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2025 ATLS PRETEST, FINAL EXAM AND PRACTICE
EXAM/UPDATED 350Qs&As|100%
VERIFIED|A+GRADE
A trauma client presents to your emergency departmentwith inspiratory stridor and a suspected c-spine injury. Oxygen saturation is 88% on high-flow oxygen via a nonrebreathing mask. The most appropriate next step is to: - ...ANS:->>>restrict cervical motion and establish adefinitive airway When applying the Rule of Nines to infants: - ...ANS:->>>The head is proportionally larger in infantsthan in adults. A healthy young male is brought to the emergency department following a motor vehicle crash. His vital signs are a blood pressure of 84/60, pulse 123, GCS 10. The client moans when his pelvis is palpated. After initiating fluid resuscitation, the next step in management is: - ...ANS:->>>placement of a pelvic binder Which one of the following situations requires Rh immunoglobulin administration to an injured woman? - ...ANS:->>>positive pregnancy test, Rh negative, and hastorso trauma A 22 - year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the emergency department and 15 minutes after the incident, she is awake and alert. Her heart rate is 100 beats per minute, blood pressure 80/60 mm Hg, and respiratory rate 20 breaths per minute. A chest x-ray reveals a large left hemothorax. A left chest tube is placed with an immediate return of 1600 mL of blood. The next management step for this client is: - ...ANS:->>>prepare for an exploratory thoracotomy A 6-year-old boy walking across the street is struck by the front bumper of a sports utility vehicle traveling at 32 kph (20 mph). Which one of the following statements is TRUE about this client? - ...ANS:->>>A pulmonary contusion may be present in the absence of rib fractures. When something crashes in secondary survey, you... - ...ANS:->>>GO BACK TO PRIAMRY SURVEY If the question says you do not have capabilities, you will most likely - ...ANS:-
PREPARE FOR AND DO NOTDELAY TRANSPORT How much blood can femur lose - ...ANS:->>>2L What is always going to be the shock type to pick - ...ANS:->>>Hemorrhagic What are the classes of hemorrhagic shock -
Verbal spont is 5 Verbal confused is 4Inappropriate 3 Garbling is 2 None is 1 Motor spont is 6 Localize pain is 5 Withdrawal pain is 4 Decorticating (flexion) is 3Decebrate (extension) is 2 None is 1 Two main reasons to think about why GCS goes down? - ...ANS:->>>TBI Hemorrhagic shock Why do you want to put in chest tube before needle decompression? - ...ANS:-
SIMPLE PTX can turn intoTENSION PTX When is DPL useful over fast? - ...ANS:->>>Noultrasound available. What is LEMON for airway patency - ...ANS:->>>LookEvaluate Malay-ATI Obstruction Neck mobility
What is DEFINITIVE airway? - ...ANS:->>>Tube intrachea BELOW vocal cords WHEN is surgical airway indicated? - ...ANS:->>>Whenyou CANNOT do any other form of airway (2 attempts typically) What is contraindicated with suspicion of basilar skull frx? - ...ANS:->>>OPA, put in gastric tube for suction because itcan go through up into cranium thru cribiform plate Peds kid with bicycle trauma is most likely goin to be? - ...ANS:->>>PANCREATIC injury Organ tear is more common with? - ...ANS:->>>Penetrating injury What type of pelvic fracture is binder indicated in - ...ANS:->>>Open book If there is BLOOD at the meatus, then what do you need to do? - ...ANS:->>>RUG first, because if you do a cyst gramyou will be spilling into the abd cavity If client is unstable, free air/blood on CT, peritoneal signsyield what? - ...ANS:-
Apical capping and widened mediastinum are reflective ofwhat? - ...ANS:-
Aortic trauma Circumferential burn? - ...ANS:->>>Escharotomy What is main goal of priamry brain injury? - ...ANS:->>>Preventing secondary brain injury 2 big causes of secondary brain injury? - ...ANS:->>>HYPOVOLEMIA and HYPOXEMIA SIMPLE PTX can turn intoTENSION PTX When is DPL useful over fast? - ...ANS:->>>Noultrasound available. What is LEMON for airway patency - ...ANS:->>>LookEvaluate Malay-ATI Obstruction Neck mobility What is DEFINITIVE airway? - ...ANS:->>>Tube intrachea BELOW vocal cords WHEN is surgical airway indicated? - ...ANS:->>>Whenyou CANNOT do any other form of airway (2 attempts typically) What is contraindicated with suspicion of basilar skull frx? - ...ANS:->>>OPA, put in gastric tube for suction because itcan go through up into cranium thru cribiform plate Peds kid with bicycle trauma is most likely goin to be? - ...ANS:->>>PANCREATIC injury Organ tear is more common with? - ...ANS:->>>Penetrating injury What type of pelvic fracture is binder indicated in - ...ANS:->>>Open book If there is BLOOD at the meatus, then what do you need to do? - ...ANS:->>>RUG first, because if you do a cyst gramyou will be spilling into the abd cavity If client is unstable, free air/blood on CT, peritoneal signsyield what? - ...ANS:- Apical capping and widened mediastinum are reflective ofwhat? - ...ANS:- >>>Aortic trauma Circumferential burn? - ...ANS:->>>Escharotomy What is main goal of priamry brain injury? - ...ANS:->>>Preventing secondary brain injury 2 big causes of secondary brain injury? - ...ANS:->>>HYPOVOLEMIA and HYPOXEMIA Girl falls on her