ATLS Nursing Exam Practice Questions and Answers, Exams of Nursing

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Hemostatic agents applied directly to the source of bleeding must be used in conjunction with:

A. direct pressure to the wound

B. tourniquets proximal to the wound

C. pressure points to arteries proximal to the wound

D. elevation of the wound above the level of the heart - Correct Ans:

✔✔A. direct pressure to the wound

Which assessment tool(s) may assist in predicting patient deterioration for someone who otherwise appears stable?

A. Serum lactate levels

B. Blood sugar levels

C. Abdominal ultrasound

D. A&C - Correct Ans: ✔✔D. A&C

You have a patient with an isolated stab wound to the lateral chest. According to recent studies, which of the following procedures should be avoided?

A. Assisting ventilations

B. Supplemental oxygen

C. Occlusive dressing

D. Spinal motion restriction - Correct Ans: ✔✔D. Spinal motion restriction

The "Golden Period" begins:

A. at the time of injury

B. at the time your unit is dispatched

C. when your unit arrives on scene

D. when your unit leaves the scene for the hospital - Correct Ans:

✔✔A. at the time of injury

Pulsus paradoxus is best described by which of the following?

A. The radial pulse disappears upon inspiration

B. The radial pulse is absent

C. The radial pulse is stronger than the carotid pulse

D. There are unequal radial pulses - Correct Ans: ✔✔A. The radial pulse disappears upon inspiration

You respond to an adult patient who has a respiratory rate of 36 per minute, end tidal carbon dioxide level of 30 mmHg and an oxygen saturation of 80%. You should administer

oxygen via:

A. Non-rebreather mask at 12 liters per minute

B. Nasal cannula at 6 liters per minute

C. Venturi mask at 40%

Which one of the following mnemonics can be used to help predict which patients might potentially have difficult bag mask ventilation?

A. MMAP

B. IPPV

C. RSI

D. BOOTS - Correct Ans: ✔✔D. BOOTS

B=Beard

O=Obese

O=Old age

T=Toothless

S=Snoring

A 23 year old female has won the "Let's-see-who-can-lean-the- farthest-backward-over- the-second-story-balcony-railing" contest. You arrive to find her boyfriend standing over her, holding two beers, as she lies on the grass under the balcony. She opens her eyes to voice, her skin is normal in color, respirations about 16 and unlabored, pulse 54 and a little weak at the wrist, with no external bleeding. She has flat neck veins, a normal chest and abdomen and a stable pelvis. First responders who arrived just before you, tell you that her pulse ox reading is 94 and her blood pressure is 74/30. What type of shock is present?

A. Hypovolemic shock

B. Relative hypovolemic (high-space) shock

C. Mechanical (obstructive) shock

D. Cardiogenic shock - Correct Ans: ✔✔B. Relative hypovolemic (high-space) shock

As intracerebral pressure rises, after an isolated head injury, what does the systolic blood pressure do?

A. Stays the same

B. Decreases

C. Increases

D. Changes randomly - Correct Ans: ✔✔C. Increases

Definitive control of the airway is achieved by ____________ -

Correct Ans: ✔✔Endotracheal intubation

How do you treat hypothermia in the ED? - Correct Ans:

✔✔crystalloid fluids at 102.2 degrees F and warmed treatment area

What does definitive hemorrhage control refer to?

(3) - Correct Ans: ✔✔1) Possible surgery

2. Stabilizing of pelvis

3. Angioembolization

What are rates of fluid administration measured by? - Correct Ans:

✔✔Size and length of catheter

Minimum flow rate of oxygen reservoir mask - Correct Ans: ✔✔ 11 L/min

What does the Monro Kellie doctrine describe? - Correct Ans:

✔✔The relationship between IC volume and pressure

Normal resting ICP - Correct Ans: ✔✔10 mm Hg

How do you reduce elevated ICP? - Correct Ans: ✔✔Mannitol in a 20% solution

How do you temporarily control pelvic hemorrhage and instability? -

Correct Ans: ✔✔Internal traction and external counter-pressure

How do you initially manage major arterial injury? - Correct Ans:

✔✔Direct pressure and fluid resuscitation

Full thickness burn - Correct Ans: ✔✔Third degree burn

What is used to estimate the size and depth of burns? - Correct Ans:

✔✔Rule of 9's

Head= 9%

Each arm=9%

Front Trunk= 18%

Back Trunk= 18%

Upper leg= 9%

Lower leg= 9%

What type of burns appear wet and blistered? - Correct Ans:

✔✔Partial thickness burns (second degree)

How do you treat CO exposed pt? - Correct Ans: ✔✔100% oxygen flow through non re-breather mask

What is a reliable measure of circulating blood volumes in burn

patients? - Correct Ans: ✔✔Hourly urine output

Goal= 0.5-1.0 ml/kg body weight

Hospital admission criteria for burn pt

(8) - Correct Ans: ✔✔1) Partial-thickness burns greater than 10% total BSA (TBSA)

2. Full-thickness burns greater than 2% TBSA

3. Burns involving the face, hands, genitalia, perineum, or major joints

4. Circumferential extremity burns

5. All high-voltage electrical burns, including lightning injury-- Admission of low-voltage electrical burns is selective

6. Chemical burns

7. Inhalation injury

8. Burn injuries in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality (eg, diabetes, immunosuppression)

A. A method allowing the rescuer to hold a mask on the face with both hands

B. A system used to calculate minute volume

C. Another name for Mallampati

D. Posteriorly directed pressure applied to the cricoid cartilage -

Correct Ans: ✔✔D. Posteriorly directed pressure applied to the cricoid cartilage

A 16 year old girl is rescued from a burning house. She has 25% partial thickness burns, and the burned areas are hot to the touch. What is the appropriate treatment?

