ATLS PRE-TEST 4 LATEST VERSIONS 2023-2024 REAL EXAM 40 QUESTIONS AND CORRECT ANSWERS, Exams of Nursing

Download ATLS PRE-TEST 4 LATEST VERSIONS 2023-2024 REAL EXAM 40 QUESTIONS AND CORRECT ANSWERS and more Exams Nursing in PDF only on Docsity! ATLS PRE-TEST 4 LATEST VERSIONS 2023-2024 REAL EXAM 40 QUESTIONS AND CORRECT ANSWERS | GRADED A pre-test Question 3 Question 1 A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood pressure isinitially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to 122/84 mm Hg. His heart rate isnow 100 beats per minute and his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed fordecreased left chest breath sounds with the return of a small amount of blood and no air leak. After chest tubeinsertion, what is the most appropriate next step? Question 2 A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. In the emergencydepartment, he is alert, vital signs are normal, and he is complaining of severe pain in both heels and his lower back.Lower extremity pulses are strong and there is no other deformity. Which of the following is most likely to confirm thesuspected diagnosis? Your answer Choice Correct answer Re-examine the chest Perform an aortogram Obtain a CT scan of the chest Obtain arterial blood gas analysis Perform transesophageal echocardiography Your answer Choice Correct answer Angiography Compartment pressures Retrograde urethrogram Doppler ultrasound studies Complete spine x-ray series Which of the following is TRUE regarding the initial resuscitation of a trauma patient? Your answer Choice Correct answer Acidosis x Hypotension x Increased vascular resistance x > Evidence of inadequate organ perfusion aS Question 9 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. What should immediate management of the wound consist of? Your answer Choice Correct answer Application of a tourniquet x > Direct pressure on the wound Packing the wound with gauze Direct pressure on the femoral artery at the groin x x * <¢ Debridement of devitalized tissue Question 10 For the patient with severe traumatic brain injury, avoiding profound hypocarbia will prevent what from happening? Your answer Choice Correct answer Respiratory acidosis Metabolic acidosis > Cerebral vasoconstriction with diminished perfusion Neurogenic pulmonary edema Shift of the oxyhemoglobin dissociation curve x x <¢ Xx  Question 11 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 (CT) 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. What is the next step? Your answer Choice Correct answer Obtain contrast angiography x Transfer to a higher level trauma center > Perform an exploratory laparotomy Infuse additional crystalloid fluids x * <€ Xx Obtain transesophageal echocardiography Question 12 Which one of the following statements regarding abdominal trauma in the pregnant patient isTRUE? Your Choice Correct answer answer The fetus is in jeopardy only with major abdominal trauma. x Leakage of amniotic fluid is an indication for hospital admission. WV Indications for peritoneal lavage are different from those in the nonpregnant patient. x With penetrating trauma, injury to the mother’s abdominal hollow viscus is more common x in late than in early pregnancy. > The secondary survey follows a different pattern from that of the nonpregnant patient. x Question 13 What is the first maneuver to improve oxygenation after chest injury? Your answer Choice Correct answer Intubate the patient x Assess arterial blood gases x > Administer supplemental oxygen Vv Question 16 Which one of the following findings in an adult is most likely to require immediate management during the primary survey? Obtain a CT of the chest Your answer Choice Correct answer x Perform an angiography > Urgently transfer the patient to the operating room x Immediately transfer the patient to a trauma center r- Question 22 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. What is the most appropriate next step? Your Choice Correct answer answer Perform a surgical cricothyroidotomy x Attempt nasotracheal intubation x Ventilate him with a bag-mask device until c-spine injury can be excluded x > Restrict cervical motion and attempt orotracheal intubation using 2 people Ss Ventilate the patient with a bag-mask device until his beard can be shaved for better x mask fit Question 23 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? Your answer Choice Correct answer Vasoactive medications have no role in this patient's management. x The hypotension should be managed with volume resuscitation alone. x Flexion and extension views of the c-spine should be performed early. x Abdominal visceral injuries can be excluded as a cause of hypotension. x > Flaccidity of the lower extremities and loss of deep tendon reflexes are expected. JS  Question 24 Which one of the following is the most effective method