ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH, Exams of Nursing

Download ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH and more Exams Nursing in PDF only on Docsity! ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate management of the wound should consist of: - CORRECT ANSWERS direct pressure on the wound For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: - CORRECT ANSWERS cerebral vasoconstriction with diminished perfusion 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: - CORRECT ANSWERS perform an exploratory laparotomy Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? - CORRECT ANSWERS Leakage of amniotic fluid is an indication for hospital admission. The first maneuver to improve oxygenation after chest injury is: - CORRECT ANSWERS administer supplemental oxygen A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department. His pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he does moan periodically. His right arm is deformed and does not respond to pressure; however, his left hand reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS score is: - CORRECT ANSWERS 9 A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath, extremely anxious, and yelling for help. Breath sounds are diminished in the right chest. The most appropriate first step is to: - CORRECT ANSWERS perform needle or finger decompression of the right chest Which one of the following findings in an adult is most likely to require immediate management during the primary survey? - CORRECT ANSWERS respiratory rate of 40 breaths per minute ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | The most important, immediate step in the management of an open pneumothorax is: - CORRECT ANSWERS placement of an occlusive dressing over the wound The following are contraindications for tetanus toxoid administration: - CORRECT ANSWERS history of neurological reaction or severe hypersensitivity to the product A 56-year-old man is thrown violently against the steering wheel of his truck during a motor vehicle crash. On arrival in the emergency department he is diaphoretic and complaining of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per minute. Which of the following best differentiates cardiac tamponade from tension pneumothorax as the cause of his hypotension? - CORRECT ANSWERS breath sounds Bronchial intubation of the right or left mainstem bronchus can easily occur during infant endotracheal intubation because: - CORRECT ANSWERS The trachea is relatively short. A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation and is brought by ambulance to a hospital that has full surgical capabilities. His wounds are all above the nipple. He is endotracheally intubated, closed tube thoracostomy is performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% O2). 1500 mL of blood has drained from the right chest. The most appropriate next step in managing this patient is to: - CORRECT ANSWERS urgently transfer the patient to the operating room A 39-year-old man is admitted to the emergency department after an automobile collision. He is cyanotic, has insufficient respiratory effort, and has a GCS score of 6. His full beard makes it difficult to fit the oxygen facemask to his face. The most appropriate next step is to: - CORRECT ANSWERS restrict cervical motion and attempt orotracheal intubation using 2 people A patient is brought to the emergency department after a motor vehicle crash. He is conscious and there is no obvious external trauma. He arrives at the hospital completely immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. His skin is warm. Which one of the following statements is TRUE? - CORRECT ANSWERS Flaccidity of the lower extremities and loss of deep tendon reflexes are expected. ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following statements applies to this patient? - CORRECT ANSWERS An ABG would demonstrate a base deficit between -6 and -10 mEq/L. The physiological hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by: - CORRECT ANSWERS increasing the volume of blood loss to produce maternal hypotension The best assessment of fluid resuscitation of the adult burn patient is: - CORRECT ANSWERS urinary output of 0.5 mL/kg/hr The diagnosis of shock must include: - CORRECT ANSWERS evidence of inadequate organ perfusion A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade III (moderately severe) splenic injury has been confirmed by computed tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)? - CORRECT ANSWERS development of peritonitis on physical exam A 40-year-old woman who was a restrained driver in a