ATLS Exam 2026/2027 | Actual
Questions
American College of Surgeons | Actual Q&A | Trauma Care
Providers and Surgeons
Introduction
This original ATLS Exam practice set covers Initial Assessment and Resuscitation, Secondary
Assessment, Specific Trauma Injuries, Special Populations, and Definitive Care/Triage. The questions
emphasize the ABCDE systematic approach, rapid recognition of life-threatening injuries, damage
control resuscitation, trauma triage, diagnostic adjuncts, and preparation for definitive care. This
document is independent study content designed to reinforce ACS ATLS course objectives for exam
readiness and acute trauma care mastery.
Content Area Overview
Content Area Questions Key Topics Weight
ABCDE approach, advanced
Initial Assessment and
airway, shock recognition,
Resuscitation (Primary 12 30%
trauma triage, damage
Survey)
control resuscitation
Head-to-toe exam, AMPLE
Secondary Assessment and
8 history, FAST, DPL, 20%
Diagnostic Adjuncts
radiography, CT imaging
TBI, spinal cord injury,
Specific Trauma Injuries
tension pneumothorax,
(Head, Spine, Chest, 10 25%
hemothorax, flail chest,
Abdomen)
abdominal injuries
Special Populations and Pediatric, geriatric, pregnant
6 15%
Interfacility Transfer trauma, interfacility transfer
Burn management,
Definitive Care, Burns, and
4 maxillofacial trauma, mass 10%
Triage
casualty triage
Complete ATLS initial
Total 40 assessment and trauma 100%
management coverage
Actual Questions
Domain: Initial Assessment and Resuscitation (Primary Survey)
1. During the initial evaluation of a severely injured patient, which sequence best reflects
the ATLS primary survey?
A. Airway with cervical spine protection, breathing, circulation with hemorrhage control, disability,
exposure/environment
B. Circulation, airway, disability, exposure, breathing
C. Head-to-toe exam, AMPLE history, CT imaging, labs, disposition
D. Airway, CT scan, antibiotics, splinting, transfer
Answer: A
Rationale: ATLS prioritizes immediate life threats using the ABCDE approach, with cervical spine protection
integrated into airway assessment.
ATLS Exam 2026/2027
, 2. A trauma patient is agitated, has gurgling respirations, and visible blood in the
oropharynx. What is the most appropriate immediate action?
A. Obtain a CT scan of the head first
B. Clear the airway with suction while maintaining cervical spine protection
C. Begin oral fluids to assess swallowing
D. Delay airway management until the secondary survey
Answer: B
Rationale: Airway obstruction is an immediate threat; suctioning and airway positioning must occur while
protecting the cervical spine.
3. Which finding is the clearest indication for a definitive airway in a blunt trauma
patient?
A. Isolated forearm fracture
B. Normal voice with stable oxygen saturation
C. Inability to maintain oxygenation and protect the airway
D. Minor scalp abrasion with normal mental status
Answer: C
Rationale: A definitive airway is required when the patient cannot maintain oxygenation, ventilation, or airway
protection.
4. While opening the airway of an unconscious patient after a motor vehicle crash, what
maneuver is preferred initially?
A. Head-tilt/chin-lift without stabilization
B. Hyperextension of the neck
C. Seated flexion of the cervical spine
D. Jaw-thrust maneuver with manual in-line stabilization
Answer: D
Rationale: The jaw-thrust helps open the airway while minimizing cervical spine movement in suspected trauma.
5. A hypotensive trauma patient has severe respiratory distress, absent left breath sounds,
distended neck veins, and tracheal deviation. What is the priority intervention?
A. Immediate decompression of suspected tension pneumothorax
B. Portable chest radiograph before treatment
C. Oral analgesia and observation
D. Delayed CT angiography
Answer: A
Rationale: Tension pneumothorax is a clinical diagnosis requiring immediate decompression before confirmatory
imaging.
6. Which intervention is most appropriate for life-threatening external extremity
hemorrhage during the primary survey?
A. Delay control until after CT imaging
B. Direct pressure and rapid tourniquet placement when bleeding is not controlled
C. Elevate the extremity only
D. Administer antibiotics before controlling bleeding
Answer: B
Rationale: ATLS emphasizes immediate control of external hemorrhage as part of circulation assessment.
7. A patient with tachycardia, cool clammy skin, narrowed pulse pressure, and altered
mentation after trauma should be presumed to have what until proven otherwise?
