ATLS Practice Test 4
1. A 25-year-old man, injured in a motor vehicular 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 t...
mcatestwixsitecomatls atls practice test 4 1 a 25 year old man
injured in a motor vehicular crash
is admitted to the emergency department his pupils react sluggishly and his eyes open to painf
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ATLS Practice Test 4
1. A 25-year-old man, injured in a motor vehicular 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; however, his left hand reaches toward it. Both legs are stiffly extended. His Glasgow
Coma Scale score is
a. two
b. four
c. six
d. nine
e. twelve
2. Which one of the following statements concerning massive hemothorax is TRUE?
a. It is usually caused by blunt thoracic trauma.
b. It is commonly confused with a pneumothorax.
c. The diagnosis should be confirmed by upright, plain chest roentgenograms prior to
treatment.
d. The initial draining of 1,000 mL of blood after chest tube insertion requires immediate
thoracotomy.
e. The condition should be suspected in situations associated with shock and unilateral absent
breath sounds.
3. A 25-year-old man is brought to the hospital after being involved in a motor vehicular crash when
his car struck a bridge abutment. He is intoxicated, has a Glasgow Coma Scale score of 13, 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 110/70 with the administration of
intravenous fluids. His heart rate is now 120 beats per minute. The chest roentgenogram shows
loss of the aortic knob, widening of the mediastinum, no rib fractures, and no
hemopneumothorax. Contrast CT angiography
a. is not indicated.
b. should be performed after tube thoracostomy.
c. is not necessary if non-contrast CT scan of the chest is normal.
d. should be performed after a FAST scan.
e. is positive for aortic rupture in 80% of similar cases.
4. 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 different pattern from that of the nonpregnant patient.
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5. The first maneuver to improve oxygenation after chest injury is
a. intubate the patient.
b. assess arterial blood gases.
c. administer supplemental oxygen.
d. ascertain the need for a chest tube.
e. obtain a lateral cervical spine roentgenogram.
6. A 17-year-old helmeted motorcyclist loses consciousness when he is struck broad side by an
automobile at an intersection. He arrives in the emergency department with a blood pressure of
140/92, pulse rate of 88 beats per minute, a respiratory rate of 18 breaths per minute, and a
Glasgow Coma Scale score of seven. Appropriate initial immobilization of this patient should
include a semi-rigid cervical collar and
a. a scoop stretcher.
b. a long spine board.
c. a short spine board.
d. cervical traction tongs.
e. pneumatic antishock garment.
7. A 34-year-old man is brought to the hospital after being pinned to the wall of a building by a
cement truck. He is in obvious shock, and has deformities and marked swelling of both thighs,
although no open wounds are present. His shock
a. cannot be explained without concomitant pelvic fracture.
b. signifies a loss of approximately 15% of his blood volume.
c. is consistent with blood loss from bilateral femoral fractures.
d. will likely be reversed if appropriate traction splints are applied.
e. cannot be explained by his observed injuries unless a major arterial injury exists.
8. Prior to passage of a urinary catheter, it is essential to
a. examine the abdomen.
b. determine pelvic stability.
c. examine the rectum and perineum.
d. perform a retrograde urethrogram.
e. know the history and mechanism of injury.
9. The best guide for adequate 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. total fluids in 24 hours = 4 x weight (kg) x percent body surface area burned.
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