motor vehicle crash is evaluated in the emergency department. She is hemodynamically normal and found to be paraplegic at the level of T10. Which of the following are true regarding her evaluation and management? - CORRECT ANSWERS Log rolling using 4 people is a safe approach to restrict spinal motion when moving her. A trauma patient presents to your emergency department with inspiratory stridor and a suspected c-spine injury. Oxygen saturation is 88% on high-flow oxygen via a nonrebreathing mask. The most appropriate next step is to: - CORRECT ANSWERS restrict cervical motion and establish a definitive airway When applying the Rule of Nines to infants: - CORRECT ANSWERS The head is proportionally larger in infants than in adults. A healthy young male is brought to the emergency department following a motor vehicle crash. His vital signs are a blood pressure of 84/60, pulse 123, GCS 10. The patient moans ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | when his pelvis is palpated. After initiating fluid resuscitation, the next step in management is: - CORRECT ANSWERS placement of a pelvic binder Which one of the following situations requires Rh immunoglobulin administration to an injured woman? - CORRECT ANSWERS positive pregnancy test, Rh negative, and has torso trauma A 22-year-old female athlete is stabbed in her left chest at the third interspace in the anterior axillary line. On admission to the emergency department and 15 minutes after the incident, she is awake and alert. Her heart rate is 100 beats per minute, blood pressure 80/60 mm Hg, and respiratory rate 20 breaths per minute. A chest x-ray reveals a large left hemothorax. A left chest tube is placed with an immediate return of 1600 mL of blood. The next management step for this patient is: - CORRECT ANSWERS prepare for an exploratory thoracotomy A 6-year-old boy walking across the street is struck by the front bumper of a sports utility vehicle traveling at 32 kph (20 mph). Which one of the following statements is TRUE about this patient? - CORRECT ANSWERS A pulmonary contusion may be present in the absence of rib fractures. Assessed first in trauma patient - CORRECT ANSWERS Airway (*)Degree of burn that is characterized by bone involvement - CORRECT ANSWERS Fourth Complications of head trauma - CORRECT ANSWERS Intracerebral hematoma Extradural hematoma Brain abscess Most common cause of laryngotracheal stenosis - CORRECT ANSWERS Trauma Intervention that can help prevent development of acute renal failure - CORRECT ANSWERS Infusion of normal saline ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | 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 - CORRECT ANSWERS D. Transfusion reaction Skin antiseptic - CORRECT ANSWERS -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 Class IV hemorrhage indicates what % blood loss - CORRECT ANSWERS 55% How does shivering affect body temperature - CORRECT ANSWERS Increases body temperature Class III hemorrhage indicates what % of blood loss - CORRECT ANSWERS 35% Management of a stable patient with kidney contusion - CORRECT ANSWERS Observation Associated with hypovolemic shock - CORRECT ANSWERS -Inadequate tissue perfusion with resultant 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 ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Decreased compliance Asymmetric chest movement NOT hypertension, audible bronchial sounds Not recommended as a mode of ventilation for a patient with a diaphragmatic hernia A. Bag and mask B. LMA C. Endotracheal intubation D. Jet ventilation - CORRECT ANSWERS A. Bag and mask What is the next step in the assessment of a traumatic patient after airway is established? - CORRECT ANSWERS Breathing Blood group that is considered a universal donor - CORRECT ANSWERS O A provider is examining a patient who sustained a severe traumatic head injury. He documents no Doll's eyes. What does this signify? - CORRECT ANSWERS Brainstem injury Which of the following is the least preferred method of administering IV fluids? A. Cubital veins B. Cephalic veins C. Subclavian veins D. Saphenous vein - CORRECT ANSWERS Subclavian veins Dermatome level for nipple sensation Dermatome level for umbilicus - CORRECT ANSWERS T4 T10 ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | At which temperature would a hypothermic patient stop shivering? - CORRECT ANSWERS 88 degrees F What is the energy recommendation for the first defibrillation in an adult (*) - CORRECT ANSWERS 300 J Pharmacologic effects of Morphine - CORRECT ANSWERS Behavioral changes Analgesia Respiratory depression NOT diarrhea A patient with which condition should be