car-old athlete is involved in a motorcycle crash ncy department, he shouts he cannot move his ation, there are no abnormalities of the che sation in his legs and cannot move them, but hi Paticnt’s respiratory rate is 22, heart rate is 88, and blood pre He is pale and sweaty. What is the most likely cause of his ce abdomen, oF pe ser @® neurogenic shock b. cardiac tamponade ©. myocardial contusion 4. hyperthermia abdominal hemorthage A 22-year-old male presents following a motorcycle crash. He complains of the inability to move or feel his legs. His blood pressure is 80/50 mm He, heart rate is 70, respiratory rate is 18, and Glasgow Coma Seale score is 15. Oxygen saturation is 99% on 21 nasal prongs. Chest x-ray, pelvic x-ray, and FAST are normal. Extremities are normal, His management should be: ® 21 of IV crystalloid and two units of pRBCs (packed red blood cells) b. 2L of IV crystalloid, mannitol, and IV steroids ¢. 1 unit of albumin and compression stockings d._vasopressors and laparotomy ©. 2 L of crystalloid and vasopressors if BP does not respond Which of the following signs is least reliable for diagnosing esophageal intubation? a. symmetrical chest wall movement b 2Edition. 1. He was involved in ency departmen! inthe me ck. His chest shows multiple seve fh 8 oo 22, heart rate is126, and systolic blood ing should be performed during the -ar-old male is brought beaten wil respiratory rate Is of the followil A 28-y fight, in which he was bruises. His airway is clear, pressure is 90 mm Hg. Whic primary survey? ” ® Glasgow Coma Score tetanus toxoid administration cervical spine x-ray blood alechottevel fe. rectal exam 6. Which one of the following injuries is addressed in the secondary survey? Forearm fracture ~ Mid-thigh amputation ¢. Open fracture with bleeding d. Unstable pelvic fracture . Bilateral femur fractures with obvious deformity 7. Which one of the following statements is true regarding access in pediatric resuscitation? ._Intraosseous access should only be considered after five percutaneous attempts. + Cuteown tthe ankle js the prefered inital access technique.ATLS 9" Edition 10. Revised Post-Test #2 A 23-year-old male is stabbed below the right nipple. He is alert, and his oxygen saturation is 98%. Chest tube was placed for treatment of a hemopneumothorax. Blood pressure is 90/60 mm Hg after administration of I L of crystalloid solution, What is the next step in treatment? a. place a left-sided chest tube b) re-examine the chest ¢, insert central venous catheter d. perform CT scan of the abdomen and pelvis €. prepare for urgent thoracotomy A 22-year-old male is assaulted in a bar. A semi-rigid cervical collar is applied, and he is immobilized on a spine board. On initial examination, his vital signs are normal, and his Glasgow Coma Scale score is 15. Which of the following is an indication for CT in this patient with possible minor traumatic brain injury? > presence of hemotympanum . blood alcohol concentration of 0.16% (160 mg/100 ml) c. presence of an isolated 10 cm scalp laceration d. presence of a mandibular fracture e. history of assault A 23-year-old construction worker is brought to emergency department after falling more than 9 meters (30 caf ital signs are: heart rate 140, blood pressure 9 ir i complaining bitterly abdominal : ty of both lower re } . ie | ti a Ce —ts 9" Editios is brought to the emerge She is conscious and A 25-year-old female in the third ee vehi fe crash 4, heart rate is 120, and Seri sa high-speed ory rate is 24, heart ra oe department flowing nih aPet Fe vest 413 of 40 mim He, Which immobilized on a long spine bo soults show # Pa result tis true? blood pressure is 70/50. The laboratory Enis patien one of the following statements concern a. Fetal assessment should take priority, ess the vena cav' @) Log rolling the patient to the right will co adasiaiate c. Rh-immunoglobulin therapy should be imme d. The patient kely impending respira €. Vasopressors should be given to the patient 13. A 30-year-old male is stabbed in the right chest. On aes department, he is very short of breath. His heart rate 1 1 80/50 mm Hg. His neck veins are flat. On auscultation 01 diminished air entry on the right side, and there is dullness These findings are most consistent with: wal in the emergency 20 and blood pressure is f the chest, there is posteriorly on percussion, a. tension pneumothorax XB pericardial tamponade hypovolemia from liver injury Y [a] hemothorax .. spinal cord injury 14. A specific aspect of the t a, chemical burns requi BsATLS 9" Edition Revised Post-Test #2 16. Which one of the following statements is truc? Elevated intracranial Pressure will not affect cerebral perfusion. Cerebrospinal fluid cannot be displaced from the cranial vault. Cerebral blood flow is increased when the PaCO2 is below 30 mm. He. . Autoregulation of cerebral blood flow normally occurs between cerebral perfusion pressures of 50 to 150 mm Hg. ¢- Hypotonie fluids should be used to limit brain edema in patients with severe head injury. 17. The first priority in the management of a long bone fracture is: a. reduction of pain prevention of infection in case of an open fracture a! eet ieee iniwy e improve long-term function A 40-year-old obese patient with a Glasgow Coma Scale score of 8 requires a CT peop20. 