Post Test ATLS Latest Exam 17 pages with Correct Answers, Exams of Community Corrections

Download Post Test ATLS Latest Exam 17 pages with Correct Answers and more Exams Community Corrections in PDF only on Docsity! Post Test ATLS Latest Exam 17 pages with Correct Answers Which of the following signs is LEAST reliable for diagnosing esophageal intubation? Symmetrical chest wall movement b End tidal C02 presence by colorimetry Bilateral breath sounds d Oxygen saturation e ETT above carina on chest x-ray Which one of the following signs necessitates a definitive airway in severe trauma patients? Facial lacerations b Repeated vomiting Severe maxillofacial fractures d Sternal fracture GCS score of 12 Twenty seven patients are seriously injured in an aircraft crash at a local airport. The principles of triage include: Establish a triage site within the internal perimeter of the crash site b Treat only the most severely injured patients first Immediately transryort all patients to the nearest hospital Treat the greatest number of patients in the shortest period of time Produce the greatest number of survivors based on available resources 4.Which one of the following statements is correct? Cerebral contusions mav coalesce to form an intracerebral hematoma b Epidural hematornas are usually seen in frontal region Subdural hematomas are caused by injury to the middle meningeal artery Subdural hematomas typically have a lenticular shape on CT scan The associated brain damage is more severe in epidural hematomas An 18 year old male is brought to the emergency department after having been shot. He has one bullet wound just below the right clavicle and another just below the costal margin in the right pyosterior axillary line. His BP is 110/80 mmHg, HR is go bpm, and RR is 34 bpm. After ensuring 8 patent airway and inserting 2 large caliber iv line, the next appropriate step Obtain a portable chest x-ray b Administer a bolus of additional iv fluid Perform a laparotomy Obtain an abdominal CT scan Perform diagnostic peritoneal lavage An 8 year old bov falls meters (IS feet) from a tree and is brought to the emergency department by his family. His vital signs are normal, but he complains of left upper quadrant pain. An abdominal CT scan reveals a moderately severe laceration of the spleen. The receiving institution does not have 1 24 hour a day operating room capabilities. The most appropriate management of this patient would be: Type and crossmatch for blood b Request consultation of a pediatrician Transfer the patient to a trauma center Admit the patient to the ICU Prepare the patient for surgery the next day A 17 year old helmeted motorcyclist is struck broadside by an automobile at an intersection. He is unconscious at the scene with BP of 140/90 mmHg, HR of 90 bpm, and RR of 22 bpm. His respirations are sonorous and deep. His GCS score is S. Immobilization of the entire patient may include the use of all the following, except: a Air splints b Bolstering devices A construction worker falls from a scaffold and is transferred to the emergency department. His HR is 124 bpm and BP is 85/60 mmHg. He complains of lower abdominal ryain. After assessing the airway and chest, 10. 11. 12. 2 5 bPlace a left-sided chest tube 21. The most common acid base disturbance encountered in injured pediatric Insert central venous catheter patients is caused by: Perform CT scan of the abdomen and pelvis Hemorrhage Prepare for urgent thoracotomy Changes in ventilation Renal failure IS. You are treating a trauma patient and attempt a definitive airway by Injudicious bicarbonate administration intubation. However, the vocal cords are not visible. What tool would be the most valuable for achieving successful intubation? Insufficient sodium chloride administration Gum elastic bougie 22. A 17 year old female is brought to the emergency department following a 2 bLateral cervival spine x-ray meters (6 feet) fall onto concrete. She is unresponsive and found to have a Nasopharyngeal airway RR Of 32 bpm, 90/60 mmHg, and HR of bpm. The first step in Ov„'gen treatment is: Laryngeal mask airway Administering vasopressors Establishing iv access for drug assisted intubation 16. A 79 year old female is involved in a motor vehicle crash and presents to Seeking the cause of her decreased level of consciousness the emergency department. She on Coumadin and a beta blocker. Which Applying oxygen and maintaining airway of the following statements is true concerning her management? The risk of subdural hemorrhage is decreased eExcluding hemorrhage as a cause of shock bAbsence of tachycardia indicates that the patient is23. A 25 year old male is brought to the emergency department following a bar hemodyna mica 11M normal fight. He has an altered of