ATLS 10TH EDITION POST TEST 1 ACTUAL EXAM 2026/2027
| Verified Answers | 100% Pass Guarantee | A+ Graded
Section 1: Primary Survey & Resuscitation (ABCDE) (Q1-10)
Question 1
A 28-year-old male is brought to the emergency department following a high-speed
motorcycle crash. He is moaning, has a respiratory rate of 32, and a palpable radial
pulse. Which step in the primary survey takes priority?
A. Obtain a complete history from EMS
B. Assess airway patency and cervical spine protection
C. Insert two large-bore IV catheters
D. Perform a detailed neurologic examination
B. Assess airway patency and cervical spine protection [CORRECT]
Rationale: The ATLS primary survey follows the ABCDE sequence: Airway with
simultaneous cervical spine protection is always first. A moaning patient indicates a
patent airway but vigilance is required. History, IV access, and detailed neuro exams
occur during the secondary survey or concurrently with resuscitation after life threats
are addressed.
Correct Answer: B
Question 2
A 45-year-old female pedestrian struck by a vehicle arrives with a Glasgow Coma Scale
of 8, snoring respirations, and an open scalp laceration. During the primary survey,
which intervention is indicated?
A. Immediate CT scan of the head
B. Endotracheal intubation with in-line spinal stabilization
C. Suturing of the scalp laceration to control bleeding
D. Placement of a nasogastric tube
,B. Endotracheal intubation with in-line spinal stabilization [CORRECT]
Rationale: A GCS of 8 with snoring respirations indicates a compromised airway and
inadequate ventilation, requiring definitive airway management (endotracheal
intubation). In-line spinal stabilization is mandatory during intubation until cervical spine
injury is excluded. CT scan, wound closure, and NGT placement are secondary to airway
protection.
Correct Answer: B
Question 3
Which vital sign combination is most consistent with Class III hemorrhagic shock
(30-40% blood loss)?
A. HR 90, BP 120/80, RR 14, confused
B. HR 110, BP 100/70, RR 20, anxious
C. HR 135, BP 80/60, RR 30, confused
D. HR 55, BP 70/40, RR 8, unresponsive
C. HR 135, BP 80/60, RR 30, confused [CORRECT]
Rationale: Class III hemorrhagic shock (30-40% blood loss, 1500-2000 mL in 70 kg
adult) presents with marked tachycardia (120-140 bpm), hypotension (systolic 70-90
mmHg), tachypnea (30-40), and altered mental status (confusion). Class I is normal
vitals; Class II shows mild tachycardia and anxiety; Class IV shows profound
hypotension, bradycardia (pre-terminal), and unresponsiveness.
Correct Answer: C
Question 4
The 10th Edition ATLS emphasizes which change in initial fluid resuscitation for
hemorrhagic shock compared to previous editions?
A. Aggressive crystalloid bolus of 2-3 liters before blood products
B. Limited crystalloid, early blood product administration with balanced ratio
resuscitation
, C. Colloid solutions as first-line resuscitation fluid
D. Hypertonic saline as the preferred initial fluid
B. Limited crystalloid, early blood product administration with balanced ratio
resuscitation [CORRECT]
Rationale: The 10th Edition ATLS de-emphasizes large-volume crystalloid resuscitation
in favor of damage control resuscitation: limited crystalloid (250-500 mL boluses), early
blood products in a balanced 1:1:1 ratio (PRBC:FFP:Platelets), and permissive
hypotension until definitive hemorrhage control. This reduces dilutional coagulopathy,
hypothermia, and acidosis (the lethal triad).
Correct Answer: B
Question 5
During the primary survey, a patient is found to have absent breath sounds on the right,
tracheal deviation to the left, and distended neck veins. The patient is hypotensive.
Which intervention is immediately required?
A. Needle decompression of the right hemithorax
B. Tube thoracostomy on the left side
C. Pericardiocentesis
D. Immediate intubation and mechanical ventilation
A. Needle decompression of the right hemithorax [CORRECT]
Rationale: Absent unilateral breath sounds, contralateral tracheal deviation, and JVD in a
hypotensive patient constitute Beck's triad variant for tension pneumothorax—a clinical
diagnosis requiring immediate needle decompression (14-16 gauge, 2nd intercostal
space midclavicular line or 4th-5th intercostal space anterior axillary line). Tube
thoracostomy follows. Pericardiocentesis is for cardiac tamponade. Intubation does not
treat the underlying problem.