triaged to receive medical attention first? A. Choking B. Dizziness C. Leg cramp D. Vomiting - CORRECT ANSWERS A. Choking 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 - CORRECT ANSWERS D. 10 to 20 mL/kg of Ringers lactate 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 ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | C. Airway D. Obtain blood work - CORRECT ANSWERS C. Airway Basilar skull fracture - CORRECT ANSWERS PE: raccoon eyes, battle sign, CSF ottorrhea (rhinorrhea), loculated pneumoencephalocele Bone MC involved = Temporal A patient with von Willebrand disease is bleeding after sustaining a knife wound. Which of the following is most appropriate for the treatment of this patient? A. Vitamin K B. Cryoprecipitate C. Protamine D. DDAVP - CORRECT ANSWERS D. DDAVP What is the total body surface area involved in a burn to both lower extremities? - CORRECT ANSWERS 36% Which injury is most common in rear end motor vehicle accidents? A. Cervical fractures B. Hypextension-hyperflexion neck injuries C. Forearm fractures D. Rotational neck injuries - CORRECT ANSWERS B. Hypextension-hyperflexion neck injuries What is true about an unrestrained pregnant driver? A. She is at increased risk of placenta previa B. She is at increased risk of placental abruption C. At 33 weeks, her fetus is well protected by an amniotic fluid cushion and thus the pregnancy is not at risk D. If the mother's vital signs are stable, complications are unlikely - CORRECT ANSWERS B. She is at increased risk of placental abruption ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | 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 - CORRECT ANSWERS D. Venous bleeding Hemothorax facts - CORRECT ANSWERS -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 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 - CORRECT ANSWERS B. Power of attorney 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 measures 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 - CORRECT ANSWERS A. Obtain culture and close wound using a sterile technique ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | During resuscitation, your intubated patient's intravenous fluid infiltrates. You know that you may deliver the following drugs via the endotracheal tube: - CORRECT ANSWERS Lidocaine Atropine Naloxone Epinephrine 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 - CORRECT ANSWERS C. 100% oxygen prior to suctioning In a patient with a pneumothorax following a stab wound, the chest tube is best inserted at which level? - CORRECT ANSWERS Between the 4th and 5th intercostal spaces, just anterior to the mid axillary line Indications for a CT scan of the head in trauma patients - CORRECT ANSWERS -Glasgow coma scale score of less than 14 -Evidence of basilar skull fracture -Amnesia lasting more than 30 minutes Most common Emergency Medical Services pediatric calls - CORRECT ANSWERS -Seizures -Respiratory problems -Trauma Treatments utilized in a patient with head trauma and raised intracranial pressure - CORRECT ANSWERS -Elevation of the head -Sedation -Use of diuretics NOT fluid restriction ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | How deep should the provider depress the patient's sternum during CPR in adults? - CORRECT ANSWERS 2 to 3 inches First parameter to change in patient's with hypovolemic shock? A. Systolic blood pressure B. Pulse rate C. Respiratory rate D. Skin vasoconstriction - CORRECT ANSWERS B. Pulse rate A 34-year-old with severe head trauma and elevated intracranial pressures is intubated. Which of the following should be the target for mechanical ventilation? - CORRECT ANSWERS Set PaCO2 between 30-35 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 C. Nasotracheal intubation must be done urgently to prevent airway obstruction D. Plain radiographs are preferred to CT in emergencies - CORRECT ANSWERS A. Cervical spine evaluation takes precedence over facial injuries Which US industry has the highest accidental death rate? A. Construction B. Agriculture C. Manufacturing D. Transportation - CORRECT ANSWERS B. Agriculture Subdural hematoma facts - CORRECT ANSWERS Etiology: tearing of bridging veins ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Should be avoided in patient with suspected nasal fracture - CORRECT ANSWERS Nasal intubation What is the best way to evaluate a cardiac contusion? A. CT scan of the chest B. Echocardiogram C. ECG monitoring x 24 hours D. Cardiac enzymes - CORRECT ANSWERS C. ECG monitoring x 24 hours Cerebral contusions - CORRECT ANSWERS May happen opposite to the point of impact An 18-year-old is thrown off his motorbike on a