ATLS Test Real Exam Questions with 100% Correct Answers Latest Update 2024/2025, Exams of Nursing

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A 22-year-old man is hypotensive and tachycardic a5er a shotgun wound to the le5 shoulder. His blood pressure is ini<ally 80/40 mm Hg. A5er ini<al fluid resuscita<on his blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for decreased le5 chest breath sounds with the return of a small amount of blood and no air leak. A5er chest tube inser<on, the most appropriate next step is: Select one: a. Reexamine the chest b. Perform an aortogram c. Obtain a CT scan of the chest d. Obtain arterial blood gas analyses e. Perform transesophageal echocardiography A) Reexamine the chest A construc<on worker falls two stories from a building and sustains bilateral calcaneal fractures. In the emergency department, he is alert, vital signs are

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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. The suspected diagnosis is most likely to be confirmed by: Select one: a. Angiography b. Compartment pressures c. Retrograde urethrogram d. Doppler ultrasound studies e. Complete spine x-ray series E) Complete spine x-ray series Which of the following is true regarding the ini<al resuscita<on of a trauma pa<ent? Select one: a. A pa<ent that presents with a torso gunshot wound and is hypotensive should receive crystalloid fluid resuscita<on un<l the blood pressure is normal b. Evidence of improved perfusion a5er fluid resuscita<on could include improvement in Glasgow coma scale score on reevalua10 of packed red blood cells and plasma in 24 hours

d. When tranexamic acid is administered by pre-hospital providers a second dose is required within 24 hours e. Fluid resuscita<on is far more important than bleeding control in trauma pa<ents B. Evidence of improved perfusion a5er fluid resuscita<on could include improvement in Glasgow coma scale score on reevalua<on In managing a pa<ent with a severe trauma<c brain injury, the most important ini<al step is to: Select one: a. Secure the airway b. Obtain a c-spine film c. Support the circula<on d. Control scalp hemorrhage e. Determine the GCS score Feedback Your answer is corr A. Secure the airway

A previously healthy, 70-kg (154-pound) man suffers an es<mated acute blood loss of 2 liters. Which one of the following statements applies to this pa<ent? Select one: a. His pulse pressure will be widened. B. His urinary output will be at the lower limits of normal. C. He will have tachycardia, but no change in his systolic blood pressure. D. An ABG would demonstrate a base deficit between - 6 and - 10 meq/L e. His systolic blood pressure will be maintained with an elevated diastolic pressure. D. An ABG would demonstrate a base deficit between - 6 and - 10 meq/L The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by: Select one: a. Reducing the need for blood transfusion b. Resul<ng in an elevated hematocrit c. Complica<ng the management of closed head injury d.

Reducing the volume of crystalloid required for resuscita<on e. Increasing the volume of blood loss to produce maternal hypotension E. Increasing the volume of blood loss to produce maternal hypotension The best assessment of fluid resuscita<on of the adult burn pa<ent is: Select one: a. Urine output of 0.5 ml/kg/hr b. Normaliza<on of blood pressure c. Normaliza<on of the heart rate d. Measuring a normal central venous pressure e. Providing 4 ml/kg/percent body burn/24 hours of crystalloid fluid A. Urine output of 0.5 ml/kg/hr The diagnosis of shock must include: Select one: a. Hypoxemia b. Acidosis c. Hypotension

d. Increased vascular resistance e. Evidence of inadequate organ perfusion E. Evidence of inadequate organ perfusion A 7-year-old boy is brought to the emergency department by his parents several minutes a5er 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: Select one: a. Applica<on of a tourniquet b. Direct pressure on the wound c. Packing the wound with gauze d. Direct pressure on the femoral artery at the groin e. Debridement of devitalized <ssue B. Direct pressure on the wound For the pa<ent with severe trauma<c brain injury, profound hypocarbia should be avoided to prevent: Select one: a.

Respiratory acidosis b. Metabolic acidosis c. Cerebral vasoconstric<on with diminished perfusion d. Neurogenic pulmonary edema e. Shi5 of the oxyhemoglobin dissocia<on curve C. Cerebral vasoconstric<on with diminished perfusion A5er being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has surgery capabili<es available.. Computed tomography of the chest and abdomen shows an aor<c injury and splenic lacera<on with free abdominal fluid. His blood pressure falls to 70 mm Hg a5er CT. The next step is: Select one: a. Obtain contrast angiography b. Transfer to a higher level trauma center c. Perform an exploratory laparotomy d. Infuse addi<onal crystalloid fluids e. Obtain transesophageal echocardiography

C.

