ATLS Student Refresher Module 4-6 Practice Exam Q&A 2024, Exams of Nursing

Download ATLS Student Refresher Module 4-6 Practice Exam Q&A 2024 and more Exams Nursing in PDF only on Docsity! ATLS STUDENT REFRESHER Module 4 - 6 PRACTICE EXAM Q & A 2024 1. Which of the following is a common mechanism of thoracic injury in blunt trauma? A) Deceleration B) Compression C) Penetration D) Shear Answer: B) Compression. Compression occurs when the chest wall is crushed between an external force and the spine, resulting in rib fractures, lung contusions, or cardiac injuries. Deceleration, penetration, and shear are more likely to cause injuries to the aorta, great vessels, or mediastinal structures. 2. What is the most sensitive and specific imaging modality for diagnosing a pneumothorax? A) Chest X-ray B) Ultrasound C) CT scan D) MRI Answer: B) Ultrasound. Ultrasound has a sensitivity and specificity of nearly 100% for detecting pneumothorax, especially in the supine position. Chest X-ray can miss up to 50% of pneumothoraces in trauma patients, and CT scan and MRI are not readily available or indicated in most cases. 3. What is the initial management of a tension pneumothorax in a trauma patient? Rationale: Rebound tenderness refers to pain that occurs when pressure is released from the abdomen, indicating possible peritoneal irritation. This finding is highly concerning and should prompt further evaluation and intervention to rule out significant abdominal injury. 3. A patient presents with blunt trauma to the abdomen and exhibits signs of shock. What is the INITIAL management priority for this patient? a) Administering intravenous fluids b) Controlling external bleeding c) Assessing airway, breathing, and circulation (ABCs) d) Ordering immediate imaging studies Answer: c) Assessing airway, breathing, and circulation (ABCs) Rationale: In any trauma patient, the initial management priority is to assess and stabilize airway, breathing, and circulation, as immediate life-threatening conditions must be addressed first. Once the ABCs are addressed, further evaluation and interventions can be initiated. 4. Which of the following imaging studies is the GOLD STANDARD for diagnosing abdominal and pelvic injuries? a) X-ray b) Computed tomography (CT) scan c) Ultrasound d) Magnetic resonance imaging (MRI) Answer: b) Computed tomography (CT) scan Rationale: CT scan is considered the gold standard for diagnosing abdominal and pelvic injuries due to its ability to provide detailed imaging of soft tissues and organs. It helps in identifying injuries such as fractures, organ parenchymal injuries, and intra-abdominal bleeding. 5. A patient with suspected pelvic fracture presents with signs of hypovolemic shock. In addition to fluid resuscitation, which of the following interventions should be performed? a) Applying a pelvic binder b) Administering pain medication c) Performing a pelvic exploration d) Initiating anticoagulant therapy Answer: a) Applying a pelvic binder Rationale: Applying a pelvic binder helps stabilize the pelvis, reducing further injury and controlling bleeding. This intervention should be performed early in the management of a suspected pelvic fracture, along with fluid resuscitation, to prevent hypovolemic shock. 6. A patient with a suspected abdominal injury is stable and is scheduled for imaging studies. Which of the following is an appropriate fasting duration before a contrast-enhanced CT scan? a) 2 hours b) 4 hours c) 8 hours d) 12 hours Answer: c) 8 hours Rationale: A fasting duration of at least 8 hours is recommended before a contrast-enhanced CT scan to decrease the risk of aspiration if intervention or surgery is required during imaging or afterwards. 7. Which of the following signs or symptoms is associated with a potential bladder injury? a) Hematuria b) Left lower quadrant pain c) Referred shoulder pain d) Right upper quadrant tenderness Answer: a) Hematuria Rationale: Hematuria, or blood in the urine, is a common sign associated with potential bladder injury. Other signs may include inability to void, suprapubic pain, and a palpable bladder on physical examination. 8. During the initial assessment of a patient with potential abdominal injuries, which of the following should be performed FIRST? a) Assessing vital signs a) Intravenous morphine b) Nonsteroidal anti-inflammatory drugs (NSAIDs) c) Paracetamol (acetaminophen) d) Intramuscular opioids Answer: a) Intravenous morphine Rationale: Intravenous morphine is an appropriate choice for analgesia in the management of a suspected abdominal injury. It provides effective pain relief and can be titrated based on the patient's needs. 13. Which of the following structures is commonly involved in a blunt abdominal trauma? a) Kidneys b) Spleen c) Liver d) All of the above Answer: d) All of the above Rationale: Blunt abdominal trauma can involve multiple structures, including the kidneys, spleen, and liver. These organs are susceptible to injury due to their position within the abdominal cavity and their proximity to the impact site. 14. Which of the following is a potential sign of an ectopic pregnancy? a) Elevated human chorionic gonadotropin (hCG) levels b) Vaginal bleeding c) Pelvic pain or tenderness d) All of the above Answer: d) All of the above Rationale: An ectopic pregnancy, where the fertilized egg implants outside the uterus, can present with elevated hCG levels, vaginal bleeding, and pelvic pain or tenderness. Prompt diagnosis and management are crucial to prevent life-threatening complications. 