slippery road. At the scene, what is the first priority in the management of this patient? A. Assess vital signs B. Stabilize cervical spine C. Assess airway D. Start IV fluids - CORRECT ANSWERS C. Assess airway Normal adult respiratory rate - CORRECT ANSWERS 12-20 breaths per minute Scapular fracture - CORRECT ANSWERS -Usually requires a tremendous force to fracture -May be uneasily visible on plain xray -Treatment requires prolonged immobilization -Usually associated with other chest injuries A patient suffers a stab wound to the chest. In the emergency room, he is found to have an 80 percent pneumothorax with a midline shift of the trachea to the contralateral chest. There is evidence of circulatory and respiratory dysfunction. What is the next step in the management of this patient? A. Endotracheal tube B. Fluid bolus ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | C. Epinephrine D. 20 gauge needle - CORRECT ANSWERS D. 20 gauge needle Flail chest - CORRECT ANSWERS Mediastinum is pulled toward affected side during expiration Epidural hematoma - CORRECT ANSWERS MC due to injury of Middle meningeal artery Temporoparietal = area that has most epidural hematomas from trauma -Can be intracranial or intraspinal (may follow LP) -Often associated with skull fractures 7-year-old girl is found at the bottom of a swimming pool. Initially she was in full arrest but after 5 minutes she showed sinus tachycardia but no respiratory effort. Intubation was done in the field and cervical collar placed. After transport to the emergency department she was unresponsive with a blood pressure of 100/60 mmHg, pulse 105, temperature 34.3C, and oxygen saturation 100%. The pupils were 3 mm and sluggishly responsive to light. There is no response to pain. The lungs show wheezing on the left and coarse breath sounds bilaterally. The monitor shows sinus tachycardia. There is no rectal tone. Which of the following should be the next step in management? A. Cervical spine films and CT of the head B. Portable chest radiograph C. Arterial blood gas D. Right and left decubitus chest radiographs - CORRECT ANSWERS A. Cervical spine films and CT of the head Position patient should be transported in when patient complains of neck pain and is 32 weeks pregnant - CORRECT ANSWERS Supine on a backboard with her right hip elevated Air embolism - CORRECT ANSWERS PE: murmur, petechiae, desaturation Tx: turn patient on left side in Trendelenburg position ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Fat embolism - CORRECT ANSWERS MCC = bone fx Clinical presentation -Fever -Petechial hemorrhage -Desaturation -Hypotension -Altered mental status Cauda equina syndrome - CORRECT ANSWERS -Bilateral sciatica -Bowel dysfunction -Saddle sensory changes At what point should hyper oxygenation be administered when performing 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 - CORRECT ANSWERS C. Before and after the procedure Nerve to muscle relationship - CORRECT ANSWERS C5 - Deltoid C6 - Wrist extension C7 - Elbow extension Most common cause of kidney injuries - CORRECT ANSWERS Motor vehicle accidents Crystalloid solutions - CORRECT ANSWERS Ringer's lactate Dextrose 5% D5W plus 1/2 NS ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Which of the following injuries is most critical? A. Fractured femur B. Fractured pelvis C. Fractured humerus D. Fractured fibula - CORRECT ANSWERS B. Fractured pelvis 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 - CORRECT ANSWERS B. Vecuronium 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 - CORRECT ANSWERS D. Brain perfusion 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 - CORRECT ANSWERS A. Fractured femur Reason epinephrine is added to local anesthetics - CORRECT ANSWERS Prolongs its action Used to treat high ICP - CORRECT ANSWERS Control BG Hyperventilation (pCO2 30-35) Elevate head of bed ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Mannitol (osmotic diuretic) Furosemide (loop diur.) Earliest symptom of local anesthetic toxicity - CORRECT ANSWERS Tongue and circumoral numbness A 18-year-old male sustains a right femur fracture and a cerebral concussion in a motor vehicle accident. His initial blood pressure is 75/50 mmHg with a pulse of 90 beats per minute. After giving him 2 liters of Ringer lactate he stabilizes, but the blood pressure falls when he is seen in the ER. Which of the following would be the cause of suspected hypotension in this patient? A. Subdural hematoma B. Undiagnosed facial fracture C. Ruptured spleen D. 10% pneumothorax - CORRECT ANSWERS C. Ruptured spleen An unrestrained driver involved in a high speed MVA is