ATLS practice Exam Questions and Answers 2024.pdf, Exams of Medicine

Download ATLS practice Exam Questions and Answers 2024.pdf and more Exams Medicine in PDF only on Docsity! 1 / 33 ATLS practice Exam Questions and Answers 2024 1. Assessed first in trauma patient: Airway 2. (*)Degree of burn that is characterized by bone involvement: Fourth 3. Complications of head trauma: Intracerebral hematoma Extradural hematoma Brain abscess 4. Most common cause of laryngotracheal stenosis: Trauma 5. Intervention that can help prevent development of acute renal failure: In- fusion of normal saline 6. 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 patient becomes febrile, hypotensive with a normal CVP, and oliguric. Upon examination, the patient 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 insufficiency C. Fat embolism syndrome D. Transfusion reaction: D. Transfusion reaction 7. Skin antiseptic: -Ethanol 70% is an effective skin antiseptic -Acetic acid can be used to treat Gram- skin infections -Salicylic acid is used to treat certain skin yeast infections 2 / 33 8. Class IV hemorrhage indicates what % blood loss: 55% 9. How does shivering affect body temperature: Increases body temperature 10. Class III hemorrhage indicates what % of blood loss: 35% 11. Management of a stable patient with kidney contusion: Observation 12. Associated with hypovolemic shock: -Inadequate tissue perfusion with re- sultant tissue hypoxia -Blood shunting to vital organs -Decreased circulating blood volume and decreased venous return -Low cardiac output -Loss of less than 20% of the blood volume is usually without symptom except for mild tachycardia -Patients become orthostatic with losses between 20 and 40% -Shock is evidenced by tachycardia, hypotension, oliguria, flat neck veins 13. The most effective method of monitoring the success of resuscitation during CPR?: Reactivity of pupils to light 5 / 33 22. After abdominal injury, which of the following urinalysis findings would be an indication for further testing? A. 0-5 casts/HPF B. 5-10 WBC/HPF C. 10-20 RBC/HPF D. Gross hematuria: D. Gross hematuria 23. A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at its midpoint would cause bleeding from which structure?: External jugular vein 24. Clinical features associated with tension pneumothorax: Unilateral de- crease in breath sounds Hyperresonance Respiratory distress Tachycardia Tracheal shift Desatruation Decreased breath sounds Decreased compliance Asymmetric chest movement NOT hypertension, audible bronchial sounds 25. Not recommended as a mode of ventilation for a patient with a diaphrag- matic hernia A. Bag and mask B. LMA C. Endotracheal intubation D. Jet ventilation: A. Bag and mask 26. What is the next step in the assessment of a traumatic patient after airway is established?: Breathing 27. Blood group that is considered a universal donor: O 6 / 33 28. A provider is examining a patient who sustained a severe traumatic head injury. He documents no Doll's eyes. What does this signify?: Brainstem injury 29. Which of the following is the least preferred method of administering IV fluids? A. Cubital veins B. Cephalic veins 7 / 33 C. Subclavian veins D. Saphenous vein: Subclavian veins 30. Dermatome level for nipple sensation Dermatome level for umbilicus: T4 T10 31. At which temperature would a hypothermic patient stop shivering?: 88 degrees F 32. What is the energy recommendation for the first defibrillation in an adult (*): 300 J 33. Pharmacologic effects of Morphine: Behavioral changes Analgesia Respiratory depression NOT diarrhea 34. A patient with which condition should be triaged to receive medical attention first? A. Choking B. Dizziness C. Leg cramp D. Vomiting: A. Choking 35. For pediatric patients, what volume of fluid resuscitation should be given initially in the setting of shock? A. 750 mL of saline uniformly B. 1 liter of saline C. 20 mL/kg of 0.45% NaCl with 5% glucose D. 10 to 20 mL/kg of Ringers lactate: D. 10 to 20 mL/kg of Ringers lactate 36. A patient is found unconscious after a fire in his