periodically.

His right arm is deformed and does not respond to pressure; however, his

left hand reaches purposefully toward the stimulus. Both legs are stiffly

extended. His GCS score is:: 9

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