ATLS Test 1 Practice Exam 2026 | Verified Answers |
Exam Prep
1. In a patient who has lost 20% of their blood volume and presents with
tachycardia, what immediate intervention should be prioritized?
Fluid resuscitation
Administering pain medication
Performing a CT scan
Initiating blood transfusion
2. What physical exam finding indicates the need for prompt celiotomy in a
patient with a splenic injury?
development of peritonitis on physical exam
evidence of retroperitoneal hematoma on CT scan
a serum amylase of 200
a leukocyte count of 14,000
3. After being involved in a motor vehicle crash, a 25-year-old man is brought
to a hospital with a general surgeon on duty. He has a GCS of 13 and
complains of abdominal pain. His blood pressure was 80mmHg systolic by
palpation on arrival at the hospital, but increases to 110/70 wit the
administration of 2L of IV-fluid. His heart rate remains 120 beats per minute.
CT shows an aortic injury and splenic laceration with free abdominal fluid. His
blood pressure falls to 70mmHg after CT. The next step is to
Transesophageal echocardiography
Transfuse packed red blood cells
Contrast angiography
, Exploratory laparotomy
Transfer to a higher level trauma center
4. A 64-year-old man involved in a high-speed car crash is resuscitated initially
in a small hospital without surgical capabilities. He has a closed head injury
with a GCS score of 13. He has a widened mediastinum on chest x-ray with
fractures of left ribs 2 through 4, but no pneumothorax. After initiating fluid
resuscitation, his blood pressure is 110/74 mm Hg, heart rate is 100 beats per
minute, and respiratory rate is 18 breaths per minute. He has gross hematuria
and a pelvic fracture. You decide to transfer this patient to a facility capable
of providing a higher level of care. The facility is 128 km (80 miles) away.
Before transfer, you should first:
intubate the patient
call the receiving hospital and speak to the surgeon on call
perform diagnostic peritoneal lavage or FAST
insert a left chest tube
discuss the advisability of transfer with the patient's family
5. For a person with a major burn, which of the following evaluation criteria
indicate that fluid resuscitation is effective during the first 24 hours of care?
Blood pressure of 97/70
Central venous pressure of 18
Heart rate of 130 beats per minute
Urine output of 30 to 50mL/h
6. In a clinical scenario, if a patient presents with a documented history of
severe hypersensitivity to tetanus toxoid, what would be the most
appropriate course of action regarding vaccination?
, Administer the vaccine with caution.
Administer a lower dose of the vaccine.
Refer the patient for an allergy consultation before vaccination.
Provide the vaccine and monitor for side effects.
Do not administer the tetanus toxoid vaccine.
7. Blunt abdominal trauma in a pregnant female which is potentially life
threatening to mom and baby is most likely
Placenta previa with severe pain and lots of external bleeding
Abruptio placenta with severe pain and lots of external bleeding
Placenta previa with severe pain and minimal external bleeding
Abruptio placentae associated with severe pain and minimal
external bleeding
8. What is the primary confirmation method for proper placement of an
intraosseous needle?
Observation of fluid flow through the needle.
Palpation of the surrounding tissue.
Visual inspection of the insertion site.
Aspiration of bone marrow confirms appropriate positioning of the
needle.
9. What anatomical feature of infants contributes to the risk of bronchial
intubation during endotracheal intubation?
The epiglottis is more rigid.
The larynx is positioned higher in the neck.
, The bronchi are wider in diameter.
The trachea is relatively short.
The vocal cords are more developed.
10. The diagnosis of shock must include:
Increased vascular resistance
Evidence of inadequate organ perfusion
Hypoxemia
Acidosis
Hypotension
11. A seven-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding
profusely from a 6 cm (2.4 inch) wound of his medial right thigh. Immediate
management of the wound should consist of
Apply a hemostat to bleeding vessels.
Direct pressure on the femoral artery at the groin.
Application of the pediatric PASG and inflation of the right leg
compartment.
Direct pressure on the wound.
Application of a tourniquet.
