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2023-2024 ATLS Pre Test Practice Exam with Answers (350 Solved Questions)

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    lOMoAR cPSD| 37795687 ATLS PRE TEST QUESTIONS AND VERIFIED ANSWERS UPDATED 202 3 /202 4 A TLS PRE TEST 1 - ATLS PRE TEST 1 NURSING (CHAMBERLAIN UNIVERSITY)

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    ATLS PRE TEST 1 – 4 QUESTIONS AND CORRECT

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    ANSWERS 320+ QUESTIONS AND ANSWERS| GRADED A 1. Whic h of the following physical findings suggest a cause of hypotension other than spinal cord injury? A. Prispism B. Bradycardia C. Diaphragmatic breathing D. Presence of deep tendon reflexes E. Ability to flex forearms but not extend them - ANSWER - D. Presence of deep te ndon reflexes. Spinal shock refers to loss of muscle toe (flaccidty) and loss of reflexes. 2. The primary indication for transferring A patient to a higher level trauma center is: A. Unavailibility of surgeon or operating staff B. Multiple system injuries, incl uding severe head injury C. Resource limitations as determined by the transferring doctor D. Resource limitations as determined by the hospital administration E. Widened mediastinum on chest x - ray following blunt trauma - ANSWER - C. Resource limitations as determin ed by the transferring doctor (MÅ SJEKKES)

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    3. A young man sustains a rifle wound to the mid - abdomen. He is brought promptly to the ED by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58mmHg. Warmed crystalloid fl uids are initiated without improvement in his vital signs. The next, most appropriate, step is to perform: A. a laparotomy B. An ab dominal CT - scan C. Diagnostic laparoscopy D. Abdominal ultrasonography E. A diagnostic peritoneal lavage - ANSWER - A. Laparotomy bec ause of hemodynamic abnormality 4. A 42 - year - old man is trapped from the waist down beneath his overturned tractor for several hours before medical assistance arrives. He is awake and alert until just before arriving in the ED. He is now unconscious and resp onds only to painful stimuli by moaning. His pupils are 3mm in diameter and symmetrically reactive to light. Prehospital personnel indicate that they have not seen the patient move either of his lower extremities. On examination in the ED, no movement of h is lower

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    e xtremities are detected, even in response to painful stimuli. The most likely cause for this finding is: A. An epidural hematoma B. A pelvic fracture C. Central cord syndrome D. Intracerebral hemorrhage E. Bilateral compartment syndrome - ANSWER - MÅ SJEKKES 5. A 6 - year - o boy is struck by an automobile and brought to the ED. He is lethargic, but withdraws purposefully from painful stimuli. His blood pressure is 90mmHg systolic, heart rate 140 beats per minute and his respiratory rate is 36 breaths per minute. The preferred route of venous access in this patient is: A. Percutaneous femoral vein cannulation B. Cutdown on the saphenous vein at the ankle C. Intraosseous catheter placement in the proximal tibia D. Percutaneous peripheral veins in the upper extremiti es D. Central venous access via the subclavian or internal jugular vein - ANSWER - D. Percutaneous peripheral veins in the upper extremities 6. A young man sustains a gunshot wound to the abdomen and is brought promptly to the ED by prehospital personnel. His sk in is cool and diaphoretic,

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    and he is confused. His pulse is thready and his femoral pulse is only weakly palpable. The definitive treatment in managing this patient is to: A. Administer O - negative blood B. Apply exte rnal warming devices C. Control internal h emorrhage operatively D. Apply a pneumatic antishock garment (PASG) E. Infuse large volumes of intravenous crystalloid solutions. - ANSWER - C. Control internal hemorrhage operatively 7. Regarding shock in the child, which of the following is FALSE? A. Vital signs a re age - related B. Children have greater physiologic reserves than do adults C. Tachycardia is the primary physiologic response to hypovolemia D. The absolute volume of blood loss required to produce shock is the same as in adults E. An initial fluid bolus for resuscit ation should approximate 20ml/kg Ringers Lactate - ANSWER - D. The absolute volume of blood loss required to produce shock is the same as in adults

