Realistic ATLS written exam. Answers with explanations can be purchased at atls.yolasite.com
Realistic full-length ATLS practice test. Answers with full explanations may be purchased at atls.yolasite.com
Very realistic ATLS written exam.
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Descripción: ATLS Post-test
Realistic ATLS written exam. Answers with explanations can be purchased at atls.yolasite.com
Post tes ATLSFull description
Very realistic ATLS written exam.
Descrição: Post tes ATLS
Descripción: Very realistic ATLS written exam.
AtlsDescripción completa
Descripción: TRADUCCION A ESPAÑOL
Post tes ATLSDeskripsi lengkap
Post tes ATLS
atls post test partial
atls post test partialDeskripsi lengkap
Descripción: atls post test partial
ATLS Post-test
Descripción: testing
TRADUCCION A ESPAÑOLFull description
TRADUCCION A ESPAÑOL
A&E ATLS TEST – answers at the end 1- 1 . A 22-yea shoulder. er. His blood pressure 22-year-o r-old ld man sustain sustainss a shotgu shotgun n wound wound to the left should pres sure is initially 80/40. After two liters of Ringer's lactate solution his blood pressure increases to 122/84. His pulse rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. minute. His breath brea th sounds soun ds are decreas dec reased ed in the left hemitho hemi thora! ra! and a closed clos ed tube thoraco thor acostomy stomy is performed perfor med with the return of a small amount of blood with no air leak. "he most appropriate
net step is to a. b. c. d. e.
re-eamine the chest. perfo rm an a n aortog ao rtogram. ram. obtain a #" #" scan of the chest. obtain arterial blood gas analyses. perform transesophageal echocardiography.
$
1-2. A four-year-old girl! weighing approimately 20 %g &44 pounds'! is admitted in shoc% after an automobile crash. "he initial fluid challenge or bolus should consist of (inger)s lactate solution in the *olume of
a. 2 00 m +. b. 400 40 0 m +. c. 44 0 m +. d. , 00 m+. e. 8 80 m+. 1-. All of the following are considered minimal precautions for the pre*ention of the spread of communicable diseases during resuscitation #" a. goggles. b. face face mas%. c. water-imper*ious gown. d. water-imper*ious leggings. e. needle-impenetrable sterile glo*es. 1-4. n managing the head-inured patient! the most important initial step is to
a. b. #.
d. e.
secure the airway. immobilie the nec%. support the circulation. control scalp hemorrhage. determine the 3lasgow #oma cale core.
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1-!. A pre*iously healthy! 0 kg "1#! pound' man suffers an estimated acute blood loss of two liters. 9hich one of the following statements apply to this patient:
a. b. c. d. e.
His pulse pressure will be widened. His urinary output will be at the lower limits of normal. He will ha*e tachycardia! but no change in his systolic blood pressure. His systolic blood pressure will be decreased with a narrowed! pulse pressure. His systolic blood pressure will be maintained with an ele*ated diastolic pressure.
1-,. "he ;physiologic hyper*olemia; of pregnancy has clinical significance in the management of the se*erely inured! gra*id woman by a. b. c. d. e.
reducing the need for blood transfusion. increasing the ris% of pulmonary edema. complicating the management of closed head inury. increasing the *olume of blood loss to produce shoc%. reducing the *olume of crystalloid re
1-. A 1-year-old helmeted motorcyclist loses consciousness when he is struc% broad side by an automobile at an intersection. He arri*es in the emergency department with a blood pressure of 140/52! pulse rate of 88. beats per minute! a respiratory rate of 18 breaths per minute! and a 3lasgow #oma cale core of se*en. Appropriate initial immobiliation of this patient should include a semi-rigid cer*ical collar and 1-$. A 64-year-old man is brought to the hospital after being pinned to the wall of a building by a a scoop stretcher. a. b. #.
d. e.
a long spine board. a short spine board. cer*ical traction tongs. the pneumatic antishoc% garment.
cement truc%. He is in ob*ious shoc%! and has deformities and mar%ed swelling of both thighs! although no open wounds are present. His shoc% a. b. c. d. e.
cannot be eplained without concomitant pel*ic fracture. signifies a loss of approimately 1= > of his blood *olume. is consistent with blood loss from bilateral femoral fractures. will li%ely be re*ersed if appropriate traction splints are applied. cannot be eplained by his obser*ed inuries unless a maor arterial inury eists.
