ATLS Exam Expert-Verified Questions and Complete
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High Academic Standards
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 ANS- -True
In the elderly population, what is decreased physiological reserve? - CORRECT ANS- -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 ANS- -
cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
What is the most common mechanism of injury in the elderly? - CORRECT ANS- -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 ANS- -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 ANS- -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 ANS- -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 ANS- -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 ANS- -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 ANS- -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 ANS- -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 ANS- -
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 ANS- -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 ANS- -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 ANS- -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 ANS-
-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 ANS- -
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
ANS- -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 ANS- -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 ANS- -
aging causes dura to become more adherent to the skull increasing risk of injury and older
patients are on anticoagulant and antiplatelet medications.
