ATLS 10 Post-Test Exam QUESTIONS ,CORRECT DETAILED, Exams of Nursing

Download ATLS 10 Post-Test Exam QUESTIONS ,CORRECT DETAILED and more Exams Nursing in PDF only on Docsity! QUESTIONS AND ANSWERS Exam ATLS 10 Post-Test Exam QUESTIONS ,CORRECT DETAILED ANSWERS (|ALREADY GRADED A+) AND RATIONALE TESTED AND CONFIRMED A+ ANSWERS 1. A 24-year-old male pedestrian, struck by an automobile, is admitted to the emergency department 1 hour after injury. His blood pressure is 80/60 mmHg, heart rate 140 beats per minute and respiratory rate is 36 per minute. He is lethargic. Oxygen is delivered via face mask, and two large-caliber IVs are initiated. Arterial blood gases are obtained. His PaO2 is 118 mmHg (15.7 kPa), PaCO2 is 30 mmHg (4.0 kPa), and pH is7.21. The treatment of his acid-base disorder is best accomplished by: a. Hyperventilation b. Restoration of normal perfusion c. Initiation of low-dose dopamine d. Administration of sodium bicarbonate e. Initiation of phenylepinephrine infusion 2. The highest priority in managing a patient whose injuries include closed extremity fractures is: a. Assesing limb perfusion b. Preventing necrosis of the skin c. Decompressing compartment syndrome d. Addressing respiratory insufficiency Identifying crush syndrome 3. A 34-year-old female is involved in a motor vehicle crash is brought to the emergency department. She is talking, but her voice is hoarse and on exposure she has diagonal bruising of the chest and anterior neck. What is the next step? a. Direct laryngoscopy to exclude laryngeal trauma b. Oxygen by non-rebreathing mask c. Protecting the spine by making her lie down d. Palpation of the anterior neck e. Attaching a pulse oximeter to her finger 4. 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 hospitalthat has full surgical capabilities. In the emergency department he is endotracheally intubated, fluid resuscitation is initiated through two large-caliber IV lines, and a d. Treat the greatest number of patients in the shortest period of time e. Produce the greatest number of survivors based on available resources 12. A 35-year-old female falls down a flight of stairs. She has extensive bruising of her face and head. Her heart rate is 120, blood pressure 90/70 mmHg, and respiratory rate is 26. The patient`s condition is most readily explained by: a. Associated head injury b. Hypovolemia from hemorrhagic shock c. Alcohol intoxication d. Spinal shock from cervical spine injury e. Neurogenic shock from cervical spine injury 13. Which one of the following statements is 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 scan e. The associated brain damage is more severe in epidural hematomas 14. An 18-year-old is brought to the emergency department after having been 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 mmHg, heartrate is 90 beats per minute, and respiratory rate is 34 breaths per minute. After ensuring a patent airway and inserting two large-caliber IV lines, the next appropriate step is to: a. Obtain a portable chest x-ray b. Administer a bolus of additional IV fluid c. Perform a laparotomy d. Obtain an abdominal CT scan e. Perform diagnostic peritoneal lavage 15. Which one of the following statements is true concerning cranial anatomy relatedto traumatic injury? a. A scalp laceration is an unlikely source of bleeding in a patient with a long transport time. b. The meninges are comprised of the dure, pia, and arachnoid. c. The middle meningeal artery lies between the dura and pia mater. d. Effacement or shift of the ventricles occurs commonly with concussions. e. A dilated pupil is produced when the sympathetic nerve fibers located on the third cranial nerve are compressed by the temporal lobe. 16. A 47-year-old house painter is brought to the hospital after falling 6 meters (20 feet) from a ladder and landing straddling a fence. Examination of his perineum reveals extensive ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study for evaluation of the urinary tract in this patent should be: a. Cystoscopy b. Cystography c. Intravenous pyelography d. CT scan e. Retrograde urethrography 17. Which of the following statements is true? a. The laryngeal mask airway is an infraglottic device. b. The multilumen esophageal airway occludes the supraglottic lumen and ventilates through the port placed distal to the vocal cords. c. The nasopharyngeal airway is an ideal supraglottic device for patients with cribiform plate fractures. d. Nasotracheal tubes position a cuffed airway in the infraglottic space. e. Tracheostomy tubes are placed in apneic, hypoxic patients in the supraglottic space. 