ATLS POST TEST LATEST VERSIONS REAL EXAM 160 QUESTIONS AND CORRECT ANSWERS GRADE A PASS, Exercises of Nursing

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ATLS POST TEST LATEST VERSIONS REAL EXAM

160 QUESTIONS AND CORRECT ANSWERS GRADE

A PASS 2024- 2025

A 23-year-old man is brought immediately to the ED from the hospitals parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconsious and has no detectable blood pressure. Optimale immediate management is to: A. Perform a FAST B. Initiate infusion of packed red blood cells C. Insert a nasogastric tube and urinary catheter D. Transfer the patient to the operating room, while initiating fluid therapy E. Initiate fluid therapy to return his blood pressure to normotensive - D. Transfer the patient to the operating room, while initiating fluid therapy A 22 year old male present following a motorcycle crash. He complains of the inability to move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His management should be: A: 1L of iv. crystalloid and two units of pRBCs B. 1L of iv. crystalloid, mannitol and iv steroids C. 1 unit of albumin and compression stockings D. Vasopressors and laparotomy E. 1 L of cystalloid and vasopressors if blood pressure does not respond - E. 1 L of cystalloid and vasopressors if blood pressure does not respond Which of the following is MOST RELIABLE to confirm endotracheal intubation? a. presence of breath sounds bilaterally b. absence of borborygmi in the epigatrium on ascultation c. presence of CO2 in exhaled air via capnography d. appearance of fog in the endotracheal tube e. chest xray with endotracheal tube tip appearing above the carina - e. chest xray with endotracheal tube tip appearing above the carina A 6 month old infant, being held in her mothers arms, is ejected on impact from a vehicle that is struck head on by an oncoming car traveling at 64kph. The infant arrives in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress. Respiratory support is not effective using a bag mask device, and her oxygen saturation is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most appropriate procedure to perform next is: A.Administer heliox and racemic epinephrine B. Perform nasotracheal intubation

C.Perform surgical cricothyroidotomy D.Repeat orotracheal intubation E. Perform needle cricothyroidotomy with jet insufflation - E. Perform needle cricothyroidotomy with jet insufflation A 28 year olf male is brought to the ED. He was involved in a fight, during which he was beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear, resp rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the following should be performed during the primary survey a. glasgow coma b. tetanus status c. cervical spine xray d. blood alcohol level e. rectal exam - a. glasgow coma A 15 year old is brought to the ED after being involved in a MVA. He was intubated by emergency medical personnal with subsequent bilateral breath sounds per their report. Upon arrival to the ED the patients O2 saat is 92%, heart 96, and blood pressure 150/85. Breath sounds are decreased in the left side of the thorax. The next step is a. immediate needle cricothyroidotomy b. immediate needle thoracentesis c. chest tube insertion d. reassess the position of the endotracheal tube e. obtain a chest CT - d. reassess the position of the endotracheal tube an 18yo male is brought to the emergency department after being dumped by a large wave while surfing. He landed head first on the firm beach sand. His vital signs are blood pressure 85/60 mmHg, heart rate 60, and respiratory rate 18; he is unable to move his lower extremities. He appears calm and asks if he will ever walk again. The most appropriate next step is to: a. reassure patient that he will walk again b. proceed to a more detailed neuro exam c. obtain c spin xrays d. begin infusion of vasopressors e. begin bolus of warm IV crystalloid - e. begin bolus of warm IV crystalloid Whic one of the following statements is true regarding access in pediatric resuscitation? a. intraosseous access should be considered only after 5 percutaneous attempts b. cutdown at teh ankle is the preferred initial access technique

a. pelvic injury can be ruled out, based on the MOI b. blood loss from the lower limbs is the most likely cause of his tachycardia c. xrays of the patient chest and pevlic are important adjuncts in the inital assessment d. spinal cord injury is the most likely cause of hypotension e. aortic injury is likely - c. xrays of the patient chest and pevlic are important adjuncts in the inital assessment 25 yo female in the third trimester of preganacy is brought to the ED following a high speed MVA. She is conscious, and her vital signs are RR 16, HR 120, BP 70/50. The laboratory results show a PaCO2 of 50mmHg/5.3kPa (normal range 35-45). Which one of the following statments concerning this patient is true? a. fetal assessment should take priority b. logrolling the patient to the right will decompress the vena cava c. Rh immuno therapy sshould be immediately adminstered d. normal PaCO2 is concerning for impending RR e. vasopressors should be given to the patient - d. normal PaCO2 is concerning for impending RR a 30 year old male is stabbed in the right chest. on arrival in the ED he is very short of breath. His heart rate is 120, and blood pressure is 80/50 mmHg. His neck veins are flat. On auscultation of the chest, there is diminished air entry on the right side and on percussion there is dullness posteriorly. These findings are most consistent with a. tension pneumothorax b. pericardial tamponade c. hypovolemia from liver injury d. massive hemothorax e. spinal cord injury - d. massive hemothorax which one of the following is true regarding burns? a. alkali chemica burns should be neutralized with a dilute acid rather than irrigated with warm water b. patients who sustain thermal burns are at a lower risk for hypothermia c. initial treatment of partial thickness thermal burns should include antibiotic cream and cold compress d. an electrical burn with only a small external injury associated with a clenched hand indicates deep ST injury e. The parkland formula should be used to determine adequacy of resuscitation - d. an electrical burn with only a small external injury associated with a clenched hand indicates deep ST injury Which one of the following statements is true regrading patients with severe traumatic brain injuries

