ATLS EXAM QUESTIONS AND ANSWERS
A 23-year-old man is brought immediately to the ED from the hospitals parking lot
where he was shot in the lower abdomen. Examination reveals a single bullet wound.
He is breathing and has a thready pulse. However, he is unconsious and has no
detectable blood pressure. Optimale immediate management is to:
A. Perform a FAST
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - Answers -D.
Transfer the patient to the operating room, while initiating fluid therapy
A 6 month old infant, being held in her mothers arms, is ejected on impact from a
vehicle that is struck head on by an oncoming car traveling at 64kph. The infant arrives
in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress.
Respiratory support is not effective using a bag mask device, and her oxygen saturation
is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most
appropriate procedure to perform next is:
A.Administer heliox and racemic epinephrine
B. Perform nasotracheal intubation
C.Perform surgical cricothyroidotomy
D.Repeat orotracheal intubation
E. Perform needle cricothyroidotomy with jet insufflation - Answers -E. Perform needle
cricothyroidotomy with jet insufflation
A 28 year olf male is brought to the ED. He was involved in a fight, during which he was
beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear,
resp rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the
following should be performed during the primary survey
a. glasgow coma
b. tetanus status
c. cervical spine xray
d. blood alcohol level
e. rectal exam - Answers -a. glasgow coma
an 18yo male is brought to the emergency department after being dumped by a large
wave while surfing. He landed head first on the firm beach sand. His vital signs are
blood pressure 85/60 mmHg, heart rate 60, and respiratory rate 18; he is unable to
move his lower extremities. He appears calm and asks if he will ever walk again. The
most appropriate next step is to:
a. reassure patient that he will walk again
b. proceed to a more detailed neuro exam
c. obtain c spin xrays
d. begin infusion of vasopressors
, e. begin bolus of warm IV crystalloid - Answers -e. begin bolus of warm IV crystalloid
Whic one of the following statements is true regarding access in pediatric resuscitation?
a. intraosseous access should be considered only after 5 percutaneous attempts
b. cutdown at teh ankle is the preferred initial access technique
c. internal jugular cannulation is the next preferred option when percutaneous venous
access fails
d. intraosseous cannulation should be the first choice
e. blood transfusion can be delivered through intraosseous access - Answers -e. blood
transfusion can be delivered through intraosseous access
a 35 year old female ustains multiple linjuries in a MVA and is transported to a small
hospital. She has a GCS of V2E2M2. Spinal motion restrictions are in place. ET is
performed, IV and wamred fluids are administered. She remains hemodynamically
normal, and preparations are made to transfer to another facility for definitive neuro
care. Which of the following tests or treatment should occur before transport?
a. ct abdomen and chest
b. chest xray
c. lateral cervical spine xray
d. admin of methlyprednisolone
e. transfusion of 2 units packed RBCs - Answers -b. chest xray
A 22 year old male sustains a shotgun wound to the left shoulder and chest at close
range. His BP is 80/40mmHg and his HR is 130bpm. Fluid resusciation is initiated, his
BP increases to 122/84, and HR decreases to 100bpm. He is tachypneic with RR of 28.
On physical examination, his breath sounds are decreased at the left upper chest with
dullness on percussion. A tube thoracostomy is inserted in the fifth intercostal space
with the return of 200ml of blood and no air leak. The most appropriate next step is to:
a. measure blood pressure again
b. begin transfuse O negative blood
c. wait until the chest xray is completed
d. obtain a CT scan of the chest and abdomen
e. repeat the physical exam of the chest - Answers -e. repeat the physical exam of the
chest
A 22 yo male is brought to the ED after being assaulted in a bar. On intial exam, his vital
signs are normal and his Glasgow Coma scale is V5E4M6. A definite indication for a
head CT is
a. prescence of hemotympanum
b. complains of headache
c. prescense of 10cm scapl laceration
d. prescence of mandibular fracture
e. history of assault - Answers -a. prescence of hemotympanum
a 23 yo construction worker is brought to the ED after falling more than 9 meters from
scaffolding. He is reported to have landed on his feet and then been unable to bear
A 23-year-old man is brought immediately to the ED from the hospitals parking lot
where he was shot in the lower abdomen. Examination reveals a single bullet wound.
