ATLS Exam Practice Questions & Answers
(*)Degree of burn that is characterized by bone involvement - Fourth
7-year-old girl is found at the bottom of a swimming pool. Initially she was in full
arrest but after 5 minutes she showed sinus tachycardia but no respiratory effort.
Intubation was done in the field and cervical collar placed. After transport to the
emergency department she was unresponsive with a blood pressure of 100/60
mmHg, pulse 105, temperature 34.3C, and oxygen saturation 100%. The pupils
were 3 mm and sluggishly responsive to light. There is no response to pain. The
lungs show wheezing on the left and coarse breath sounds bilaterally. The monitor
shows sinus tachycardia. There is no rectal tone. Which of the following should be
the next step in management?
A. Cervical spine films and CT of the head B. Portable chest radiograph
C. Arterial blood gas
D. Right and left decubitus chest radiographs - A. Cervical spine films and CT of
the head
37-year-old man is struck on the side of the head but is conscious and talkative
after the injury. No evidence of skull fracture. Several days later, he becomes
increasingly lethargic, somewhat confused, and unable to move his right side.
Which type of event has most likely occurred?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion - A. Subdural hematoma
A 13 year old boy fell while riding his bicycle and hit his head. He was
unconscious for 4 or 5 minutes. He vomited twice. He has no memory of the event
or a headache. His exam is entirely normal. Glasgow coma score is 15. Select the
next step in management.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation - B. CT of the head
A 17-year-old male is hit on the head with a baseball bat. He withdraws and opens
his eyes in response to deep painful stimuli. He also mumbles incomprehensibly.
What is his Glasgow coma scale score? - 8
A 18-year-old male sustains a right femur fracture and a cerebral concussion in a
motor vehicle accident. His initial blood pressure is 75/50 mmHg with a pulse of
90 beats per minute. After giving him 2 liters of Ringer lactate he stabilizes, but the
blood pressure falls when he is seen in the ER. Which of the following would be
the cause of suspected hypotension in this patient?
A. Subdural hematoma
B. Undiagnosed facial fracture
C. Ruptured spleen
D. 10% pneumothorax - C. Ruptured sple
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