Perform an exploratory laparotomy Which one of the following statements regarding abdominal trauma in the pregnant pa<ent is TRUE? Select one: a. The fetus is in jeopardy only with major maternal abdominal trauma. B. Leakage of amnio<c fluid is an indica<on for hospital admission. C. Indica<ons for peritoneal lavage are different from those in the nonpregnant pa<ent. D. With penetra<ng trauma, injury to the mother's abdominal hollow viscus is more common in late than in early pregnancy. E. The secondary survey follows a different pagern from that of the nonpregnant pa<ent. B. Leakage of amnio<c fluid is an indica<on for hospital admission. The first maneuver to improve oxygena<on a5er chest injury is to: Select one: a. Intubate the pa<ent b. Assess arterial blood gases c.

Administer supplemental oxygen d. Ascertain the need for a chest tube e. Obtain a chest x-ray C. Administer supplemental oxygen A 25-year-old man, injured in a motor vehicular crash, is admiged 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 le5 hand reaches purposefully toward the s<mulus. Both legs are s<ffly extended. His GCS score is: Select one: a: 2 b: 4 c: 6 d: 9 e: 12 D: 9 Which one of the following findings in an adult is most likely to require immediate management during the primary survey? Select one: a. Distended abdomen b. Glasgow Coma Scale score of 11

c. Temperature of 36.5°C (97.8°F) d. Deformity of the right thigh e. Respiratory rate of 40 breaths per minute E. Respiratory rate of 40 breaths per minute A 20-year-old woman that is 32 weeks gesta<on , 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: Select one: a. Perform tracheal intuba<on b. Insert an oropharyngeal airway c. Perform needle or finger decompression of the right chest d. Manually displace the gravid uterus to the le5 side of the abdomen e. Ini<ate 2, large-caliber peripheral IV lines and crystalloid infusion C. Perform needle or finger decompression of the right chest An important, immediate step in the management of an open pneumothorax is:

Select one: a. Endotracheal intuba<on b. Opera<on to close the wound c. Placing a chest tube through the chest wound d. Placement of an occlusive dressing over the wound secured on three sides e. Ini<a<on of 2, large-caliber ivs and infusing crystalloid solu<on D. Placement of an occlusive dressing over the wound secured on three sides Which of the following is a contraindica<on for tetanus toxoid administra<on? Select one: a. History of neurological reac<on or severe hypersensi<vity to the product b. Local side effects c. Muscular spasms d. Pregnancy e. All of the above A. History of neurological reac<on or severe hypersensi<vity 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 to the emergency department he is diaphore<c 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 differen<ates cardiac tamponade from tension pneumothorax as the cause of his hypotension? Select one: a. Tachycardia b. Pulse volume c. Breath sounds d. Pulse pressure e. Jugular venous pressure C. Breath sounds Bronchial intuba<on of the right or le5 mainstem bronchus can easily occur during infant endotracheal intuba<on because: Select one: a. The trachea is rela<vely short. B. The distance from the lips to the larynx is rela<vely short. C.

The use of cuffed endotracheal tubes eliminates this issue. D. The mainstem bronchi are less angulated in their rela<on to the trachea. E. So ligle fric<on exists between the endotracheal tube and the wall of the trachea. A. The trachea is rela<vely short. A 23-year-old man sustains 4 stab wounds to the upper right chest during an alterca<on and is brought by ambulance to a hospital that has full surgical capabili<es. His wounds are all above the nipple. He is endotracheally intubated, closed tube thoracostomy is performed, fluid resuscita<on is ini<ated 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 (ven<lated with 100% O2). 1500 ml of blood has drained from the right chest. The most appropriate next step in managing this pa<ent is to Select one: a. Perform diagnos<c peritoneal lavage b. Obtain a CT of the chest c. Perform an angiography d. Urgently transfer the pa<ent to the opera<ng room

e. Immediately transfer the pa<ent to a trauma center D. Urgently transfer the pa<ent to the opera<ng room A 39-year-old man is admiged to the emergency department a5er an automobile collision. He is cyano<c, 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 Select one: a. Perform a surgical cricothyroidotomy b. Agempt nasotracheal intuba<on c. Ven<late him with a bag-mask device un<l c-spine injury can be excluded d. Restrict cervical mo<on and agempt orotracheal intuba<on using 2 people e. Ven<late the pa<ent with a bag-mask device un<l his beard can be shaved for beger mask fit a. Perform a surgical cricothyroidotomy b. Agempt nasotracheal intuba<on c. Ven<late him with a bag-mask device un<l c-spine injury can be excluded d.