conciousness, open his eyes on command, Non-operative management of abdominal injuries is more likely to moans without forming, discernible words, and localizes to painful stimuli. be successful in older adults than in younger patients Which one of the following statements concerning this patient is true? Vigorous fluid resuscitation may be associated with Hyperoxia should be avoided cardiorespiratory failure CT scanning is an important part of neurological assessment Epinephrine should be infused immediately for hypotension Mandatory intubation to protect his airway is required His GCS suggests a severe head injury 17. A 22 year old male is brought by ambulance to a small community hospital His level of consciousness can be solely attributed to elevated blood after falling from the top of a 2,4 meter (8 foot) ladder. Initially, he was found to have a large right pneumothorax. A chest tube was inserted and alcohol connected to an underwater seal drainage collection system with negative 24.Which one of the following statements regarding genitourinary injuries is Which one of the following injuries is addressed in the secondary survey? Bilateral femur fractures with obvious deformity bOpen fracture with bleeding Pulmonary contusion Milg thigh amputation Hypovolemia Unstable pelvic fracture Small penumothorax Forearm fracture Flail chest 29. A 22 year old male present following motorcycle crash. He complains of 36. A 14 year old female is brought to the emergency department after falling the inability to move or feel his legs. His BP is 80/50 mmHg, HR is 70 bpm, from a horse. She is immobilized on a long spine board with a hard collar RR is 18 bprn, and GCS score is IS. Oxygen saturation is on 21 nasal and blocks. Cervical spine x-ray: prongs. Chest x-ray, pelvic x-ray, and FAST are normal. Extremities are Will show cervical spine injury in more than 20% of these patients normal. His management should be: Will exclude cervical spine injury if no abnormalities are found on 2L of iv crystalloid and units of pRBCs the x-rays b2L of crystalloid and vasopressors if BP does not respond Are not needed if she is awake, alert, neurologically normal, and has 2L of iv crystalloid, manitol, and iv steroids no neck pain or midline tenderness Vasopressors and laparotornv Should be performed before addressing potential breathing or 1 unit of albumin and compression stockings circulatory problems e May show atlanto occipital dislocation if the Power's ratio is 30.Which of the following signs is least reliable for diagnosing esophageal intubation? normal, >1: anterior, posterior a Chest x-ray demonstrating the ETT tip positioned above the carina 37. The most specific test to evaluate for injuries of solid abdominal organs is: b Symmetrical chest wall mcrvement Abdominal x-ray End tidal C02 Abdominal ultrasonographv Bilateral breath sounds Diagnostic peritoneal abdominal bleeding e Oxygen saturation Frequent abdominal examination e CT of abdominal and pelvis 31. A 3S year old female sustains multiple injuries in a motor vehicle crash and 6 is transryorted to a small hospital in full spinal protection. She has a GCS 38. The most important consequence of inadequate organ perfusion is: score of 4 and is being mechanically ventilated. Iv access is established and Vasodilatation warmed crystalloid is infused. She remains hemodvnamicallv normal and b Multiple organ failure full spinal protection is maintained. Preparations are made to transfer her Decreased base deficit to another facility for definitive neurosurgical care. Prior to transport, Acute glomerulonephritis which of the following tents or treatments mandatory? FAST exam Increased cellular ATP production bLateral cervical spine x-ray 39. A 23 year old construction worker us brought to the emergency Chest x-ray department after falling more than g meters (30 feet) from scaffolding. His Administration of methylprednisolon vital signs are: HR 140 bpm, BP 96/60 mmHg, and RR 38 bpm. He is Computerized tomography of the abdomen complaining bitterly of lower abdominal and lower limb ryain, and has obvious deformity of both lower legs with bilateral open tibial fractures. 32. A 22 year old male is assaulted in a bar. A semi rigid cervical collar is Which one of the following statement concerning this patient is true? applied, and he is immobilized on a spine board. On initial examination, his Pelvic injury can be ruled out based on the mechanism of injury vital signs are normal, and his GCS score is IS. Which of the following is an Blood loss from the lower limb is most likely cause of his indication for CT in this patient with possible minor traumatic brain injury? hwotension Blood alcohol concentration of (ISO mg/lOO ml) Spinal cord injury is the most likely cause of hypotension bPresence of an isolated 10 cm scalp laceration X-ray of the chest and pyelvis are important adjuncts in his Presence of a mandibular fracture assessment Presence of hemotyrnpanum History of assault eAortic injury is the most likely cause of his tachycardia 40. A 82 year old male falls down five stairs and presents to the emergency 33.Which one of the following statement is true? department. All following are true statements regarding his condition Hypotonic fluids should be used to limit brain edema in patients compared to a younger patient with similar mechanism, except? 