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1-5. rior to passage of a urinary catheter in a man! it is essential to a b. #.
d. e.
eamine the abdomen. determine pel*ic stability. eamine the rectum and perineum. perform a retrograde urethrogram. %now the history and mechanism of inury. 1-10. "he best guide for ade
ade
1-11. "he +A" li%ely cause of a depressed le*el of consciousness in the multisystem inured patient is
a. b. c. d.
e.
shoc%. head inury. hyperglycemia. impaired oygenation. alcohol and other drugs.
1-12. stablishing a diagnosis of shoc% must include a. b. c. d.
e.
confirming hypoemia. the finding of acidosis. confirming increased *ascular resistance. documenting hypotension and low cardiac output. e*idence of inade
1-1. A se*en-year-old boy is brought to the emergency department by his parents se*eral minutes after he fell through a window. He is bleeding profusely from a ,-cm &2.4-inch' wound of his medial right thigh. mmediate management of the wound should consist of
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a. b. c. d. e.
application of a tourni
1-14. ?or the trauma patient with cerebral edema! hypercarbia should be a%oided to pre*ent a. b. c. d. e.
metabolic acidosis. respiratory acidosis. cerebral *asodilatation. neurogenic pulmonary edema. reciprocal high le*els of a#@2.
1-1!. A 2=-year-old man is brought to the hospital after being in*ol*ed in a motor *ehicular crash when his car struc% a bridge abutment. He is intoicated! has a 3lasgow #oma cale core of 16! and complains of abdominal pain. His blood pressure was 80 mm Hg systolic by palpation on admission to the hospital! but it rapidly increased to 110/0 with the administration of intra*enous fluids. His heart rate is now 120 beats per minute. "he chest roentgenogram shows loss o f the aortic %nob! wid ening o f the med iastinu m! no rib fr acture s! and n o hemopneumothora. #ontrast angiography
a. b. c. d. e.
is not indicated. sho uld be performe d a fter a #" scan of the chest . is not necessary if the #" scan of the chest is normal. should be performed.after diagnostic peritoneal la*age. is positi*e for aortic rupture in 80> of similar cases.
1-1. 9hich one of the following statements regarding abdomina l trauma in the pregnant patient is "(:
a. b. c. d. e.
"he fetus is in eopardy only with maor abdominal trauma. +ea% age of amniotic fluid is an indication for hospital admission. ndications for peritoneal la*age are different from those in the nonpregnant patient. enetration of an abdominal hollow *iscus is more common in late than in early pregnancy. "he secondary sur*ey follows a different pattern from that of the nonpregnant patient.
1-1. "he first maneu*er to impro*e oygenation after chest inury is a. b. #.
d.
intubate the patient. assess arterial blood gases. administer supplemental oygen. ascertain the need for a chest tube.
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e.
obtain a lateral cer*ical spine roentgenogram.
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1-1$. A 2=-year-old man! inured in a motor *ehicular crash! is admitted to the emergency department. His pupils react sluggishly and his eyes open to painful stimuli. He does not follow commands! but he does moan periodically. His right arm is deformed and.does not respond to painful stimulus$ howe*er! his left hand reaches toward it. Both legs are stiffly !ende d. His 3las gow #oma cale core is
a. two. B. four c. si d. nine e. twel*e 1-15. 9hich one of the following statements concerning massi*e hemothora is "(: a. b. c. d. e.
t is usually caused by blunt thoracic trauma. t is commonly confused with a pneumothora. "he diagnosis should be confirmed by upright! plain chest roentgenograms prior to treatment. "he initial draining of 1!000 m+ of blood after chest tube insertion re
1-20. 9hich one of the following findings should prompt immediate management during the primary sur*ey: a. b. c. d. e.
Cistended abdomen 3lasgow #oma cale core of 11 ulse rate of 120 beats per minute "e mper ature of 6,.=) # &5.8) ?' (espiratory rate of 62 breaths per minute.
1-21. Curing the primary and secondary sur*eys! the patient inured by blunt trauma should be completely immobilied until a. b. c. d. e.
the neurologic eamination has been completed. the patient is transferred to a definiti*e care area. the patient is able to indicate that he has no nec% pain. a spinal fracture has been ecluded by roentgenograms. the patient complains of potential pressure sores due to the spine board.
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1-22. "he most important! immediate step in the management of an open pneumothora is a. b. c. d. e.
endotracheal intubation. ope ration to close the wound. placing a chest tube through the chest wound. placement of an occlusi*e dressing o*er the wound. initiation of two! large-caliber Ds with (inger)s lactate.