head, loses consciousness, and is nowunstable. What kind of Noultrasound available. What is LEMON for airway patency - ...ANS:->>>LookEvaluate Malay-ATI Obstruction Neck mobility What is DEFINITIVE airway? - ...ANS:->>>Tube intrachea BELOW vocal cords WHEN is surgical airway indicated? - ...ANS:->>>Whenyou CANNOT do any other form of airway (2 attempts typically) What is contraindicated with suspicion of basilar skull frx? - ...ANS:->>>OPA, put in gastric tube for suction because itcan go through up into cranium thru cribiform plate Peds kid with bicycle trauma is most likely goin to be? - ...ANS:->>>PANCREATIC injury Organ tear is more common with? - ...ANS:->>>Penetrating injury What type of pelvic fracture is binder indicated in - ...ANS:->>>Open book If there is BLOOD at the meatus, then what do you need to do? - ...ANS:->>>RUG first, because if you do a cyst gramyou will be spilling into the abd cavity If client is unstable, free air/blood on CT, peritoneal signsyield what? - ...ANS:- Apical capping and widened mediastinum are reflective ofwhat? - ...ANS:- >>>Aortic trauma Circumferential burn? - ...ANS:->>>Escharotomy What is main goal of priamry brain injury? - ...ANS:->>>Preventing secondary brain injury 2 big causes of secondary brain injury? - ...ANS:->>>HYPOVOLEMIA and HYPOXEMIA Girl falls on her head, loses consciousness, and is nowunstable. What kind of hematoma is this? - ...ANS:->>>EPIDURAL, lucid interval is commonbetween time of injury and presentation What is more common, subdural or epidural -
...ANS:->>>Subdural What is considered mid TBI? - ...ANS:->>> 13 - 15 T/o secondary management of mild TBI? - ...ANS:->>>CTrepeat if first is abnormal OR GCS persists at under 15.
Serial exams Initial management of TBI? - ...ANS:->>>elevate headNS (3%) Indications of transport to higher Level of care with TBI? - ...ANS:->>>Worsening GCS, GCS <8. Lesions on CT Above what level can you get neurogenic shock - ...ANS:->>>T Description of neurogenic shock client? - ...ANS:->>> What is bulbovesicular reflex indicative of? - ...ANS:->>>NOT qualify as sacral sparing. If there is ANY motor or sensory function below level ofinjury, constitutes as incomplete injury and should be documented appropriately T/F: Stridor is LATE finding of airway damage in burn pt? - ...ANS:->>>TRUE Initial management of burn? - ...ANS:->>>DRY dressing.NOT moist!
of 2 liters. Which one of the following statements applies to this client? - ...ANS:->>>An ABG would demonstrate a base deficitbetween - 6 and - 10 mEq/L. The physiological hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by: - ...ANS:->>>increasing the volume ofblood loss to produce maternal hypotension The best assessment of fluid resuscitation of the adult burn client is: - ...ANS:-
urinary output of 0.5 mL/kg/hr The diagnosis of shock must include: - ...ANS:->>>evidence of inadequate organ perfusion A 7 - year-old boy is brought to the emergency department byhis parents several minutes after he fell through a window. He is bleeding profusely from a 6-cm wound of his medialright thigh. Immediate management of the wound should consist of: - ...ANS:->>>direct pressure on the wound For the client with severe traumatic brain injury, profoundhypocarbia should be avoided to prevent: - ...ANS:->>>cerebral vasoconstriction with diminishedperfusion
After being involved in a motor vehicle crash, a 25-year-oldman is brought to a hospital that has surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg afterCT. The next step is: - ...ANS:->>>perform an exploratorylaparotomy Which one of the following statements regarding abdominaltrauma in the pregnant client is TRUE? - ...ANS:->>>Leakage of amniotic fluid is an indication forhospital admission. The first maneuver to improve oxygenation after chest injury is: - ...ANS:-
administer supplemental oxygen A 25-year-old man, injured in a motor vehicular crash, isadmitted to the emergency department. His pupils react
motor vehicle crash. On arrivalin the emergency department he is diaphoretic and complaining of chest pain. His blood pressure is 60/40 mmHg and his respiratory rate is 40 breaths per minute. Which of the following best differentiates cardiac tamponade fromtension pneumothorax as the cause of his hypotension? - ...ANS:->>>breath sounds Bronchial intubation of the right or left mainstem bronchuscan easily occur during infant endotracheal intubation because: - ...ANS:->>>The trachea is relatively short. A 23-year-old man sustains 4 stab wounds to the upper rightchest during an altercation and is brought by ambulance to ahospital that has full surgical capabilities. His wounds are allabove the nipple. He is endotracheally intubated, closed tubethoracostomy is performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and respiratory rate is14 breaths per minute (ventilated with 100% O2). 1500 mL of blood has drained from the right chest. The most appropriate next step in managing this client is to: - ...ANS:->>>urgently transfer the client to the operatingroom A 39 - year-old man is admitted to the emergency departmentafter an automobile collision. He is cyanotic, has insufficientrespiratory effort, and has a GCS score of 6. His full beard makes it difficult to fit the oxygen facemask to his face. The most appropriate