for initially treating frostbite? Your answer Choice Correct answer > Moist heat a Early amputation Padding and elevation Vasodilators and heparin x x xX X Topical application of silver sulfadiazine Question 25 A 32-year-old man’s right leg is trapped beneath his overturned car for nearly 2 hours before he is extricated. On arrival in the emergency department, his right lower extremity is cool, mottled, insensate, and motionless. Despite normal vital signs, pulses cannot be palpated below the right femoral artery and the muscles of the lower extremity are firm and hard. During the management of this patient, which of the following is most likely to improve the chances for limb salvage? Your answer Choice Correct answer Applying skeletal traction x Administering anticoagulant drugs Administering thrombolytic therapy > Surgical consultation for right lower extremity fasciotomy x < * x Transferring the patient to the trauma center 120 km away y- Question 26 A patient arrives in the emergency department after being beaten about the head and face with a wooden club. He is comatose and has a palpable depressed skull fracture. His face is swollen and ecchymotic. He has gurgling respirations and vomitus on his face and clothing. What is the most appropriate step after providing supplemental oxygen and elevating his jaw? Your answer Choice Correct answer Request a CT scan x Insert a gastric tube x  Choice Correct answer Aggressively treat systemic hypertension x Reduce metabolic requirements of the brain x Distinguish between intracranial hematoma and cerebral edema x Question 32 A 33-year-old woman is involved in a head-on motor vehicle crash. It took 30 minutes to extricate her from the car. Upon arrival in the emergency department, her heart rate is 120 beats per minute, BP is 90/70 mm Hg, respiratory rate is 16 breaths per minute, and her GCS score is 15. Examination reveals bilaterally equal breath sounds, anterior chest wall ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not tender. Her pelvis is stable. Palpable distal pulses are found in all 4 extremities. Which of the following is the most likely diagnosis? Your answer Choice Correct answer Hemorrhagic shock x > Cardiac tamponade Massive hemothorax Tension pneumothorax x x * <¢ Diaphragmatic rupture Question 33 A hemodynamically normal 10-year-old girl is hospitalized for observation after a Grade Ill (moderately severe) splenic injury has been confirmed by computed tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)? Your answer Choice Correct answer Aserum amylase of 200 x A leukocyte count of 14,000 Evidence of retroperitoneal hematoma on CT scan Development of peritonitis on physical exam x < * x > A fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours  Question 34 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? Your Choice Correct answer answer Neurogenic shock is likely to develop. x Imaging of her complete spine is required prior to transfer to a trauma center. x Given the injury level knee extension would be expected. x > Log rolling using 4 people is a safe approach to restrict spinal motion when moving ve her. Presence of bulbocarvenous reflex indicates a better prognosis. x Question 35 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. What is the most appropriate next step? Your answer Choice Correct answer Apply cervical traction Perform immediate tracheostomy Insert bilateral thoracostomy tubes Maintain 100% oxygen and obtain immediate c-spine x-rays < x x x > Restrict cervical motion and establish a definitive airway y- Question 36 Which of the following is TRUE when applying the Rule of Nines to infants? Your answer Choice Correct answer It is not reliable. x The body is proportionally larger in infants than in adults. x  Choice Correct answer > The head is proportionally larger in infants than in adults. Sf The legs are proportionally larger in infants than in adults. x The arms are proportionally larger in infants than in adults. x Question 37 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 when his pelvis is palpated. After initiating fluid resuscitation, what is the next step in the management of this patient? Your answer Choice Correct answer > Placement of a pelvic binder wa Transfer to a trauma center Pelvic x-ray Insert urinary catheter x x xX X Repeat examination of pelvis ;- Question 38. Which one of the following situations requires Rh immunoglobulin administration to an injured woman? Your answer Choice Correct answer Negative pregnancy test, Rh negative, and has torso trauma > Positive pregnancy test, Rh positive, and has torso trauma Positive pregnancy test, Rh negative, and has torso trauma Positive pregnancy test, Rh positive, and has an isolated wrist fracture x x <€ x Positive pregnancy test, Rh negative, and has an isolated wrist fracture Question 39