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2025 ATLS Post Test – Advanced Trauma
Life Support MCQs with Correct
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A 28 y/o woman sustains multiple injuries in a car crash and is brought by ambulance to a small hospital in full spinal protection. GCS of 4 and is being mechanically ventilated. Intravenous access is established and warmed crystalloid is infused. She remains hemodynamically normal and full spinal protection is maintained. Preparations are made to transfer her to another facility for definitive neurosurgical care. Prior to transport, which of the following tests or treatments is mandatory?: FAST exam.
Chest xray.
Change in voice tone. Stridor. Decreased pulse pressure. Dyspnea and agitation. Tachypnea. - ✔✔✔ANSWER-Decreased pulse pressure. A 26 year • old woman is brought to the Emergency Department 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?: The deployment of the airbag increases the risk of fetal loss. The use of seatbelts is associated with increased risk of maternal death. The mechanism of injury suggests the need for emergency caesarean section due to the risk of impending abruptio placentae. The risk of premature fetal delivery and death is reduced by the use of restraints.
The deployment of the airbag increases the risk of maternal abdominal injury. - ✔✔✔ANSWER-The risk of premature fetal delivery and death is reduced by the use of restraints. Regarding cardiac tamponade, which of the following statements is CORRECT?: Is definitively managed by needle pericardiocentesis. Is most common with blunt thoracic trauma and anterior rib fractures. Is easily diagnosed by discovery of Beck's triad in the emergency department. Is indicated by Kussmaul breathing. Requires surgical intervention. - ✔✔✔ANSWER-Requires surgical intervention. A 24 year - old man is brought to the Emergency Department after falling from a bull. He is immobilized on a long spine board with a
Frequent abdominal examinations. CT of abdomen and pelvis. - ✔✔✔ANSWER-CT of abdomen and pelvis. A 35 year-old female obese patient, agitated with a Glasgow Coma Scale score of 8 requires to be transferred to have a brain CT Scan. Before transferring to the scanner, which is the main measure you should take care of?: Give more sedative drugs. Insert a multilumen esophageal airway. Insert a definitive airway. Request a lateral cervical spine film. Insert a nasogastric tube. - ✔✔✔ANSWER-Insert a definitive airway. A 37 y/o construction worker is brought to the ED after falling from a 9 meter (30 feet) scaffolding. Heart rate 140, blood pressure 96/ mm Hg, and RR 36. He is complaining of lower abdominal and lower limb pain, and has obvious deformity of both lower legs with bilateral open tibial fractures. Which one of the following statements concerning this patient is CORRECT?:
Pelvic injury can be ruled out based on the mechanism of injury. Blood loss from the lower limbs is the most likely cause of his hypotension. Xrays of the chest and pelvis are important adjuncts in his initial assessment. Spinal cord injury is the most likely cause of his hypotension. Aortic injury is the most likely cause of his tachycardia. - ✔✔✔ANSWER-Xrays of the chest and pelvis are important adjuncts in his initial assessment. A 29 year - old lady in the third trimester of pregnancy is brought to the Emergency Department following a highspeed motor vehicle crash. She is conscious and immobilized on a long spine board. Her respiratory rate is 25, heart rate is 110, and blood pressure is 75/55. The laboratory results show PaC02of 40 mm Hg (5.3 kPa). Which one of the following statements regarding this patient is true?: Fetal assessment should take priority. Logrolling the patient to the right will decompress the vena cava.
Should be treated to reduce intracranial pressure. May indicate imminent herniation from critically high intracranial pressure. Indicates preexisting hypertension. Mandates prompt administration of mannitol. Should prompt burr hole drainage of potential subdural hematomas.
- ✔✔✔ANSWER-Should be treated to reduce intracranial pressure. Regarding frostbite injuries, which of the following measures is part of the initial treatment?: Application of dry heat. Rapid rewarming of the body part in circulating warm water. Debridement of hemorrhagic blisters. Early amputation to prevent septic complications. Massage of the affected area. - ✔✔✔ANSWER-Rapid rewarming of the body part in circulating warm water.
