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ATLS 7th Edition - vragen
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ATLS 7th Edition - vragen
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Voorbeeld 3 van de 22 pagina's
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Door: jelmerjoustra • 1 jaar geleden
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thATLS 7 Edition - questions
2 initial assessment 44 qustions
1. Which of the following should prompt transport to a trauma center?
a. Glasgow Coma Scale (GCS) < 14
b. Respiratory rate < 10 breaths/min or greater than 29 breaths/min
c. Systolic blood pressure < 90 mm Hg
d. All of the above
2. Which of the following should prompt transport to a trauma center?
a. MVA with death of one victim in the same passenger compartment
b. Restrained passenger in MVA with vehicle traveling greater than 30 mph
c. Fall from greater than 10 ft
d. All motorcycle crashes
e. All of the above
3. Which of the following should prompt transport to a trauma center?
a. Suspected isolated humerus fracture
b. Finger amputation
c. Penetrating injury to the hand
d. Combination trauma with burns
e. All of the above
4. What is the first priority in evaluating a trauma patient following a fall > 20 ft from a power line pole?
a. Protect the cervical spine
b. Evaluate airway
c. Check for a pulse due to the high risk of electrical injury
d. Start chest compressions
5. Which of the following would be an indication to intubate a trauma patient?
a. Respiratory rate greater than 29 breaths/min
b. Mandible fracture
c. Glasgow coma scale (GCS) < 10
d. Nonpurposeful motor responses
6. Following intubation a trauma patient deteriorates. Which of the following may be the cause?
a. Unrecognized laryngeal fracture
b. Incomplete upper airway transection
c. Unrecognized pneumothorax
d. Improper endotracheal tube placement
e. All of the above
7. What is the # 1 cause of preventable post-traumatic death?
a. Improper airway management
b. Missed cervical spine fracture
c. Hemorrhage
d. Cardiac contusion
8. A trauma patient is hypotensive. The primary and secondary surveys do not reveal any external hemorrhage. Which of the
following is the least likely cause?
a. Hemorrhage into the thoracic or abdominal cavities
b. Hemorrhage surrounding a femur fracture
c. Pelvic fracture with retroperitoneal hemorrhage
d. Neurogenic shock secondary to spinal cord injury
9. Which trauma patient may not demonstrate tachycardia as an early sign of significant blood loss?
a. Elderly patient on multiple medications
b. Pediatric patient
c. Athlete
d. All of the above
e. Both A + C
10. How should rapid external hemorrhage be controlled during the primary survey?
a. Direct manual compression
b. Tourniquets
c. Hemostats
d. Rapid external hemorrhage should be controlled during the secondary survey
11. Which of the following could contribute to a low Glasgow Coma Scale (GCS)?
a. Hemorrhage
b. Hypoglycemia
c. Medications and drugs
d. Cervical spine injury
e. All of the above
,12. Classically an epidural hematoma as compared to a subdural hematoma leads to rapid alteration in mental status
sometimes after a lucid interval.
a. true
b. false
13. What determines the maximum rate of fluid administration?
a. Internal diameter of the intravenous catheter
b. Size of the vein
c. Length of the intravenous catheter
d. All of the above
e. Both A + C
14. According to the ATLS textbook, which warmed initial intravenous fluid is preferred in the resuscitation of trauma patients
with hypotension?
a. Normal saline
b. 5% Dextrose in Water (D5W)
c. Ringers lactate
d. Any of the above would be acceptable
15. A female trauma patient has persistent hypotension that is refractory to crystalloid (normal saline or Ringer?s lactate
solution). There is not enough time to obtain matched type specific blood. What is the preferred order of resuscitative fluids
that should be administered to this patient?
a. Unmatched type specific blood. If unmatched type specific blood is not available administer O negative blood.
b. O negative blood. If O negative blood is not available administer type specific blood.
c. O negative blood. If O negative blood is not available administer O positive blood.
d. Any of the above would be acceptable
16. A trauma patient presents with pulseless electrical activity (PEA). Which of the following should be considered in the
differential diagnosis?
