ATLS Post-Test | 2025/2026 Complete Package
Deal | 6 Versions + Individual Tests | Questions
and Answers | Fully Aligned with ATLS 10th Edition
Section 1: Initial Assessment and Primary Survey (Q1–Q15)
1. A 28-year-old male is brought in after a motorcycle crash. He is unconscious, making
gurgling sounds. Oxygen saturation is 82% on room air. What is the immediate next step?
A. Apply non-rebreather mask
B. Jaw thrust with suctioning
C. Orotracheal intubation
D. Cricothyroidotomy
Answer: B
Rationale: Gurgling respirations indicate blood or secretions in the oropharynx. The immediate
priority is to clear the airway with suctioning while maintaining cervical spine protection using a
jaw thrust. Definitive airway management follows initial clearing.
2. Which finding indicates a definitive airway is required?
A. GCS 14
B. Respiratory rate 24
C. Extensive facial burns with hoarseness
D. Chest wall contusion
Answer: C
Rationale: Hoarseness with facial burns indicates impending airway obstruction from edema.
This requires definitive airway management before the airway becomes completely obstructed.
3. A patient has a suspected cervical spine injury. Which airway maneuver is safest?
A. Head tilt-chin lift
B. Jaw thrust without head extension
C. Nasopharyngeal airway only
D. Supraglottic airway
Answer: B
Rationale: The jaw thrust maneuver opens the airway without extending the cervical spine,
making it the safest initial maneuver for patients with suspected C-spine injury.
4. The most reliable sign of adequate oxygenation during bag-mask ventilation is:
A. Rise in end-tidal CO₂
B. Chest rise and fall
,C. Pulse oximetry >92%
D. Normal breath sounds
Answer: A
Rationale: Capnography (end-tidal CO₂) is the most reliable indicator of adequate ventilation
and tube placement. Chest rise alone can occur with esophageal intubation.
5. Failed intubation after 2 attempts requires:
A. Third attempt with different blade
B. Surgical airway
C. Laryngeal mask airway placement
D. Awake fiberoptic intubation
Answer: C
Rationale: After two failed intubation attempts, a supraglottic airway such as an LMA should be
placed as a rescue device. This provides oxygenation while preparing for a surgical airway if
needed.
6. Which patient needs immediate intubation?
A. GCS 13, talking normally
B. GCS 8 with loss of gag reflex
C. GCS 10 with oxygen saturation 94%
D. GCS 15 with stridor at rest
Answer: B
Rationale: GCS ≤8 with loss of protective airway reflexes indicates the need for definitive
airway management to prevent aspiration and ensure adequate ventilation.
7. Needle cricothyroidotomy provides approximately how many minutes of ventilation?
A. 5-10 minutes
B. 15-20 minutes
C. 30-45 minutes
D. 60 minutes
Answer: C
Rationale: Needle cricothyroidotomy provides adequate ventilation for approximately 30-45
minutes, allowing time for a definitive surgical airway to be established.
8. A 45-year-old with blunt neck trauma has an expanding hematoma and hoarseness. Next
step:
A. Observe in ED
B. Immediate CT neck
C. Oral intubation
D. Awake fiberoptic or surgical airway
,Answer: D
Rationale: An expanding hematoma with hoarseness indicates impending airway compromise.
Awake fiberoptic intubation or surgical airway is preferred over oral intubation, which could
worsen the injury.
9. In a patient with apnea and no gag reflex, the preferred initial airway device is:
A. Laryngeal mask airway
B. Oropharyngeal airway with bag-mask
C. Endotracheal tube
D. Nasopharyngeal airway
Answer: C
Rationale: Endotracheal intubation is the preferred definitive airway in an apneic patient
without protective reflexes, providing secure airway protection and ventilation.
10. Capnography confirmation of ETT placement shows no waveform after intubation. What
should you do?
A. Order chest X-ray
B. Remove tube and ventilate by bag-mask
C. Auscultate both lung fields
D. Increase ventilation rate
Answer: B
Rationale: Absence of a capnography waveform indicates esophageal intubation. The tube
must be removed immediately and the patient ventilated by bag-mask.
11. A 24-year-old male arrives by EMS after a high-speed motorcycle crash. He is
unresponsive, snoring respirations at 8/min, and has obvious facial injuries. What is the FIRST
priority in the primary survey?