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    8. A 33 - year - old man is struck by a car travelling at 56km/h (35mph). He has obvious fractures of the left tibia near the knee, pain in the pelvic area, and severe dyspnea. His heart rate is 182 beats per minute, and his respiratory rate is 48 breaths per minute with no breath sounds heard in the left chest. A tension pneumothorax is relieved by immediate needle dec ompression and tube thoracostomy. Subsequently, his heart rat e decreases to 144 beats per minute, his respirartory rate decreases to 36 breaths per minute and his blood pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered intravenously. The next p riority should be to: A. Perform external fixation of the pelvis B. Obtain abdominal and pelvic CT - scans C. Perform arterial embolization of the pelvic vessel D. Perform diagnostic peritoneal lavage or FAST E. Perform a urethrogram and cystogram - ANSWER - D . Perform diagnostic peritoneal lavage or FAST 9. A 42 - year - old man, injured in a motor vehicle crash, suffers a closed head injury, multiple palpable left rib fractures, and bilateral femur fractures. He is intubated orotracheally without difficulty. Initia lly, his ventilations are Reasily assisted with a bag - mask device. It becomes more difficult to ventilate the patient over the next 5 minutes, and his hemoglobin oxygen saturation level

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    decreases from 98% to 89%. The most appropriate next step is to: A. Obtai n a chest x - ray B. Decrease the tidal volume C. Decrease PEEP D. Increase the rate of assisted ventilations E. Perform needle decompression of the left chest. - ANSWER - A. Obtain a chest x - ray (MÅ SJEKKES) 10. A 30 - year - old man sustains a severely comminuted, ope n, distal right femur fracture in a motorcycle crash. The wound is actively bleeding. Normal sensation is present over the lateral aspect of the foot but decreased over the medial foot and great toe. Normal motion of the foot is observed. Dorsalis pedis an d posterior tibial pulses are easily palpable on the left, but heard only by Doppler on the r ight. Immediate efforts to improve circulation to the injured extremity should involve: A. Immediate angiography B. Tamponade of the wound with a pressure dressing C. Wound exploration and removal of bony fragments D. Realignment of the fracture segments with a traction splint

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    E. Fasciotomy of all four compartments in the lower extremity - ANSWER - B. Tamponade of the wound with a pressure dressing 11. An 18 - yeard - old, unhelmeted motorcyclist is brought by ambulance to the ED following a crash. He had decreased level of consciousness at the scene, but then was alert and conversational during transportation. Now his GCS is only 11. Which of the following statements is TRU E? A. Cerebral perfusion is intact B. Intravascular volume status is normal C. The patient is in a postictal state D. Intra - abdominal visceral injury is unlikely E. The patient probably has an acute epidural hematoma - ANSWER - E. The patient probably has an acute epidural hematoma 12. A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss of two liters. Which one of the following statements apply to this patient? A. His pulse pressure will be widened B. His urinary output will be at the lowe r limits of normal C. He will have tachycardia, but no change in systolic blood pressure D. His systolic blood pressure will be decreased with a narrowed, pulse pressure

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    E. His systolic blood pressure will be maintained with an elevated diastolic pressure . - ANS WER - E. His systolic blood pressure will be maintained with an elevated diastolic pressure. 13. The physioclogic hypervolemia of pregnancy has clinical significance in the management of the severely injured gravid woman by A. Reducing the need for blood trans fusion B. Increasing the risk of pulmonary edema C. Complicating the management of closed head injury D. Increasing the volume of blood loss to produce shock/maternal hypotension E. Reducing the volume of crystalloid required for resuscitation - ANSWER - D. Increasing the volume of blood loss to produce shock 14. A 17 - year - old helmeted motorcyclist loses consciousness when he is struck broad side by an automobile at an intersection. He arrives in the ED with a blood pressure of 140/92, pulse rate 88 beats per mi nute, a respiratory rate of 18 breaths per minue, and a GCS of 7. Appropriate initial immobilization of this patient should include a semi - rigid cervical collar and: A. A scoop stretcher B. A long spine board