1-26. mportant screening roentgenograms to obtain in the multiple-system trauma patient are a.
s%ull! chest! and abdomen.
b. c. d. e.
chest! abdomen! and pel*is. cer*ical spine! chest! and pel*is. s%ull! cer*ical spine! and chest. cer*ical spine! chest! and abdomen.
All of the following statements regarding pulse oimetry are true E(E)T* a. b. c. d. e.
cessi*e surrounding room light can interfere with the accuracy of the readings. ig nificant le* els of dysfunctio nal hemoglob in can affect the a ccura cy of the readings. t pro*ides a continuous! nonin*asi*e measurement of the partial pressure of oygen. t is dependent on differential light absorption by oygenated and deoygenated hemoglobin. t pro*ides a continuous! nonin*asi*e measurement of pulse rate that is updated with each heart beat.
1-2=. A =,-year-old man is thrown *iolently against the steering wheel of his truc% during a motor *ehicular crash. @n arri*al in the emergenc y department he is diaphoretic and cEalpl g of chest pain. His blood pressure is ,0/40 and h is respira tory rate is 40 moths per minute. 9hich of the following would best differentiate cardiac tamponade from tension pneumothora as the cause of his hypotension: a . "achycardia
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b. ulse *olume c . Breath sounds
d . ulse pressure
e . Fugular *enous pressure
1-2,. Bronchial intubation of the right or left mainstem bronchus can easily occur during infant endotracheal intubation because
t
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a. b. c. d. e.
the trachea is relati*ely short. ) the distan ce from the lips to the laryn is relati *el y short. the use of tubes without cuffs allows the tube to slip distally. the mainstem bronchi are less angulated iin their relation to the trachea. so little friction eists between the endotracheal tube))and the wall of the trachea.
1-2 . A =2-year-old woman sustains =0 > total body-surface flame burns in an eplosion. he has burns aro und the chest and of both upp er arm s. Ade . Her arterial blood gas analyses re*eal a@ 2 of 40 mm Hg! a#@ 2 of ,0 mm Hg! and pH of .2=. Appropriate immediate management at this time is to a. b. c. d e
ensure ade
1-28. A 26-year-old man sustains four stab wounds to the upper right hemithora during an altercation and is brought by ambulance to a community hospital. "he wounds are all abo*e the nipple. He is endotracheally intubated! closed tube thoracostomy is performed! and two liters of !(inger)s lactate solution are infused through two large-caliber Ds. His blood pressure now is ,0/0! pulse rate is 1,0 beats per minute! and respiratory rate is 14 breaths per minute &*entilated with 100> 02'. "he most appropriate net step in manag ing this patient is a.
angiography..
b. c. d. e.
thoracotomy. #" of the chest. application of A3. immediate transfer to another facility
.
1-25. All of the following suggest urethral inury #"G a. b. c. d. e.
scrotal hematoma. blood in the 9ctal lumen... blood at the eternal urethral meatus. high-riding prostate on rectal eamination. ! absence of a palpable prostate on rectal eamination.
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1-+. A 68-year-old construction wor%er is brought to the hospital after being crushed in a foundation ca*e-in. A pneumatic antishoc% garment &A3' was applied and inflated by prehosp ital personnel. He has no symp toms of resp iratory compromise. His blood pressure is 120/80 and his pulse rate is 110 beats per minute. He is conscious and alert. He reportedly has open fractures of both legs. amination of the patient)s legs is best accomplished by
a. b. c. d. e.
de fl ati ng th e g arme nt on e leg at a ti me . %eeping the A3 inflated and obtaining roentgenograms. deflating the A3 guided by the patient)s circulatory status. immediately and temporarily deflating and remo*ing the A3. deflating one leg compartment and %eeping the A3 abdominal compartment inflated.
1-61. "he primary indication for transferring a patient to a higher le*el trauma center is a. b. c. d. e.
multisystem inuries! including se*ere head inury. una*ailability o f a surgeon or operating room staff. una*ailability of an intensi*e care unit bed or # staff. resource limitations as determined by the referring physician. a widened mediastinum on chest roentgenogram after blunt thoracic trauma.