Correct Answer: A
| Verified Answers | 100% Pass Guarantee | A+ Graded
Section 1: Primary Survey & Resuscitation (ABCDE) (Q1-10)
Question 1
A 28-year-old male is brought to the emergency department following a high-speed
motorcycle crash. He is moaning, has a respiratory rate of 32, and a palpable radial
pulse. Which step in the primary survey takes priority?
A. Obtain a complete history from EMS
B. Assess airway patency and cervical spine protection
C. Insert two large-bore IV catheters
D. Perform a detailed neurologic examination
B. Assess airway patency and cervical spine protection [CORRECT]
Rationale: The ATLS primary survey follows the ABCDE sequence: Airway with
simultaneous cervical spine protection is always first. A moaning patient indicates a
patent airway but vigilance is required. History, IV access, and detailed neuro exams
occur during the secondary survey or concurrently with resuscitation after life threats
are addressed.
Correct Answer: B
Question 2
A 45-year-old female pedestrian struck by a vehicle arrives with a Glasgow Coma Scale
of 8, snoring respirations, and an open scalp laceration. During the primary survey,
which intervention is indicated?
A. Immediate CT scan of the head
B. Endotracheal intubation with in-line spinal stabilization
C. Suturing of the scalp laceration to control bleeding
D. Placement of a nasogastric tube
,B. Endotracheal intubation with in-line spinal stabilization [CORRECT]
Rationale: A GCS of 8 with snoring respirations indicates a compromised airway and
inadequate ventilation, requiring definitive airway management (endotracheal
intubation). In-line spinal stabilization is mandatory during intubation until cervical spine
injury is excluded. CT scan, wound closure, and NGT placement are secondary to airway
protection.
Correct Answer: B
Question 3
Which vital sign combination is most consistent with Class III hemorrhagic shock
(30-40% blood loss)?
A. HR 90, BP 120/80, RR 14, confused
B. HR 110, BP 100/70, RR 20, anxious
C. HR 135, BP 80/60, RR 30, confused
D. HR 55, BP 70/40, RR 8, unresponsive
C. HR 135, BP 80/60, RR 30, confused [CORRECT]
Rationale: Class III hemorrhagic shock (30-40% blood loss, 1500-2000 mL in 70 kg
adult) presents with marked tachycardia (120-140 bpm), hypotension (systolic 70-90
mmHg), tachypnea (30-40), and altered mental status (confusion). Class I is normal
vitals; Class II shows mild tachycardia and anxiety; Class IV shows profound
hypotension, bradycardia (pre-terminal), and unresponsiveness.
Correct Answer: C
Question 4
The 10th Edition ATLS emphasizes which change in initial fluid resuscitation for
hemorrhagic shock compared to previous editions?
A. Aggressive crystalloid bolus of 2-3 liters before blood products
B. Limited crystalloid, early blood product administration with balanced ratio
resuscitation
, C. Colloid solutions as first-line resuscitation fluid
D. Hypertonic saline as the preferred initial fluid
B. Limited crystalloid, early blood product administration with balanced ratio
resuscitation [CORRECT]
Rationale: The 10th Edition ATLS de-emphasizes large-volume crystalloid resuscitation
in favor of damage control resuscitation: limited crystalloid (250-500 mL boluses), early
blood products in a balanced 1:1:1 ratio (PRBC:FFP:Platelets), and permissive
hypotension until definitive hemorrhage control. This reduces dilutional coagulopathy,
hypothermia, and acidosis (the lethal triad).
Correct Answer: B
Question 5
During the primary survey, a patient is found to have absent breath sounds on the right,
tracheal deviation to the left, and distended neck veins. The patient is hypotensive.
Which intervention is immediately required?
A. Needle decompression of the right hemithorax
B. Tube thoracostomy on the left side
C. Pericardiocentesis
D. Immediate intubation and mechanical ventilation
A. Needle decompression of the right hemithorax [CORRECT]
Rationale: Absent unilateral breath sounds, contralateral tracheal deviation, and JVD in a
hypotensive patient constitute Beck's triad variant for tension pneumothorax—a clinical
diagnosis requiring immediate needle decompression (14-16 gauge, 2nd intercostal
space midclavicular line or 4th-5th intercostal space anterior axillary line). Tube
thoracostomy follows. Pericardiocentesis is for cardiac tamponade. Intubation does not
treat the underlying problem.
Correct Answer: A