12. In a scenario where a patient with a closed head injury is stable but requires
urgent transfer, what would be the most appropriate initial step to ensure
optimal care during transfer?
perform a full physical examination
Exam Prep
1. In a patient who has lost 20% of their blood volume and presents with
tachycardia, what immediate intervention should be prioritized?
Fluid resuscitation
Administering pain medication
Performing a CT scan
Initiating blood transfusion
2. What physical exam finding indicates the need for prompt celiotomy in a
patient with a splenic injury?
development of peritonitis on physical exam
evidence of retroperitoneal hematoma on CT scan
a serum amylase of 200
a leukocyte count of 14,000
3. After being involved in a motor vehicle crash, a 25-year-old man is brought
to a hospital with a general surgeon on duty. He has a GCS of 13 and
complains of abdominal pain. His blood pressure was 80mmHg systolic by
palpation on arrival at the hospital, but increases to 110/70 wit the
administration of 2L of IV-fluid. His heart rate remains 120 beats per minute.
CT shows an aortic injury and splenic laceration with free abdominal fluid. His
blood pressure falls to 70mmHg after CT. The next step is to
Transesophageal echocardiography
Transfuse packed red blood cells
Contrast angiography
, Exploratory laparotomy
Transfer to a higher level trauma center
4. A 64-year-old man involved in a high-speed car crash is resuscitated initially
in a small hospital without surgical capabilities. He has a closed head injury
with a GCS score of 13. He has a widened mediastinum on chest x-ray with
fractures of left ribs 2 through 4, but no pneumothorax. After initiating fluid
resuscitation, his blood pressure is 110/74 mm Hg, heart rate is 100 beats per
minute, and respiratory rate is 18 breaths per minute. He has gross hematuria
and a pelvic fracture. You decide to transfer this patient to a facility capable
of providing a higher level of care. The facility is 128 km (80 miles) away.
Before transfer, you should first:
intubate the patient
call the receiving hospital and speak to the surgeon on call
perform diagnostic peritoneal lavage or FAST
insert a left chest tube
discuss the advisability of transfer with the patient's family
5. For a person with a major burn, which of the following evaluation criteria
indicate that fluid resuscitation is effective during the first 24 hours of care?
Blood pressure of 97/70
Central venous pressure of 18
Heart rate of 130 beats per minute
Urine output of 30 to 50mL/h
6. In a clinical scenario, if a patient presents with a documented history of
severe hypersensitivity to tetanus toxoid, what would be the most
appropriate course of action regarding vaccination?
, Administer the vaccine with caution.
Administer a lower dose of the vaccine.
Refer the patient for an allergy consultation before vaccination.
Provide the vaccine and monitor for side effects.
Do not administer the tetanus toxoid vaccine.
7. Blunt abdominal trauma in a pregnant female which is potentially life
threatening to mom and baby is most likely
Placenta previa with severe pain and lots of external bleeding
Abruptio placenta with severe pain and lots of external bleeding
Placenta previa with severe pain and minimal external bleeding
Abruptio placentae associated with severe pain and minimal
external bleeding
8. What is the primary confirmation method for proper placement of an
intraosseous needle?
Observation of fluid flow through the needle.
Palpation of the surrounding tissue.
Visual inspection of the insertion site.
Aspiration of bone marrow confirms appropriate positioning of the
needle.
9. What anatomical feature of infants contributes to the risk of bronchial
intubation during endotracheal intubation?
The epiglottis is more rigid.
The larynx is positioned higher in the neck.
, The bronchi are wider in diameter.
The trachea is relatively short.
The vocal cords are more developed.
10. The diagnosis of shock must include:
Increased vascular resistance
Evidence of inadequate organ perfusion
Hypoxemia
Acidosis
Hypotension
11. A seven-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding
profusely from a 6 cm (2.4 inch) wound of his medial right thigh. Immediate
management of the wound should consist of
Apply a hemostat to bleeding vessels.
Direct pressure on the femoral artery at the groin.
Application of the pediatric PASG and inflation of the right leg
compartment.
Direct pressure on the wound.
Application of a tourniquet.
12. In a scenario where a patient with a closed head injury is stable but requires
urgent transfer, what would be the most appropriate initial step to ensure
optimal care during transfer?
perform a full physical examination