1-62. A patient is brought to the emergency department 20 minutes after a motor *ehicular crash. He is conscious and there is no ob*ious eternal trauma. He arri*es at the hospital intubated and completely immobilied on a long spine board. His blood pressure is ,0/40 and his pulse rate is 0 beats per minute. His s%i n is war m and he has no rectal tone. 9hich one of the following statements is "(: a. b. c. d. e.
Dasoacti*e medications ha*e no role in early management. "he hypotension should be managed with *olume resuscitation alone. ?leion and etension *iews of the c-spine should be performed early. @ccult abdominal *isceral inuries can be ecluded as a cause of hypotension. ?laccidity of the lower etremities and loss of deep tendon reflees are epected.
1-66. 9hich one of the following is the recommend ed method for treating frostbite:
a. b. c. d. e.
oist heat arly amputation adding and ele*ation Dasodilators and heparin "opical application of sil*asulphadiaine
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1-,. A 62-year-old man is trapped from the waist down beneath his o*erturned car for a period eceeding eight hours. @n arri*al in the emergency department! both lower etremities are cool! mottled! insensate! and motionless. Cespite normal *ital signs! pulses cannot be palpated below the femoral *essels and the muscles of the lower etremities are firm and hard. Curing the initial management of this patient! which of the following is most li%ely to impro*e the chances for limb sal*age:
a. b. c. d. e.
Applying s%eletal traction Administering anticoagulant drugs Administering thrombolytic therapy erforming lower etremity fasciotomies mmediately transferring the patient to a trauma center
1-6=. #er*ical spine inury a. b. c. d. e.
is ecluded by a normal neurologic eamination. is not present if the patient has normal range of nec% motion. can be detected safely by careful fleion and etension of the nec%. can be ecluded by a crosstable lateral roentgenogram of the c-spine. may be first manifested by neurologic deficit after mo*ement of the nec%.
1-6,.. An 18-year-old man is brought to the hospital after smashing his motorcycle into a tree. He is conscious and alert! but paralyed in both arms and legs. His s%in is pale and cold. He complains of thirst and difficulty in breathing. His airway is clear. His blood pressure is ,0/40 and his pulse rate is 140 beats per minute. Breath sounds are full and e
d. e.
undergo eploratory celiotomy & I laparotomy' be treated for neurogenic shoc%. be treated for hypo*olemic! shoc%. undergo immediate nasotracheal intubation. be placed in cer*ical traction tongs before any other treatment is instituted.
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1-#. A ,4-year-old man! in*ol*ed in a high-speed car crash! is resuscitated initially in a small rural hospital with limited resources. He has a closed head inury with a 3lasgow #oma cale core of 16. He has a widened mediastinum on hest roentgenogra with /ratures o/ le/t ribs two through four! but no pneumothora. After infusing four liters of (inger)s lactate solution! hid blood pressure is 100/4! pulse rate is 110 beats pe r minu te! and resp iratory rate is 18 breaths per minute. He has gross hematuria and a pel*ic fracture. "he referring physician decides to transfer this patient to a facility capable of deli*ering a higher le*el of care which is 128 %m &80 miles' away. Before transfer! the physician should first
a. b. c. d. e.
intubate the patient. perform diagnostic peritoneal la*age. apply the pneumatic antishoc% garment. call the recei*ing hospital and spea% to the surgeon on call. discuss the ad*isability of transfer with the patient)s family.
1-6. Hemorrhage of 20> of the patient)s blood *olume is associated usually with a. b. c. d. e.
oliguria. confusion. hypotension. tachycardia. blood transfusion re
1-65. 9hich one of the following statements concerning intraosseous infusion in children is "(: a. b. c. d. e.
@nly crystalloid solutions may be safely infused through the needle. Aspi ration of bone marrow confirms appropriate positioning of the needle. ntraosseous infusion is the preferred route for *olume resuscitation in small children. ntraosseous infusion may be utilied indefinitely in the management of inured children. welling in the soft tissue around the intraosseous site is not a reason to discontinue infusion.
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1-,+. A 2,-year-old seat-belted dri*er is brought to the hospital after a car crash. rimary sur*ey re*eals no e*idence of serious inury ecept for diffuse! mild abdominal tenderness. Bowel sounds are hypoacti*e and li*er dullness is
a.
undergo peritoneal la*age.
b. c. d. e.
undergo prompt celiotomy I &laparotomy' be carefully obser*ed for further e*idence of intra-abdominal inury. ha*e a contrast roentgenographic study of her gastrointestinal tract! be suspected of ha*ing a ruptured diaphragm and accompanying pneumothora.