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ATLS Pretest
Istilah di set ini (40)

A 22-year-old man is re-examine the chest

hypotensive and tachycardic
after a shotgun wound to the
left shoulder. His blood
pressure is initially 80/40 mm
Hg. After initial fluid
resuscitation 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. A tube
thoracostomy is performed
for decreased left chest
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:

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A construction worker falls complete spine x-ray series

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:

Which of the following is true Evidence of improved perfusion after fluid

regarding the initial resuscitation could include improvement in
resuscitation of a trauma Glasgow Coma Scale score on reevaluation.
patient?

In managing a patient with a secure the airway

severe traumatic brain injury,
the most important initial step
is to:

A previously healthy, 70-kg An ABG would demonstrate a base deficit

(154-pound) man suffers an between -6 and -10 mEq/L.
estimated acute blood loss of
2 liters. Which one of the
following statements applies
to this patient?

The physiological increasing the volume of blood loss to produce

hypervolemia of pregnancy maternal hypotension
has clinical significance in the
management of the severely
injured, gravid woman by:

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The best assessment of fluid urinary output of 0.5 mL/kg/hr

resuscitation of the adult burn
patient is:

The diagnosis of shock must evidence of inadequate organ perfusion

include:

A 7-year-old boy is brought direct pressure on the wound

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:

For the patient with severe cerebral vasoconstriction with diminished

traumatic brain injury, perfusion
profound hypocarbia should
be avoided to prevent:

After being involved in a perform an exploratory laparotomy

motor vehicle crash, a 25-
year-old man is brought to a
hospital that has surgery
capabilities available..
Computed tomography of the
chest and abdomen 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:

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Which one of the following Leakage of amniotic fluid is an indication for

statements regarding hospital admission.
abdominal trauma in the
pregnant patient is TRUE?

The first maneuver to improve administer supplemental oxygen

oxygenation after chest injury
is:

A 25-year-old man, injured in 9

a motor vehicular crash, is
admitted to the emergency
department. His pupils react
sluggishly and his eyes open
to pressure. He does not
follow commands, but he
does moan periodically. His
right arm is deformed and
does not respond to
pressure; however, his left
hand reaches purposefully
toward the stimulus. Both legs
are stiffly extended. His GCS
score is:

Masuk Daftar

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A 20-year-old woman who is perform needle or finger decompression of the

at 32 weeks gestation, is right chest
stabbed in the upper right
chest. In the emergency
department, her blood
pressure is 80/60 mm Hg. She
is gasping for breath,
extremely anxious, and yelling
for help. Breath sounds are
diminished in the right chest.
The most appropriate first
step is to:

Which one of the following respiratory rate of 40 breaths per minute

findings in an adult is most
likely to require immediate
management during the
primary survey?

The most important, placement of an occlusive dressing over the

immediate step in the wound
management of an open
pneumothorax is:

The following are history of neurological reaction or severe

contraindications for tetanus hypersensitivity to the product
toxoid administration:

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A 56-year-old man is thrown breath sounds

violently against the steering
wheel of his truck during a
motor vehicle crash. On
arrival in the emergency
department he is diaphoretic
and complaining of chest
pain. His blood pressure is
60/40 mm Hg and his
respiratory rate is 40 breaths
per minute. Which of the
following best differentiates
cardiac tamponade from
tension pneumothorax as the
cause of his hypotension?

Bronchial intubation of the The trachea is relatively short.

right or left mainstem
bronchus can easily occur
during infant endotracheal
intubation because:

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A 23-year-old man sustains 4 urgently transfer the patient to the operating

stab wounds to the upper room
right chest during an
altercation and is brought by
ambulance to a hospital that
has full surgical capabilities.
His wounds are all above the
nipple. He is endotracheally
intubated, closed tube
thoracostomy is performed,
fluid resuscitation is initiated
through 2 large-caliber IVs.
FAST exam does not reveal
intraabdominal injuries. 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% O2).
1500 mL of blood has drained
from the right chest. The most
appropriate next step in
managing this patient is to:

A 39-year-old man is restrict cervical motion and attempt orotracheal

admitted to the emergency intubation using 2 people
department after an
automobile collision. He is
cyanotic, has insufficient
respiratory effort, and has a
GCS score of 6. His full beard
makes it difficult to fit the
oxygen facemask to his face.
The most appropriate next
step is to:

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A patient is brought to the Flaccidity of the lower extremities and loss of

emergency department after deep tendon reflexes are expected.
a motor vehicle crash. He is
conscious and there is no
obvious external trauma. He
arrives at the hospital
completely immobilized on a
long spine board. His blood
pressure is 60/40 mm Hg and
his heart rate is 70 beats per
minute. His skin is warm.
Which one of the following
statements is TRUE?

Which one of the following is moist heat

the most effective method for
initially treating frostbite?

