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ATLS Practice Test (2025) Exam With
Detailed & Verified Questions and
Answers | Latest Update | 100%
Confirmed Pass…Grade A+
Which one of the following is the recommended method for initially treating frostbite? vasodilators anticoagulants warm (40°C) water padding and elevation application of heat from a hair dryer A 6•year•old boy is struck by an automobile and brought to the emergency department. He is lethargic, but withdraws purposefully from painful stimuli. His blood pressure is 90 mm Hg systolic, heart rate is 140 beats per minute, and his respiratory rate is 36 breaths per minute. The preferred route of venous access in this patient is: percutaneous femoral vein cannulation. cutdown on the saphenous vein at the ankle. intraosseous catheter placement in the proximal tibia. percutaneous peripheral veins in the upper extremities. central venous access via the subclavian or internal jugular vein.
Which one of the following physical findings suggests a cause of hypotension other than spinal cord injury? priapism. bradycardia. diaphragmatic breathing. presence of deep tendon reflexes. ability to flex forearms but inability to extend them. A young man sustains a gunshot wound to the abdomen and is brought promptly to the emergency department by prehospital personnel. His skin is cool and diaphoretic, 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: administer O•negative blood. apply external warming devices. control internal hemorrhage operatively. apply a pneumatic antishock garment (PASG). infuse large volumes of intravenous crystalloid solution. Regarding shock in the child, which of the following is FALSE? Vital signs are age•related. Children have greater physiologic reserves than do adults. Tachycardia is the primary physiologic response to hypovolemia.
decrease PEEP. increase the rate of assisted ventilations. perform needle decompression of the left chest. A young man sustains a rifle wound to the mid•abdomen. He is brought promptly to the emergency department by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood pressure is 58 mm Hg. Warmed crystalloid fluids are initiated without improvement in his vital signs. The next, most appropriate, step is to perform: a laparotomy. an abdominal CT scan. diagnostic laparoscopy. abdominal ultrasonography. a diagnostic peritoneal lavage. The primary indication for transferring a patient to a higher level trauma center is: unavailability of a surgeon or operating room staff. multiple system injuries, including severe head injury. resource limitations as determined by the transferring doctor. resource limitations as determined by the hospital administration. widened mediastinum on chest x•ray following blunt thoracic trauma. 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 emergency department. He is now unconscious and responds
only to painful stimuli by moaning. His pupils are 3 mm 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 emergency department, no movement of his lower extremities is detected, even in response to painful stimuli. The most likely cause for this finding is: an epidural hematoma. a pelvic fracture. central cord syndrome. intracerebral hemorrhage. bilateral compartment syndrome. A 30•year•old man sustains a severely comminuted, open, 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 and posterior tibial pulses are easily palpable on the left, but heard only by Doppler on the right. Immediate efforts to improve circulation to the injured extremity should involve: immediate angiography. tamponade of the wound with a pressure dressing. wound exploration and removal of bony fragments. realignment of the fracture segments with a traction splint. fasciotomy of all four compartments in the lower extremity. An 18•year•old, unhelmeted motorcyclist is brought by ambulance to the emergency department following a crash. He had decreased level of consciousness
left simple pneumothorax left diaphragmatic rupture right tension pneumothorax. A 23•year•old man is brought immediately to the emergency department from the hospital's parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconscious and has no detectable blood pressure. Optimal immediate management is to: perform diagnostic peritoneal lavage. initiate infusion of packed red blood cells. insert a nasogastric tube and urinary catheter. transfer the patient to the operating room, while initiating fluid therapy. A teen•aged bicycle rider is hit by a truck traveling at high speed. In the emergency department, she is actively bleeding from open fractures of her legs, and has abrasions on her chest and abdominal wall. Her blood pressure is 80/50 mm Hg, heart rate is 140 beats per minute, respiratory rate is 8 breaths per minute, and GCS score is 6. The first step in managing this patient is to: obtain a lateral cervical spine x•ray. insert a central venous pressure line. administer 2 liters of crystalloid solution. perform endotracheal intubation and ventilation. apply a pneumatic antishock garment (PASG) and inflate the leg compartments.
An 8•year•old boy falls 4.5 meters (15 feet) from a tree and is brought to the emergency department by his family. His 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 operating room capabilities. The most appropriate management of this patient would be to: type and crossmatch for blood. request consultation of a pediatrician. transfer the patient to a trauma center. admit the patient to the intensive care unit. prepare the patient for surgery the next day. Which of the following statements regarding injury to the central nervous system in children is TRUE? Children suffer spinal cord injury without x•ray abnormality more commonly than adults. An infant with a traumatic brain injury may become hypotensive from cerebral edema. Initial therapy for the child with traumatic brain injury includes the administration of methylprednisolone intravenously. Children have more focal mass lesions as a result of traumatic brain injury when compared to adults. Young children are less tolerant of expanding intracranial mass lesions than adults.
