Emergency Medicine: Trauma and Critical Care, Exams of Nursing

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ATLS PRETEST 2024 EXAM AND

PRACTICE EXAM 350 QUESTIONS WITH

DETAILED VERIFIED ANSWERS AND

RATIONALES (100% CORRECT) /A+

GRADE ASSURED

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: - ...ANSWER...restrict cervical motion and establish a definitive airway When applying the Rule of Nines to infants: - ...ANSWER...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 when his pelvis is palpated. After initiating fluid resuscitation, the next step in management is: - ...ANSWER...placement of a pelvic binder Which one of the following situations requires Rh immunoglobulin administration to an injured woman? - ...ANSWER...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: - ...ANSWER...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? - ...ANSWER...A pulmonary contusion may be present in the absence of rib fractures. When something crashes in secondary survey, you... - ...ANSWER...GO BACK TO PRIAMRY SURVEY If the question says you do not have capabilities, you will most likely - ...ANSWER...PREPARE FOR AND DO NOT DELAY TRANSPORT How much blood can femur lose - ...ANSWER...2L What is always going to be the shock type to pick - ...ANSWER...Hemorrhagic What are the classes of hemorrhagic shock - ...ANSWER... 0 - 15% is class 1 15 - 30 is class 2

30 - 40% is class 3

40% is class 4 What is the EARLIEST predictor of shock at what class - ...ANSWER...Narrowed pulse pressure in class 2 What will be base deficit for class 2 shock? - ...ANSWER...- 2 to - 6 meQ What will be the deficit for class 4? - ...ANSWER...-10 or less When will urine output start to decrease in shock? - ...ANSWER...Class 3 and 4 When does BP start to fall in shock - ...ANSWER...Class 3 What is GCS? - ...ANSWER...E- 4 V- 5 M- 6 Eye spont 4 To command 3 To pain 2 None 1 Verbal spont is 5 Verbal confused is 4 Inappropriate 3 Garbling is 2 None is 1

Motor spont is 6 Localize pain is 5 Withdrawal pain is 4 Decorticating (flexion) is 3 Decebrate (extension) is 2 None is 1 Two main reasons to think about why GCS goes down? - ...ANSWER...TBI Hemorrhagic shock Why do you want to put in chest tube before needle decompression? - ...ANSWER...SIMPLE PTX can turn into TENSION PTX When is DPL useful over fast? - ...ANSWER...No ultrasound available. What is LEMON for airway patency - ...ANSWER...Look Evaluate Malay-ATI Obstruction Neck mobility What is DEFINITIVE airway? - ...ANSWER...Tube in trachea BELOW vocal cords WHEN is surgical airway indicated? - ...ANSWER...When you CANNOT do any other form of airway (2 attempts typically)

What is contraindicated with suspicion of basilar skull frx? - ...ANSWER...OPA, put in gastric tube for suction because it can go through up into cranium thru cribiform plate Peds kid with bicycle trauma is most likely goin to be? - ...ANSWER...PANCREATIC injury Organ tear is more common with? - ...ANSWER...Penetrating injury What type of pelvic fracture is binder indicated in - ...ANSWER...Open book If there is BLOOD at the meatus, then what do you need to do? - ...ANSWER...RUG first, because if you do a cyst gram you will be spilling into the abd cavity If patient is unstable, free air/blood on CT, peritoneal signs yield what? - ...ANSWER...EMERGENT laparotomy What lab value is good for assessing hydration in burn patient? - ...ANSWER...URINE OUTPUT How do you determine difference between PTX and tamponade? - ...ANSWER...BREATH SOUNDS Blowing air leak on chest tube is sign of? - ...ANSWER...TRACHEOBRONCHIAL RUPTURE Bowel sounds on chest auscultation are reflective of - ...ANSWER...Diaphragm injury

Apical capping and widened mediastinum are reflective of what? - ...ANSWER...Aortic trauma Circumferential burn? - ...ANSWER...Escharotomy What is main goal of priamry brain injury? - ...ANSWER...Preventing secondary brain injury 2 big causes of secondary brain injury? - ...ANSWER...HYPOVOLEMIA and HYPOXEMIA Girl falls on her head, loses consciousness, and is now unstable. What kind of hematoma is this? - ...ANSWER...EPIDURAL, lucid interval is common between time of injury and presentation What is more common, subdural or epidural - ...ANSWER...Subdural What is considered mid TBI? - ...ANSWER... 13 - 15 T/o secondary management of mild TBI? - ...ANSWER...CT repeat if first is abnormal OR GCS persists at under 15. Serial exams Initial management of TBI? - ...ANSWER...elevate head NS (3%) Indications of transport to higher Level of care with TBI? - ...ANSWER...Worsening GCS, GCS <8. Lesions on CT

Above what level can you get neurogenic shock - ...ANSWER...T Description of neurogenic shock patient? - ...ANSWER... What is bulbovesicular reflex indicative of? - ...ANSWER...NOT qualify as sacral sparing. If there is ANY motor or sensory function below level of injury, constitutes as incomplete injury and should be documented appropriately T/F: Stridor is LATE finding of airway damage in burn pt? - ...ANSWER...TRUE Initial management of burn? - ...ANSWER...DRY dressing. NOT moist! Transfer indications for burn? - ...ANSWER...Partial thickness >40% BSA A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation 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 left chest breath sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the most appropriate next step is: - ...ANSWER...re-examine the chest

