ATLS Exam Practice Questions and Answers Latest Updates 2024, Exams of Nursing

Download ATLS Exam Practice Questions and Answers Latest Updates 2024 and more Exams Nursing in PDF only on Docsity! ATLS Exam Practice Questions and Answers Latest Updates 2024 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 spleen A 22-year-old man sustains a gunshot wound to the abdomen and presents with shock. He requires multiple units of packed red blood cells during resuscitation. Later he complains of numbness around his mouth. Physical exam reveals carpopedal spasm and a positive Chvostek sign. An electrocardiogram demonstrates a prolonged QT interval. Which of the following is the most appropriate treatment? A. IV bicarbonate B. IV furosemide C. IV calcium D. IV insulin - C. IV calcium A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was complicated by a fractured pelvis. A few hours later, the patient becomes febrile, hypotensive with a normal CVP, and oliguric. Upon examination, the patient is found to be bleeding from the NG tube and IV sites. Which of the following is the most likely diagnosis? A. Hemorrhagic shock B. Acute adrenal insufficiency C. Fat embolism syndrome D. Transfusion reaction - D. Transfusion reaction A patient injures his left arm and is found to have a transected nerve. Which is true about this injury? A. Nerves tend to recover and grow at a rate of 1 mm/day B. The growing ends of the nerve can be located by EMG studies C. All cut nerves should be immediately resutured D. The neuromuscular junction end plates start to degenerate 2-3 weeks after the nerve is transected - A. Nerves tend to recover and grow at a rate of 1 mm/day A patient involved in a road accident is brought to the emergency department in an unconscious state. On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold, shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain. On physical examination, she has no obvious sign of external bleeding. Which of the following cannot be the cause of hypotension in this patient? A. Pelvic fracture B. Fracture of femur C. Intracranial hemorrhage D. Hemothorax - C. Intracranial hemorrhage A patient is found unconscious after a fire in his bedroom. He is found to have severe burns around his face. What is the first aspect of treatment? A. Tetanus toxoid B. Cover the wound C. Airway D. Obtain blood work - C. Airway A patient is hit by a car and has severe injuries to his extremities. He is immediately brought to the emergency room by EMS. Evaluation reveals that he has multiple organ injuries. He has an open, gaping wound which measures 2 x 2 centimeters, just below the right knee. The leg appears dislocated and ecchymotic. However, pulses are present in the distal extremity. He does not complain of any paresthesias. X-ray reveals that there is a fracture of the tibia. The trauma team is called. As their arrival is awaited, which of the following should NOT be done to help manage this patient? A. Obtain culture and close wound using a sterile technique B. Don't reduce the dislocation C. Give tetanus toxoid/booster shot D. Give antibiotics - A. Obtain culture and close wound using a sterile technique A patient is involved in a motor vehicle accident. He is brought into the ER and found to have a broken femur. His blood work reveals an hemoglobin of eight and an Hct of 28. It is decided to transfuse him with three units of blood. Soon after the blood is started, he develops a fever and becomes hypotensive. In a patient suspected of having a hemolytic transfusion reaction, one should do which of the following?A A. Inserting a foley catheter B. Fluid restriction C. 0.1N HCL to reverse the alkalosis D. Fluids and mannitol - D. Fluids and mannitol A patient is involved in a MVA and suffers multiorgan trauma. He is brought to the ER by EMS and found to be hypotensive with bradycardia and his abdomen is not distended. He is disoriented and confused. He has a GCS of 9; his legs are warm and the pulses thready. His CVP is 9, his HR is 42, and his BP is 80/40. What is the most likely cause of his shock state? A. Closed head injury B. Ongoing intra-abdominal hemorrhage C. Pneumothorax D. Neurogenic shock - D. Neurogenic shock A patient is involved in a MVA. He suffers a left femur fracture with head trauma. He is resuscitated at the scene and stabilized. Upon transfer to the ER, his blood pressure gradually decreases and then suddenly drops to 60/40. He has a splint on the left leg. What is the most likely cause of his decreased blood pressure? A. Head