A 31 year - old pregnant lady is brought to the Emergency Department after being involved in a car crash with a hit by a car from behind suffering a blunt trauma. Which of the following statements is CORRECT?: Early gastric decompression is important. A hemoglobin level of 10 g/dL (hematocrit 30) indicates recent blood loss. The central venous pressure response to volume resuscitation is blunted in pregnant patients. A lap belt is the best form of restraint due to the size of the gravid uterus. A PaC02of 40 mmHg (5.3 kPa) provides reassurance about the adequacy of respiratory function. - ✔✔✔ANSWER-The central venous pressure response to volume resuscitation is blunted in pregnant patients. A 19 year - old girl with learning disabilities and severe cervical kyphoscoliosis is brought to the Emergency Department with a GCS of 6. Intubation is performed but you are not completely sure that you are in the airway tract. Which of the following signs is least reliable for diagnosing the esophageal intubation?:
Repeat orotracheal intubation. Perform needle cricothyroidotomy with jet insufflation. - ✔✔✔ANSWER-Perform needle cricothyroidotomy with jet insufflation. A 32 year - old gentleman is brought to the Emergency Department after being assaulted. His chest shows multiple severe bruises. His airway is clear, respiratory rate is 22, HR is 126, and systolic blood pressure is 90 mm Hg. Which of the following should be performed during the primary survey? A Glasgow Coma Score. B Tetanus toxoid administration. C Cervical spine xray. D Blood alcohol level. E Rectal exam. - ✔✔✔ANSWER-A Glasgow Coma Score. A 29 year - old mountaineer is rescued by a medical helicopter and brought to a Trauma Centre due to severe injuries: a forearm fracture, a mid - thigh amputation, and open fracture with bleeding, an unstable pelvic fracture and bilateral femur fractures with obvious deformity. Which one of these injuries should be addressed in the secondary survey?: Forearm fracture.
Mid-thight amputation. Open fracture with bleeding. Unstable pelvic fracture. Bilateral femur fractures with obvious deformity. - ✔✔✔ANSWER- Forearm fracture. An 18 year - old boy is stabbed in the right chest during a gang fight. On arrival to the ED, he is very short of breath. His heart rate is 122 and his blood pressure is 78/47 mm Hg. His neck veins are flat. On auscultation of the chest, there is diminished air entry on the right side, and there is dullness posteriorly on percussion, These findings are most consistent with: Tension pneumothorax. Pericardial tamponade. Hypovolemia from liver injury. Hemothorax. Spinal cord injury. - ✔✔✔ANSWER-Hemothorax.
Immediate needle cricothyroidotomy. Immediate needle thoracentesis. Chest tube insertion. Reassess the position of the endotracheal tube. Obtain a chest xray. - ✔✔✔ANSWER-Reassess the position of the endotracheal tube. (breath sounds were decreased on L - > R mainstem intubation Regarding traumatic brain injury, which of the following statements is CORRECT?: Elevated intracranial pressure will not affect cerebral perfusion. Cerebrospinal fluid cannot be displaced from the cranial vault. Cerebral blood flow is increased when the Pac02 is below 30 mm Hg.
Autoregulation of cerebral blood flow normally occurs between mean arterial pressures of 50 to 150 mm Hg. Hypotonic fluids should be used to limit brain edema in patients with severe head injury. - ✔✔✔ANSWER-Autoregulation of cerebral blood flow normally occurs between mean arterial pressures of 50 to 150 mm Hg. A 22 year - old man is stabbed in the abdomen. He is brought to the Emergency Department where his blood pressure shows 85/60 mm Hg with heart rate of 130, respiratory rate of 25 bpm, and Glasgow Coma Scale score is 14. Neck veins are flat, and chest examination is clear with bilateral breath sounds. Optimal resuscitation should include: Transfusion of fresh frozen plasma and platelets. 500 mL of hypertonic saline and transfusion of packed red blood cells. Resuscitation with crystalloid and packed red blood cells until base excess is normal. Preparation for laparotomy while initiating fluid resuscitation.
Her Glasgow Coma Scale suggests a severe head injury. Her level of consciousness can be solely attributed to elevated blood alcohol. CT Scanning is an important part of neurological assessment. A 2L fluid bolus is indicated. - ✔✔✔ANSWER-CT Scanning is an important part of neurological assessment. (GCS 10 - E3V2M5) Regarding access in pediatric resuscitation, which of the following statements is CORRECT?: Intraosseous access should only be considered after five percutaneous attempts. Cutdown at the ankle is the preferred initial access technique. Internal jugular cannulation is the next preferred option when percutaneous.
Intraosseous cannulation should be the first choice for access. Blood transfusion can be delivered through intraosseous access. - ✔✔✔ANSWER-Blood transfusion can be delivered through intraosseous access. A 32 y/o man is assaulted in a bar. He is immobilized on a spine board. On initial examination, his vital signs are normal, and his Glasgow Coma Scale score is 15. Which of the following is an indication for CT in this patient with possible minor traumatic brain injury?: Presence of hemotympanum. Blood alcohol concentration of 0.16% (160 mg/100 ml). Presence of an isolated 10 cm scalp laceration. Presence of a mandibular fracture. History of assault. - ✔✔✔ANSWER-Presence of hemotympanum. 55 + 28. Regarding supraglottic airway devices, which of the following statements is CORRECT?: Are equivalent to endotracheal intubation. Require neck extension for proper placement.