next step is to: - ...ANS:->>>restrict cervical motion and attempt orotracheal intubation using 2 people A client is brought to the emergency department after a motor vehicle crash. He is conscious and there is no obvious external trauma. He arrives at the hospital completely immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. Hisskin is warm. Which one of the following statements is TRUE? - ...ANS:->>>Flaccidity of the lower extremitiesand loss of deep tendon reflexes are expected. Which one of the following is the most effective method forinitially treating frostbite? - ...ANS:->>>moist heat A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he is extricated. Onarrival in the emergency department, his right lower extremity is cool, mottled, insensate, and motionless. Despite normal vital signs, pulses cannot be palpated belowthe right femoral artery and the muscles of the lower extremity are firm and hard. During the management of this client, which of the following is most likely to improve thechances for limb salvage? - ...ANS:->>>surgical consultation for right lower extremity fasciotomy A client arrives in the emergency department after being beaten about the head and face with a wooden club. He is comatose and has a palpable depressed skull fracture. His face
Hemorrhage of 20% of the client's blood volume isassociated usually with: - ...ANS:->>>tachycardia Which one of the following statements concerning intraosseous infusion is TRUE? - ...ANS:->>>Aspirationof bone marrow confirms appropriate positioning of the needle. A young woman sustains a severe head injury as the result of a motor vehicle crash. In the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is intubated and mechanically ventilated. Her pupils are 3 mm in size and equally reactive to light. There is no other apparent injury.The most important principle to follow in the early management of her head injury is to: - ...ANS:-
avoidhypotension A 33 - year-old woman is involved in a head-on motor vehicle crash. It took 30 minutes to extricate her from the car. Upon arrival in the emergency department, her heart rate is 120 beats per minute, BP is 90/70 mm Hg, respiratoryrate is 16 breaths per minute, and her GCS score is 15. Examination reveals bilaterally equal breath sounds, anteriorchest wall ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not tender. Her pelvis is stable. Palpable distal pulses are found in all 4 extremities. Of thefollowing, the most likely diagnosis is: -
...ANS:->>>cardiac tamponade A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III (moderately severe) splenicinjury has been confirmed by computed tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)? - ...ANS:-
development of peritonitis onphysical exam A 40-year-old woman who was a restrained driver in a motor vehicle crash is evaluated in the emergency department. She is hemodynamically normal and found to be paraplegic at the level of T10. Which of the following aretrue regarding her evaluation and management? - ...ANS:->>>Log rolling using 4 people is a safe approachto restrict spinal motion when moving her. What is dark urine reflective of in burn pt? - ...ANS:->>>RHABDO What do you constantly need to replenish burn pt? - ...ANS:->>>Cellular losses 2/2 inflammation What is GOAL urine output in burn? - ...ANS:->>> 3 - 50mL per hour, BEST
abscess Most common cause of laryngotracheal stenosis - ....ANS:->>>Trauma Intervention that can help prevent development of acuterenal failure - ....ANS:-
Infusion of normal saline A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was complicated by a fractured pelvis. A few hours later, the client becomes febrile, hypotensive with a normal CVP, and oliguric. Uponexamination, the client is found to be bleeding from the NG tube and IV sites. Which of the following is the most likely diagnosis?
A. Hemorrhagic shock
B. Acute adrenal insufficiencyC. Fat
embolism syndrome D. Transfusion reaction - ....ANS:->>>D. Transfusionreaction Skin antiseptic - ....ANS:->>>-Ethanol 70% is an effectiveskin antiseptic
- Acetic acid can be used to treat Gram- skin infections
- Salicylic acid is used to treat certain skin yeast infections Class IV hemorrhage indicates what % blood loss -
....ANS:->>>55%
How does shivering affect body temperature - ....ANS:->>>Increases body temperature Class III hemorrhage indicates what % of blood loss - ....ANS:->>>35% Management of a stable client with kidney contusion - ....ANS:->>>Observation Associated with hypovolemic shock - ............................ ANS:->>>- Inadequate tissue perfusion with resultant tissue hypoxia
- Blood shunting to vital organs
- Decreased circulating blood volume and decreased venousreturn
- Low cardiac output
- Loss of less than 20% of the blood volume is usuallywithout symptom except for mild tachycardia
- Clients become orthostatic with losses between 20 and 40%
- Shock is evidenced by tachycardia, hypotension, oliguria,flat neck veins The most effective method of monitoring the success of resuscitation during CPR?
- ....ANS:->>>Reactivity ofpupils to light