trauma B. Abdominal organ rupture C. Rib fracture D. Cardiac contusion - B. Abdominal organ rupture A patient is on mechanical ventilator and his arterial blood gas reveals a PCO2 of 38 and a pH of 7.41. What is the appropriate next step? A. Increase oxygen B. Observe C. Increase rate D. Increase tidal volume - B. Observe A patient is placed on a heating blanket for hypothermia. It is most important to monitor which of the following? A. Vital signs B. Neurologic status C. Sensory deficits D. Oxygenation - A. Vital signs A patient is thrown out of a car. He is hemodynamically stable, asymptomatic, and the only finding is a right sided pneumothorax. What is the best treatment for this man? A. Aspiration of pneumothorax B. Monitor pneumothorax C. CT scan D. Placement of chest tube - D. Placement of chest tube A patient on a mechanical ventilator is fighting the machine, and has elevated peak airway pressures. What medication should be used? A. Benzodiazepines B. Vecuronium C. Barbiturates D. Baclofen - B. Vecuronium A patient presents to the emergency room after a motor vehicle accident with hypotension, tachycardia, and abdominal distension. What is the most likely diagnosis? A. Closed head injury B. Splenic injury C. Pneumothorax D. Neurogenic shock - B. Splenic injury D. Add CO2 to the system - C. Immediately remove the endotracheal tube and reintubate A trauma patient is receiving fluids at 150 cc/hr. He received two units of blood because his initial hemoglobin was 7.3 g. After 4 hours, his urine output is 7 cc/hr and his central venous pressure is 3 cm of water. What is the next step in his management? A. Start furosemide drip B. Start dopamine at renal dose C. Administer 500 cc of NS bolus over 1 hour D. Decrease the rate of fluid administration - C. Administer 500 cc of NS bolus over 1 hour A young motorcycle driver is thrown against a concrete bridge and sustains severe trauma about the face, with marked deformity and bleeding. Which of the following statements regarding this scenario is TRUE? A. Cervical spine evaluation takes precedence over facial injuries B. LeFort fractures rarely cause severe hemorrhage C. Nasotracheal intubation must be done urgently to prevent airway obstruction D. Plain radiographs are preferred to CT in emergencies - A. Cervical spine evaluation takes precedence over facial injuries A young woman sustains a 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: A. avoid hypotension B. administer an osmotic diuretic C. aggressively treat systemic hypertension D. reduce metabolic requirements of the brain E. distinguish between intracranial hematoma and cerebral edema - A. avoid hypotension After a femur fracture, which of the following is LEAST likely? A. Severe pain B. Expanding hematoma C. Severe nerve injury D. Absent distal pulses - C. Severe nerve injury After abdominal injury, which of the following urinalysis findings would be an indication for further testing? A. 0-5 casts/HPF B. 5-10 WBC/HPF C. 10-20 RBC/HPF D. Gross hematuria - D. Gross hematuria After being involved in a 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: - perform an exploratory laparotomy After placement of a chest tube for a traumatic pneumothorax, subcutaneous emphysema is observed. After checking the drainage and chest tube site, what else should be done? - -Increase level of suction -Insert second chest tube -Adjust chest tube Do NOT flush tube with saline Air embolism - PE: murmur, petechiae, desaturation Tx: turn patient on left side in Trendelenburg position An 8-year old child is brought to the ER after being struck by a car while crossing the street. He is not alert and required immediate intubation at the scene by EMS. His GCS is 8 T. He appears to have a significant laceration of his scalp on the left side but there are no skeletal fractures. The initial chest x-ray revealed a right sided pneumothorax and a chest tube was inserted. His hematocrit is 23.5 and hemoglobin is 7.6. The next thing you would do is: A. CT head B. CT abdomen C. Repeat blood work D. Observe patient - B. CT abdomen An 18-year-old is thrown off his motorbike on a slippery road. At the scene, what is the first priority in the management of this patient? A. Assess vital signs B. Stabilize cervical spine C. Assess airway D. Start IV fluids - C. Assess airway An adult with a widened mediastinum might have which of the following? - Aortic dissection An investigational drug is being tried on health volunteers for its safety and pharmacokinetic properties. Which of