bedroom. He is found to have severe burns around his face. What is the first aspect of treatment? A. Tetanus toxoid B. Cover the wound C. Airway D. Obtain blood work: C. Airway 37. Basilar skull fracture: PE: raccoon eyes, battle sign, CSF ottorrhea (rhinor- rhea), loculated pneumoencephalocele 10 / 33 C. Diastolic blood pressure D. None of the above: B. The circulating blood volume is reaching end organs 52. Which of the following generally causes hemorrhage associated with pelvic fractures? A. Obturator artery injury B. Superior gluteal artery C. Lateral sacral artery injury D. Venous bleeding: D. Venous bleeding 53. Hemothorax facts: -Must have at least 500 cc of blood to make a diagnosis on chest x-rayin an adult -Incomplete evacuation of hemothorax can lead to empyema -Initial treatment of hemothorax is always a chest tube 54. In a 66 year old intubated, comatose patient, what is one of the most important information that one needs to obtain? A. Organ donation status B. Power of attorney C. Lawyer D. Driver's license: B. Power of attorney 55. A patient is hit by a car and has severe injuries to his extremities. He is immediately brought to the emergency room by EMS. Evaluation reveals that he has multiple organ injuries. He has an open, gaping wound which mea- sures 2 x 2 centimeters, just below the right knee. The leg appears dislocated and ecchymotic. However, pulses are present in the distal extremity. He does not complain of any paresthesias. X-ray reveals that there is a fracture of the tibia. The trauma team is called. As their arrival is awaited, which of the following should NOT be done to help manage this patient? A. Obtain culture and close wound using a sterile technique B. Don't reduce the dislocation C. Give tetanus toxoid/booster shot D. Give antibiotics: A. Obtain culture and close wound using a sterile technique 56. During resuscitation, your intubated patient's intravenous fluid infil- trates. You know that you may deliver the following drugs via the endotra- cheal tube:: Lidocaine Atropine Naloxone Epinephrine 11 / 33 57. Prior to tracheobronchial suctioning, the patient should receive: A. 5cc normal saline lavage B. Be placed on NPO status C. 100% oxygen prior to suctioning D. Versed 1 mg/mL: C. 100% oxygen prior to suctioning 58. In a patient with a pneumothorax following a stab wound, the chest tube is best inserted at which level?: Between the 4th and 5th intercostal spaces, just anterior to the mid axillary line 59. Indications for a CT scan of the head in trauma patients: -Glasgow coma scale score of less than 14 -Evidence of basilar skull fracture -Amnesia lasting more than 30 minutes 60. Most common Emergency Medical Services pediatric calls: -Seizures -Respiratory problems -Trauma 61. Treatments utilized in a patient with head trauma and raised intracranial pressure: -Elevation of the head -Sedation -Use of diuretics NOT fluid restriction 62. How deep should the provider depress the patient's sternum during CPR in adults?: 2 to 3 inches 63. First parameter to change in patient's with hypovolemic shock? A. Systolic blood pressure B. Pulse rate C. Respiratory rate D. Skin vasoconstriction: B. Pulse rate 64. A 34-year-old with severe head trauma and elevated intracranial pres- sures is intubated. Which of the following should be the target for mechanical ventilation?: Set PaCO2 between 30-35 65. A young motorcycle driver is thrown against a concrete bridge and sustains severe trauma about the face, with marked deformity and bleeding. Which of the following statements regarding this scenario is TRUE? A. Cervical spine evaluation takes precedence over facial injuries B. LeFort fractures rarely cause severe hemorrhage 12 / 33 C. Nasotracheal intubation must be done urgently to prevent airway obstruc- tion D. Plain radiographs are preferred to CT in emergencies: A. Cervical spine evaluation takes precedence over facial injuries 66. Which US industry has the highest accidental death rate? A. Construction B. Agriculture C. Manufacturing D. Transportation: B. Agriculture 67. Subdural