Download PHTLS & ATLS Exam Questions and Answers: Trauma Management and more Exams Nursing in PDF only on Docsity!
Question And Answers 2025
2 big causes of secondary brain injury? - correct answers ✅HYPOVOLEMIA and HYPOXEMIA A 20 year old female was ejected from her vehicle during a high speed roll-over motor vehicle collision. She has significant bleeding from a large laceration. Your initial assessment reveals a GCS score of 7, systolic blood pressure of 70 mm Hg and pupils that are equal but respond sluggishly to light. After establishing two large bore IV lines, you should titrate the infusion rate to achieve a target blood pressure of at least A) 60 mm Hg. B) 70 mm Hg. C) 80 mm Hg. D) 90 mm Hg. - correct answers ✅D) 90 mm Hg. 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
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diminished in the right chest. The most appropriate first step is to: - correct answers ✅perform needle or finger decompression of the right chest 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 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
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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 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 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? - correct answers ✅surgical consultation for right lower extremity fasciotomy
Question And Answers 2025
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: - correct answers ✅cardiac tamponade 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 40-year-old woman who was a restrained driver in a motor vehicle crash is evaluated in the emergency department. She
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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
- 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: - correct answers ✅call the receiving hospital and speak to the surgeon on call 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 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
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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: - correct answers ✅complete spine x-ray series 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: - correct answers ✅placement of a pelvic binder 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 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
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(probably too low velocity for Coup & Contre Coup) A patient who withdraws from painful stimuli, opens eyes on verbal command, and cannot speak because of intubation has a Glasgow Coma Scale of which of the following: A. 8 B. 8T C. 7 D. 7T - correct answers ✅B. 8T (E-3, V-T, M-4) 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.
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A regional resource center with a full spectrum of trauma services from prevention to rehabilitation which serves as the leader in trauma care for a geographical region is a: A. Level IV trauma center B. Level III trauma center C. Level II trauma center D. Level I trauma center - correct answers ✅D. Level I trauma center A traction splint may be used for which of the following injuries? A. Knee dislocation B. Pelvic fractures C. Femur fractures D. All of the above - correct answers ✅C. Femur fractures A trauma patient presents to your emergency department with inspiratory stridor and a suspected c-spine injury.
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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: - correct answers ✅avoid hypotension Above what level can you get neurogenic shock - correct answers ✅T 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 An 18-year-old female was struck by a car and has sustained an apparent left femur fracture. Communication with her is hampered because she only speaks a foreign language. Which finding, by itself, does not mandate immobilization of the cervical spine?
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A) Fracture of the femur B) Inability to communicate C) Mechanism of injury D) Tenderness over the cervical spine - correct answers ✅C) Mechanism of injury An adult male sustained a deep laceration to his distal thigh. Bright red blood is spurting from the wound. Direct pressure is not controlling the bleeding. What is the most appropriate next step? A) Apply a topical hemostatic agent and transport B) Apply a tourniquet and tighten it until bleeding stops C) Elevate the leg and apply pressure to the femoral artery D) Maintain direct pressure and transport immediately - correct answers ✅B) Apply a tourniquet and tighten it until bleeding stops Apical capping and widened mediastinum are reflective of what? - correct answers ✅Aortic trauma
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Delayed death due to trauma is usually a result of: A. Biochemical and pathophysiological effects of inadequate initial resuscitation B. Acute circulatory failure C. Brain injury D. Acute hypoxia - correct answers ✅A. Biochemical and pathophysiological effects of inadequate initial resuscitation Description of neurogenic shock patient? - correct answers ✅ Deterioration of ventilation and oxygenation after inflation of a PASG in a patient who has sustained a high-pressure compression injury of the abdomen, such as a sudden deceleration with the lap belt placed across the abdomen, most likely represents which of the following injuries? A. Abdominal aortic aneurysm B. Ruptured diaphragm
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C. Ruptured esophagus D. "Paper bag" syndrome of the lungs - correct answers ✅B. Ruptured diaphragm During the primary survey and management of a trauma patient, the E in ABCDE stands for _________? A. Edema B. Eyes & ears C. Expose/Environment D. Electrical therapy - correct answers ✅C. Expose/Environment During the primary survey of a trauma patient, you note that the patient is agitated and confused, and has multiple injuries from an altercation. Which of the following choices is the most appropriate first treatment priority? A) Blood glucose determination B) Correction of possible hypoxia
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answers ✅EPIDURAL, lucid interval is common between time of injury and presentation Hemorrhage of 20% of the patient's blood volume is associated usually with: - correct answers ✅tachycardia How do you determine difference between PTX and tamponade? - correct answers ✅BREATH SOUNDS How much blood can femur lose - correct answers ✅2L Hypotension of unknown etiology in a trauma patient should be assumed to result from which of the following? A) Blood loss B) Cardiac tamponade C) Spinal injury D) Tension pneumothorax - correct answers ✅A) Blood loss
Question And Answers 2025
If patient is unstable, free air/blood on CT, peritoneal signs yield what? - correct answers ✅EMERGENT laparotomy If the question says you do not have capabilities, you will most likely - correct answers ✅PREPARE FOR AND DO NOT DELAY TRANSPORT If there is BLOOD at the meatus, then what do you need to do? - correct answers ✅RUG first, because if you do a cyst gram you will be spilling into the abd cavity If you fail an IV in a kid what is next step? - correct answers ✅IO In an adult patient, blood loss into the tissue from a fractured femur may be as much as which of the following? A. 150 to 500 mL B. 500 to 1000 mL C. 1000 2000 mL