transported by paramedics with c- spine precautions. GCS score is 7, but there is no obvious trauma. Respirations are shallow, and BVM is not providing adequate ventilation. Extremities are cool, and the pulses are thready. Prior to rapid sequence intubation, what should be done? A. Brief neurologic examination B. Immediate chin lift and jaw thrust maneuver C. Assess all vital signs D. Administer 4-5 quick tidal volume breaths with an FIO2 of 100% using a bag mask ventilatory device - CORRECT ANSWERS D. Administer 4-5 quick tidal volume breaths with an FIO2 of 100% using a bag mask ventilatory device Which of the following is indicative of a kidney injury? A. Ascites B. Flank tenderness C. Hematuria D. Hematemesis - CORRECT ANSWERS C. Hematuria ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Can occur during massive blood transfusions - CORRECT ANSWERS -Dilutional thrombocytopenia -Hypocalcemia -Coagulation abnormalities NOT hypokalemia Which of the following most likely will result in a favorable outcome in pediatric drowning? A. Spontaneous circulation established in the ER B. Core temperature in the ER <33ºC C. Return of spontaneous circulation at the scene of the drowning D. Reactive pupils at the scene of the drowning - CORRECT ANSWERS C. Return of spontaneous circulation at the scene of the drowning Underlying pathophysiology of a decrease in urine output - CORRECT ANSWERS Compromised organ perfusion Which of the following clinical signs is the most worrisome in a patient whom elevation of ICP is a concern? A. Tachycardia B. Asymmetric pupils C. Hypothermia D. Decreased blood pressure - CORRECT ANSWERS B. Asymmetric pupils Battle sign - CORRECT ANSWERS (Mastoid ecchymosis) Etiology: fracture of middle cranial fossa of skull Posterior auricular = artery that causes the bruising ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | C. Mepivacaine (Carbocaine) D. Lidocaine (Xylocaine) - CORRECT ANSWERS B. Bupivacaine (Marcaine) When the cephalic vein cut down is done in the deltopectoral groove, the vein is usually found between the.... - CORRECT ANSWERS Deltoid and pectoralis muscles What is the most important factor in preventing accidental pool drowning? A. Pool covers B. Fences around pools C. Swimming lessons D. Parental supervision - CORRECT ANSWERS D. Parental supervision Characteristics of early hemorrhagic shock - CORRECT ANSWERS Cold skin Slow capillary refill Confusion NOT bradycardia A patient is thrown out of a car. He is hemodynamically stable, asymptomatic, 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 - CORRECT ANSWERS D. Placement of chest tube Important landmark for location of second rib - CORRECT ANSWERS Sternal angle Contributes to a low score on the Glasgow coma scale - CORRECT ANSWERS Paralysis Low blood sugar Use of narcotics ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Pericardiocentesis is done by needle insertion through which of the intercostal spaces? - CORRECT ANSWERS Fifth intercostal space 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 - CORRECT ANSWERS C. Severe nerve injury 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 - CORRECT ANSWERS B. Pneumatic anti-shock garment (PASG) 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. A. Discharge home with concussion instructions B. CT of the head C. Skull films D. Admit for observation - CORRECT ANSWERS B. CT of the head Cerebral edema treatment - CORRECT ANSWERS Mannitol Head up position Hyperventilation Sellick maneuver - CORRECT ANSWERS Minimizes the chances of regurgitation during intubation ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | 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 - CORRECT ANSWERS A. Venous air embolism Normal capillary refill time - CORRECT ANSWERS 2 seconds Which of the following cannot be administered via endotracheal (ET) tube? A. Atropine B. Atenolol C. Epinephrine D. Lidocaine - CORRECT ANSWERS B. Atenolol Can be added to lidocaine to reduce the burning sensation when administered - CORRECT ANSWERS Sodium bicarbonate Nerve + sensory relationships - CORRECT ANSWERS C6 - Thumb C7 - Middle finger C8 - Little finger True regarding the initial resuscitation of a trauma patient - CORRECT ANSWERS Evidence of improved perfusion after fluid resuscitation could include improvement of GCS on reevaluation For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: - CORRECT ANSWERS cerebral vasoconstriction with diminished perfusion 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 ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Which one of the following statements concerning intraosseous infusion is