2023-2024 ATLS Pre Test Practice Exam with Answers (350 Solved Questions)

Name: 2023-2024 ATLS Pre Test Practice Exam with Answers (350 Solved Questions)
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lOMoAR cPSD| 37795687
ATLS PRE TEST QUESTIONS AND
VERIFIED ANSWERS UPDATED
2023/2024
ATLS PRE TEST 1 - ATLS PRE TEST 1
NURSING (CHAMBERLAIN UNIVERSITY)

ATLS PRE TEST 1 – 4 QUESTIONS AND CORRECT

ANSWERS 320+ QUESTIONS AND ANSWERS|
GRADED A
1. Which of the following physical findings suggest a cause of hypotension other
thanspinal cord injury?
A. Prispism B.
Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them -ANSWER- D. Presence of deep
tendon reflexes. Spinal shock refers to loss of muscle toe (flaccidty) and loss of
reflexes.
2. The primary indication for transferring A patient to a higher level trauma center
is:A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma
-ANSWER- C.Resource limitations as determined by the transferring doctor
(MÅ SJEKKES)

3. A young man sustains a rifle wound to the mid-abdomen. He is brought
promptly tothe ED by prehospital personnel. His skin is cool and diaphoretic,
and his systolic blood pressure is 58mmHg. Warmed crystalloid fluids are
initiated without improvement in his vital signs. The next, most appropriate, step
is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage -ANSWER- A. Laparotomy because of
hemodynamic abnormality
4. 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 justbefore arriving in the ED. He is now unconscious and responds
only to painful stimuli by moaning. His pupils are 3mm in diameter and
symmetrically reactive tolight. Prehospital personnel indicate that they have not
seen the patient move eitherof his lower extremities. On examination in the ED,
no movement of his lower

extremities are detected, even in response to painful stimuli. The most likely cause
for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome D.
Intracerebral hemorrhage
E. Bilateral compartment syndrome -ANSWER- MÅ SJEKKES
5. A 6-year-o boy is struck by an automobile and brought to the ED. He is
lethargic,but withdraws purposefully from painful stimuli. His blood pressure is
90mmHg systolic, heart rate 140 beats per minute and his respiratory rate is 36
breaths per minute. The preferred route of venous access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
D. Central venous access via the subclavian or internal jugular vein -ANSWER-
D.Percutaneous peripheral veins in the upper extremities
6. A young man sustains a gunshot wound to the abdomen and is brought
promptly tothe ED by prehospital personnel. His skin is cool and diaphoretic,

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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:
A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions. -ANSWER- C.
Control internal hemorrhage operatively
7. Regarding shock in the child, which of the following is
FALSE?A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the same as in
adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg Ringers
Lactate -ANSWER- D. The absolute volume of blood loss required to produce
shock is the same as in adults

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8. A 33-year-old man is struck by a car travelling at 56km/h (35mph). He has
obviousfractures of the left tibia near the knee, pain in the pelvic area, and severe
dyspnea.His heart rate is 182 beats per minute, and his respiratory rate is 48
breaths per minute with no breath sounds heard in the left chest. A tension
pneumothorax is relieved by immediate needle decompression and tube
thoracostomy.
Subsequently, his heart rate decreases to 144 beats per minute, his respirartory rate
decreases to 36 breaths per minute and his blood pressure is 81/53 mmHg.
Warmed Ringers lactate is adminstered intravenously. The next priority should be
to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
C. Perform arterial embolization of the pelvic vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram -ANSWER- D. Perform diagnostic
peritoneal lavage or FAST
9. A 42-year-old man, injured in a motor vehicle crash, suffers a closed head
injury, multiple palpable left rib fractures, and bilateral femur fractures. He is
intubated orotracheally without difficulty. Initially, his ventilations are Reasily
assisted witha bag-mask device. It becomes more difficult to ventilate the
patient over the next5 minutes, and his hemoglobin oxygen saturation level

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decreases from 98% to 89%. The most appropriate next step is to:
A. Obtain a chest x-ray
B. Decrease the tidal
volume C. Decrease PEEP
D. Increase the rate of assisted ventilations
E. Perform needle decompression of the left chest. -ANSWER- A. Obtain a chest
x-ray (MÅ SJEKKES)
10.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 ispresent 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:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint

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E. Fasciotomy of all four compartments in the lower extremity -ANSWER- B.
Tamponade of the wound with a pressure dressing
11.An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the
ED following a crash. He had decreased level of consciousness at the scene,
but thenwas 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 is in a postictal state
D. Intra-abdominal visceral injury is unlikely
E. The patient probably has an acute epidural hematoma -ANSWER- E. The
patient probably has an acute epidural hematoma
12.A previously healthy, 70kg (175 pound) man suffers an estimated acute blood
lossof two liters. Which one of the following statements apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
C. He will have tachycardia, but no change in systolic blood pressure
D. His systolic blood pressure will be decreased with a narrowed, pulse
pressure

