ATLS POST TEST
1. The primary indication for transferring a
patient to a higher level trauma center is:
4. Which one of the following statements
regarding patients with thoracic spine injuries is
TRUE?
unavailability of a surgeon or operating room
staff.
multiple system injuries, including severe
head injury.
resource limitations as determined by the
transferring doctor.
resource limitations as determined by the
hospital administration.
widened mediastinum on chest x-ray
following blunt thoracic trauma.
2.
teen-aged bicycle rider is hit by a truck
traveling at a high rate of speed. In the
emergency department, she is actively bleeding
from open fractures of her legs, and has
abrasions on her chest and abdominal wall. Her
blood pressure is 80/50 mm Hg, heart rate is
140 beats per minute, respiratory rate is 8
breaths per minute, and GCS score is 6.
The first step in managing this patient is to:
obtain a lateral cervical spine x-ray.
insert a central venous pressure line.
administer 2 liters of crystalloid solution.
perform endotracheal intubation and
ventilation.
apply the PASG and inflate the leg
compartments.
3.
Contraindication to nasogastric intubation is
the presence of a:
gastric perforation.
diaphragmatic rupture.
open depressed skull fracture.
fracture of the cervical spine.
fracture of the cribriform plate.
Log-rolling may be destabilizing to
fractures from T-12 to L-1.
Adequate immobilization can be
accomplished with the scoop stretcher.
Spinal cord injury below T-10 usually spares
bowel and bladder function.
Hyperflexion fractures in the upper
thoracic spine are inherently unstable.
These patients rarely present with spinal
shock in association with cord injury.
5.
young man sustains a ritle wound to the mid-
abdomen. He is brought promptly to the
emergency department by prehospital
personnel. His skin is cool and diaphoretic, and
his systolic blood pressure is 58 rnm Hg.
Warmed crystalloid fluids are initiated without
improvement in his vital signs. The next, most
appropriate step is to perform:
a celiotomy.
an abdominal CT scan.
diagnostic laparoscopy.
abdominal
ultrasonography.
a diagnostic peritoneal lavage.
6.
young woman sustains a severe head injury
as the result of a motor vehicular crash. In the
emergency department, her GCS score is 6. Her
blood pressure is 140/90 mm Hg and her heart
rate is 80 beats per minute. She is intubated and
is being 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:
administer an osmotic diuretic.
prevent secondary brain injury.
