1. A 24-year-old male pedestrian, struck by an automobile, is admitted to the
emergency department 1 hour after injury. His blood pressure is 80/60 mmHg, heart
rate 140 beats per minute and respiratory rate is 36 per minute. He is lethargic.
Oxygen is delivered via face mask, and two large-caliber IVs are initiated. Arterial
blood gases are obtained. His PaO2 is 118 mmHg (15.7 kPa), PaCO2 is 30 mmHg
(4.0 kPa), and pH is7.21. The treatment of his acid-base disorder is best
accomplished by:
a. Hyperventilation
b. Restoration of normal perfusion
c. Initiation of low-dose dopamine
d. Administration of sodium bicarbonate
e. Initiation of phenylepinephrine infusion
2. The highest priority in managing a patient whose injuries include closed
extremity fractures is:
a. Assesing limb perfusion
b. Preventing necrosis of the skin
c. Decompressing compartment syndrome
d. Addressing respiratory
insufficiency Identifying
crush syndrome
3. A 34-year-old female is involved in a motor vehicle crash is brought to the emergency
department. She is talking, but her voice is hoarse and on exposure she has diagonal
bruising of the chest and anterior neck. What is the next step?
a. Direct laryngoscopy to exclude laryngeal trauma
b. Oxygen by non-rebreathing mask
c. Protecting the spine by making her lie down
d. Palpation of the anterior neck
e. Attaching a pulse oximeter to her finger
4. A 30-year-old male sustains a gunshot wound to the right lower chest, midway
between the nipple and the costal margin. He is brought by ambulance to a hospital
that has full surgical capabilities. In the emergency department he is endotracheally
intubated, fluid resuscitation is initiated through two large-caliber IV lines, and a
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