TRUE?A. Only crystalloid solutions may be safely infused through the needle. B. Aspiration of bone marrow confirms appropriate positioning of the needle. C. Intraosseous infusion is the preferred route for volume resuscitation in small children. D. Intraosseous infusion may be utilized indefinitely. E. Swelling in the soft tissues around the intraosseous site is not a reason to discontinue infusion. - CORRECT ANSWERS B. Aspiration of bone marrow confirms appropriate positioning of the needle. A young woman sustains a severe head injury as the result of a motor vehicle crash. In the emergency department, her GCS is 6. Her blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is intubated and 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: A. avoid hypotension 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 - CORRECT ANSWERS A. avoid hypotension A hemodynamically normal 10-year-old girl is hospitalized for observation 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 - CORRECT ANSWERS D. development of peritonitis on physical exam A patient presents to the emergency room after a motor vehicle accident with hypotension, tachycardia, and abdominal distension. What is the most likely diagnosis? ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | A. Closed head injury B. Splenic injury C. Pneumothorax D. Neurogenic shock - CORRECT ANSWERS B. Splenic injury Considered a mechanically stable cervical spine injury - CORRECT ANSWERS -Clay shoveler's fracture -Simple wedge fracture not involving posterior elements -Unilateral facet dislocation NOT flexion teardrop fracture In most adults, the spinal cord terminates at what vertebrae? - CORRECT ANSWERS L1 Which is the best diagnostic test of nonpenetrating renal injuries? A. KUB B. IVP C. CT D. Laparoscopy - CORRECT ANSWERS C. CT Which arterial blood gas finding is most suggestive of acute respiratory failure? A. PCO2= 50, PO2= 80 B. PCO2 =40, PO2=60 C. PCO2=60, PO2= 50 D. PCO2= 30, PO2=70 - CORRECT ANSWERS C. PCO2=60, PO2= 50 Trio of hypertension, bradycardia and tachypnea - CORRECT ANSWERS Cushing's Triad During neck trauma, which cervical disc is most likely to herniate?Mark one answer: A. C1-C2 ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | B. C3-C4 C. C5-C6 D. C6-C7 - CORRECT ANSWERS D. C6-C7 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 - CORRECT ANSWERS D. An individual who cannot sleep 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 - CORRECT ANSWERS B. Cervical MRI What is the most common traumatic intracranial mass lesion? A. Epidural hematoma B. Gliocytoma C. Subdural hematoma D. Subarachnoid hemorrhage - CORRECT ANSWERS C. Subdural hematoma 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 - CORRECT ANSWERS B. 1 hr before surgery In which situation should a femoral traction splint NOT be used? ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Causes of heme-positive urine - CORRECT ANSWERS Ingestion of blackberries, beets or phenolphthalein Which of the following patients is most likely going to have a difficult intubation? A. A patient with a previous tracheostomy B. A patient with COPD C. An obese patient D. A patient with a huge goiter - CORRECT ANSWERS D. A patient with a huge goiter 37-year-old man is struck on the side of the head but is conscious and talkative after the injury. No evidence of skull fracture. Several days later, he becomes increasingly lethargic, somewhat confused, and unable to move his right side. Which type of event has most likely occurred? A. Subdural hematoma B. Epidural hematoma C. Carotid dissection D. Brain contusion - CORRECT ANSWERS A. Subdural hematoma An investigational drug is being tried on health volunteers for its safety and pharmacokinetic properties. Which of the following stages in the drug development process does this scenario most closely describe? A. Phase I B. Phase II C. Phase III D. Phase IV - CORRECT ANSWERS A. Phase I What intravenous fluid is to be given with blood products? A. Normal saline B. Ringers lactate C. 5% dextrose in water D. Half normal saline with 20 mEq/L of KCl - CORRECT ANSWERS A. Normal saline ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Increases ICP after head trauma - CORRECT ANSWERS Meningitis Intracerebral bleed Cerebral edema Neurogenic pulmonary edema - CORRECT ANSWERS Treatment -Oxygenation -Reduce ICP -High PO2 A female is transported to the emergency department after a motor vehicle accident with trauma to the left leg and back. Vital signs show temperature=37.1ºC, BP= 125/75 mm Hg, HR= 94, R=20. GCS is 15. There is paraplegia, T12 sensory level, and decreased rectal tone. Hemoglobin