the following stages in the drug development process does this scenario most closely describe? A. Phase I B. Phase II C. Phase III D. Phase IV - A. Phase I An unrestrained driver involved in a high speed MVA is transported by paramedics with c-spine precautions. GCS score is 7, but there is no obvious trauma. Respirations are shallow, and BVM is not providing adequate ventilation. Extremities are cool, and the pulses are thready. Prior to rapid sequence intubation, what should be done? A. Brief neurologic examination B. Immediate chin lift and jaw thrust maneuver C. Assess all vital signs D. Administer 4-5 quick tidal volume breaths with an FIO2 of 100% using a bag mask ventilatory device - D. Administer 4-5 quick tidal volume breaths with an FIO2 of 100% using a bag mask ventilatory device C. The use of cuffed endotracehal tubes eliminates this issue. D. The mainstem bronchi are less angulated in their relation to the trachea. E. So little friction exists between the endotracheal tube and the wall of the trachea. - A. The trachea is relatively short. Can be added to lidocaine to reduce the burning sensation when administered - Sodium bicarbonate Can occur during massive blood transfusions - -Dilutional thrombocytopenia -Hypocalcemia -Coagulation abnormalities NOT hypokalemia Carbon monoxide poisoning - PE: cherry red skin Cauda equina syndrome - -Bilateral sciatica -Bowel dysfunction -Saddle sensory changes Causes of heme-positive urine - Ingestion of blackberries, beets or phenolphthalein Central venous pressure is reflective of: - Pressure of blood returning to the heart Cerebral contusions - May happen opposite to the point of impact Cerebral edema treatment - Mannitol Head up position Hyperventilation Characteristics of early hemorrhagic shock - Cold skin Slow capillary refill Confusion NOT bradycardia Class I hemorrhage indicates what percentage of blood loss? - 10% Class III hemorrhage indicates what % of blood loss - 35% Class IV hemorrhage indicates what % blood loss - 55% Clinical features associated with tension pneumothorax - Unilateral decrease in breath sounds Hyperresonance Respiratory distress Tachycardia Tracheal shift Desatruation Decreased breath sounds Decreased compliance Asymmetric chest movement NOT hypertension, audible bronchial sounds Clinical presentation of cardiogenic shock - -Hypotension -Clammy skin -Tachycardia -Confusion Complications of head trauma - Intracerebral hematoma Extradural hematoma Brain abscess Concurrent injuries occur in which percentage of thoracic spine injuries? A. 6% B. 10% C. 21% D. 30% - B. 10% Confirmatory test that is a reliable indicator of brain death A. Apnea test with a pCO2 less than 40 B. Electromyography C. 4-vessel cerebral angiography D. CT scan of the brain - C. 4-vessel cerebral angiography Considered a mechanically stable cervical spine injury - -Clay shoveler's fracture -Simple wedge fracture not involving posterior elements -Unilateral facet dislocation NOT flexion teardrop fracture Contributes to a low score on the Glasgow coma scale - Paralysis Low blood sugar Use of narcotics Crystalloid solutions - Ringer's lactate Dextrose 5% D5W plus 1/2 NS NOT albumin Dermatome level for nipple sensation Dermatome level for umbilicus - T4 T10 During an MVA, what is most likely injury to occur after knees strike the dashboard A. Fractured femur B. Fractured humerus C. Lacerated spleen D. None of the above - A. Fractured femur During CPR, the highest amount of blood flow is observed with which technique? - High impulse CPR at 100-120 compressions per min For pediatric patients, what volume of fluid resuscitation should be given initially in the setting of shock? A. 750 mL of saline uniformly B. 1 liter of saline C. 20 mL/kg of 0.45% NaCl with 5% glucose D. 10 to 20 mL/kg of Ringers lactate - D. 10 to 20 mL/kg of Ringers lactate For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: - cerebral vasoconstriction with diminished perfusion Head trauma in children - -Brain doubles in size in first 6 months of life and achieves 80% of adult size at 2 years of age -Subarachnoid space is smaller and offers less protection to the brain because there is less buoyancy and momentum is more likely to cause parenchymal structural damage -Cerebral blood flow increases to nearly twice adult levels by age 5, then decreases, placing children at greater risk of cerebral hypoxia and edema -Children have a better outcome than adults who suffer brain injuries Hemothorax facts - -Must have at least 500 cc of blood to make a