2026 Complete ATLS Actual Exam
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Which one of the following should be performed first in any patient whose
injuries may include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Maneuvers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - ✔✔✔ Correct Answer > D. Ensuring
adequate oxygenation and ventilation ✔✔
A patient arrives in the ED 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. Request a CT-scan
B. Insert a gastric tube
C. Suction of the oropharynx
D. Obtain a lateral cervical spine x-ray
E. Ventilate the patient with a bag-mask - ✔✔✔ Correct Answer > C. Suction
of the oropharynx ✔✔
Neurogenic shock has all of the following classic characteristics except which one:
A. Hypotension
B. Vasodilatation
C. Bradycardia
D. Neurologic deficit
E. Narrowed pulse pressure - ✔✔✔ Correct Answer > E. Narrowed pulse
pressure ✔✔
,Which of the following physical findings suggest a cause of hypotension other
than spinal cord injury?
A. Prispism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them - ✔✔✔ Correct Answer
> D. Presence of deep tendon reflexes. Spinal shock refers to loss of muscle
toe (flaccidty) and loss of reflexes. ✔✔
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 - ✔✔✔ Correct
Answer > C. Resource limitations as determined by the transferring doctor (MÅ
SJEKKES) ✔✔
A young man sustains a rifle wound to the mid-abdomen. He is brought promptly
to the 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 - ✔✔✔ Correct Answer > A.
Laparotomy because of hemodynamic abnormality ✔✔
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