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ATLS Pre-Test Examination, Complete exam questions with answers
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10/19/201 web20.facs.org/atls_cr/ATLS_PRE_TEST_EXAM.cfm?9 PID=570928&CID=48368&EID=4192&VID=1
We are transitioning to a new Course Management System for ATLS in Fall/Winter 2019. This site will no longer be available once the
new system is available.
These test items are ATLS Pre-Test
undergoing Examination
psychometric analysis.
Note: It is understood that medical practices vary with institutional policies and individual preferences.
This test is designed in conjunction with the material presented in the 9th edition of the ATLS® Course.
Please answer the questions accordingly.
Important directions before you begin this test:
This test consists of 40 multiple-choice questions.
Read each question thoroughly and select the one best answer.
Please note: Questions and/or concerns about test items are referred to the ACS ATLS® Program Office.
The course director or coordinator cannot give credit for a response that you mark incorrectly according
to the answer key.
Prepared by the American College of Surgeons Committee on Trauma for sole use in an approved ACS
ATLS® Course.
Please select the appropriate answer for each question.
Once finished, please click the Submit Button.
Question:1 A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
shoulder. His blood pressure is initially 80/40 mm Hg. After 2 liters of crystalloid solution his
blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and his
respiratory rate is 28 breaths per minute. His breath sounds are decreased in the left
hemithorax, and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for
decreased left breath sounds with the return of a small amount of blood and no air leak. After
chest tube insertion, the most appropriate next step is
A) reexamine the chest.
B) perform an aortogram.
C) obtain a CT scan of the chest.
D) obtain arterial blood gas analyses
E) perform transesophageal echocardiography.
Question:2 A construction worker falls two stories from a building and sustains bilateral
calcaneal fractures. In the emergency department, he is alert, vital signs are normal, and he is
complaining of severe pain in both heels and his lower back. Lower extremity pulses are strong
and there is no other deformity. The suspected diagnosis is most likely to be confirmed by
A) angiography.
B) compartment pressures
C) retrograde urethrogram
D) Doppler-ultrasound studies.
E) complete spine x-ray series.
Question:3 The principle of balanced resuscitation is:
A) Permissive hypotension and early plasma infusion
B) Equal amounts of crystalloid and colloids
C) Simultaneous management of breathing and circulation
D) Maintenance of a normal acid base balance
E) Achieving a pulse rate <90
Question:4 In managing the head-injured patient, the most important initial step is to
A) secure the airway.
B) obtain c-spine film.
C) support the circulation.
D) control scalp hemorrhage.
E) determine the GCS Score.
Question:5 A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of
2 liters. Which one of the following statements applies to this patient?
A) His pulse pressure will be widened.
B) His urinary output will be at the lower limits of normal.
C)
ed by He will have tachycardia, but no change in his systolic blood pressure.
000848036778 from CourseHero.com on 05-31-2022 01:26:01 GMT -05:00
100
His systolic blood pressure will be decreased with a narrowed pulse pressure.
This study source was
web20.facs.org/atls_cr/ATLS_PRE_TEST_EXAM.cfm?
PID=570928&CID=48368&EID=4192&VID=1 1
, 10/19/201 web20.facs.org/atls_cr/ATLS_PRE_TEST_EXAM.cfm?
9 PID=570928&CID=48368&EID=4192&VID=1
D)
E) His systolic blood pressure will be maintained with an elevated diastolic pressure.
Question:6 The physiologic hypervolemia of pregnancy has clinical significance in the
management of the severely injured, gravid woman by
A) reducing the need for blood transfusion.
B) increasing the risk of pulmonary edema.
C) complicating the mangement of closed head injury.
D) reducing the volume of crystalloid required for resuscitation.
E) increasing the volume of blood loss to produce maternal hypotension.
Question:7 The best assessment of fluid resuscitation of the burn patient is
A) adequate urinary output.
B) reversal of systemic acidosis.
C) normalization of the heart rate.
D) a normal central venous pressure.
E) 4 mL/kg/percent body burn/ 24 hours.
Question:8 The diagnosis of shock must include
A) hypoxemia.
B) acidosis.
C) hypotension.
D) increased vascular resistance.
E) evidence of inadequate organ perfusion.
Question:9 A 7-year-old boy is brought to the emergency department by his parents several
minutes after he fell through a window. He is bleeding profusely from a 6-cm wound of his
medial right thigh. Immediate management of the wound should consist of
A) application of a tourniquet.
B) direct pressure on the wound.
C) packing the wound with gauze.
D) direct pressure on the femoral artery at the groin.
E) debridement of devitalized tissue.
Question:10 For the patient with severe traumatic brain injury, profound hypocarbia should be
avoided to prevent
A) respiratory acidosis.
B) metabolic acidosis.
C) cerebral vasoconstriction with diminished perfusion.
D) neurogenic pulmonary edema.
E) shift of the oxyhemoglobin dissociation curve.
Question:11 A 25-year-old man is brought to a hospital with a general surgeon after being
involved in a motor vehicle crash. Computed tomography shows an aortic injury and splenic
laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next
step is
A) contrast angiography.
B) transfer to a higher level trauma center.
C) exploratory laparotomy.
D) infuse additional crystalloids.
E) transesophageal echocardiography.
Question:12 Which one of the following statements regarding abdominal trauma in the pregnant
patient is TRUE?
A) The fetus is in jeopardy only with major abdominal trauma.
B) Leakage of amniotic fluid is an indication for hospital admission.
C) Indications for peritoneal lavage are different from those in the nonpregnant patient.
D) Penetration of an abdominal hollow viscus is more common in late than in early
pregnancy.
E) The secondary survey follows a pattern from that of the nonpregnant patient.
Question:13 The first maneuver to improve oxygenation after chest injury is
A) intubate the patient.
B) assess arterial blood gases.
edC)by 100administer supplemental
000848036778 oxygen.
from CourseHero.com on 05-31-2022 01:26:01 GMT -05:00
D) ascertain the need for a chest tube.
This study source was
web20.facs.org/atls_cr/ATLS_PRE_TEST_EXAM.cfm?
PID=570928&CID=48368&EID=4192&VID=1 2
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