a. Cardiac tamponade
b. Tension pneumothorax
c. Massive hemorrhage with hypovolemia
d. All of the above
17. Under what circumstances would insertion of a Foley catheter be relatively contraindicated?
a. Blood at the penile urethral meatus
b. Perineal ecchymosis
c. Nonpalpable prostate (high-riding prostate)
d. Gross hematuria
18. What is the best way to diagnose a urethral injury?
a. Abdominal/Pelvic CT scan
b. Retrograde urethrogram
c. Urinalysis
d. Foley catheter insertion
19. Which of the following is NOT a complication of nasogastric tube insertion?
a. Insertion into the brain via a fractured cribiform plate
b. Pulmonary aspiration of oropharyngeal or gastric contents
c. Bradycardia
d. Vomiting
e. All of the above are complications
20. Which statement regarding a proper color change of an end-tidal carbon dioxide monitor following intubation is CORRECT?
a. Proper color change confirms proper placement of the endotracheal tube in the airway
b. Proper color change rules out esophageal intubation
c. Proper color change can be caused by blood in the endotracheal tube
d. Proper color change confirms adequate ventilation
21. What does the pulse oximeter measure?
a. The percent of hemoglobin saturated with oxygen
b. Partial pressure of oxygen dissolved within the blood (PaO2)
c. The adequacy of ventilation
d. Carbon monoxide
22. A normal cervical spine X-ray series including a lateral, AP, odontoid and right and left lateral oblique views rules out
cervical spine injury.
a. true
b. false
, 23. When should the secondary survey begin?
a. After the ABCs have been addressed
b. After the initial resuscitative efforts have been instituted
c. After the primary survey has been completed
d. After the tension pneumothorax has been treated
e. After all of the above have been completed
24. Patients with facial/maxillofacial trauma should be presumed to have potential injury to the cervical spine and should have
their cervical spine immobilized during the primary survey.
a. true
b. false
25. Injury to the cervical vasculature (carotid arteries, vertebral arteries) can occur secondary to both penetrating trauma and
blunt trauma.
a. true
b. false
26. Which of the following usually necessitates surgical exploration in the operating room for a penetrating injury to the neck?
a. Expanding hematoma
b. Airway compromise
c. Arterial bleeding
d. Bruit
e. All of the above
27. A trauma patient presents with a penetrating injury to the neck. It is unclear if the injury penetrates the platysma. What is
the best course of action?
a. Explore the wound with either a sterile cotton tipped applicator or an appropriate sterile surgical instrument to
determine if the wound does penetrate the platysma and its depth. Involve a surgeon if platysma penetration is
confirmed by probing.
b. Don?t explore the wound. Involve a trauma surgeon.
c. Don?t explore the wound. Order radiologic studies.
d. Suture the area closed. Send the patient for follow-up with a head and neck surgeon within 24 hours.
28. Which of the following is an example of a traumatic injury that may not present until days following the initial injury without
antecedent signs or symptoms?
a. Small bowel injury
b. Splenic rupture
c. Pancreatic injury
d. All of the above
e. Both A + C
29. Which findings are consistent with tension pneumothorax?
a. Distended neck veins
b. Hyporresonance to percussion
c. Decreased breath sounds
d. All of the above
e. Both A + C
30. Which radiographic findings are consistent with aortic rupture?
a. Tracheal deviation to the left
b. Depression of left mainstem bronchus
c. Deviation of the esophagus to the left (NG tube is pushed to the right)
d. All of above
e. Both A + C
31. Elderly patients can develop acute respiratory distress with even minor chest injures.
a. true
b. false
32. Pediatric trauma patients without physical exam evidence of muculoskeletal thoracic injury may have life-threatening
intrathoracic injury.
a. true
b. false
33. Which of the following are indications for diagnostic peritoneal lavage (DPL) in a severely injured trauma patient?
a. Unexplained hypotension
b. Abdominal pain and tenderness
c. Inability to perform a reliable abdominal examination due to neurologic injury or altered mental status
d. All of the above
e. Both A + C
34. A vaginal examination should be performed as part of the secondary survey.
a. true
b. false
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