A 32-year-old man's right leg surgical consultation for right lower extremity
is trapped beneath his fasciotomy
overturned car for nearly 2
hours before he is extricated.
On arrival in the emergency
department, his right lower
extremity is cool, mottled,
insensate, and motionless.
Despite normal vital signs,
pulses cannot be palpated
below the right femoral artery
and the muscles of the lower
extremity are firm and hard.
During the management of
this patient, which of the
following is most likely to
improve the chances for limb
salvage?

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A patient arrives in the suction the oropharynx

emergency department after
being beaten about the head
and face with a wooden club.
He is comatose and has a
palpable depressed skull
fracture. His face is swollen
and ecchymotic. He has
gurgling respirations and
vomitus on his face and
clothing. The most
appropriate step after
providing supplemental
oxygen and elevating his jaw
is to:

A 22-year-old man sustains a repeat the primary survey and proceed with
gunshot wound to the left transfer
chest and is transported to a
small community hospital no
surgical capabilities are
available. In the emergency
department, a chest tube is
inserted and 700 mL of blood
is evacuated. The trauma
center accepts the patient in
transfer. Just before the
patient is placed in the
ambulance for transfer, his
blood pressure decreases to
80/68 mm Hg and his heart
rate increases to 136 beats
per minute. The next step
should be to:

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A 64-year-old man involved call the receiving hospital and speak to the
in a high-speed car crash, is surgeon on call
resuscitated initially in a small
hospital without surgical
capabilities. He has a closed
head injury with a GCS score
of 13. He has a widened
mediastinum on chest x-ray
with fractures of left ribs 2
through 4, but no
pneumothorax. After initiating
fluid resuscitation, his blood
pressure is 110/74 mm Hg,
heart rate is 100 beats per
minute, and respiratory rate is
18 breaths per minute. He has
gross hematuria and a pelvic
fracture. You decide to
transfer this patient to a
facility capable of providing a
higher level of care. The
facility is 128 km (80 miles)
away. Before transfer, you
should first:

Hemorrhage of 20% of the tachycardia

patient's blood volume is
associated usually with:

Which one of the following Aspiration of bone marrow confirms appropriate

statements concerning positioning of the needle.
intraosseous infusion is TRUE?

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A young woman sustains a avoid hypotension

severe head injury as the
result of a motor vehicle
crash. In the emergency
department, her GCS is 6. Her
blood pressure is 140/90 mm
Hg and her heart rate is 80
beats per minute. She is
intubated and 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:

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A 33-year-old woman is cardiac tamponade

involved in a head-on motor
vehicle crash. It took 30
minutes to extricate her from
the car. Upon arrival in the
emergency department, her
heart rate is 120 beats per
minute, BP is 90/70 mm Hg,
respiratory rate is 16 breaths
per minute, and her GCS
score is 15. Examination
reveals bilaterally equal
breath sounds, anterior chest
wall ecchymosis, and
distended neck veins. Her
abdomen is flat, soft, and not
tender. Her pelvis is stable.
Palpable distal pulses are
found in all 4 extremities. Of
the following, the most likely
diagnosis is:

A hemodynamically normal development of peritonitis on physical exam

10-year-old girl is hospitalized
for observation after a Grade
III (moderately severe) splenic
injury has been confirmed by
computed tomography (CT).
Which of the following
mandates prompt celiotomy
(laparotomy)?

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A 40-year-old woman who Log rolling using 4 people is a safe approach to

was a restrained driver in a restrict spinal motion when moving her.
motor vehicle crash is
evaluated in the emergency
department. She is
hemodynamically normal and
found to be paraplegic at the
level of T10. Which of the
following are true regarding
her evaluation and
management?

A trauma patient presents to restrict cervical motion and establish a definitive

your emergency department airway
with inspiratory stridor and a
suspected c-spine injury.
Oxygen saturation is 88% on
high-flow oxygen via a
nonrebreathing mask. The
most appropriate next step is
to:

When applying the Rule of The head is proportionally larger in infants than in
Nines to infants: adults.

A healthy young male is placement of a pelvic binder

brought to the emergency
department following a motor
vehicle crash. His vital signs
are a blood pressure of
84/60, pulse 123, GCS 10. The
patient moans when his pelvis
is palpated. After initiating
fluid resuscitation, the next
step in management is:

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Which one of the following positive pregnancy test, Rh negative, and has
situations requires Rh torso trauma
immunoglobulin
administration to an injured
woman?

A 22-year-old female athlete prepare for an exploratory thoracotomy

is stabbed in her left chest at
the third interspace in the
anterior axillary line. On
admission to the emergency
department and 15 minutes
after the incident, she is
awake and alert. Her heart
rate is 100 beats per minute,
blood pressure 80/60 mm
Hg, and respiratory rate 20
breaths per minute. A chest x-
ray reveals a large left
hemothorax. A left chest tube
is placed with an immediate
return of 1600 mL of blood.
The next management step
for this patient is:

A 6-year-old boy walking A pulmonary contusion may be present in the

across the street is struck by absence of rib fractures.
the front bumper of a sports
utility vehicle traveling at 32
kph (20 mph). Which one of
the following statements is
TRUE about this patient?

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