These test items are undergoing psychometric analysis.
Note: It is understood that medical practices vary with institutional policies and individual preferences. This test is
designed in conjunction with the material presented in the 9th edition of the ATLS® Course. Please answer the
questions ...
these test items are undergoing psychometric analysis note it is understood that medical practices vary with institutional policies and individual preferences this test is designed in conjunction w
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ATLS Pre-Test Examination
These test items are undergoing psychometric analysis.
Note: It is understood that medical practices vary with institutional policies and individual preferences. This test is
designed in conjunction with the material presented in the 9th edition of the ATLS® Course. Please answer the
questions accordingly.
Important directions before you begin this test:
This test consists of 40 multiple-choice questions.
Read each question thoroughly and select the one best answer.
Please note: Questions and/or concerns about test items are referred to the ACS ATLS® Program Office. The course
director or coordinator cannot give credit for a response that you mark incorrectly according to the answer key.
Prepared by the American College of Surgeons Committee on Trauma for sole use in an approved ACS ATLS®
Course.
Please select the appropriate answer for each question.
Once finished, please click the Submit Button.
Question:1 A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His
blood pressure is initially 80/40 mm Hg. After 2 liters of crystalloid solution his blood pressure increases to
122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute.
His breath sounds are decreased in the left hemithorax, and after initial IV fluid resuscitation, a closed tube
thoracostomy is performed for decreased left breath sounds with the return of a small amount of blood and no
air leak. After chest tube insertion, the most appropriate next step is
A) reexamine the chest.
B) perform an aortogram.
C) obtain a CT scan of the chest.
D) obtain arterial blood gas analyses
E) perform transesophageal echocardiography.
Question:2 A construction worker falls two stories from a building and sustains bilateral calcaneal fractures.
In the emergency department, he is alert, vital signs are normal, and he is complaining of severe pain in both
heels and his lower back. Lower extremity pulses are strong and there is no other deformity. The suspected
diagnosis is most likely to be confirmed by
A) angiography.
B) compartment pressures
C) retrograde urethrogram
D) Doppler-ultrasound studies.
E) complete spine x-ray series.
Question:3 The principle of balanced resuscitation is:
A) Permissive hypotension and early plasma infusion
B) Equal amounts of crystalloid and colloids
C) Simultaneous management of breathing and circulation
D) Maintenance of a normal acid base balance
E) Achieving a pulse rate <90
Question:4 In managing the head-injured patient, the most important initial step is to
A) secure the airway.
B) obtain c-spine film.
C) support the circulation.
D) control scalp hemorrhage.
E) determine the GCS Score.
Question:5 A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters.
Which one of the following statements applies to this patient?
A) His pulse pressure will be widened.
B) His urinary output will be at the lower limits of normal.
C) He will have tachycardia, but no change in his systolic blood pressure.
This study source was downloaded by 100000807711539 from CourseHero.com on 02-28-2022 12:49:21 GMT -06:00
His systolic blood pressure will be decreased with a narrowed pulse pressure.
E) His systolic blood pressure will be maintained with an elevated diastolic pressure.
Question:6 The physiologic hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by
A) reducing the need for blood transfusion.
B) increasing the risk of pulmonary edema.
C) complicating the mangement of closed head injury.
D) reducing the volume of crystalloid required for resuscitation.
E) increasing the volume of blood loss to produce maternal hypotension.
Question:7 The best assessment of fluid resuscitation of the burn patient is
A) adequate urinary output.
B) reversal of systemic acidosis.
C) normalization of the heart rate.
D) a normal central venous pressure.
E) 4 mL/kg/percent body burn/ 24 hours.
Question:8 The diagnosis of shock must include
A) hypoxemia.
B) acidosis.
C) hypotension.
D) increased vascular resistance.
E) evidence of inadequate organ perfusion.
Question:9 A 7-year-old boy is brought to the emergency department by his parents several minutes after
he fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of
A) application of a tourniquet.
B) direct pressure on the wound.
C) packing the wound with gauze.
D) direct pressure on the femoral artery at the groin.
E) debridement of devitalized tissue.
Question:10 For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to
prevent
A) respiratory acidosis.
B) metabolic acidosis.
C) cerebral vasoconstriction with diminished perfusion.
D) neurogenic pulmonary edema.
E) shift of the oxyhemoglobin dissociation curve.
Question:11 A 25-year-old man is brought to a hospital with a general surgeon after being involved in a
motor vehicle crash. Computed tomography shows an aortic injury and splenic laceration with free abdominal
fluid. His blood pressure falls to 70 mm Hg after CT. The next step is
A) contrast angiography.
B) transfer to a higher level trauma center.
C) exploratory laparotomy.
D) infuse additional crystalloids.
E) transesophageal echocardiography.
Question:12 Which one of the following statements regarding abdominal trauma in the pregnant patient is
TRUE?
A) The fetus is in jeopardy only with major abdominal trauma.
B) Leakage of amniotic fluid is an indication for hospital admission.
C) Indications for peritoneal lavage are different from those in the nonpregnant patient.
D) Penetration of an abdominal hollow viscus is more common in late than in early pregnancy.
E) The secondary survey follows a pattern from that of the nonpregnant patient.
Question:13 The first maneuver to improve oxygenation after chest injury is
A) intubate the patient.
B) assess arterial blood gases.
C) administer supplemental oxygen.
This study source was downloaded by 100000807711539 from CourseHero.com on 02-28-2022 12:49:21 GMT -06:00
D) ascertain the need for a chest tube.
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