A. Apply ice to burned areas until cool to touch

B. Apply clean water to burned areas for up to 1-2 minutes

C. Apply iced water to burned areas until cool to touch

D. Do not apply anything to burned areas other than clean sheets -

Correct Ans: ✔✔B. Apply clean water to burned areas for up to 1- minutes

What treatment is NOT indicated in the routine management of the patient with a head injury?

A. Administration of 100% oxygen

B. Fluid resuscitation to a BP of 110-120 systolic if the patient is hypotensive

C. Hyperventilating to obtain an EtCO2 of less than 30

D. Stabilization of the cervical spine - Correct Ans: ✔✔C. Hyperventilating to obtain an EtCO2 of less than 30

Which of the following sets of vital signs is most compatible with a diagnosis of isolated head injury with increasing intracranial pressure?

A. BP 170/100, pulse 50/min

B. BP 80/60, pulse 130/min

C. BP 80/60, pulse 50/min

D. BP 170/100, pulse 130/min - Correct Ans: ✔✔A. BP 170/100, pulse 50/min

Which one of the following is a reason to interrupt the initial assessment?

A. Cardiac arrest

B. Multiple open (compound) fractures

C. Severe head injury with brain tissue visible

D. Severe shock - Correct Ans: ✔✔A. Cardiac arrest

What site is the first choice for intraosseous infusion?

A. Proximal tibia

B. Distal humerus

C. Proximal femur

D. Distal fibula - Correct Ans: ✔✔A. Proximal tibia

A 34 year old man has a gunshot wound to the right groin area. Arterial bleeding, which cannot be controlled with direct pressure, is

Which of the following is most typical of early, neurogenic shock?

A. Increased pulse, clammy skin

B. Increased pulse, warm and dry skin

C. Decreased pulse, clammy skin

D. Decreased pulse, warm and dry skin - Correct Ans: ✔✔D. Decreased pulse, warm and dry skin (skin is warm due to vasodilation)

Which of the following is an acceptable location to insert a needle when decompressing a

tension pneumothorax?

A. Directly under the bottom of the second rib, midclavicular line

B. Directly under the bottom of the third rib, midclavicular line

C. Directly over the top of the fourth rib, midaxillary line

D. Directly over the top of the third rib, midclavicular line - Correct

Ans: ✔✔D. Directly over the top of the third rib, midclavicular line

What is the most common cause of cardiopulmonary arrest in the trauma patient?

A. Brain injury

B. Hypoxemia

C. Myocardial contusion

D. Ventricular arrhythmia - Correct Ans: ✔✔B. Hypoxemia

A 49 year old man is involved in a motor vehicle collision. First responders are doing CPR. Findings include a distended abdomen and obviously deformed pelvis and a quick look at the monitor shows asystole. Which of the following is the most appropriate act?

A. Establish intravenous access and administer a 20mL/kg bolus

B. Establish intravenous access and administer a 1 liter bolus

C. Establish intravenous access and administer a 2-4 liter bolus

D. Resuscitative efforts should not be started and the patient

pronounced dead - Correct Ans: ✔✔D. Resuscitative efforts should not be started and the patient pronounced dead

Which of the following statements concerning treatment of shock in the pregnant, burn patient is TRUE?

A. Oxygen should be used sparingly so as to avoid oxygen toxicity to the fetus

B. Pressor agents such as dopamine should be used to improve circulation to the fetus

C. Volume replacement should be given earlier and in larger amounts to the pregnant, burn patient

D. Volume replacement should be given more slowly so as to avoid

fluid overloading the fetus - Correct Ans: ✔✔C. Volume replacement should be given earlier and in larger amounts to the pregnant, burn patient

Which area of the spine is most susceptible to injury in a rear-impact motor vehicle crash?

A. Cervical

Which of the following may affect the reliability of a pulse oxymetry reading?

A. Cyanide poisoning

B. High ambient light

C. Carbon monoxide poisoning

D. All of the above - Correct Ans: ✔✔D. All of the above

Which of the following conditions is your FIRST priority in management of a trauma patient?

A. Open the airway and assess for breathing

B. Provide ventilator support for your patient

C. Control major external bleeding

D. Begin chest compressions if pulses are absent - Correct Ans:

✔✔C. Control major external bleeding

Not sure why this is the answer since we were taught Airway is first but okay...

In the absence of herniation syndrome, adult head injured patients should be:

A. ventilated at a rate of 8-10 per minute

B. ventilated at a rate of 12-14 per minute

C. ventilated at a rate of 16-18 per minute

D. ventilated at a rate of 20 per minute - Correct Ans: ✔✔A. ventilated at a rate of 8-10 per minute

Tourniquet application should be limited to less than:

A. 1 hour

B. 2 hours

C. 3 hours

D. 4 hours - Correct Ans: ✔✔B. 2 hours