Restrict cervical mo<on and agempt orotracheal intuba<on using 2 people e. Ven<late the pa<ent with a bag-mask device un<l his beard can be shaved for beger mask fit D. Restrict cervical mo<on and agempt orotracheal intuba<on using 2 people A pa<ent is brought to the emergency department a5er a motor vehicle crash. He is conscious and there is no obvious external trauma. 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? Select one: a. Vasoac<ve medica<ons have no role in this pa<ent's management. B. The hypotension should be managed with volume resuscita<on alone. C. Flexion and extension views of the c-spine should be performed early. D. Abdominal visceral injuries can be excluded as a cause of hypotension. E. Flaccidity of the lower extremi<es and loss of deep tendon reflexes are expected. E. Flaccidity of the lower extremi<es and loss of deep tendon reflexes are expected Which one of the following is the most effec<ve method for ini<ally trea<ng frostbite?

Select one: a. Moist heat b. Early amputa<on c. Padding and eleva<on d. Vasodilators and heparin e. Topical applica<on of silver sulfadiazine A. Moist heat A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he is extricated. On arrival to the emergency department, his right lower extremity is cool, mogled, insensate, and mo<onless. Despite normal vital signs, a pulse cannot be palpated below the right femoral artery and the muscles of the lower extremity are firm and hard. During the management of this pa<ent, which of the following is most likely to improve the chances for limb salvage? Select one: a. Applying skeletal trac<on b. Administering an<coagulant drugs c. Administering thromboly<c therapy

d. Surgical consulta<on for right lower extremity fasciotomy e. Transferring the pa<ent to the trauma center 120 km away D. Surgical consulta<on for right lower extremity fasciotomy A pa<ent arrives in the emergency department a5er 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 ecchymo<c. He has gurgling respira<ons and vomitus on his face and clothing. The most appropriate step a5er providing supplemental oxygen and eleva<ng his jaw is to: Select one: a. Request a CT scan b. Insert a gastric tube c. Suc<on the oropharynx d. Obtain a lateral cervical spine x-ray e. Ven<late the pa<ent with a bag-mask C. Suc<on the oropharynx A 22-year-old man sustains a gunshot wound to the le5 chest and is transported to a small community hospital; no surgical capabili<es are available. In the emergency department, a chest tube is inserted and 700 ml of

blood is evacuated. The trauma center accepts the pa<ent in transfer. Just before the pa<ent is placed in the ambulance for transfer, his blood pressure decreases to 80/68 mm Hg and his heart rate increases to 136 beats per minute. The next step should be to: Select one: a. Clamp the chest tube b. Cancel the pa<ent's transfer c. Perform an emergency department thoracotomy d. Repeat the primary survey and proceed with transfer e. Delay the transfer un<l the referring doctor can contact a thoracic surgeon D. Repeat the primary survey and proceed with transfer A 64-year-old man involved in a high-speed car crash, is resuscitated ini<ally in a small hospital without surgical capabili<es. He has a closed head injury with a GCS score of 13. He has a widened medias<num on chest x-ray with fractures of le5 ribs 2 through 4, but no pneumothorax. A5er ini<a<ng fluid resuscita<on, his blood pressure is 110/74 mm Hg, heart rate is 100 beats per minute, and respiratory rate is 18 breaths per minute. He has gross hematuria and a pelvic fracture. You decide to transfer this pa<ent to a facility capable of providing a higher level of care. The facility is 128 km (80 miles) away. Before transfer, you should first: Select one:

a. Intubate the pa<ent b. Perform diagnos<c peritoneal lavage or FAST c. Insert a le5 chest tube d. Call the receiving hospital and speak to the surgeon on call e. Discuss the advisability of transfer with the pa<ent's family D. Call the receiving hospital and speak to the surgeon on call Hemorrhage of 20% of the pa<ent's blood volume is associated usually with: Select one: a. Oliguria b. Confusion c. Hypotension d. Tachycardia e. Blood transfusion requirement D. Tachycardia