7 Should be combined with clinical exam, AP and odontoid, or CT The use of seatbelts is associated with increased risk of maternal Require the following films: oblique views, AP, odontoid and flexion death extention views prior to spinal clearance in trauma patient d The mechanism of injury suggests the need for emergency Caesarean section due to the risk of impending abruptio placentae 43. A 30 year old male is stabbed in the right chest. On arrival in the emergency e The deployment of the airbag increases the risk of maternal department, he is very short of breath. His HR is 120 bpm, and BP is 80/50 mmHg. His neck veins are flat. On auscultation of the chest, there is abdominal injury diminished air entry on the right side, and there is dullness posteriorly on SO. Supraglottic airway devices: percussion. These finding are most consistent with: Are equivalent to endotracheal intubation Hemothorax Require neck extension for proper placement bPericardial tamponade Are preferable to endotracheal intubation in a patient who cannot Tension pneumothorax lie flat Hypovolemia from the liver injury Are of value as part of a difficult or failed intubation plan Spinal cord injury Provide one form of definitive airway 44. A specific aspect of the treatment of thermal injury is: 51. A 25 year old male is brought to the hospital after sustaining partial and full Chemical burn require the immediate removal of clothing thickness burns involving of his body surface area. His right arm and bPatients who sustain thermal injury are at lower risk for hand are severely burned. There are obvious full thickness burns of the hypothermia entire right hand and a circumferential burn ofthe right arm. Pulses are Patients with circumferential truncal burns need prompt absent at the right wrist and are not detected by Doppler examination. The fasciotomies first step in management of the right upper extremity should be: Electrical burns are associated with extensive skin necrosis(from Fasciotomv entry point to exit) Angiography The Parkland formula should be used to determine Escharatomv 10 adequacy of resuscitation Heparinization Tangential excision 45. A IS year old male is brought to the emergency department after being involved in a motor vehicle crash . he is unconscious and was intubated at 52. All of the following signs on the chest x-ray of a patient who sustained a the scene by emergency medical personnel. upon arrival at the emergency blunt injury may suggest aortic rupture except which one? department, the patient's oxygen saturation is 92%, HR is YS bpm, and BP is Mediastinal emphysema ISO/8S mmHg. Breath sounds are decreased on the left side of the thorax. Presence of a pleural cap The next step is: Obliteration of the aortic knob Immediate needle crycothyroidotomv Deviation of the trachea to the right bReassess the position of the endotracheal tube Chest tube insertion Depression of the left mainstream bronchus Immediate needle thoracentesis 53. A 30 year old woman fell down four stairs landing on concrete.witnesses Obtain a chest x-ray report she was unconscious for five minutes beginning immediately after the fall. She regained full consciousness during the ten minute transport to 46. The first priority in management of a long bone fracture is: the hospital. CWon arrival in the emergency department, she is awake, Reduction of pain alert, and responsive with a GCS score of IS. Her only complain is a slight bPrevention of infection in case of an open fracture headache. Thirty minutes later, she becomes unresponsive with a GCS Prevention of further soft tissue injury score of S. On the exam, her left pupil is large and nonreactive. The right Improve long term function pupil is normal. The one type of neurological injury most consistent with Control of hemorrhage this patient's entire clinical course since her fall: A subdural hematoma 47. A 30 year old female is brought to the emergency department after being An epidural hematoma injured in motor vehicle crash. Her initial BP is 90/60 mmHg, and her HR is An occipital lobe hemorrhage 122 bpm. She responds to the rapid infusion of 1 liter crystalloid solution Focal subarachnoid