ATLS Quiz Test Exam MOD 002 with Verified answers
Graded Brain Strom 2023
True or false? Although the mechanism of injury may be similar to those for the younger population,
data shows increased mortality with similar severity of injury in older adults. correct answers True
In the elderly population, what is decreased physiological reserve? correct answers aging is
characterized by impaired adaptive and homeostatic mechanisms that caused an increased susceptibility
to the stress of injury. Insults tolerated by the younger population can lead to devastating results in
elderly patients.
Pre-existing conditions that affect morbidity and mortality include: correct answers cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? correct answers Fall. Nonfatal falls are
common in women and fractures are common in women who fall. Falls are the most common cause of
TBI.
In the elderly population, what are risk factors for falls? correct answers advanced age, physical
impairment, history of previous fall, medication use, dementia, unsteady gait, and visual, cognitive
impairment
Most of elderly traffic fatalities occur in the daytime and on weekends and typically involve other
vehicles. Why? correct answers Older people drive on more familiar roads and at lower speeds and tend
to drive during the day. Older people have slower reaction time, a larger blind spot, limited cervical
mobility, decreased hearing, and cognitive impairment.
True or False? Mortality associated with small to moderate sized burns in older adults remains high
correct answers True
Spilled hot liquids on the leg, which in younger patients may re-epithelialize due to an adequate number
of hair follicles, will result in a full thickness burn in older patients. correct answers this is true
Airway-patients may have dentures that may loosen or obstruct the airway. If dentures are not
obstructing the airway, leave them in place for what? correct answers bag mask ventilation, as it
improves mask fitting.
When preforming rapid sequence intubation, the dose of benzos, barbiturates, and other sedatives
should be reduced to what percentage to minimize the risk of cardiovascular depression? correct
answers 20-40%
Functional changes in cardiac system include declining function, decreased sensitivity to
catecholamines, atherosclerosis of coronary vessels, increased afterload, fixed heart rate (beta blockers)
correct answers this results in lack of classic response to hypovolemia, risk for cardiac ischemia, elevated
BP at baseline, and increased risk of dysrythmias.
,Functional changes in pulmonary system include decreased elastic recoil, reduced residual capacity,
decreased gas exchange and decreased cough reflex correct answers thus they are at increased risk for
respiratory failure, increased risk for pneumonia, and poor tolerance to rib fractures
Functional changes in renal system include loss of renal mass, decreased GFR, and decreased sensitivity
to ADH and aldosterone correct answers resulting in drug dosing for renal insufficiency, decreased
ability to concentrate urine, increased risk for AKI and urine flow may be normal with hypovolemia
Functional changes to MSK include loss of lean body mass, osteoporosis, changes in joints and cartilage,
c spine degenerative changes and loss of skin elastin and subcutaneous fat correct answers resulting in
increased risk for fractures, decreased mobility, difficulty for oral intubation, risk of skin injury, increased
risk for hypothermia, challenges in rehabiliation
Functional changes in Endocrine system include decreased production and response to thyroxin and
decreased dehydroepiandrosterone (DHEA) correct answers resulting in occult hypothyroidism, relative
hypercortisone states and increased risk of infection
True or false: Arthritis can complicate the airway and cervical spine. Patients can have multilevel
degenerative changes affecting disk spaces and posterior elements associated with severe central canal
stenosis, cord compression, and myelomalacia correct answers true
In elderly population, due to their changes in pulmonary system, placing a gauze between gums and
cheek to achieve seal when using bag valve mask ventilation is okay. In addition, because aging causes a
suppressed heart rate response to hypoxia...... correct answers respiratory failure may present
insidiously in older adults.
Age related changes in the cardiovascular system place the elderly trauma patient at significant risk for
being inaccurately categorized as hemodynamically stable. correct answers Elderly patients have a fixed
heart rate and fixed cardiac output, thus, their response to hypovolemia will involve increasing their
systemic vascular resistance. Furthermore, since older patients have HTN, an acceptable BP may truly
reflect a hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identifying
hypotension in patients 65 and older.
Do no equate blood pressure with shock in older patients correct answers BP in older patients may look
normal due to the medications they are on. Use lactate and base deficit to evaluate for evidence of
shock
what 2 factors place elderly patients at risk for intracranial hemorrhage? correct answers aging causes
dura to become more adherent to the skull increasing risk of injury and older patients are on
anticoagulant and antiplatelet medications.
Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions place elderly patients as
risk for hypothermia and complications for immobility. correct answers Rapid evaluation and when
possible early liberation from spine boards and cervical collars will minimize complications.
True or False: Fall prevention is the mainstay of reducing the mortality associated with pelvic fractures.
correct answers true
, poor hygiene, dehydration, oral injury, contusions affecting the inner arms, inner thighs, palms, soles,
scalp, ear, nasal bridge and temple injury from being struck while wearing glasses, contact burns and
scalds. These are all signs of.......? correct answers Elder maltreatment. The presence of physical findings
of maltreatment should prompt a detailed history. if history conflicts with findings, immediately report
findings to authorities.
True of false: early activation of the trauma team may be required for elderly patients who do not meet
traditional criteria for activation correct answers True. A simple injury such as an open tibia fracture in a
frail elderly patient may become life threatening.
Common mechanisms of injury include falls, MVC, burns, and penetrating injuries correct answers
common injuries in the elderly include rib fractures, TBI, pelvic fractures
The best initial treatment for the fetus is to provide optimal resuscitation of the mother. True or False?
correct answers True. Also if xray examination is indicated during the pregnant patient's treatment, it
should not be withheld because of the pregnancy.
What happens as the uterus enlarged and the bowel is pushed cephalad. correct answers When the
uterus enlarges it pushes the bowel cephalad and the uterus lies in the upper abdomen. As a result, the
bowel is somewhat protected from blunt abdominal trauma, whereas the uterus and its contents (fetus
and placenta) become more vulnerable. Uterus remains intrapelvic until 12 weeks and then at 20 weeks
it is at the umbilicus, and at 34-36 weeks it reaches the costal margin.
Amniotic fluid can cause amniotic fluid embolism and disseminated intravascular coagulation following
trauma if fluid enters maternal intravascular space. True or False correct answers True
By the third trimester, what is the complication of trauma to the pelvis of the mother? correct answers
by the third trimester, the uterus is large and thin walled. In vertex presentation, fetal head is usually in
the pelvis and the remainder of the fetus is exposed above the pelvic brim. Pelvic fractures in late
gestation can result in skull fracture or intracranial injury to the fetus. Also we can have a placental
abruption due to its little elasticity and vulnerability to sheer forces.
An abrupt decrease in maternal intravascular volume can result in a profound increase in uterine
vascular resistance reducing fetal oxygenation despite reasonably normal maternal vital signs. correct
answers this is true
Physiological anemia of pregnancy correct answers A smaller increase in red blood cell volume can occur
resulting in a decreased hematocrit level. Thus, in late pregnancy a hematocrit of 31-33% is normal.
Healthy pregnancy patients can lose 1200-1500 mL of blood before exhibiting signs and symptoms of
hypovolemia. How can this manifest? correct answers this amount of hemorrhage may be reflected by
fetal distress as evidenced by an abnormal fetal heart rate.
What are some of the lab changes in pregnancy? correct answers WBC increases to 12000 and during
labor can be 25000. Fibrinogen and other clotting factors are mildly elevated and PT and pTT are
shortened, but bleeding time and clotting time are unchanged.
