ATLS 9" Edition i Evaluation of the retroperitoneum ina hemodynamically stable patient is most accurately accomplished by: G) CT sean B. diagnostic peritonea! lavage (DPL) FAST exam 4. angiography ¢. physical exam A 12-year-old hemodynama semi mi een upper quadrant alee 1 football. A focused assessment "AST) © trates fluid in the hepatorenal P ‘next step in the assessmentA 25-year-old female in the third trimester of pregnancy is involved in a motor vehicle crash in which she is the front seat passenger. The driver is dead on scene. Which one of the following statements concerning this patient is true? a. The patient should be told as soon as possible that her husband is dead. b. Palpation of clearly definable fetal parts allows for assessment of the stage of pregnancy. ¢. The thick-walled uterus provides protection for the fetus. d. Absence of fetal movements indicates maternal shock. @) Clear fluid from the vagina is an indication for hospital admission. ‘The cause 0 ‘obstruction most likely to be alleviated by a properly ina single car crash and is taken to a al, but has obvious, multiple facial ‘slightly decreased over the right abdomen is soft and active bowel is 7. A chest x-ray lalty capabilities are not available (40 miles) away. InitialATLS 9" Edition 9. Which of the following is the best ne xa step ina hypotensive patient with 4 stab ‘wound to the upper abdomen? © a. e Chest and abdominal X-ray FAST Local wound exploration CT abdomen and pelvis t after being dumped by 10. An 18-year old F ees dum a large wave: fe He landed head-first on the firm beach sand. His vital art rate 60, and respiratory rate 18. He k again. The most appropriate next step isATLS 9” Edition Revised Post-Test #4 13. A. 42-year-old male presents to the emer i tial vi gency department with burns. Initial vital signs are: Glasgow Coma Scale score is 15, heart rate is 110, and blood pressure is 110/65 mm Hg, Indications for transfer of this patient to a burn center include: a. burns to bo i f burns < 10% speed, head-on car crash. She complains ows only a widened mediastinum. ent includes: (25 feet) to escape from a legs. The priority in thisATLS ™ EaitION ah head injuries exhibit: ents with head i") s, elderly Pat 7. Compared with younger adult fewer subdural hematomas b. fewer severe cerebral contusions ¢. increased cerebral blood flow 4. decreased movement of the brain on an @ less stretching of bridging veins povolemic shock is not influenced by: ar goceleration/deceleration The clinical presentation of hyl a. gender b. extremes of age © pre-injury fitness ‘concomitant medication os in anspor to oeATs 9” Eamon 2 A S-year-old boy is struck by an automobile and brought to the emergency department. He is lethargic but withdraws from painful stimuli. His blood pressure is 90 mm Hg systolic, heart rate is 140 beats per minute, and respiratory rate is 36 breaths per minute. The preferred route of venous access in this patient is: 4. percutaneous femoral vein cannulation '. cutdown on the saphenous vein at the ankle &_intraosseous catheter placement in the proximal tibia (@® percutaneous peripheral venous access in the upper extremities ‘©. central venous access via the subclavian or internal jugular vein 23. In trauma patients, abnormally high intracranial pressure should be suspected when: rate slow, and blood pressure falls are irregular, and blood pressure rises rapid, and hypertension occurs nw, and systolic pressure rises rs heart rate is rapid, and blood pressure falls al response to pregnancy during the third Je traveling at 60 kph most appropriatenevised Post-Test #4 arse nich one of the following injuries is 37 peritonea! lavage? ont katy 10 be minsed by diagnonle a. liver laceration b perforated jejunum e perforated transverse colon: C3 mesenteric laceration @S subcapsular splenic hematoma ing struck by a scooter. Her respira rate is ‘Coma Seale 100/70 mm Hg. Her Glasgow ci ‘of the following, _An 80-year-old female presents after be! Which one 20, heart rate is 86, and blood pressure i Kore is 12, and she is bleeding from a sealp laceration treatment steps is the priority? a. administering | L of crystalloid controlling bleeding from the scalp & performing neurological examination d. obtaining CT scan of the head ¢. obtaining detailed information about medication and previous history A 72-year-old female is brought in. She fell down a flight of stairs and has a painful right leg. Her thigh is deformed. Her heart rate is 84, blood pressure is 90/60, and respiratory rate is 18, Which one of the following statements is true regarding this patient? Significant blood loss is unlikely. © Previous illnesses and medications are very relevant. be postponed until surgery. » ‘c. Realignment of the right leg can d. Acompartment syndrome is likely. e. There is no need for IV infusion. * A 45-year-old female presents after an explosion. She is confused on arrival with the ratory rate 16, heart rate 120, and blood pressure 105/60 re is 34.7°C (04.5 F). Her arms and legs show initial step in resuscitation is:ATLS 9” Edition Revised Post-Test #4 vi Test 31. A S2-yearold male is brow; i ici i fs Mi ight in following attempted suicide by hanging. On arrival, hhe exhibits stridor and has palpable crepitus in the neck. Immediate management should include: G@) needle cricothyroidotomy ‘b.lateral x-ray of the neck to include the airway ‘surgical tracheostomy in the operating room ad. direct ‘and endotracheal intubation oxygen mixture) js brought to the emergency department with a Glasgow ndary assessment, he is noted to have poor rectal sphincter g, His arms are flexed across his chest. These is the presence of: in an unconscious patientRevised Post-Test iq following maior mechanisms of injury ak. _Typhealpetsis ecoure poserns sd BUTS nchode resulting in ope? pelvic fractures a jin shifting of the iliac bones vertically lipetvis, typically resulting in disruption of the & lateral compression fore >. anterior compression, resulting vertical displacement of the hemi iliac crest of the pelvis, resulting in Ss posterioe displacement ofthe knee and fernur in MOIOr V th acetabular factures with anterior hip dislocation d to the left shoulder and chest at close heart rate is 130 beats per minute. He ‘per minute. On physical eft upper chest with dullness on infused, blood pressure eats per minute. A large- sacral fractures cchicle crashes, resultingATLS 9" Edition Revised Post-Test #4 38. Et oe logger is struck in the right chest by the large limb of a falling tree. He bce aa and complains of severe chest wall pain. He arrives in the rerueney department 45 minutes afer the injury, tll éyspneic snd complaining of 22 with respiratory efforts. The patient has shallow respirations Beets aa esliting ofthe right chest wal. Brest sounde ae slihly don the right. His blood pressure is 104/60 mm Hg, heart rate is 120 beats fics inute, and respiratory rate is 30 breaths per minute. He is receiving oxygen at 6 per minute by face mask. The results of his arterial blood gas analyses are: PaO, of 52 mm Hg (6.9 kPa), PaCO, of 33 mm Hg (4.4 kPa), and pH of 7.44. The most likely explanation for his hypoxia is: na balcony onto concrete 4 meters (greater than 12 is moaning, and does not open his eyes. His 84 beats per minute, and respiratory rate is 16. is correct regarding this patient? Glasgow Coma Scale score. I spine injury. assessment. hypotension. chest against the dashboard during a is placed for monitoring ntral venous pressure could