ATLS PRE-TEST EXAM QUESTIONS AND ANSWERS
2026-2027
A 22-year-
old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood press
ure is initially 80/40 mm Hg. After initial fluid resuscitation his bloodSpressureSincreases to 122/84
mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minut
e. A tube thoracostomy is performed for decreased left chest breath sounds with the return of a sma
ll amount of blood and no air leak. After chest tube insertion, the most appropriate next step is: -
correct answer-- *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
A construction worker falls two stories from a building and sustains bilateralScalcaneal fractures. I
n the emergency department, he is alert, vital signs are normal, and he is complaining of severe pai
n in both heels and his lower back. Lower extremity pulses are strong and there is no other deformi
ty. The suspected diagnosis is most likely to be confirmed by: - correct answer-- complete spine x-
ray series
Which of the following is trueSregarding the initial resuscitation of a trauma patient? -
correct answer--
A patient with a torso gunshot wound and hypotension should receive crystalloid fluid resuscitatio
n until the blood pressure is normal
-
* Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow
Coma Scale score on reevaluation*
-
Massive transfusion is defined as transfusion of more than 10 units of packedSred blood cells and pl
asma within 24 hours
- When tranexamic acid is administered by pre-
hospital providers, a second dose is required within 24 hours
- Fluid resuscitation is far more important than bleeding control in trauma patient
In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
correct answer-- Secure the airway
, A previously healthy, 70-kg (154-
pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following statements
applies to this patient? - correct answer-- His pulse pressure will be widened.
- His urinary output will be at the lower limits of normal. xxx
- He will have tachycardia, but no change in his systolic blood pressure.
- *An ABG would demonstrate a base deficit between -6 andS-10 mEq/L.*
- His systolic blood pressure will beSmaintained with an elevated diastolic pressure.
TheSphysiological hypervolemia of pregnancy has clinical significance in the management of the sev
erely injured, gravid woman by: - correct answer--
increasing the volume of blood loss to produce maternalShypotension.
TheSbest assessment of fluid resuscitation of the adult burn patient is: - correct answer--
urinary output of 0.5 mL/kg/hr
TheSdiagnosis of shock must include: - correct answer-- evidence of inadequate organ perfusion
A 7-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 wound of his medial right thigh. Immediate management of the wound should consist of: -
correct answer-- direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prev
ent: - correct answer-- respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
After being involved in aSmotor vehicle crash, a 25-year-
old man is brought to a hospital that has surgery capabilities available. Computed tomography of t
he chest and abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His
bloodSpressure falls to 70 mm Hg after CT. The next step is: - correct answer--
perform an exploratory laparotomy
2026-2027
A 22-year-
old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood press
ure is initially 80/40 mm Hg. After initial fluid resuscitation his bloodSpressureSincreases to 122/84
mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minut
e. A tube thoracostomy is performed for decreased left chest breath sounds with the return of a sma
ll amount of blood and no air leak. After chest tube insertion, the most appropriate next step is: -
correct answer-- *Re-examine the chest*
- Perform an aortogram
- Obtain a CT scan of the chest
- Obtain ABG analysis
- Transesophageal echocardiography
A construction worker falls two stories from a building and sustains bilateralScalcaneal fractures. I
n the emergency department, he is alert, vital signs are normal, and he is complaining of severe pai
n in both heels and his lower back. Lower extremity pulses are strong and there is no other deformi
ty. The suspected diagnosis is most likely to be confirmed by: - correct answer-- complete spine x-
ray series
Which of the following is trueSregarding the initial resuscitation of a trauma patient? -
correct answer--
A patient with a torso gunshot wound and hypotension should receive crystalloid fluid resuscitatio
n until the blood pressure is normal
-
* Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow
Coma Scale score on reevaluation*
-
Massive transfusion is defined as transfusion of more than 10 units of packedSred blood cells and pl
asma within 24 hours
- When tranexamic acid is administered by pre-
hospital providers, a second dose is required within 24 hours
- Fluid resuscitation is far more important than bleeding control in trauma patient
In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
correct answer-- Secure the airway
, A previously healthy, 70-kg (154-
pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following statements
applies to this patient? - correct answer-- His pulse pressure will be widened.
- His urinary output will be at the lower limits of normal. xxx
- He will have tachycardia, but no change in his systolic blood pressure.
- *An ABG would demonstrate a base deficit between -6 andS-10 mEq/L.*
- His systolic blood pressure will beSmaintained with an elevated diastolic pressure.
TheSphysiological hypervolemia of pregnancy has clinical significance in the management of the sev
erely injured, gravid woman by: - correct answer--
increasing the volume of blood loss to produce maternalShypotension.
TheSbest assessment of fluid resuscitation of the adult burn patient is: - correct answer--
urinary output of 0.5 mL/kg/hr
TheSdiagnosis of shock must include: - correct answer-- evidence of inadequate organ perfusion
A 7-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 wound of his medial right thigh. Immediate management of the wound should consist of: -
correct answer-- direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prev
ent: - correct answer-- respiratory acidosis xxx
- metabolic acidosis
- *Cerebral vasoconstriction with diminished perfusion*
- neurogenic pulmonary edema
- shift of the oxyhemoglobin dissociation curve
After being involved in aSmotor vehicle crash, a 25-year-
old man is brought to a hospital that has surgery capabilities available. Computed tomography of t
he chest and abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His
bloodSpressure falls to 70 mm Hg after CT. The next step is: - correct answer--
perform an exploratory laparotomy