21. An 82-year-old male falls down fi 22. > 5 9" Edition 30-year-old mi Inspection reveals an obvi0 Breath sounds are present i dullness, Arterial blood gas OPE 45 are; PaO2 of 45 mm Hg (6 KPa), toy ee component of injury that is most likely patient’s blood gases is a. hypoventilation b. hypovolemia ¢. small pneumothorax @ pulmonary contusion , flail chest its to the emergency department. red toa ve stairs and presents to th 4 All of the following are true statements regarding his condition compé younger patient with similar mechanism, except? tracted circulatory volume prior to his injury. increased due to degeneration, stenosis, and a. He is more likely to have had a co His risk of cervical spine injury is i loss of disk compressibility. ; ¢. Intracranial hemorrhage will become : more A d. His risk of occult fractures is inerease eee oe of occult fractures is inereased. ee €. His risk of bleeding may be ine A 14-year-old female is bro horse: She is immobilized ong Cervical spine x-rays: a. will show cervical will exclude cx @® are not needed or midline tene should be pRevised Post-Test #2 ATLS 9" Edition 24, The most important consequence of inadequate organ perfusion is: @® multiple organ failure b. decreased base deficit ¢. acute glomerulonephritis d. increased cellular adenosine triphosphate (ATP) production €. vasodilation 25. _ Hypertension following a head injury: should be treated to reduce intracranial pressure may indicate imminent herniation from critically high intracranial pressure indicates pre-existing hypertension mandates prompt administration of mannitol should prompt burr hole drainage of potential subdural hematomas ie feege 26. _Initial treatment of frostbite injuries involves: a. application of dry heat ©) rapid rewarming of the body part in circulating WARM water ¢. debridement of hemorthagic blisters d. early amputation to prevent septic eS e. massage of the affected area Signs and symptoms of airway comprom su Fe towing except a ae :ATLS 9" Edition cent after being injured in 29. 31. argency departn' nerBer™%90/60 mm Hg, and her heart rate jg iysion of | liter of crystalloid jg and a decrease in her ases tO 96/66 mm prought 1 the - i. x initial plood eet de Js t0 esponds re to 118/88. mm Hi re tore then suddenly deere dynamic © A 30-year-old female i$ ash. He motor vehicle cra os 122 beats per minute. She # solution with arse in her 00d ae heart rate to 90 beats permminule. He. The least likely cause of her Ne ange is: traumatic brain injury © ongoing blood loss . blunt cardiac injury d. inadequate resuscitation tension pneumothorax . Limb-threatening extremity injuries: ic or crushed tissue require a tourniquet ion of a traction splint are characterized by the presence of ischem' should be definitively managed by applicati are rarely present without an open wound (S indicate a different order of priorities for the patient’s initial assessment and resuscitation Re oe A 29-year-old female arrives in the emer; ing i i - : gency department after being involved in a jee = She is 30 weeks pregnant. She was restrained with a lap and i It, and an. airbag deployed. Which one of the following statements best describes the risk of injury? a. The deployment of the airbag. b. The use of seatbelts is i ‘The mechanism of in of restraints. ral injury.33. 34, A 70-year-old male suffers blunt chest trauma after being struck by a car. On Presentation, his Glasgow Coma Scale score is 15, blood pressure is 145/90 mm Hg, heart rate is 72, respiratory rate is 24, and oxygen saturation on 5 L is 91%. Chest x- ray demonstrates multiple right-sided rib fractures. ECG demonstrates normal sinus thythm with no conduction abnormalities. Management should include: a. placement of a 22-French, right-sided chest tube b. serial troponins and cardiac monitoring thoracic splinting, taping, and immobilization monitored intravenous analgesia e bronchoscopy to exclude tracheobronchial injury A 15-year-old male presents following a motorcycle crash. Initial examination reveals normal vital signs. There is a large bruise over his epigastrium that extends to the left flank. He has no other apparent injuries. A CT scan of the abdomen demonstrates a ruptured spleen surrounded by a large hematoma and fluid in the pelvis. The next step in this patient's management is:Revised Post-reu ATLS 9" Edition jepartment following a bar figh, on command, moans witgg h one of the jt o the emerBency d ness, opens his eyes © ee to painful stimuli. WI tient is true? 37. A 25-year-old male is brou has an altered level of conscious forming discernible words, and following statements concerning this P2 n to protect his airway #6 required. suggests a severe head injury. eee solely attributed to elevated blood alcohol, neurological assessment. a. Mandatory intubatio b. His Glasgow Coma Scale © His level of consciousness [CT scanning is an important part © ¢. Hyperoxia should be avoided. 38. Which one of the following statements regarding genitourinary injuries is true? iated with pelvic fractures. ire evaluation of the genitourinary (@) Urethral injuries are assoc . All patients with microscopic hematuria requi ‘tract. Patients presenting with gross hematuria and shock wi i i cee sagt pos aturia and shock will have a major renal injury traperitoneal bladder injuries are usually managed definitively with a urinary catheter. Urit Cf it i irinary catheters should be placed in all patients with pelvic fractures during the