hemorrhage 11 with rise in her BP to 118/88 mmHg and decrease in her HR to 90 bpm. Her pressure then suddenly deceased to 98/68 mmHg. The least likely A cerebellar hemorrhage cause of her hemodvnamic change is: 54. Hypertension following a head injury: Ongoing blood loss Should be treated to reduce intracranial pressure bBlunt cardiac injury Indicates pre-existing hypertension Traumatic brain injury May indicate imminent herniation from critically high intracranial Inadequate resuscitation pressure Tension pneumothorax dMandates prompt administration a mannitol Should prompt burr hole drainage of potential subdural hematomas 48. Limb threatening extremity injuries: Require a tourniquet Initial treatment of frostbite injuries involves: bShould be definitively managed by application of a traction splint Application of dry heat Are rarely present without an cwen wound Debridement of hemorrhagic blisters Are characterized by the presence of ischemic or crushed tissue Early amputation to prevent septic complications Indicate a different order of priorities for the patient's initial Rapid rewarming of the body part in circulating warm water assessment and resuscitation eMassage of the affected area 49. A 29 year old female arrives in the emergency department after being SS. Signs and symptoms of airway compromise include all of the following involved in a motor vehicle crash. She is 30 weeks pregnant. She was except: restrained with a lap and shoulder belt, and an airbag deployed. Which one Change in voice of the following statement best describes the risk of injury? Stridor a The deployment of the airbag increased the risk of fetal loss Tachvpnea b The risk of premature fetal delivery and death is reduced by the use Dvspnea and agitation restrains Decrease pulse pressure 57. Which one of the following statements is true regarding a pregnant patient who p resents following blunt trauma? 12 It occurs in blunt or ryenetrating abdominal trauma It is produced by minor degrees of fetomaternal hemorrhage Rh immunoglobulin therapy should be administered to pregnant females who have sustained a gunshot wound to the leg d This is not a problem in traumatized, Rh positive pregnant patients Initiation of Rh immunoglobulin therapy does not require proof of fetomaternal hemorrhage An 18 year old motorcyclist sustains maasive facial injuries in a head on crash with a pick up truck. He is brought to the emergency department completely immobilized on a long spine board and wearing a cervical collar. His is 150/88 mmHg, HR is 88 bpm and reguler, and RR is 26 born. His respirations are labored and sonorous. His GCS score is 7. Attempts at orotracheal intubation with manual inline stabilization of the c-spine are unsuccessful due to bleeding and distorted anatomy. The patient becomes apneic. The best procedure for airway management in this situation is: Nasotracheal intubation b Emergency tracheostomv Surgical cricothvroidotomv Placement of an oropharyngeal airway Placement of an nasopharyngeal airway A 24 year old pedestrian, struck by an automobile, is admitted to the emergency department 1 hour after injury. His BP is 80/60 mmHg, HR is 140 bpm, and RR is 38 bpm. He is lethargic. Oxygen is delivered via face mask, and tv.o large caliber Ms are initiated. Arterial blood gases are obtained. His Pa02 is 118 mmHg (15,7 08), PaC02 is 30 mmHg (4 a n d p H is 7 , 2 1 . T h e t r e a t m e n t o f his acid base disorder best accomplished by: Hyperventilation Restoration of normal perfusion Initiation of low dose dopamine Administration of sodium bicarbonate Initiation of phenylephrine infusion Which of the following should be performed first in any patient whose injuries may include multiple closed extremity fractures? A thorough assessment of four limb perfusion Maneuvers to prevent necrosis of the skin Extremity compartment syndrome release d Ensuring adequate oxygenation and ventilation e Evaluation for occult crush syndrome A 30 year old male sustains a gunshot wound to the right lower chest, midway between the nipple and the costal margin. He is brought by ambulance to a hospital that has full surgical capabilities. In the emergency department he is endotracheallv intubated, 2 L of crystalloid solution are infused rapidly through two large caliber iv lines, and a closed tube thoracostomv is performed with the return of 200 ml of blood. A chest xrav reveals correct placement of the chest tube and a small residual hemothorax. His BP is now 70/50 mmHg, and his HR is 140 bpi-n. The most appropriate next step in managing this patient is to: Insert a second chest tube b Obtain a CT scan of the abdomen 15 Perform a thoracotomy in the emergency department Perform laparotomv in the operating room Perform a FAST exam 16