Which one of the following statements concerning intraosseous infusion is TRUE? Select one: a. Only crystalloid solu<ons may be safely infused through the needle. B. Aspira<on of bone marrow confirms appropriate posi<oning of the needle. C. Intraosseous infusion is the preferred route for volume resuscita<on in small children. D. Intraosseous infusion may be u<lized indefinitely. E. Swelling in the so5 <ssues around the intraosseous site is not a reason to discon<nue infusion. B. Aspira<on of bone marrow confirms appropriate posi<oning of the needle. A young female sustains a severe head injury as the result of a motor vehicle crash. In the emergency department, her GCS is 6, blood pressure is 140/ mm Hg, and her heart rate is 80 beats per minute. She is intubated and mechanically ven<lated. Her pupils are 3 mm in size and equally reac<ve to light. There is no other apparent injury. The most important principle to follow in the early management of her head injury is to: Select one: a. Avoid hypotension b.

Administer an osmo<c diure<c c. Aggressively treat systemic hypertension d. Reduce metabolic requirements of the brain e. Dis<nguish between intracranial hematoma and cerebral edema A. Avoid hypotension A 33-year-old female 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. Examina<on reveals bilaterally equal breath sounds, anterior chest wall ecchymosis, and distended neck veins. Her abdomen is flat, so5, and not tender. Her pelvis is stable. Palpable distal pulses are found in all 4 extremi<es. Of the following, the most likely diagnosis is: Select one: a. Hemorrhagic shock b. Cardiac tamponade c. Massive hemothorax d. Tension pneumothorax

e. Diaphragma<c rupture B. Cardiac tamponade A hemodynamically normal 10-year-old girl is hospitalized for observa<on a5er a Grade III (moderately severe) splenic injury has been confirmed by computed tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)? Select one: a. A serum amylase of 200 b. A leukocyte count of 14,000 c. Evidence of retroperitoneal hematoma on CT scan d. Development of peritoni<s on physical exam e. A fall in the hemoglobin level from 12 g/dl to 8 g/dl over 24 hours D. Development of peritoni<s 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 evalua<on and management? Select one: a.

Neurogenic shock is likely to develop b. Imaging of her complete spine is required prior to transfer to a trauma center c. Given the injury level knee extension would be expected d. Log rolling using 4 people is a safe approach to limit spinal mo<on when moving her e. Presence of bulbocarvenous reflex indicates a beger prognosis D. Log rolling using 4 people is a safe approach to limit spinal mo<on when moving her A trauma pa<ent presents to your emergency department with inspiratory stridor and a suspected c- spine injury. Oxygen satura<on is 88% on high-flow oxygen via a nonrebreathing mask. The most appropriate next step is to: Select one: a. Apply cervical trac<on b. Perform immediate tracheostomy c. Insert bilateral thoracostomy tubes d. Maintain 100% oxygen and obtain immediate c-spine x-rays e. Restrict cervical mo<on and establish a defini<ve airway

E.

Restrict cervical mo<on and establish a defini<ve airway When applying the Rule of Nines to infants: Select one: a. It is not reliable. B. The body is propor<onally larger in infants than in adults. C. The head is propor<onally larger in infants than in adults. D. The legs are propor<onally larger in infants than in adults. E. The arms are propor<onally larger in infants than in adults. C. The head is propor<onally 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 pa<ent moans when his pelvis is palpated. A5er ini<a<ng fluid resuscita<on, the next step in management is: Select one: a. Placement of a pelvic binder b. Transfer to a trauma center c. Pelvic x-ray

d. Insert urinary catheter e. Repeat examina<on of pelvis A. Placement of a pelvic binder Which situa<on requires Rh immunoglobulin administra<on to an injured female? Select one: a. Nega<ve pregnancy test, Rh nega<ve, and has torso trauma b. Posi<ve pregnancy test, Rh posi<ve, and has torso trauma c. Posi<ve pregnancy test, Rh nega<ve, and has torso trauma d. Posi<ve pregnancy test, Rh posi<ve, and has an isolated wrist fracture e. Posi<ve pregnancy test, Rh nega<ve, and has an isolated wrist fracture C. Posi<ve pregnancy test, Rh nega<ve, and has torso trauma A 22-year-old female athlete is stabbed in her le5 chest at the third interspace in the anterior axillary line. On admission to the ED and 15 minutes a5er the incident, she is awake and alert. Her heart rate is 100 beats per minute, blood pressure is 80/60 mm Hg, and respiratory rate is 20 breaths per minute. A chest x-ray reveals a large le5 hemothorax. A le5 chest tube is placed with an immediate return of 1600 ml of blood. The next management step for this