15. When a patient presents with a suspected abdominal injury, what is the appropriate position for them during the initial assessment? a) Supine with a head-down tilt b) Supine with a head-up tilt c) Trendelenburg position d) Left lateral decubitus position Answer: b) Supine with a head-up tilt Rationale: The appropriate position for a patient with a suspected abdominal injury during the initial assessment is supine with a head-up tilt. This position facilitates abdominal examination and helps prevent potential aspiration and respiratory compromise. Question: Which of the following is NOT a common cause of head injury? A) Falls B) Motor vehicle accidents C) Sporting injuries D) Gastrointestinal disorders Answer: D) Gastrointestinal disorders Rationale: Gastrointestinal disorders are not typically associated with head injuries. Falls, motor vehicle accidents, and sporting injuries are common causes of head trauma. Question: What is the first step in assessing a patient with a suspected head injury? A) Assess airway, breathing, and circulation B) Perform a neurological examination C) Obtain a detailed medical history D) Order a CT scan of the head Answer: A) Assess airway, breathing, and circulation Rationale: The initial assessment of a patient with a suspected head injury should prioritize airway, breathing, and circulation to ensure immediate life-saving interventions if necessary. Question: Which of the following signs or symptoms is indicative of a more severe head injury? A) Brief loss of consciousness B) Confusion and disorientation C) Pupillary asymmetry D) Scalp laceration without underlying skull fracture Rationale: Coup-contrecoup injury refers to the occurrence of injury at the site of impact and on the opposite side of the brain due to rapid deceleration forces. Question: What is the recommended position for a patient with a suspected cervical spine injury and altered mental status? A) Supine position with a cervical collar in place B) Sitting position with head support C) Prone position with a cervical collar in place D) Lateral recumbent position with head elevation Answer: A) Supine position with a cervical collar in place Rationale: Maintaining a supine position with a cervical collar helps prevent further injury to the cervical spine in the setting of altered mental status. Question: Which of the following is a potential complication of a basilar skull fracture? A) Epidural hematoma B) Subarachnoid hemorrhage C) Olfactory nerve injury D) Meningitis Answer: D) Meningitis Rationale: Meningitis is a potential complication of basilar skull fractures due to the risk of CSF leakage and bacterial contamination. Question: What is the Glasgow Coma Scale (GCS) score indicative of severe brain injury? A) GCS score of 8 or less B) GCS score of 10 or less C) GCS score of 12 or less D) GCS score of 14 or less Answer: A) GCS score of 8 or less Rationale: A GCS score of 8 or less indicates severe brain injury and impaired consciousness. Question: Which of the following symptoms is characteristic of a concussion? A) Focal neurological deficits B) Prolonged loss of consciousness C) Retrograde amnesia D) Headache and dizziness Answer: D) Headache and dizziness Rationale: Headache and dizziness are common symptoms of concussion, often accompanied by confusion and memory problems. Question: What is the recommended duration of observation for a patient with a minor head injury and no evidence of intracranial abnormalities on CT scan? A) 2 hours B) 4 hours C) 6 hours D) 8 hours Answer: C) 6 hours Rationale: A period of 6 hours of observation is recommended for patients with minor head injury and normal CT findings to monitor for delayed neurological deterioration. Question: Which of the following is a key component of long-term management for patients with persistent post- concussive symptoms? A) Early return to contact sports B) Cognitive and physical rest C) Immediate initiation of anticoagulant therapy D) High-dose corticosteroid therapy Answer: B) Cognitive and physical rest Rationale: Cognitive and physical rest is a key component of long-term management for patients with persistent post-concussive symptoms to allow for recovery and symptom resolution. Question: What is the initial treatment priority for an open head injury with visible brain matter? A) Immediate surgical debridement B) Application of a sterile dressing C) Administration of broad-spectrum antibiotics D) Rapid sequence intubation Answer: B) Application of a sterile dressing Rationale: The initial priority for an open head injury with visible brain matter is to apply a sterile dressing to protect the exposed brain tissue and prevent infection.