diagnosis on chest x-rayin an adult -Incomplete evacuation of hemothorax can lead to empyema -Initial treatment of hemothorax is always a chest tube How deep should the provider depress the patient's sternum during CPR in adults? - 2 to 3 inches How does shivering affect body temperature - Increases body temperature How should epinephrine should be injected for treatment of anaphylaxis? - Intramuscularly (IM) into vastus lateralis How would a patient with a change in mental status would be triaged using the simple triage and rapid treatment (START)? A. Delayed B. Immediate C. Minor D. Critical - B. Immediate Hypersensitivity is most commonly reported after use of which type of suture? A. Nylon B. Stainless steel wire C. Chromic catgut D. Silk - C. Chromic catgut Hypoxia - PE: cyanosis Can be rapidly measured with pulse ox If a trauma patient has clear fluid draining from the nose the provider should do which of the following? A. Tilt the head back B. Apply pressure C. Collect the fluid D. Insert nasal tampons - C. Collect the fluid Important landmark for location of second rib - Sternal angle In a 66 year old intubated, comatose patient, what is one of the most important information that one needs to obtain? A. Organ donation status B. Power of attorney C. Lawyer D. Driver's license - B. Power of attorney In a patient with a pneumothorax following a stab wound, the chest tube is best inserted at which level? - Between the 4th and 5th intercostal spaces, just anterior to the mid axillary line In a patient with head trauma, what indicates rising intracranial pressure (ICP)? - Pupillary dilation Wide pulse pressure Rising BP In adults, an aspirated foreign body is most likely to get stuck in the: A. Left main bronchus B. Carina C. Right main bronchus D. Esophagus - C. Right main bronchus In comparison to the vocal cords, where is the laryngeal mask airway usually placed? A. Superior B. Inferior C. Adjacent D. Flush - A. Superior In head trauma, the majority of patients with post-traumatic CSF otorrhea: A. Need surgery B. Should be started on antibiotics C. Heal spontaneously D. Develop meningitis - C. Heal spontaneously In most adults, the spinal cord terminates at what vertebrae? - L1 In which of the following clinical contexts is an urgent, post-traumatic head CT NOT necessary? A. Individual with seizures B. Individual with a progressive headache C. Individual with an unreliable history D. Individual with a Glasgow coma scale score of 15 - D. Individual with a Glasgow coma scale score of 15 In which patients can an oropharyngeal airway be used? - Non-gag reflex In which situation should a femoral traction splint NOT be used? A. Hip dislocation B. Femur fracture JVD Equalization of cardiac chamber pressure NOT hypertension Pericardiocentesis is done by needle insertion through which of the intercostal spaces? - Fifth intercostal space Pharmacologic effects of Morphine - Behavioral changes Analgesia Respiratory depression NOT diarrhea Position patient should be transported in when patient complains of neck pain and is 32 weeks pregnant - Supine on a backboard with her right hip elevated Principle that most closely aligns with the oath, "Do no harm." - Nonmaleficence Prior to tracheobronchial suctioning, the patient should receive: A. 5cc normal saline lavage B. Be placed on NPO status C. 100% oxygen prior to suctioning D. Versed 1 mg/mL - C. 100% oxygen prior to suctioning Reason epinephrine is added to local anesthetics - Prolongs its action Scapular fracture - -Usually requires a tremendous force to fracture -May be uneasily visible on plain xray -Treatment requires prolonged immobilization -Usually associated with other chest injuries Sellick maneuver - Minimizes the chances of regurgitation during intubation Should be avoided in patient with suspected nasal fracture - Nasal intubation Signs and symptoms of cardiac tamponade may be listed as: A. Virchow's Triad B. Brudzinski's signs C. Phalen's signs D. Beck's Triad - D. Beck's Triad - hypotension, muffled heart sounds, JVD Pulsus parodoxus: larger than normal drop of SBP during inspiration Skin antiseptic - -Ethanol 70% is an effective skin antiseptic -Acetic acid can be used to treat Gram- skin infections -Salicylic acid is used to treat certain skin yeast infections Skin finding characteristic of second-degree burns - Blisters Step in a patient diagnosed with tension pneumothorax - 1. Needle decompression/ thoracotomy 2. Chest tube Studies used for a patient with widened mediastinum after injury - CT scan