ATLS POST TEST. MCQ - UPDATED.PDF Question 1: A 22-year-old man is hy...

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ATLS POST TEST. MCQ

QUESTIONS WITH ANSWE RS

UPDATED.PDF

Question 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 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:

• reexamine the chest
• perform an aortogram
• obtain a CT scan of the chest
• obtain arterial blood gas analyses
• perform transesophageal echocardiography

CORRECT ANSWER : a. Reexamine the chest

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Question 2: A construction worker falls two stories from a

building and sustains bilateral calcaneal fractures. In the emergency department, he is alert, vital signs 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:

• angiography
• compartment pressures
• retrograde urethrogram
• Doppler ultrasound studies
• complete spine x-ray series

CORRECT ANSWER : e. Complete spine x-ray series

Question 3: Which of the following is true regarding the

initial resuscitation of a trauma patient?

• A patient that presents with a torso gunshot wound and

is hypotensive should receive crystalloid fluid resuscitation until the blood pressure is normal

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• 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 of packed red blood cells and plasma in 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 patients

CORRECT ANSWER : b. Evidence of improved

perfusion after fluid resuscitation could include improvement in Glasgow coma scale score on reevaluation

Question 4: In managing a patient with a severe traumatic

brain injury, the most important initial step is to:

• Secure the airway
• obtain a c-spine film
• support the circulation
• control scalp hemorrhage

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• determine the GCS score

CORRECT ANSWER : a. Secure the airway

Question 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?

• His pulse pressure will be widened.
• His urinary output will be at the lower limits of normal.
• 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.

CORRECT ANSWER : d. An ABG would demonstrate a

base deficit between -6 and -10 mEq/L

Question 6: The physiologic hypervolemia of pregnancy

has clinical significance in the management of the

severely injured, gravid woman by: