ATLS POST TEST – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
1. Initial Assessment and Resuscitation
2. Airway and Ventilatory Management
3. Shock and Hemodynamic Monitoring
4. Thoracic and Abdominal Trauma
5. Head and Spinal Cord Injuries
6. Musculoskeletal and Pelvic Trauma
7. Burn Injuries and Thermal Trauma
8. Special Populations (Pediatric, Elderly, Pregnant)
9. Trauma System and Triage Protocols
10. Disaster Management and Mass Casualty Incidents
Introduction
This comprehensive examination is designed to assess the candidate's mastery of the Advanced
Trauma Life Support (ATLS) principles and protocols. The assessment evaluates core competencies in
the systematic approach to trauma care, from the primary survey through definitive management.
Candidates will demonstrate their ability to prioritize life-threatening conditions, make critical
decisions under pressure, and apply evidence-based interventions in complex trauma scenarios. The
examination comprises multiple-choice questions and clinical vignettes that test both foundational
knowledge and advanced clinical reasoning. Emphasis is placed on real-world application,
multidisciplinary coordination, and adherence to established trauma care standards. Successful
completion of this assessment indicates readiness to provide expert trauma care in emergency and
critical care settings.
SECTION ONE: QUESTIONS 1-100
Question 1
A 45-year-old male is brought to the emergency department following a motor vehicle collision at
60 mph. He is unresponsive with a Glasgow Coma Scale (GCS) score of 7. His airway is patent, but
,he has shallow respirations at 8 breaths per minute with an oxygen saturation of 88% on room air.
What is the MOST appropriate next step?
A. Apply a non-rebreather mask at 15 L/min
B. Perform rapid sequence intubation (RSI)
C. Insert a nasopharyngeal airway
D. Administer naloxone 2 mg IV
🟢 B. Perform rapid sequence intubation (RSI)
🔴 Explanation: The patient has a GCS ≤ 8 with inadequate ventilation and hypoxia, indicating an
unprotected airway and the need for definitive airway management. RSI is the preferred method for
securing the airway in trauma patients with suspected head injury or altered mental status, as it
minimizes aspiration risk and allows for controlled intubation.
Question 2
During the primary survey of a trauma patient, you note jugular venous distention, tracheal
deviation to the left, and absent breath sounds on the right side. The patient is hypotensive with a
blood pressure of 85/50 mmHg. What is the MOST likely diagnosis?
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Aortic dissection
🟢 B. Tension pneumothorax
🔴 Explanation: The classic triad of tension pneumothorax includes hypotension, jugular venous
distention, and tracheal deviation away from the affected side. The absent breath sounds on the
right with tracheal deviation to the left strongly indicate a right-sided tension pneumothorax
requiring immediate needle decompression.
Question 3
A 32-year-old female is stabbed in the left chest. She is alert and oriented, with a blood pressure of
110/70 mmHg, heart rate of 110 bpm, and respiratory rate of 24 breaths per minute. On
examination, you note an open sucking chest wound with bubbling blood. What is the FIRST
intervention?
A. Apply a sterile occlusive dressing taped on three sides
B. Insert a chest tube at the 5th intercostal space
C. Administer IV antibiotics
D. Close the wound with sutures
🟢 A. Apply a sterile occlusive dressing taped on three sides
,🔴 Explanation: An open pneumothorax requires immediate conversion to a closed pneumothorax
by applying an occlusive dressing taped on three sides. This allows air to escape during expiration
while preventing air entry during inspiration, effectively managing the sucking chest wound until
definitive chest tube placement.
Question 4
Which of the following statements about the secondary survey is CORRECT?
A. It should be performed before the primary survey
B. It includes a complete head-to-toe examination and history
C. It takes priority over identifying life-threatening injuries
D. It should be delayed until all diagnostic imaging is completed
🟢 B. It includes a complete head-to-toe examination and history
🔴 Explanation: The secondary survey is a systematic head-to-toe examination performed after the
primary survey and initial resuscitation are completed. It includes a complete physical examination
and the AMPLE history (Allergies, Medications, Past medical history, Last meal, Events) to identify all
injuries that were not immediately life-threatening.
Question 5
A 60-year-old male with a history of hypertension presents with blunt abdominal trauma. His blood
pressure is 90/60 mmHg, heart rate is 130 bpm, and he is complaining of severe left shoulder pain.
Focused Assessment with Sonography for Trauma (FAST) reveals free fluid in the left upper
quadrant. What is the MOST appropriate management?
A. Observe with serial abdominal examinations
B. Perform diagnostic peritoneal lavage (DPL)
C. Proceed immediately to laparotomy
D. Administer 2 L of isotonic crystalloid and repeat FAST
🟢 C. Proceed immediately to laparotomy
🔴 Explanation: A positive FAST examination in a hypotensive patient with blunt abdominal trauma
indicates significant intra-abdominal hemorrhage requiring immediate surgical intervention. The
presence of free fluid in the left upper quadrant in a patient with hemodynamic instability is an
indication for emergent laparotomy.
Question 6
What is the recommended initial fluid bolus for resuscitation of a hypotensive trauma patient?
A. 500 mL of crystalloid
B. 1 L of crystalloid
, C. 2 L of crystalloid
D. 500 mL of colloid
🟢 B. 1 L of crystalloid
🔴 Explanation: The ATLS guidelines recommend an initial fluid bolus of 1 L of isotonic crystalloid
(typically Ringer's lactate or normal saline) for hypotensive trauma patients. This bolus should be
given rapidly and the patient's response assessed to guide further resuscitation and determine if
ongoing hemorrhage is present.
Question 7
A 28-year-old male presents with a gunshot wound to the right lower chest. He is hemodynamically
unstable with a blood pressure of 80/40 mmHg. FAST examination is negative. The patient has
decreased breath sounds on the right side. What is the MOST likely diagnosis?
A. Pericardial tamponade
B. Diaphragmatic rupture
C. Hemothorax
D. Pulmonary contusion
🟢 C. Hemothorax
🔴 Explanation: Gunshot wounds to the lower chest can cause hemothorax from injury to the
intercostal vessels or lung parenchyma. Decreased breath sounds with hemodynamic instability in
the setting of penetrating chest trauma is highly suggestive of significant hemothorax requiring
chest tube drainage.
Question 8
Which of the following findings on a cervical spine X-ray is concerning for an unstable cervical
spine injury?
A. Anterior vertebral body height loss
B. Widening of the predental space > 3 mm
C. Loss of cervical lordosis
D. Degenerative disc disease
🟢 B. Widening of the predental space > 3 mm
🔴 Explanation: A predental space (the distance between the anterior aspect of the dens and the
posterior aspect of the anterior arch of C1) greater than 3 mm in adults indicates disruption of the
transverse ligament and suggests an unstable atlantoaxial injury. This requires immediate cervical
spine immobilization and further imaging.
Question 9
AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
1. Initial Assessment and Resuscitation
2. Airway and Ventilatory Management
3. Shock and Hemodynamic Monitoring
4. Thoracic and Abdominal Trauma
5. Head and Spinal Cord Injuries
6. Musculoskeletal and Pelvic Trauma
7. Burn Injuries and Thermal Trauma
8. Special Populations (Pediatric, Elderly, Pregnant)
9. Trauma System and Triage Protocols
10. Disaster Management and Mass Casualty Incidents
Introduction
This comprehensive examination is designed to assess the candidate's mastery of the Advanced
Trauma Life Support (ATLS) principles and protocols. The assessment evaluates core competencies in
the systematic approach to trauma care, from the primary survey through definitive management.
Candidates will demonstrate their ability to prioritize life-threatening conditions, make critical
decisions under pressure, and apply evidence-based interventions in complex trauma scenarios. The
examination comprises multiple-choice questions and clinical vignettes that test both foundational
knowledge and advanced clinical reasoning. Emphasis is placed on real-world application,
multidisciplinary coordination, and adherence to established trauma care standards. Successful
completion of this assessment indicates readiness to provide expert trauma care in emergency and
critical care settings.
SECTION ONE: QUESTIONS 1-100
Question 1
A 45-year-old male is brought to the emergency department following a motor vehicle collision at
60 mph. He is unresponsive with a Glasgow Coma Scale (GCS) score of 7. His airway is patent, but
,he has shallow respirations at 8 breaths per minute with an oxygen saturation of 88% on room air.
What is the MOST appropriate next step?
A. Apply a non-rebreather mask at 15 L/min
B. Perform rapid sequence intubation (RSI)
C. Insert a nasopharyngeal airway
D. Administer naloxone 2 mg IV
🟢 B. Perform rapid sequence intubation (RSI)
🔴 Explanation: The patient has a GCS ≤ 8 with inadequate ventilation and hypoxia, indicating an
unprotected airway and the need for definitive airway management. RSI is the preferred method for
securing the airway in trauma patients with suspected head injury or altered mental status, as it
minimizes aspiration risk and allows for controlled intubation.
Question 2
During the primary survey of a trauma patient, you note jugular venous distention, tracheal
deviation to the left, and absent breath sounds on the right side. The patient is hypotensive with a
blood pressure of 85/50 mmHg. What is the MOST likely diagnosis?
