ATLS Metabolic Response to Severe
Injury Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
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1.
A patient sustains major blunt trauma with hemorrhagic shock. Which metabolic
response is expected during the early phase of severe injury?
A. Reduced sympathetic activity
B. Increased metabolic rate and oxygen consumption
C. Decreased catecholamine release
D. Increased insulin sensitivity
Answer: B. Increased metabolic rate and oxygen consumption
Rationale: Severe injury produces a stress response characterized by increased
sympathetic activity, catecholamine release, hypermetabolism, and increased
oxygen requirements.
2.
Which hormone is primarily responsible for promoting hepatic glucose production
during the stress response to trauma?
,A. Insulin
B. Growth hormone
C. Glucagon
D. Aldosterone
Answer: C. Glucagon
Rationale: Glucagon promotes glycogenolysis and gluconeogenesis, contributing
to trauma-associated hyperglycemia.
3.
A severely injured patient develops hyperglycemia despite having no history of
diabetes. What best explains this finding?
A. Increased insulin sensitivity
B. Stress-induced insulin resistance
C. Excessive glucose excretion
D. Decreased catecholamine activity
Answer: B. Stress-induced insulin resistance
Rationale: Trauma increases catecholamines, cortisol, glucagon, and
inflammatory mediators, producing insulin resistance and increased hepatic
glucose production.
4.
Which catecholamine response is expected following severe trauma?
A. Decreased epinephrine release
B. Increased epinephrine and norepinephrine release
C. Complete suppression of sympathetic activity
D. Increased parasympathetic activity
Answer: B. Increased epinephrine and norepinephrine release
Rationale: Catecholamine release is a central component of the neuroendocrine
response to injury and helps maintain cardiovascular function and mobilize
energy substrates.
,5.
Which metabolic substrate is mobilized through lipolysis during the stress
response?
A. Fatty acids
B. Albumin
C. Hemoglobin
D. Creatinine
Answer: A. Fatty acids
Rationale: Catecholamines and other stress hormones stimulate lipolysis,
releasing free fatty acids that can serve as an energy source.
6.
Which process converts amino acids and other noncarbohydrate substrates into
glucose?
A. Glycolysis
B. Lipogenesis
C. Gluconeogenesis
D. Glycogenesis
Answer: C. Gluconeogenesis
Rationale: Gluconeogenesis produces glucose from substrates such as amino
acids, lactate, and glycerol, and is increased after severe injury.
7.
What is the major physiologic purpose of the early stress response after major
trauma?
A. Promote long-term fat storage
B. Preserve vital organ perfusion and provide energy substrates
C. Suppress inflammation completely
D. Promote immediate muscle growth
, Answer: B. Preserve vital organ perfusion and provide energy substrates
Rationale: The stress response attempts to maintain cardiovascular stability and
provide glucose and other substrates needed by vital organs and injured tissues.
8.
Which hormone generally decreases during the acute stress response because of
insulin resistance?
A. Insulin effectiveness
B. Cortisol activity
C. Glucagon activity
D. Catecholamine activity
Answer: A. Insulin effectiveness
Rationale: Although insulin secretion may occur, peripheral insulin resistance
develops, limiting glucose uptake by many tissues and contributing to
hyperglycemia.
9.
A patient with extensive trauma develops elevated blood glucose. Which
combination most directly contributes to this response?
A. Increased insulin and decreased cortisol
B. Increased catecholamines, cortisol, and glucagon
C. Decreased glucagon and increased insulin sensitivity
D. Decreased sympathetic activity and increased parasympathetic activity
Answer: B. Increased catecholamines, cortisol, and glucagon
Rationale: These counter-regulatory hormones increase glucose availability
through glycogenolysis, gluconeogenesis, and insulin resistance.
10.
Which inflammatory mediator is strongly associated with the systemic response to
severe tissue injury?
Injury Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1.
A patient sustains major blunt trauma with hemorrhagic shock. Which metabolic
response is expected during the early phase of severe injury?
A. Reduced sympathetic activity
B. Increased metabolic rate and oxygen consumption
C. Decreased catecholamine release
D. Increased insulin sensitivity
Answer: B. Increased metabolic rate and oxygen consumption
Rationale: Severe injury produces a stress response characterized by increased
sympathetic activity, catecholamine release, hypermetabolism, and increased
oxygen requirements.
2.
Which hormone is primarily responsible for promoting hepatic glucose production
during the stress response to trauma?
,A. Insulin
B. Growth hormone
C. Glucagon
D. Aldosterone
Answer: C. Glucagon
Rationale: Glucagon promotes glycogenolysis and gluconeogenesis, contributing
to trauma-associated hyperglycemia.
3.
A severely injured patient develops hyperglycemia despite having no history of
diabetes. What best explains this finding?
A. Increased insulin sensitivity
B. Stress-induced insulin resistance
C. Excessive glucose excretion
D. Decreased catecholamine activity
Answer: B. Stress-induced insulin resistance
Rationale: Trauma increases catecholamines, cortisol, glucagon, and
inflammatory mediators, producing insulin resistance and increased hepatic
glucose production.
4.
Which catecholamine response is expected following severe trauma?
A. Decreased epinephrine release
B. Increased epinephrine and norepinephrine release
C. Complete suppression of sympathetic activity
D. Increased parasympathetic activity
Answer: B. Increased epinephrine and norepinephrine release
Rationale: Catecholamine release is a central component of the neuroendocrine
response to injury and helps maintain cardiovascular function and mobilize
energy substrates.
,5.
Which metabolic substrate is mobilized through lipolysis during the stress
response?
A. Fatty acids
B. Albumin
C. Hemoglobin
D. Creatinine
Answer: A. Fatty acids
Rationale: Catecholamines and other stress hormones stimulate lipolysis,
releasing free fatty acids that can serve as an energy source.
6.
Which process converts amino acids and other noncarbohydrate substrates into
glucose?
A. Glycolysis
B. Lipogenesis
C. Gluconeogenesis
D. Glycogenesis
Answer: C. Gluconeogenesis
Rationale: Gluconeogenesis produces glucose from substrates such as amino
acids, lactate, and glycerol, and is increased after severe injury.
7.
What is the major physiologic purpose of the early stress response after major
trauma?
A. Promote long-term fat storage
B. Preserve vital organ perfusion and provide energy substrates
C. Suppress inflammation completely
D. Promote immediate muscle growth
, Answer: B. Preserve vital organ perfusion and provide energy substrates
Rationale: The stress response attempts to maintain cardiovascular stability and
provide glucose and other substrates needed by vital organs and injured tissues.
8.
Which hormone generally decreases during the acute stress response because of
insulin resistance?
A. Insulin effectiveness
B. Cortisol activity
C. Glucagon activity
D. Catecholamine activity
Answer: A. Insulin effectiveness
Rationale: Although insulin secretion may occur, peripheral insulin resistance
develops, limiting glucose uptake by many tissues and contributing to
hyperglycemia.
9.
A patient with extensive trauma develops elevated blood glucose. Which
combination most directly contributes to this response?
A. Increased insulin and decreased cortisol
B. Increased catecholamines, cortisol, and glucagon
C. Decreased glucagon and increased insulin sensitivity
D. Decreased sympathetic activity and increased parasympathetic activity
Answer: B. Increased catecholamines, cortisol, and glucagon
Rationale: These counter-regulatory hormones increase glucose availability
through glycogenolysis, gluconeogenesis, and insulin resistance.
10.
Which inflammatory mediator is strongly associated with the systemic response to
severe tissue injury?
