ATLS 2024 POST TEST SOAL POST TEST

ATLS 2024 POST TEST (SOAL POST TEST

VERSION 3)

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. - ANSWER✔✔c)

resource limitations as determined by the transferring doctor.A 42yearold 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.
• bilateral compartment syndrome. - ANSWER✔✔d) bilateral compartment syndrome. 1 / 4

A 30yearold 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.
• 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. - ANSWER✔✔d)

fasciotomy of all four compartments in the lower extremity.An 18yearold, unhelmeted motorcyclist is brought by ambulance to the emergency department 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 TRUE?

a) Cerebral perfusion is intact.

b) Intravascular volume status is normal.

c) The patient probably has an acute epidural hematoma.

d) Intraabdominal visceral injuries are unlikely. - ANSWER✔✔c) The patient probably

has an acute epidural hematoma.During an altercation, a 36yearold 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 2 / 4

transported by ambulance to a community hospital without surgical services. He is endotracheally intubated, closed tube thoracostomy is performed, and 2 liters of Ringer's lactate solution are infused via 2 largecaliber IVs. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per minute (ventilated with 100% 02). The most appropriate next step in managing this

patient is:

• laparotomy.
• diagnostic peritoneal lavage.
• arterial blood gas determination.
• administer packed red blood cells. - ANSWER✔✔d) administer packed red blood

cells.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. -

ANSWER✔✔d) transfer the patient to the operating room, while initiating fluid therapy. 3 / 4

A teenaged 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 xray.
• administer 2 liters of crystalloid solution.
• insert a central venous pressure line.
• perform endotracheal intubation and ventilation. - ANSWER✔✔d) perform

endotracheal intubation and ventilation.An 8yearold 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 24houraday 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. - ANSWER✔✔c) transfer the patient to a

trauma center.Which of the following statements regarding injury to the central nervous system in children is TRUE?

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