A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. In the emergency department, 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. The suspected diagnosis is most likely to be confirmed by: - ...ANSWER...complete spine x-ray series Which of the following is true regarding the initial resuscitation of a trauma patient? - ...ANSWER...Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow Coma Scale score on reevaluation. In managing a patient with a severe traumatic brain injury, the most important initial step is to: - ...ANSWER...secure the airway 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? - ...ANSWER...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: - ...ANSWER...increasing the volume of blood loss to produce maternal hypotension The best assessment of fluid resuscitation of the adult burn patient is: - ...ANSWER...urinary output of 0.5 mL/kg/hr

The diagnosis of shock must include: - ...ANSWER...evidence of inadequate organ perfusion 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: - ...ANSWER...direct pressure on the wound For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: - ...ANSWER...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: - ...ANSWER...perform an exploratory laparotomy Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? - ...ANSWER...Leakage of amniotic fluid is an indication for hospital admission. The first maneuver to improve oxygenation after chest injury is: - ...ANSWER...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: - ...ANSWER... 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: - ...ANSWER...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? - ...ANSWER...respiratory rate of 40 breaths per minute The most important, immediate step in the management of an open pneumothorax is: - ...ANSWER...placement of an occlusive dressing over the wound The following are contraindications for tetanus toxoid administration: - ...ANSWER...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? - ...ANSWER...breath sounds Bronchial intubation of the right or left mainstem bronchus can easily occur during infant endotracheal intubation because: - ...ANSWER...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: - ...ANSWER...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: - ...ANSWER...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? - ...ANSWER...Flaccidity of the lower extremities and loss of deep tendon reflexes are expected. Which one of the following is the most effective method for initially treating frostbite? - ...ANSWER...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 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? - ...ANSWER...surgical consultation for right lower extremity fasciotomy 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. The most appropriate step after providing supplemental oxygen and elevating his jaw is to: - ...ANSWER...suction the oropharynx A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small community hospital no surgical capabilities are available. In the emergency

department, a chest tube is inserted and 700 mL of blood is evacuated. The trauma center accepts the patient in transfer. Just before the patient 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: - ...ANSWER...repeat the primary survey and proceed with transfer A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small hospital without surgical capabilities. He has a closed head injury with a GCS score of 13. He has a widened mediastinum on chest x-ray with fractures of left ribs 2 through 4, but no pneumothorax. After initiating fluid resuscitation, 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 patient to a facility capable of providing a higher level of care. The facility is 128 km (80 miles) away. Before transfer, you should first: - ...ANSWER...call the receiving hospital and speak to the surgeon on call Hemorrhage of 20% of the patient's blood volume is associated usually with: - ...ANSWER...tachycardia Which one of the following statements concerning intraosseous infusion is TRUE? - ...ANSWER...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: - ...ANSWER...avoid hypotension 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. Of the following, the most likely diagnosis is: - ...ANSWER...cardiac tamponade 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)? - ...ANSWER...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? -

...ANSWER...Log rolling using 4 people is a safe approach to restrict spinal motion when moving her. What is dark urine reflective of in burn pt? - ...ANSWER...RHABDO What do you constantly need to replenish burn pt? - ...ANSWER...Cellular losses 2/2 inflammation What is GOAL urine output in burn? - ...ANSWER...3- 50mL per hour, BEST assessment of hydration What do you need to monitor for with rewarming in hypothermia - ...ANSWER...ARRYTHMIA MCC of cardiac arrest in kids? - ...ANSWER...HYPOXIA If you fail an IV in a kid what is next step? - ...ANSWER...IO What is crystalloid infusion unit for kids - ...ANSWER...20/kg Two MCC of geriatric injuries? - ...ANSWER...FALL, MVC ATLS PRETEST PRACTICE EXAM

Assessed first in trauma patient - ....ANSWER...Airway (*)Degree of burn that is characterized by bone involvement

• ....ANSWER...Fourth Complications of head trauma - ....ANSWER...Intracerebral hematoma Extradural hematoma Brain abscess Most common cause of laryngotracheal stenosis - ....ANSWER...Trauma Intervention that can help prevent development of acute renal failure - ....ANSWER...Infusion of normal saline 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 - ....ANSWER...D. Transfusion reaction Skin antiseptic - ....ANSWER...-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 - ....ANSWER...55% How does shivering affect body temperature - ....ANSWER...Increases body temperature Class III hemorrhage indicates what % of blood loss - ....ANSWER...35% Management of a stable patient with kidney contusion - ....ANSWER...Observation Associated with hypovolemic shock - .... ANSWER...- 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 The most effective method of monitoring the success of resuscitation during CPR? - ....ANSWER...Reactivity of pupils to light