Upper endoscopy Transesophageal ultrasound Subdural hematoma facts - Etiology: tearing of bridging veins -Most common in elderly individuals who fall -Hematoma should be evacuated surgically -Prognosis is much better for chronic subdurals than acute cases -More common than epidural hematomas NOT often associated with skull fractures Symptoms associated with spinal shock - -Flaccidity -Loss of anal sphincter tone or fecal incontinence -Priapism The following are contraindications for tetanus toxoid administration: A. history of neurological reaction or severe hypersensitivity to the product B. local side effects C. muscular spasms D. pregnancy E. all of the above - A. history of neurological reaction or severe hypersensitivity to the product The laryngeal mask airway is contraindicated in patients with what condition? A. Spine injury B. Head trauma C. Giving birth D. Propensity to aspirate - D. Propensity to aspirate The most common complication after nasotracheal intubation is: A. Epistaxis B. Nasal congestion C. Infection D. Aspiration - A. Epistaxis The most effective method of monitoring the success of resuscitation during CPR? - Reactivity of pupils to light The most important, immediate step in the management of an open pneumothorax is: A. endotracheal intubation B. operation to close the wound C. placing a chest tube through the chest wound D. placement of an occlusive dressing over the wound E. initiation of 2, large-caliber IVs with crystalloid solutionE. - D. placement of an occlusive dressing over the wound To prevent a surgical infection when is the best time to administer an antibiotic? A. 2-24 hrs before surgery B. 1 hr before surgery C. After the incision is made D. During the procedure - B. 1 hr before surgery C. 5% dextrose in water D. Half normal saline with 20 mEq/L of KCl - A. Normal saline What is often caused by carotid massage? - Bradycardia What is the best test to diagnose a pneumothorax? A. Chest x-ray B. CT C. Ultrasound D. Clinical - A. Chest x-ray What is the best way to evaluate a cardiac contusion? A. CT scan of the chest B. Echocardiogram C. ECG monitoring x 24 hours D. Cardiac enzymes - C. ECG monitoring x 24 hours What is the energy recommendation for the first defibrillation in an adult (*) - 300 J What is the estimated time a person's brain can be anoxic from cardiopulmonary failure and not develop permanent brain damage? A. 10 minutes B. 5 minutes C. 2 minutes D. 20 minutes - B. 5 minutes What is the main bleeding source in a subdural hematoma? A. Capillary B. Venous C. Arterial D. Mix type - B. Venous What is the most appropriate study for a patient who suffered a fall and presents with acute cervical radiculopathy? A. Cervical CT B. Cervical MRI C. Lateral C-spine radiograph D. Myelogram - B. Cervical MRI What is the most common reason for the chest not to rise with each breath during CPR? A. Air is being delivered to the stomach B. The breaths are being given at too rapidly C. The airway is not clear D. The trachea has collapsed - C. The airway is not clear What is the most common traumatic intracranial mass lesion? A. Epidural hematoma B. Gliocytoma C. Subdural hematoma D. Subarachnoid hemorrhage - C. Subdural hematoma What is the most important factor in preventing accidental pool drowning? A. Pool covers B. Fences around pools C. Swimming lessons D. Parental supervision - D. Parental supervision What is the most likely place for an over advanced endotracheal (ET) tube to enter? A. Stomach B. Right mainstem bronchus C. Soft palate D. Left mainstem bronchus - B. Right mainstem bronchus What is the MOST sensitive test used to make a diagnosis of skull fracture? A. Physical exam B. Head CT C. Skull radiographs D. MRI - B. Head CT What is the next step in the assessment of a traumatic patient after airway is established? - Breathing What is the primary goal in the initial resuscitation of a cardiac arrest? A. Renal perfusion B. Limb perfusion C. Myocardial perfusion D. Brain perfusion - D. Brain perfusion What is the total body surface area involved in a burn to both lower extremities? - 36% What is true about an unrestrained pregnant driver? A. She is at increased risk of placenta previa B. She is at increased risk of placental abruption C. At 33 weeks, her fetus is well protected by an amniotic fluid cushion and thus the pregnancy is not at risk D. If the mother's vital signs are stable, complications are unlikely - B. She is at increased risk of placental abruption What occurs in patients developing a central herniation of