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    C. A short spine board D. Cervical traction to ngs E. Pneumatic antishock garment - ANSWER - B. A long spine board 15. During an altercation, a 36 - year - old man sustains a gunshot wound above the nipple line on the right, with an exit wound posteriorly above the scapula on the right. He is transported by amb ulance to a community hospital. He is endotracheally intubated, close tube thoracostomy is performed, and 2 liters Ringers lactate solution are infused via 2 large - caliber IV´s. His blood pressure now is 60/0mmHg, heart rate is 160 beats per minute, and re spiratory rate is 14 breaths per minute (ventilated with 100% O2). The most appropriate next step in managin this patient is: A. Laparotomy B. Diagnostic peritoneal lavage C. Arterial blood gas determination D. Administer packed red blood cells E. Chest X - ray to co nfirm tube placement - ANSWER - E. Chest X - ray to confirm tube placement 16. Abscence of breath sounds and dullness to percussion over the left hemithorax are findings best explained by:

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    A. Left hemothorax B. Cardiac contusion C. Left simple pneumothorax D. Lef t diaphragmatic rupture E. Right tension pneumothorax - ANSWER - A. Left hemothorax 17. 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 br eathing and has a thready pulse. However, he is unconsious and has no detectable blood pressure. Optimale immediate management is to: A. Perform a diagnostic peritoneal lavage B. Initiate infusion of packed red blood cells C. Insert a nasogastric tube and uri nary catheter D. Transfer the patient to the operating room, while initiating fluid therapy E. Initiate fluid therapy to return his blood pressure to normotensive - ANSWER - D. Transfer the patient to the operating room, while initiating fluid therapy 18. A teen - aged bicycle rider is hit by a truck traveling at high speed. In the ED, she is actively bleeding from open fractures of her legs, and has abrasions on her chest

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    and abdominal wall. Her blood pressure is 80/50 mmHg, heart rate is 140 beats per minute, respira tory rate is 8 breaths per minute, and GCS score is 6. The first step in managing this patient is to: A. Obtain a lateral cervical spine x - ray B. Insert av central venous pressure line C. Adminster 2 liters of crystalloid solution D. Perform endotracheal intubat ion and ventilation E. Apply a pneumatic antishock garment (PASG) and inflate the leg compartments. - ANSWER - D. Perform endotracheal intubation and ventilation 19. An 8 - year - old boy falls 4,5 meters (15 feet) from a tree and is brought to the ED by his family. H is vital signs are normal, but he complains of left upper quadrant pain. An abdominal CT - scan reveals a moderately severe laceration of the spleen. The receiving institution does not have 24 - hour - a - day o perating room capabilities. The most appropriate mana gement of this patient would be to A. Type and crossmatch for blood B. Request consultation of a pediatrician C. Transfer the patient to a trauma center D. Admit the patient to the intensive care unit E. Prepare the patient for surgery the next day - ANSWER - D. A dmit the patient to the intensive care unit

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    20. Which of the following statements regarding injury to the central nervous system in children is TRUE? A. Children suffer spinal cord injury without x - ray abnormality more commonly than adults. B. An infant with a trau matic brain injury may become hypotensive from cerebral edema C. Initial therapy for the child with traumatic brain injury includes the administration of methylprednisolone intravenously D. Children have more focal mass lesions as a result for traumatic brain in jury when compared to adults. E. Young children are less tolerant of expanding intracranial mass lesions than adults - ANSWER - A. Children suffer spinal cord injury without x - ray abnormality more commonly than adults. 21. A 17 - year - old helmeted motorcyclist is st ruck broadside by an automobile at an intersection. He is unconscious at the scene with a blood pressure of 140/90mmHg, heart rate of 90 beats per minute, and respiratory rate of 22 breaths per minute. His

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    respirations are sonorous and deep. His GCS score is 6. Immobilization of the entire patient may include the use of all the following EXCEPT: A. Air splints B. Bolstering devices C. A long spine board D. A scoop - style stretcher E. A semi - rigid cervical collar - ANSWER - A. Air splints 22. Twenty - seven patients are seriously injured in an aircraft accident at a local airport. The basic principle of triage should be to: A. Treat the most severely injured patients first B. Establish a field triage area directed by a doctor C. Rapidly transport all patients to the neare st appropriate hospital D. Treat the greatest number of patients in the shortest period of time E . Produce the greatest number of survivors based on available resources - ANSWER - E. Produce the greatest number of survivors based on available resources 23. An electrician is eletrocuted by a downed power line after a thunderstorm. He apparently made conta ct with the wire at the level of the right mid thigh. In the ED, his vital signs are normal and no dysrythmia is noted on ECG. On examination, there is an exit wound on the bottom of the right foot. His urine is

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