Used to ensure correct placement of endotracheal tube - ....ANSWER...-Ultrasound

• Bilateral breath sounds
• Sustained end-tidal CO Total body surface area involved in a burn in an adult to the anterior chest and abdomen - ....ANSWER...18% What is often caused by carotid massage? - ....ANSWER...Bradycardia Step in a patient diagnosed with tension pneumothorax - ....ANSWER...1. Needle decompression/ thoracotomy

2. Chest tube True statements regarding diaphragmatic injuries - ....ANSWER...-Blunt diaphragmatic injuries are usually associated with skeletal trauma

• Penetrating diaphragmatic injuries may be missed
• Repair of traumatic diaphragmatic injuries usually does not require prosthetic material First priority in the treatment of an unconscious patient - ....ANSWER...Checking the pulse A patient involved in a road accident is brought to the emergency department in an unconscious state. On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold, shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain. On physical

examination, she has no obvious sign of external bleeding. Which of the following cannot be the cause of hypotension in this patient? A. Pelvic fracture B. Fracture of femur C. Intracranial hemorrhage D. Hemothorax - ....ANSWER...C. Intracranial hemorrhage A patient suffered a slash to his right neck. The wound is over the mid-portion of the sternocleidomastoid. There is a large hematoma and brisk bleeding when uncovered. He is stable. What is the next step in management? A. Get an angiogram B. Close the wound in the ER C. Take him to the operating room D. CT scan to evaluate neck structure - ....ANSWER...C. Take him to the OR 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 - ....ANSWER...D. Gross hematuria A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at its midpoint would cause bleeding from which structure? - ....ANSWER...External jugular vein Clinical features associated with tension pneumothorax - ....ANSWER...Unilateral decrease in breath sounds

Hyperresonance Respiratory distress Tachycardia Tracheal shift Desatruation Decreased breath sounds 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 - ....ANSWER...A. Bag and mask What is the next step in the assessment of a traumatic patient after airway is established? - ....ANSWER...Breathing Blood group that is considered a universal donor - ....ANSWER...O A provider is examining a patient who sustained a severe traumatic head injury. He documents no Doll's eyes. What does this signify? - ....ANSWER...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 - ....ANSWER...Subclavian veins Dermatome level for nipple sensation Dermatome level for umbilicus - ....ANSWER...T4 T10 At which temperature would a hypothermic patient stop shivering? - ....ANSWER...88 degrees F What is the energy recommendation for the first defibrillation in an adult (*) - ....ANSWER...300 J Pharmacologic effects of Morphine - ....ANSWER...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 - ....ANSWER...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 - ....ANSWER...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 C. Airway D. Obtain blood work - ....ANSWER...C. Airway Basilar skull fracture - ....ANSWER...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 - ....ANSWER...D. DDAVP What is the total body surface area involved in a burn to both lower extremities? - ....ANSWER...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 - ....ANSWER...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 - ....ANSWER...B. She is at increased risk of placental abruption In adults, an aspirated foreign body is most likely to get stuck in the: A. Left main bronchus B. Carina C. Right main bronchus D. Esophagus - ....ANSWER...C. Right main bronchus Skin finding characteristic of second-degree burns - ....ANSWER...Blisters Which is true regarding cervical spine fractures? A. Seen most commonly in elderly females B. Athletic activities are the most common cause C. Falls are the most common cause D. Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours - ....ANSWER...D.

Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours In which patients can an oropharyngeal airway be used? - ....ANSWER...Non-gag reflex If a trauma patient has clear fluid draining from the nose the provider should do which of the following? A. Tilt the head back B. Apply pressure C. Collect the fluid D. Insert nasal tampons - ....ANSWER...C. Collect the fluid What is the estimated time a person's brain can be anoxic from cardiopulmonary failure and not develop permanent brain damage? A. 10 minutes B. 5 minutes C. 2 minutes D. 20 minutes - ....ANSWER...B. 5 minutes The laryngeal mask airway is contraindicated in patients with what condition? A. Spine injury B. Head trauma C. Giving birth D. Propensity to aspirate - ....ANSWER...D. Propensity to aspirate A patient sustains blunt trauma to the back and left leg. Vital signs in the emergency department show temperature 36 degrees C, BP 120/80 mm Hg, heart rate 92, respirations 19,

GCS 15. There is bilateral lower extremity paraplegia, T12 sensory level, and decreased rectal tone. Hemoglobin is 14.2 and the same in one hour. Which of the following tests is best for diagnosing an intraperitoneal bleed? A. Abdominal ultrasound B. Laparotomy C. KUB D. Diagnostic peritoneal lavage - ....ANSWER...A. Abdominal ultrasound Why is tracheostomy generally not performed at the first cartilage ring A. The trachea is too narrow B. A high chance of subglottic stenosis C. A high chance of tracheo-innominate artery fistula D. Inability to access the area - ....ANSWER...B. A high chance of subglottic stenosis What does a carotid pulse indicate? A. A functioning pump for blood flow B. The circulating blood volume is reaching end organs C. Diastolic blood pressure D. None of the above - ....ANSWER...B. The circulating blood volume is reaching end organs 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 - ....ANSWER...D. Venous bleeding