18. Neurogenic shock has all of the following characteristics except which? a. Hypotension b. Vasodilation c. Bradycardia d. Neurologic deficit e. Narrowed pulse pressure 19. Which one of the following statements concerning spinal cord trauma is true? a. A normal lateral c-spine film excludes injury. b. A vertebral fracture or dislocation is unlikely in the absence of physical findings of spinal cord injury. c. A patient should remain on a long board until injury is excluded radiographycally. d. Diaphragmatic breathing in an unconscious patient whi has fallen may Tangential excision 23. A 30-year-old male presents following a motor vehicle crash. Vital signs are respiratory rate 18, heart rate 88, blood pressure 130/72 mmHg, and Glascow Coma Scale score 13. Laparotomy is indicated when: a. There is a distinct seat-belt sign over the abdomen b. The CT scan demonstrates a grade 4 hepatic injury c. There is evidence of residual hemothorax after chest tube placement d. CT demonstrates retroperitoneal air e. CT demonstrates a retroperitoneal hematoma 24. All of the following are signs of aortic rupture on chest x-ray of a patient who sustained a blunt decelerating traume except which one? a. Mediastinal emphysema b. Presence of a pleural cap c. Obliteration of the aortic knob d. Deviation of the trachea to the right e. Depression of the left mainstem bronchus 25. A 30-year-old female is brought to the hospital after a fall from her bicycle. She was initially unconscious and then regained consciousness en route to the hospital. Thirty minutes after admission to the emergency department, her Glasoc Coma Scale score decreases to 6. her right pupil is larger than the left. She most likely has sustained: a. A subdural hemorrhage b. An epidural hemorrhage c. An occipital hemorrhage d. A subarachnoid hemorrhage e. An intracerebellar hemorrhage 26. You are treating a trauma patient and attempt a definitive airway by intubation. However, the vocal cords are not visibile. What tool would be the most valuablefor achieving uccessful intubation? a. Gum elastic bougie b. Lateral cervical spine x-ray c. Nasopharyngeal airway d. Oxygen e. Esophageal obturator airway 27. A 79-year old female is involved in a motor vehicle crash and presents to the emergency department. She is on warfarin (Coumadin®) and a beta blocker. Which of the following 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. Nonoperative management of abdominal injuries is more likely to be successful in older adults than in younger patients. d. Vigorous fluid resuscitation may be associated with cardiopulmonary failure. e. Epinephrine should be infused immidiately for hypotension. 28. A 22-year-old male is brought by ambulance to a small community hospital after falling from the top of a 2.4-meter (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 AP portable chest x- ray 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. The patient remains hemodynamically normal with no signs of respiratory distress. The most likely cause for his persistent right pneumothorax is: a. Flail chest b. Diaphragmatic injury c. Pulmonary contusion d. Esophageal perforation e. Tracheobronchial injury 29. A 22-year-old female who is in the third trimester of pregnancy presents following a motor vehicle crash. Paramedics report vaginal bleeding. What is the next 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. e. Insert a wedge under the patient´s right hip. 30. A 40-year-old male is brought to the emergency department after a fall from a heightof just over 3 meters (10 feet). His airway is clear, respiratory rate is 28, and systolicblood pressure is 140 mmHg. There is equal air entry on both sides of the chest, with comparable percussion sounds bilaterally. He complains of pain on palpation of the chest. Which intervention is most likely needed? a. Needle decompression of the chest b. Pericardiocentesis c. Pain management d. Thoracotomy e. Tube thoracostomy 31. A construction worker falls from a scaffold and is transferred to the emergency department. His heart rate is 124, and blood pressure is 85/60 mmHg. He complains of lower abdominal pain. After assessing the airway and chest, restricting cervical spinal motion, 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 32. A 22-year-old male sustains a shotgun wound to the left shoulder and chest at close range. His blood pressure is 80/40 mmHG, and his heart rate is 130 beats per minute. Fluid resuscitation is initiated, his blood pressure increases to 122/84 mmHg, and heart rate decreases to 100 beats per minute. He is tachypneic, with a respiratory rate of 28 breaths per minute. On physical examination, his breath sounds are decreased atthe left upper chest with dullness on percussion. A thoracostomy tube is inserted in the fifth intercostal space, with the return of 250 mL of blood and no air leak. The most appropriate next step is to: a. Insert a Foley catheter b. Begin to transfuse O-negative blood c. Perform thoracotomy