hematoma facts: Etiology: tearing of bridging veins -Most common in elderly individuals who fall -Hematoma should be evacuated surgically -Prognosis is much better for chronic subdurals than acute cases -More common than epidural hematomas NOT often associated with skull fractures 68. An 8-year old child is brought to the ER after being struck by a car while crossing the street. He is not alert and required immediate intubation at the scene by EMS. His GCS is 8 T. He appears to have a significant laceration of his scalp on the left side but there are no skeletal fractures. The initial chest x-ray revealed a right sided pneumothorax and a chest tube was inserted. His hematocrit is 23.5 and hemoglobin is 7.6. The next thing you would do is: A. CT head B. CT abdomen C. Repeat blood work D. Observe patient: B. CT abdomen 69. Class I hemorrhage indicates what percentage of blood loss?: 10% 70. Which is not a clinical component of the Glasgow Coma Score? A. Eye movement B. Sensation C. Verbal response D. Extremity movement: B. Sensation 71. How should epinephrine should be injected for treatment of anaphylax- is?: Intramuscularly (IM) into vastus lateralis 15 / 33 88. Position patient should be transported in when patient complains of neck pain and is 32 weeks pregnant: Supine on a backboard with her right hip elevated 89. Air embolism: PE: murmur, petechiae, desaturation Tx: turn patient on left side in Trendelenburg position 90. Fat embolism: MCC = bone fx Clinical presentation -Fever -Petechial hemorrhage -Desaturation -Hypotension -Altered mental status 91. Cauda equina syndrome: -Bilateral sciatica -Bowel dysfunction -Saddle sensory changes 92. At what point should hyper oxygenation be administered when perform- ing tracheal suctioning on a mechanically ventilated patient? A. Before the procedure B. After the procedure C. Before and after the procedure D. During the procedure: C. Before and after the procedure 93. Nerve to muscle relationship: C5 - Deltoid C6 - Wrist extension C7 - Elbow extension 94. Most common cause of kidney injuries: Motor vehicle accidents 95. Crystalloid solutions: Ringer's lactate Dextrose 5% D5W plus 1/2 NS NOT albumin 96. Indication for emergency thoracotomy A. Pulmonary contusion B. Flail chest C. Hemothorax with initial blood loss of 700 cc D. Lung collapse with an air leak: D. Lung collapse with an air leak 16 / 33 97. Studies used for a patient with widened mediastinum after injury: CT scan Upper endoscopy Transesophageal ultrasound 98. Pericardial tamponade: Muffled heart sounds JVD Equalization of cardiac chamber pressure NOT hypertension 99. Blood groups facts: -ABO compatibility is a must for renal transplant -Febrile reactions may be due to bacterial contamination -Citrate toxicity can cause hypocalcemia 100. Which statement is most accurate regarding a chest tube connected to a water seal drainage system? A. Bubbles in the water indicate that the chest tube is no longer needed B. The water level should fall slightly with each spontaneous inspiration C. The drainage system should be kept below the level of chest tube inser- tion D. The chest tube should be clamped at all times when the patient is ambula- tory: C. The drainage system should be kept below the level of chest tube insertion 101. Confirmatory test that is a reliable indicator of brain death A. Apnea test with a pCO2 less than 40 B. Electromyography C. 4-vessel cerebral angiography D. CT scan of the brain: C. 4-vessel cerebral angiography 102. MC spine problem seen in patient's with Down syndrome: Atlanto-axial instability 103. As a result of burn trauma, fluid shifts can cause hematocrit levels to A. Rise B. Fall C. Remain unchanged while hemoglobin levels drop D. Rise initially then fall dramatically: A. Rise 104. A 17-year-old male is hit on the head with a baseball bat. He withdraws and opens his eyes in response to deep painful stimuli. He also mumbles incomprehensibly. What is his Glasgow coma scale score?: 8 105. Hypoxia: PE: cyanosis Can be rapidly measured with pulse ox 17 / 33 106. After placement of a