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Aortic dissection
🟢 B. Tension pneumothorax
🔴 Explanation: The classic triad of tension pneumothorax includes hypotension, jugular venous
distention, and tracheal deviation away from the affected side. The absent breath sounds on the
right with tracheal deviation to the left strongly indicate a right-sided tension pneumothorax
requiring immediate needle decompression.
Question 3
A 32-year-old female is stabbed in the left chest. She is alert and oriented, with a blood pressure of
110/70 mmHg, heart rate of 110 bpm, and respiratory rate of 24 breaths per minute. On
examination, you note an open sucking chest wound with bubbling blood. What is the FIRST
intervention?
A. Apply a sterile occlusive dressing taped on three sides
B. Insert a chest tube at the 5th intercostal space
C. Administer IV antibiotics
D. Close the wound with sutures
🟢 A. Apply a sterile occlusive dressing taped on three sides
,🔴 Explanation: An open pneumothorax requires immediate conversion to a closed pneumothorax
by applying an occlusive dressing taped on three sides. This allows air to escape during expiration
while preventing air entry during inspiration, effectively managing the sucking chest wound until
definitive chest tube placement.
Question 4
Which of the following statements about the secondary survey is CORRECT?
A. It should be performed before the primary survey
B. It includes a complete head-to-toe examination and history
C. It takes priority over identifying life-threatening injuries
D. It should be delayed until all diagnostic imaging is completed
🟢 B. It includes a complete head-to-toe examination and history
🔴 Explanation: The secondary survey is a systematic head-to-toe examination performed after the
primary survey and initial resuscitation are completed. It includes a complete physical examination
and the AMPLE history (Allergies, Medications, Past medical history, Last meal, Events) to identify all
injuries that were not immediately life-threatening.
Question 5
A 60-year-old male with a history of hypertension presents with blunt abdominal trauma. His blood
pressure is 90/60 mmHg, heart rate is 130 bpm, and he is complaining of severe left shoulder pain.
Focused Assessment with Sonography for Trauma (FAST) reveals free fluid in the left upper
quadrant. What is the MOST appropriate management?
A. Observe with serial abdominal examinations
B. Perform diagnostic peritoneal lavage (DPL)
C. Proceed immediately to laparotomy
D. Administer 2 L of isotonic crystalloid and repeat FAST
🟢 C. Proceed immediately to laparotomy
🔴 Explanation: A positive FAST examination in a hypotensive patient with blunt abdominal trauma
indicates significant intra-abdominal hemorrhage requiring immediate surgical intervention. The
presence of free fluid in the left upper quadrant in a patient with hemodynamic instability is an
indication for emergent laparotomy.
Question 6
What is the recommended initial fluid bolus for resuscitation of a hypotensive trauma patient?
A. 500 mL of crystalloid
B. 1 L of crystalloid
, C. 2 L of crystalloid
D. 500 mL of colloid
🟢 B. 1 L of crystalloid
🔴 Explanation: The ATLS guidelines recommend an initial fluid bolus of 1 L of isotonic crystalloid
(typically Ringer's lactate or normal saline) for hypotensive trauma patients. This bolus should be
given rapidly and the patient's response assessed to guide further resuscitation and determine if
ongoing hemorrhage is present.
Question 7
A 28-year-old male presents with a gunshot wound to the right lower chest. He is hemodynamically
unstable with a blood pressure of 80/40 mmHg. FAST examination is negative. The patient has
decreased breath sounds on the right side. What is the MOST likely diagnosis?
A. Pericardial tamponade
B. Diaphragmatic rupture
C. Hemothorax
D. Pulmonary contusion
🟢 C. Hemothorax
🔴 Explanation: Gunshot wounds to the lower chest can cause hemothorax from injury to the
intercostal vessels or lung parenchyma. Decreased breath sounds with hemodynamic instability in
the setting of penetrating chest trauma is highly suggestive of significant hemothorax requiring
chest tube drainage.
Question 8
Which of the following findings on a cervical spine X-ray is concerning for an unstable cervical
spine injury?
A. Anterior vertebral body height loss
B. Widening of the predental space > 3 mm
C. Loss of cervical lordosis
D. Degenerative disc disease
🟢 B. Widening of the predental space > 3 mm
🔴 Explanation: A predental space (the distance between the anterior aspect of the dens and the
posterior aspect of the anterior arch of C1) greater than 3 mm in adults indicates disruption of the
transverse ligament and suggests an unstable atlantoaxial injury. This requires immediate cervical
spine immobilization and further imaging.
Question 9