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E. His systolic blood pressure will be maintained with an elevated
diastolic pressure. -ANSWER- E. His systolic blood pressure will be
maintained with an elevated diastolic pressure.
13. The physioclogic hypervolemia of pregnancy has clinical significance in
themanagement of the severely injured gravid woman by
A. Reducing the need for blood transfusion
B. Increasing the risk of pulmonary edema
C. Complicating the management of closed head injury
D. Increasing the volume of blood loss to produce shock/maternal hypotension
E.Reducing the volume of crystalloid required for resuscitation -ANSWER- D.
Increasing the volume of blood loss to produce shock
14. A 17-year-old helmeted motorcyclist loses consciousness when he is struck
broadside by an automobile at an intersection. He arrives in the ED with a blood
pressure of 140/92, pulse rate 88 beats per minute, a respiratory rate of 18 breaths
per minue, and a GCS of 7. Appropriate initial immobilization of this patient
should include a semi-rigid cervical collar and:
A. A scoop stretcher
B. A long spine board

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C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment -ANSWER- B. A long spine board
15. During an altercation, a 36-year-old 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 transported by ambulance to a community hospital. He is
endotracheally intubated, close tube thoracostomy is performed, and 2 liters
Ringers lactate solution are infused via 2 large-caliber IV´s. His blood pressure now
is 60/0mmHg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths
per minute (ventilated with 100% O2). The most appropriate next step in managin
this patient is:
A. Laparotomy
B. Diagnostic peritoneal lavage
C. Arterial blood gas determination
D. Administer packed red blood
cells
E. Chest X-ray to confirm tube placement -ANSWER- E. Chest X-ray to confirm
tube placement
16. Abscence of breath sounds and dullness to percussion over the left hemithorax
arefindings best explained by:

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A. Left hemothorax
B. Cardiac contusion
C. Left simple pneumothorax
D. Left diaphragmatic rupture
E. Right tension pneumothorax -ANSWER- A. Left hemothorax
17. A 23-year-old man is brought immediately to the ED from the hospitals parking
lotwhere he was shot in the lower abdomen. Examination reveals a single bullet
wound. He is breathing and has a thready pulse. However, he is unconsious and
hasno detectable blood pressure. Optimale immediate management is to:
A. Perform a diagnostic peritoneal lavage B.
Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive -ANSWER-
D. Transfer the patient to the operating room, while initiating fluid therapy
18. A teen-aged bicycle rider is hit by a truck traveling at high speed. In the ED,
she isactively bleeding from open fractures of her legs, and has abrasions on
her chest

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and abdominal wall. Her blood pressure is 80/50 mmHg, 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:
A. Obtain a lateral cervical spine x-ray
B. Insert av central venous pressure line
C. Adminster 2 liters of crystalloid solution
D. Perform endotracheal intubation and ventilation
E. Apply a pneumatic antishock garment (PASG) and inflate the leg compartments.
-ANSWER- D. Perform endotracheal intubation and ventilation
19. An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is brought to the ED
byhis 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
A. Type and crossmatch for blood
B. Request consultation of a pediatrician
C. Transfer the patient to a trauma center
D. Admit the patient to the intensive care unit
E. Prepare the patient for surgery the next day -ANSWER- D. Admit the patient to
the intensive care unit

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20. Which of the following statements regarding injury to the central nervous
systemin children is TRUE?
A. Children suffer spinal cord injury without x-ray abnormality more commonly
than adults.
B. An infant with a traumatic brain injury may become hypotensive from
cerebral edema
C. Initial therapy for the child with traumatic brain injury includes
the administration of methylprednisolone intravenously
D. Children have more focal mass lesions as a result for traumatic brain
injury when compared to adults.
E. Young children are less tolerant of expanding intracranial mass lesions than
adults -ANSWER- A. Children suffer spinal cord injury without x-ray abnormality
more commonly than adults.
21. A 17-year-old helmeted motorcyclist is struck broadside by an automobile at an
intersection. He is unconscious at the scene with a blood pressure of
140/90mmHg,heart rate of 90 beats per minute, and respiratory rate of 22
breaths per minute. His

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respirations are sonorous and deep. His GCS score is 6. Immobilization of the
entire patient may include the use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar -ANSWER- A. Air splints
22. Twenty-seven patients are seriously injured in an aircraft accident at a local
airport.The basic principle of triage should be to:
A. Treat the most severely injured patients first B.
Establish a field triage area directed by a doctor
C. Rapidly transport all patients to the nearest appropriate hospital D.
Treat the greatest number of patients in the shortest period of time
E. Produce the greatest number of survivors based on available resources -
ANSWER- E. Produce the greatest number of survivors based on available
resources
23. An electrician is eletrocuted by a downed power line after a thunderstorm. He
apparently made contact with the wire at the level of the right mid thigh. In the
ED, his vital signs are normal and no dysrythmia is noted on ECG. On
examination, there is an exit wound on the bottom of the right foot. His urine is

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