chest tube for a traumatic pneumothorax, subcuta- neous emphysema is observed. After checking the drainage and chest tube site, what else should be done?: -Increase level of suction -Insert second chest tube -Adjust chest tube Do NOT flush tube with saline 107. Which of the following injuries is most critical? A. Fractured femur B. Fractured pelvis C. Fractured humerus D. Fractured fibula: B. Fractured pelvis 108. A patient on a mechanical ventilator is fighting the machine, and has elevated peak airway pressures. What medication should be used? A. Benzodiazepines B. Vecuronium C. Barbiturates D. Baclofen: B. Vecuronium 109. What is the primary goal in the initial resuscitation of a cardiac arrest? A. Renal perfusion B. Limb perfusion C. Myocardial perfusion D. Brain perfusion: D. Brain perfusion 110. During an MVA, what is most likely injury to occur after knees strike the dashboard A. Fractured femur B. Fractured humerus C. Lacerated spleen D. None of the above: A. Fractured femur 111. Reason epinephrine is added to local anesthetics: Prolongs its action 112. Used to treat high ICP: Control BG Hyperventilation (pCO2 30-35) Elevate head of bed Mannitol (osmotic diuretic) Furosemide (loop diur.) 113. Earliest symptom of local anesthetic toxicity: Tongue and circumoral numbness 20 / 33 127. Hypersensitivity is most commonly reported after use of which type of suture? A. Nylon B. Stainless steel wire C. Chromic catgut D. Silk: C. Chromic catgut 128. A patient suffers a gunshot wound to the abdomen. She is stable and only complains of mild pain at the site. On examination, she has mild rebound tenderness. Her WBC count is 10, hematocrit is 31, and hemoglobin is 13.2. What is the next step in the management of this patient? A. Surgery B. Abdominal CT C. Abdominal Ultrasound D. Rectal exam: B. Abdominal CT 129. First step taken to minimize thermal burn injury: Remove source of heat 130. Best assessment of fluid resuscitation of adult burn patient A. Urine output of 0.5 mL/kg/hr B. Normalization of BP C. Normalization of HR D. Measuring a normal central venous pressure E. Providing 4mL/kg/% body burned/24 hours crystalloid fluid: A. urine output of 0.5 mL/kg/hr 131. Facts concerning spine trauma: -5% patients with brain injury have a spine injury -25% patients with spine injury have a brain injury -33% of patients with upper c-spine injuries die at the scene 132. Which of the following local anesthetics has the longest duration of action? A. Procaine (Novocaine) B. Bupivacaine (Marcaine) C. Mepivacaine (Carbocaine) D. Lidocaine (Xylocaine): B. Bupivacaine (Marcaine) 133. When the cephalic vein cut down is done in the deltopectoral groove, the vein is usually found between the....: Deltoid and pectoralis muscles 134. What is the most important factor in preventing accidental pool drown- ing? A. Pool covers 21 / 33 B. Fences around pools C. Swimming lessons D. Parental supervision: D. Parental supervision 135. Characteristics of early hemorrhagic shock: Cold skin Slow capillary refill Confusion NOT bradycardia 136. A patient is thrown out of a car. He is hemodynamically stable, asymp- tomatic, and the only finding is a right sided pneumothorax. What is the best treatment for this man? A. Aspiration of pneumothorax B. Monitor pneumothorax C. CT scan D. Placement of chest tube: D. Placement of chest tube 137. Important landmark for location of second rib: Sternal angle 138. Contributes to a low score on the Glasgow coma scale: Paralysis Low blood sugar Use of narcotics 139. Pericardiocentesis is done by needle insertion through which of the intercostal spaces?: Fifth intercostal space 140. After a femur fracture, which of the following is LEAST likely? A. Severe pain B. Expanding hematoma C. Severe nerve injury D. Absent distal pulses: C. Severe nerve injury 141. Which of the following is no longer indicated for routine treatment of shock patients? A. Cervical spine stabilization B. Pneumatic anti-shock garment (PASG) C. Endotracheal intubation D. Oxygen: B. Pneumatic anti-shock garment (PASG) 142. A 13 year old boy fell while riding his bicycle and hit his head. He was unconscious for 4 or 5 minutes. He vomited twice. He has no memory of the event or a headache. His exam is entirely normal. Glasgow coma score is 15. Select the next step in management. 