is normal and stable at 1 hour. Which of the following should be done to assess for intraperitoneal bleeding? A. Diagnostic peritoneal lavage B. CT of the abdomen C. Abdominal ultrasound D. Flat plate of the abdomen - CORRECT ANSWERS C. Abdominal ultrasound True statement regarding head trauma in elderly - CORRECT ANSWERS A larger subdural space in the skull requires more blood accumulation for brain compression, which often will delay presentation of symtoms What can cause unintentional airway closure in a mechanically ventilated pediatric patient? A. The Sellick maneuver B. CPR C. Hyperextension of the neck D. None of the above - CORRECT ANSWERS C. Hyperextension of the neck Blunt trauma to abdomen - CORRECT ANSWERS -Result in rupture of hollow viscus ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | -Can cause hematoma in the duodenum -May cause stress ulcers Which of the following is the best indicator of adequate shock resuscitation? A. Blood pressure B. Serum bicarbonate C. Skin capillary refill D. Urine output - CORRECT ANSWERS D. Urine output Which of the following statements is true regarding emergent pericardiocentesis? 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 - CORRECT ANSWERS B. Echocardiogram is the procedure of choice 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 - CORRECT ANSWERS B. NSAIDs and rest 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 - CORRECT ANSWERS A. Submersion time more than 10 minutes ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | An adult with a widened mediastinum might have which of the following? - CORRECT ANSWERS Aortic dissection 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 - CORRECT ANSWERS D. Beck's Triad - hypotension, muffled heart sounds, JVD Pulsus parodoxus: larger than normal drop of SBP during inspiration A patient with their neck flexed would have which vertebrae as most prominent? A. C5 B. C6 C. C7 D. T1 - CORRECT ANSWERS C. C7 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 - CORRECT ANSWERS C. The airway is not clear Which is the preferred site for arterial sampling? A. Carotid artery B. Ulnar artery C. Tibial artery D. Radial artery - CORRECT ANSWERS D. Radial artery ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | Neuromuscular blocking agent works by depolarization - CORRECT ANSWERS Succinylcholine Which of the following is of no benefit for a patient who has just aspirated during induction of anesthesia? A. Nasogastric tube placement and suction B. Bronchoscopy C. Corticosteroids D. Hydration - CORRECT ANSWERS C. Corticosteroids A healthy 24-year-old is involved in a motor vehicle accident. He loses consciousness but regains it within a few hours and appears normal to friends. He later presents to the emergency room very lethargic, weak, and with a dilated pupil on the left side. The patient most likely has which of the following conditions? A. Acute subdural hematoma B. Subarachnoid hemorrhage C. Acute epidural hematoma D. Intra-cerebral hemorrhage - CORRECT ANSWERS C. Acute epidural hematoma What is the MOST sensitive test used to make a diagnosis of skull fracture? A. Physical exam B. Head CT C. Skull radiographs D. MRI - CORRECT ANSWERS B. Head CT The most common complication after nasotracheal intubation is: A. Epistaxis B. Nasal congestion C. Infection D. Aspiration - CORRECT ANSWERS A. Epistaxis ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM REAL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (100% VERIFIED ANSWERS) | True about depressed skull fractures - CORRECT ANSWERS Any bone fragment displaced > 1 cm inward should be elevated surgically During CPR, the highest amount of blood flow is observed with which technique? - CORRECT ANSWERS High impulse CPR at 100-120 compressions per min What is the main bleeding source in a subdural hematoma? A. Capillary B. Venous C. Arterial D. Mix type - CORRECT ANSWERS B. Venous Central venous pressure is reflective of: - CORRECT ANSWERS Pressure of blood returning to the heart Why does the ACLS protocol recommend epinephrine? A. Increases muscular blood flow B. Dilates the bronchioles C. Enhances myocardial contractility D. Raises the systolic blood pressure - CORRECT ANSWERS C. Enhances myocardial contractility What occurs in patients developing a central herniation of the brain? A. One sided paralysis B. Pupillary constriction C. Bilateral deterioration of functioning D. Lower extremity paralysis - CORRECT ANSWERS C. Bilateral deterioration of functioning Blood containing HIV that is spilled on the floor can be disinfected with which of the following? A. Benzene B. Sodium hypochlorite