aggressive fluid infusion. intravenous pyelography. debridement of necrotic muscle. admission to the intensive care unit for observation. A young woman sustains a severe head injury as the result of a motor vehicular crash. In the emergency department, her GCS score is 6. Her blood pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is intubated and is being mechanically ventilated. Her pupils are 3 mm in size and equally reactive to light. There is no other apparent injury. The most important principle to follow in the early management of her head injury is to: administer an osmotic diuretic. prevent secondary brain injury. aggressively treat systemic hypertension. reduce metabolic requirements of the brain. distinguish between intracranial hematoma and cerebral edema. To establish a diagnosis of shock, systolic blood pressure must be below 90 mm Hg. the presence of a closed head injury should be excluded acidosis should be present by arterial blood gas analysis the patient must fail to respond to intravenous fluid infusion. clinical evidence of inadequate organ perfusion must be present.
A 32•year•old man is brought to the hospital unconscious with severe facial injuries and noisy respirations after an automobile collision. In the emergency department, he has no apparent injury to the anterior aspect of his neck. He suddenly becomes apneic, and attempted ventilation with a face mask is unsuccessful. Examination of his mouth reveals a large hematoma of the pharynx with loss of normal anatomic landmarks. Initial management of his airway should consist of: inserting an oropharyngeal airway. inserting a nasopharyngeal airway. performing a surgical cricothyroidotomy. performing fiberoptic•guided nasotracheal intubation. performing orotracheal intubation after obtaining a lateral c•spine x•ray. A 25•year•old woman is brought to the emergency department after a motor vehicle crash. She was initially lucid at the scene and then developed a dilated pupil and contralateral extremity weakness. In the emergency department, she is unconscious and has a GCS score of 6. The initial management step for this patient should be to: obtain a CT scan of the head. administer decadron 20 mg IV. perform endotracheal intubation. administer mannitol 1 g/kg IV. perform an emergency bone flap craniotomy on the side of the dilated pupil. A contraindication to nasogastric intubation is the presence of a:
Cardiac tamponade after trauma: is seldom life•threatening. can be excluded by an upright, AP chest x•ray. can be confused with a tension pneumothorax. causes a fall in systolic pressure of > 15 mm Hg with expiration. most commonly occurs after blunt injury to the anterior chest wall. A 22•year•old man is brought to the hospital after crashing his motorcycle into a telephone pole. He is unconscious and in profound shock. He has no open wounds or obvious fractures. The cause of his shock is MOST LIKELY caused by: a subdural hematoma. an epidural hematoma. a transected lumbar spinal cord. a basilar skull fracture. hemorrhage into the chest or abdomen. Which one of the following statements is FALSE concerning Rh isoimmunization in the pregnant trauma patient? It occurs in blunt or penetrating abdominal trauma. Minor degrees of fetomaternal hemorrhage produce it. A negative Kleihauer•Betke test excludes Rh isoimmunization. This is not a problem in the traumatized Rh•positive pregnant patient.
initiation of Rh immunoglobulin therapy does not require proof of fetomaternal hemorrhage. All of the following signs on the chest x•ray of a blunt injury victim may suggest aortic rupture EXCEPT: mediastinal emphysema. presence of a "pleural cap." obliteration of the aortic knob. deviation of the trachea to the right. depression of the left mainstem bronchus Early central venous pressure monitoring during fluid resuscitation in the emergency department has the greatest utility in a: patient with a splenic laceration. patient with an inhalation injury. 6•year•old child with a pelvic fracture. patient with a severe cardiac contusion. 24•year•old man with a massive hemothorax. A cross•table lateral x•ray of the cervical spine: must precede endotracheal intubation. excludes serious cervical spine injury. is an essential part of the primary survey.
During resuscitation, which one of the following is the most reliable as a guide to volume replacement? heart rate hematocrit blood pressure urinary output jugular venous pressure A 24•year•old woman passenger in an automobile strikes the wind screen with her face during a head•on collision. In the emergency department, she is talking and has marked facial edema and crepitus. The highest priority should be given to: lateral c•spine x•ray. upper airway protection. carotid pulse assessment. management of blood loss. determination of associated Injuries. The driver of a single car crash is orotracheally intubated in the field by prehospital personnel after they identify a closed head injury and determine that the patient is unable to protect his airway. In the emergency department, the patient demonstrates decorticate posturing bilaterally. He is being ventilated with a bag•valve device, but his breath sounds are absent in the left hemithorax. His blood pressure is 160/88 mm Hg, heart rate is 70 beats per minute, and the pulse oximeter
displays a hemoglobin oxygen saturation of 96%. The next step in assessing and managing this patient should be to: determine the arterial blood gases. obtain a lateral cervical spine x•ray. assess placement of the endotracheal tube. perform needle decompression of the left chest. insert a thoracostomy tube in the left hemithorax. The response to catecholamines in an injured, hypovolemic pregnant woman can be expected to result in: placental abruption. fetal hypoxia and distress. fetal/maternal dysrhythmia. improved uterine blood flow. increased maternal renal blood flow.