22 / 33 A. Discharge home with concussion instructions B. CT of the head C. Skull films D. Admit for observation: B. CT of the head 143. Cerebral edema treatment: Mannitol Head up position Hyperventilation 144. Sellick maneuver: Minimizes the chances of regurgitation during intubation 145. Which of the following is predominantly an iatrogenic complication? A. Venous air embolism B. Deep venous thrombosis (DVT) C. Venous thromboembolism D. None of the above: A. Venous air embolism 146. Normal capillary refill time: 2 seconds 147. Which of the following cannot be administered via endotracheal (ET) tube? A. Atropine B. Atenolol C. Epinephrine D. Lidocaine: B. Atenolol 148. Can be added to lidocaine to reduce the burning sensation when admin- istered: Sodium bicarbonate 149. Nerve + sensory relationships: C6 - Thumb C7 - Middle finger C8 - Little finger 150. True regarding the initial resuscitation of a trauma patient: Evidence of improved perfusion after fluid resuscitation could include improvement of GCS on reevaluation 151. For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent:: cerebral vasoconstriction with diminished perfu- sion 152. After being involved in a motor vehicle crash, a 25-year-old man 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 after CT. The next step is:: perform an exploratory laparotomy 25 / 33 B. administer an osmotic diuretic C. aggressively treat systemic hypertension D. reduce metabolic requirements of the brain E. distinguish between intracranial hematoma and cerebral edema: A. avoid hypotension 162. A hemodynamically normal 10-year-old girl is hospitalized for observa- tion after a Grade III (moderately severe) splenic injury has been confirmed by computed tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)? A. a serum amylase of 200 B. a leukocyte count of 14,000 C. evidence of retroperitoneal hematoma on CT scan D. development of peritonitis on physical exam E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours: D. development of peritonitis on physical exam 163. A patient presents to the emergency room after a motor vehicle accident with hypotension, tachycardia, and abdominal distension. What is the most likely diagnosis? A. Closed head injury B. Splenic injury C. Pneumothorax D. Neurogenic shock: B. Splenic injury 164. Considered a mechanically stable cervical spine injury: -Clay shoveler's fracture -Simple wedge fracture not involving posterior elements -Unilateral facet dislocation NOT flexion teardrop fracture 165. In most adults, the spinal cord terminates at what vertebrae?: L1 166. Which is the best diagnostic test of nonpenetrating renal injuries? A. KUB B. IVP C. CT D. Laparoscopy: C. CT 167. Which arterial blood gas finding is most suggestive of acute respiratory failure? A. PCO2= 50, PO2= 80 26 / 33 B. PCO2 =40, PO2=60 C. PCO2=60, PO2= 50 D. PCO2= 30, PO2=70: C. PCO2=60, PO2= 50 168. Trio of hypertension, bradycardia and tachypnea: Cushing's Triad 169. During neck trauma, which cervical disc is most likely to herniate?Mark one answer: A. C1-C2 B. C3-C4 C. C5-C6 D. C6-C7: D. C6-C7 170. Which of the following patients with head trauma does not require admission? A. An individual with alcohol intoxication B. An individual with a Glasgow coma score < 9 C. An individual with the presence of rhinorrhea D. An individual who cannot sleep: D. An individual who cannot sleep 171. What is the most appropriate study for a patient who suffered a fall and presents with acute cervical radiculopathy? A. Cervical CT B. Cervical MRI C. Lateral C-spine radiograph D. Myelogram: B. Cervical MRI 172. What is the most common traumatic intracranial mass lesion? A. Epidural hematoma B. Gliocytoma C. Subdural hematoma D. Subarachnoid hemorrhage: C. Subdural hematoma 173. To prevent a surgical infection when is the best time to