a. Dextrose is the IV fluid of choice b. prescence of hypoxia and hypotension significantly increase the risk of mortality c. Benzodiazepines are the medications of choice for sedation d. In a unresponsive patient, mannitol should be the first line therapy to treat increased ICP - b. prescence of hypoxia and hypotension significantly increase the risk of mortality The first priority in the management of a long bone fracture is a. reduction of pain b. prevention of infection in cause of open fracture c. prevention of further ST injury d. reduction of blood loss e. improvement of long term function - d. reduction of blood loss a 40 yo obese patient with a GCD of V2E2M4 requires a CT scan. Before transfer to the scanner, you should a. give more sedative drugs b. insert a multi lumen esophageal airway c. obtain a definitive airway d. request cervical spine film e. insert a NG tube - c. obtain a definitive airway Which of the following patient require imaging.....? a. 28 yo who fell from a 3 meter balcony and sustained a fracture. The patient does not have spine pain, motor or sensory deficits and has an otherwise normal PE. b. 40 yo patient who sustained a severe closed head injury and has a GCS of 8 V2M3E c. 6month old who fell from the couch to the carpted floor and has a GCS of 15 d. 10 yo who was hit in the head with a bat and has a right frontal hematoma without history of LOC and does not have neck pain or tenderness e. 30 yp man who after a MVA, briefly LOC but was ambulating at teh scene and does not have neck or back pain - b. 40 yo patient who sustained a severe closed head injury and has a GCS of 8 V2M3E A 30 year old male is brought toe the hospital after falling 6 meters. Inspection reveals an obvious flail chest on the right. Breath sounds on the right are slightly increased. Twelve hours later, the patient is in severe respiratory distress. Arterial blood gas obtained while the patient recieves oxygen by face mask are: pH of 7,47, PaO2 of 45mmHg (6Kpa), PaCO2 of 28mmHg (3,7 Kpa). The component of injury that most likely responsible for abnormalities in this patients blood gas is: a. pain b. hypovolemia c. PTX d. pulmonary contusion

Which of the following is TRUE regarding this patient's condition? a. The bradycardia is a sign of neurogenic shock b. The change in BP and HR may indicate imminent herniations from critically high ICP c. The change in BP is reflective of worsening pre existing HTN d. The change in vital signs should prompt burr hole drainage of potential subdural hematoms - b. The change in BP and HR may indicate imminent herniations from critically high ICP Initial treatment of frostbite injuries involve a. application of dry heat b. rapid rewarming of body part c. debridement of hemorrhagic blisters d. early amputation to prevent septic complications e. application of bulk dressing to rewarm the part - b. rapid rewarming of body part Signs and symptoms of airway compromise include all of the following, EXCEPT: A. change in voice B. Stridor C. Tachypnea D. Dyspnea and agitation E. Decreased pulse pressure - E. Decreased pulse pressure Which of the following statements is TRUE regarding a pregnant patient who presents following blunt trauma? a. fetal distress may be an early sign of maternal blood loss b. a hemoglobin level of 10 indicates blood loss c. cardiac output will be decreased due to decreased circulating plasma volume d. wearing lap belt only is the best form of restraint due to the size of the gravid uterus e. normal PaCO2 provides reassurance about the adequacy of the resp function - a. fetal distress may be an early sign of maternal blood loss A 30 year old female is brought to the ED after being injured in a motor vehicle crash. Her initialt BP is 90/60mmHg, and her HR is 122bpm. She responds to rapid infusion of 1L crystalloid solution with a rise in her BP to 118/88 and decrease in her HR to 90bpm. Her pressure suddenly decreased to 96/66. The least likely cause of her hemodynamic change is: A. Ongoing blood loss B. Blunt cardiac injury C. Traumatic brain injury D. Inadequate resuscitation. E. Tension pneumothorax - C. Traumatic brain injury Limb threatening extremity injuries a. require a tourniquet

b. are characterized by the presence of ischemic or crushed tissue c. should be definitively managed by application of traction splint d. are rarely present without an open wound e. indicated a different order of priorities for the patient's initial assessment and resuscitation - b. are characterized by the presence of ischemic or crushed tissue A 29 year old female arrives in the ED 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 statement best decribes the risk of injury? A. Deployment of the airbag increased the risk of fetal loss B. The risk of premature fetal delivery and death is reduced by the use of restraints C. The use of seatbelts is associated with increased risk of maternal death. D. The mechanism of injury suggest the need for emergency ceasarean section due to the risk of impending abruptio placentae E. The deployment of the airbag increases the risk of maternal abdominal injury - B. The risk of premature fetal delivery and death is reduced by the use of restraints a 28 year old man is brought in after a MVA. His airway is patent and breath sounds are equal. His GCS is E1V2M1. His BP is 146/82; HR is .... The decision is made to secure his airway. Which of the following is a definitive airway a. LMA b. oral airway c. cuffed ET d. LTA e. needle cricothyroidotomy - d. LTA A 70 year old suffers blunt chest trauma after being struck by a car. On presentation, his GCS is 15, BP is 145/90, HR is 72. RR is 24 and O2-sat on 5L is 91%. Chest x-ray demonstrates multiple right sided rib fractures. CT abdomen and pelvis is normal. ECG demonstrates normal sinus rythm with no conduction abnormalities. Management should include: A. Placement of a 22Fr right sided chest tube B. Serial troponins and cardiac monitoring C. Monitoried i.v analgesia D. Thoracic splinting, taping and immobilization E. Bronchoscopy to exclude tracheobronchial injury - C. Monitoried i.v analgesia A 15 year old male present following a motorcycle crash. INitial examinations reveals normal vital signs. There is a large bruise over his epigastrium that extends to the left flank. He has no other apparent injuries. A CT-scan of the abdomen demonstrate a ruptured spleen surrounded by a large hematoma and fluid in the pelvis. The next step in the patients management is: A. Splenic artery embolization B. Pneumococcal vaccine

Question 39 and 40? - C and E