He is breathing and has a thready pulse. However, he is unconsious and has no
detectable blood pressure. Optimale immediate management is to:
A. Perform a FAST
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - Answers -D.
Transfer the patient to the operating room, while initiating fluid therapy
A 6 month old infant, being held in her mothers arms, is ejected on impact from a
vehicle that is struck head on by an oncoming car traveling at 64kph. The infant arrives
in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress.
Respiratory support is not effective using a bag mask device, and her oxygen saturation
is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most
appropriate procedure to perform next is:
A.Administer heliox and racemic epinephrine
B. Perform nasotracheal intubation
C.Perform surgical cricothyroidotomy
D.Repeat orotracheal intubation
E. Perform needle cricothyroidotomy with jet insufflation - Answers -E. Perform needle
cricothyroidotomy with jet insufflation
A 28 year olf male is brought to the ED. He was involved in a fight, during which he was
beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear,
resp rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the
following should be performed during the primary survey
a. glasgow coma
b. tetanus status
c. cervical spine xray
d. blood alcohol level
e. rectal exam - Answers -a. glasgow coma
an 18yo male is brought to the emergency department after being dumped by a large
wave while surfing. He landed head first on the firm beach sand. His vital signs are
blood pressure 85/60 mmHg, heart rate 60, and respiratory rate 18; he is unable to
move his lower extremities. He appears calm and asks if he will ever walk again. The
most appropriate next step is to:
a. reassure patient that he will walk again
b. proceed to a more detailed neuro exam
c. obtain c spin xrays
d. begin infusion of vasopressors
, e. begin bolus of warm IV crystalloid - Answers -e. begin bolus of warm IV crystalloid
Whic one of the following statements is true regarding access in pediatric resuscitation?
a. intraosseous access should be considered only after 5 percutaneous attempts
b. cutdown at teh ankle is the preferred initial access technique
c. internal jugular cannulation is the next preferred option when percutaneous venous
access fails
d. intraosseous cannulation should be the first choice
e. blood transfusion can be delivered through intraosseous access - Answers -e. blood
transfusion can be delivered through intraosseous access
a 35 year old female ustains multiple linjuries in a MVA and is transported to a small
hospital. She has a GCS of V2E2M2. Spinal motion restrictions are in place. ET is
performed, IV and wamred fluids are administered. She remains hemodynamically
normal, and preparations are made to transfer to another facility for definitive neuro
care. Which of the following tests or treatment should occur before transport?
a. ct abdomen and chest
b. chest xray
c. lateral cervical spine xray
d. admin of methlyprednisolone
e. transfusion of 2 units packed RBCs - Answers -b. chest xray
A 22 year old male sustains a shotgun wound to the left shoulder and chest at close
range. His BP is 80/40mmHg and his HR is 130bpm. Fluid resusciation is initiated, his
BP increases to 122/84, and HR decreases to 100bpm. He is tachypneic with RR of 28.
On physical examination, his breath sounds are decreased at the left upper chest with
dullness on percussion. A tube thoracostomy is inserted in the fifth intercostal space
with the return of 200ml of blood and no air leak. The most appropriate next step is to:
a. measure blood pressure again
b. begin transfuse O negative blood
c. wait until the chest xray is completed
d. obtain a CT scan of the chest and abdomen
e. repeat the physical exam of the chest - Answers -e. repeat the physical exam of the
chest
A 22 yo male is brought to the ED after being assaulted in a bar. On intial exam, his vital
signs are normal and his Glasgow Coma scale is V5E4M6. A definite indication for a
head CT is
a. prescence of hemotympanum
b. complains of headache
c. prescense of 10cm scapl laceration
d. prescence of mandibular fracture
e. history of assault - Answers -a. prescence of hemotympanum
a 23 yo construction worker is brought to the ED after falling more than 9 meters from
scaffolding. He is reported to have landed on his feet and then been unable to bear