administer an antibiotic? A. 2-24 hrs before surgery B. 1 hr before surgery C. After the incision is made D. During the procedure: B. 1 hr before surgery 174. In which situation should a femoral traction splint NOT be used? A. Hip dislocation B. Femur fracture 27 / 33 C. Ankle fracture D. Tibia fracture: A. Hip dislocation 175. Minimal score on the Glasgow coma scale: 3 176. A stab wound at the left 5th intercostal space, 8 cm from the midline would most likely damage which of the following? A. Spleen B. Apex of the heart C. Left lung D. Left kidney: B. Apex of heart 177. A trauma patient is rapidly intubated and capnograph is hooked up to the outflow line. After five breaths the capnography tracings falls off. What is the next step in the management? A. Increased FIO2 B. Hyperventilate patient C. Immediately remove the endotracheal tube and reintubate D. Add CO2 to the system: C. Immediately remove the endotracheal tube and reintubate 178. A 28-year-old male was involved in a motor vehicle accident. He is stable. When he is asked to sit up, the umbilicus moves up toward the neck area. What type of injury can this indicate? A. Rectus hematoma B. Diastasis recti C. T6-T10 spinal cord injury D. Muscle spasms: C. T6-T10 spinal cord injury 179. Where would one attempt a second IV start if the first is unsuccessful? A. In the same location as the first attempt B. In a more proximal location C. In a more distal location D. None of the above: C. In a more distal location 180. Foot drop is caused by which of the following? A. Common peroneal nerve lesion B. Superficial peroneal nerve lesion C. Sciatic nerve D. Femoral nerve: A. Common peroneal nerve lesion 181. A 22-year-old man sustains a gunshot wound to the abdomen and presents with shock. He requires multiple units of packed red blood cells during resuscitation. Later he complains of numbness around his mouth. Physical exam reveals carpopedal spasm and a positive Chvostek sign. 30 / 33 195. Which of the following is the best indicator of adequate shock resusci- tation? A. Blood pressure B. Serum bicarbonate C. Skin capillary refill D. Urine output: D. Urine output 196. Which of the following statements is true regarding emergent pericar- diocentesis? A. Complication rate for blind approach is 50 percent B. Echocardiogram is the procedure of choice C. Subxyphoid approach increases risk of injury to the heart D. Liver laceration is not a potential complication: B. Echocardiogram is the procedure of choice 197. Following a minor motor vehicle accident, a patient is experiencing pain and stiffness in her neck. Upon physical exam, she is able to rotate her neck greater than 55 degrees and denies paresthesias in the extremities. Which of the following is the next best step for this patient? A. Exercise therapy B. NSAIDs and rest C. Neck x-rays D. Narcotics: B. NSAIDs and rest 198. Which of the following is the most reliable predictor of poor outcome for drowning victims? A. Submersion time more than 10 minutes B. Glasgow coma scale less than 10 C. Lack of spontaneous cardiac rhythm for 15 minutes D. Need for CPR at the scene: A. Submersion time more than 10 minutes 199. A patient admitted with mild hypothermia is at risk to develop: A. Atrial fibrillation B. Ventricular tachycardia C. Heart failure D. Loss of their extremity: A. Atrial fibrillation 200. Which is a sign of increasing intracranial pressure (ICP)? A. Barotrauma reflex B. Babinski reflex C. Cushing reflex None of the above: C. Cushing reflex 31 / 33 201. Clinical presentation of cardiogenic shock: -Hypotension -Clammy skin -Tachycardia -Confusion 202. A patient is involved in a MVA and suffers multiorgan trauma. He is brought to the ER by EMS and found to be hypotensive with bradycardia and his abdomen is not distended. He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses thready. His CVP is 9, his HR is 42, and his BP is 80/40. What is the most likely cause of his shock state? A. Closed head injury B. Ongoing intra-abdominal hemorrhage C. Pneumothorax D. Neurogenic shock: D. Neurogenic shock 