the brain? A. One sided paralysis B. Pupillary constriction C. Bilateral deterioration of functioning D. Lower extremity paralysis - C. Bilateral deterioration of functioning When the cephalic vein cut down is done in the deltopectoral groove, the vein is usually found between the.... - Deltoid and pectoralis muscles Where would one attempt a second IV start if the first is unsuccessful? A. In the same location as the first attempt B. In a more proximal location C. In a more distal location D. None of the above - C. In a more distal location Which arterial blood gas finding is most suggestive of acute respiratory failure? B. Fractured pelvis C. Fractured humerus D. Fractured fibula - B. Fractured pelvis Which of the following is CORRECT about visceral pain? A. Always superficial B. Difficulty to localize C. Only seen in peritonitis D. Is rarely referred - B. Difficulty to localize Which of the following is indicative of a kidney injury? A. Ascites B. Flank tenderness C. Hematuria D. Hematemesis - C. Hematuria Which of the following is no longer indicated for routine treatment of shock patients? A. Cervical spine stabilization B. Pneumatic anti-shock garment (PASG) C. Endotracheal intubation D. Oxygen - B. Pneumatic anti-shock garment (PASG) Which of the following is of no benefit for a patient who has just aspirated during induction of anesthesia? A. Nasogastric tube placement and suction B. Bronchoscopy C. Corticosteroids D. Hydration - C. Corticosteroids Which of the following is predominantly an iatrogenic complication? A. Venous air embolism B. Deep venous thrombosis (DVT) C. Venous thromboembolism D. None of the above - A. Venous air embolism Which of the following is the best indicator of adequate shock resuscitation? A. Blood pressure B. Serum bicarbonate C. Skin capillary refill D. Urine output - D. Urine output Which of the following is the least preferred method of administering IV fluids? A. Cubital veins B. Cephalic veins C. Subclavian veins D. Saphenous vein - Subclavian veins Which of the following is the most reliable predictor of poor outcome for drowning victims? A. Submersion time more than 10 minutes B. Glasgow coma scale less than 10 C. Lack of spontaneous cardiac rhythm for 15 minutes D. Need for CPR at the scene - A. Submersion time more than 10 minutes Which of the following local anesthetics has the longest duration of action? A. Procaine (Novocaine) B. Bupivacaine (Marcaine) C. Mepivacaine (Carbocaine) D. Lidocaine (Xylocaine) - B. Bupivacaine (Marcaine) Which of the following most likely will result in a favorable outcome in pediatric drowning? A. Spontaneous circulation established in the ER B. Core temperature in the ER <33ºC C. Return of spontaneous circulation at the scene of the drowning D. Reactive pupils at the scene of the drowning - C. Return of spontaneous circulation at the scene of the drowning Which of the following patients is most likely going to have a difficult intubation? A. A patient with a previous tracheostomy B. A patient with COPD C. An obese patient D. A patient with a huge goiter - D. A patient with a huge goiter Which of the following patients with head trauma does not require admission? A. An individual with alcohol intoxication B. An individual with a Glasgow coma score < 9 C. An individual with the presence of rhinorrhea D. An individual who cannot sleep - D. An individual who cannot sleep Which of the following statements is true regarding emergent pericardiocentesis? A. Complication rate for blind approach is 50 percent B. Echocardiogram is the procedure of choice C. Subxyphoid approach increases risk of injury to the heart D. Liver laceration is not a potential complication - B. Echocardiogram is the procedure of choice Which one of the following findings in an adult is most likely to require immediate management during the primary survey? A. distended abdomen B. Glasgow Coma Scale score of 11 C. temperature of 36.5°C (97.8°F) D. deforming of the right thigh E. Respiratory rate of 40 breaths per minute - E. Respiratory rate of 40 breaths per minute Which one of the following is the most effective method for initially treating frostbite? A. moist heat B. early amputation C. padding and elevation D. vasodilators and heparin E. topical application of silver sulfadiazine - A. moist heat Which one of the following statements concerning intraosseous infusion is TRUE?A. Only crystalloid solutions may be safely infused through the needle. B. Aspiration of bone marrow confirms appropriate positioning of the needle.