A. Simple anxiety
B. Primary hypoglycemia only
C. Hemorrhagic shock
D. Isolated concussion without blood loss
Answer: C
ATLS Exam 2026/2027
Questions
American College of Surgeons | Actual Q&A | Trauma Care
Providers and Surgeons
Introduction
This original ATLS Exam practice set covers Initial Assessment and Resuscitation, Secondary
Assessment, Specific Trauma Injuries, Special Populations, and Definitive Care/Triage. The questions
emphasize the ABCDE systematic approach, rapid recognition of life-threatening injuries, damage
control resuscitation, trauma triage, diagnostic adjuncts, and preparation for definitive care. This
document is independent study content designed to reinforce ACS ATLS course objectives for exam
readiness and acute trauma care mastery.
Content Area Overview
Content Area Questions Key Topics Weight
ABCDE approach, advanced
Initial Assessment and
airway, shock recognition,
Resuscitation (Primary 12 30%
trauma triage, damage
Survey)
control resuscitation
Head-to-toe exam, AMPLE
Secondary Assessment and
8 history, FAST, DPL, 20%
Diagnostic Adjuncts
radiography, CT imaging
TBI, spinal cord injury,
Specific Trauma Injuries
tension pneumothorax,
(Head, Spine, Chest, 10 25%
hemothorax, flail chest,
Abdomen)
abdominal injuries
Special Populations and Pediatric, geriatric, pregnant
6 15%
Interfacility Transfer trauma, interfacility transfer
Burn management,
Definitive Care, Burns, and
4 maxillofacial trauma, mass 10%
Triage
casualty triage
Complete ATLS initial
Total 40 assessment and trauma 100%
management coverage
Actual Questions
Domain: Initial Assessment and Resuscitation (Primary Survey)
1. During the initial evaluation of a severely injured patient, which sequence best reflects
the ATLS primary survey?
A. Airway with cervical spine protection, breathing, circulation with hemorrhage control, disability,
exposure/environment
B. Circulation, airway, disability, exposure, breathing
C. Head-to-toe exam, AMPLE history, CT imaging, labs, disposition
D. Airway, CT scan, antibiotics, splinting, transfer
Answer: A
Rationale: ATLS prioritizes immediate life threats using the ABCDE approach, with cervical spine protection
integrated into airway assessment.
ATLS Exam 2026/2027
, 2. A trauma patient is agitated, has gurgling respirations, and visible blood in the
oropharynx. What is the most appropriate immediate action?
A. Obtain a CT scan of the head first
B. Clear the airway with suction while maintaining cervical spine protection
C. Begin oral fluids to assess swallowing
D. Delay airway management until the secondary survey
Answer: B
Rationale: Airway obstruction is an immediate threat; suctioning and airway positioning must occur while
protecting the cervical spine.
3. Which finding is the clearest indication for a definitive airway in a blunt trauma
patient?
A. Isolated forearm fracture
B. Normal voice with stable oxygen saturation
C. Inability to maintain oxygenation and protect the airway
D. Minor scalp abrasion with normal mental status
Answer: C
Rationale: A definitive airway is required when the patient cannot maintain oxygenation, ventilation, or airway
protection.
4. While opening the airway of an unconscious patient after a motor vehicle crash, what
maneuver is preferred initially?
A. Head-tilt/chin-lift without stabilization
B. Hyperextension of the neck
C. Seated flexion of the cervical spine
D. Jaw-thrust maneuver with manual in-line stabilization
Answer: D
Rationale: The jaw-thrust helps open the airway while minimizing cervical spine movement in suspected trauma.
5. A hypotensive trauma patient has severe respiratory distress, absent left breath sounds,
distended neck veins, and tracheal deviation. What is the priority intervention?
A. Immediate decompression of suspected tension pneumothorax
B. Portable chest radiograph before treatment
C. Oral analgesia and observation
D. Delayed CT angiography
Answer: A
Rationale: Tension pneumothorax is a clinical diagnosis requiring immediate decompression before confirmatory
imaging.
6. Which intervention is most appropriate for life-threatening external extremity
hemorrhage during the primary survey?
A. Delay control until after CT imaging
B. Direct pressure and rapid tourniquet placement when bleeding is not controlled
C. Elevate the extremity only
D. Administer antibiotics before controlling bleeding
Answer: B
Rationale: ATLS emphasizes immediate control of external hemorrhage as part of circulation assessment.
7. A patient with tachycardia, cool clammy skin, narrowed pulse pressure, and altered
mentation after trauma should be presumed to have what until proven otherwise?
A. Simple anxiety
B. Primary hypoglycemia only
C. Hemorrhagic shock
D. Isolated concussion without blood loss
Answer: C
ATLS Exam 2026/2027