203. Which component of the Glasgow coma scale is most predictive of brain injury severity? A. Eye component B. Motor component C. Verbal component D. None of the above: B. Motor component 204. What is the best test to diagnose a pneumothorax? A. Chest x-ray B. CT C. Ultrasound D. Clinical: A. Chest x-ray 205. A patient is involved in a motor vehicle accident. He is brought into the ER and found to have a broken femur. His blood work reveals an hemoglobin of eight and an Hct of 28. It is decided to transfuse him with three units of blood. Soon after the blood is started, he develops a fever and becomes hy- potensive. In a patient suspected of having a hemolytic transfusion reaction, one should do which of the following?A A. Inserting a foley catheter B. Fluid restriction C. 0.1N HCL to reverse the alkalosis D. Fluids and mannitol: D. Fluids and mannitol 206. Concurrent injuries occur in which percentage of thoracic spine in- juries? A. 6% B. 10% 32 / 33 C. 21% D. 30%: B. 10% 207. Head trauma in children: -Brain doubles in size in first 6 months of life and achieves 80% of adult size at 2 years of age -Subarachnoid space is smaller and offers less protection to the brain because there is less buoyancy and momentum is more likely to cause parenchymal structural damage -Cerebral blood flow increases to nearly twice adult levels by age 5, then decreas- es, placing children at greater risk of cerebral hypoxia and edema -Children have a better outcome than adults who suffer brain injuries 208. An adult with a widened mediastinum might have which of the follow- ing?: Aortic dissection 209. Signs and symptoms of cardiac tamponade may be listed as: A. Virchow's Triad B. Brudzinski's signs C. Phalen's signs D. Beck's Triad: D. Beck's Triad - hypotension, muffled heart sounds, JVD Pulsus parodoxus: larger than normal drop of SBP during inspiration 210. A patient with their neck flexed would have which vertebrae as most prominent? A. C5 B. C6 C. C7 D. T1: C. C7 211. What is the most common reason for the chest not to rise with each breath during CPR? A. Air is being delivered to the stomach B. The breaths are being given at too rapidly C. The airway is not clear D. The trachea has collapsed: C. The airway is not clear 212. Which is the preferred site for arterial sampling? A. Carotid artery B. Ulnar artery C. Tibial artery D. Radial artery: D. Radial artery 213. Neuromuscular blocking agent works by depolarization: Succinylcholine 35 / 33 C. Rib fracture D. Cardiac contusion: B. Abdominal organ rupture 229. In a patient with head trauma, what indicates rising intracranial pressure (ICP)?: Pupillary dilation Wide pulse pressure Rising BP 230. In which of the following clinical contexts is an urgent, post-traumatic head CT NOT necessary? A. Individual with seizures B. Individual with a progressive headache C. Individual with an unreliable history D. Individual with a Glasgow coma scale score of 15: D. Individual with a Glasgow coma scale score of 15 231. Which of the following is CORRECT about visceral pain? A. Always superficial B. Difficulty to localize C. Only seen in peritonitis D. Is rarely referred: B. Difficulty to localize 232. Emergency decompression of the brain with a subdural hematoma should be evacuated if there is a midline shift of what amount? A. 1 mm B. 2 mm C. 5 mm D. 10 mm: C. 5 mm 233. To relieve a right tension pneumothorax, where should the needle should be placed? A. 4th intercostal space left of the mediastinum B. 2nd intercostal space left of the mediastinum C. 4th intercostal space right of the mediastinum D. 2nd intercostal space right of the mediastinum: D. 2nd intercostal space right of the mediastinum 234. A patient has been in a major MVA and is comatose. He has a high level of alcohol and is hypothermic. Which of the following test can stand alone in certifying the patient as brain dead? A. Apnea test B. Absence of oculocephalic and oculovestibular reflexes 36 / 33 C. Absence of blood flow on cerebral angiogram after warming D. EEG: C. Absence of blood flow on cerebral angiogram after warming