A. Insert an oropharyngeal airway and ventilate with a bag-valve-mask
B. Perform a rapid sequence intubation
C. Obtain a stat CT scan of the head and cervical spine
D. Establish two large-bore IVs and begin fluid resuscitation
Answer: A
Rationale: The primary survey follows ABCDE. Snoring respirations indicate partial upper airway
obstruction by the tongue; the immediate intervention is to open and secure the airway with a
basic adjunct and provide ventilation.
12. During the primary survey of a trauma patient, which finding requires IMMEDIATE
intervention before proceeding to the next step?
A. Tachycardia with a narrowed pulse pressure
B. Stridor and suprasternal retractions
, C. GCS of 12 with equal and reactive pupils
D. Distended abdomen with ecchymosis
Answer: B
Rationale: Stridor and suprasternal retractions indicate upper airway obstruction with
impending loss of airway patency — a life-threatening Airway (A) emergency requiring
immediate intervention.
13. What is the purpose of the secondary survey in trauma?
A. Identify life-threatening injuries
B. Perform a head-to-toe exam
C. Initiate fluid resuscitation
D. Prepare for surgery
Answer: B
Rationale: The secondary survey is a thorough head-to-toe examination performed after
stabilizing life-threatening conditions identified in the primary survey.
14. During primary and secondary survey, the patient injured by blunt trauma should be
completely immobilized until:
A. The neurologic exam has been completed
B. The patient is transferred to definitive care
C. The patient is able to indicate that he has no neck pain
D. A spinal fracture has been excluded by x-ray
Answer: D
Rationale: Spinal immobilization should be maintained until a spinal fracture has been
definitively excluded by radiographic evaluation.
15. A trauma patient has completed the primary survey and is now undergoing the secondary
survey. Which component is specifically part of the secondary survey rather than the primary
survey?
A. Assessment of airway patency
B. Evaluation of breathing effectiveness
C. AMPLE history
D. Assessment of circulation
Answer: C
Rationale: The AMPLE history (Allergies, Medications, Past medical history, Last meal, Events) is
part of the secondary survey. The primary survey focuses on ABCDE.
Section 2: Airway and Ventilatory Management (Q16–Q30)
Deal | 6 Versions + Individual Tests | Questions
and Answers | Fully Aligned with ATLS 10th Edition
Section 1: Initial Assessment and Primary Survey (Q1–Q15)
1. A 28-year-old male is brought in after a motorcycle crash. He is unconscious, making
gurgling sounds. Oxygen saturation is 82% on room air. What is the immediate next step?
A. Apply non-rebreather mask
B. Jaw thrust with suctioning
C. Orotracheal intubation
D. Cricothyroidotomy
Answer: B
Rationale: Gurgling respirations indicate blood or secretions in the oropharynx. The immediate
priority is to clear the airway with suctioning while maintaining cervical spine protection using a
jaw thrust. Definitive airway management follows initial clearing.
2. Which finding indicates a definitive airway is required?
A. GCS 14
B. Respiratory rate 24
C. Extensive facial burns with hoarseness
D. Chest wall contusion
Answer: C
Rationale: Hoarseness with facial burns indicates impending airway obstruction from edema.
This requires definitive airway management before the airway becomes completely obstructed.
3. A patient has a suspected cervical spine injury. Which airway maneuver is safest?
A. Head tilt-chin lift
B. Jaw thrust without head extension
C. Nasopharyngeal airway only
D. Supraglottic airway
Answer: B
Rationale: The jaw thrust maneuver opens the airway without extending the cervical spine,
making it the safest initial maneuver for patients with suspected C-spine injury.
4. The most reliable sign of adequate oxygenation during bag-mask ventilation is:
A. Rise in end-tidal CO₂
B. Chest rise and fall
,C. Pulse oximetry >92%
D. Normal breath sounds
Answer: A
Rationale: Capnography (end-tidal CO₂) is the most reliable indicator of adequate ventilation
and tube placement. Chest rise alone can occur with esophageal intubation.
5. Failed intubation after 2 attempts requires:
A. Third attempt with different blade
B. Surgical airway
C. Laryngeal mask airway placement
D. Awake fiberoptic intubation
Answer: C
Rationale: After two failed intubation attempts, a supraglottic airway such as an LMA should be
placed as a rescue device. This provides oxygenation while preparing for a surgical airway if
needed.
6. Which patient needs immediate intubation?
A. GCS 13, talking normally
B. GCS 8 with loss of gag reflex
C. GCS 10 with oxygen saturation 94%
D. GCS 15 with stridor at rest
Answer: B
Rationale: GCS ≤8 with loss of protective airway reflexes indicates the need for definitive
airway management to prevent aspiration and ensure adequate ventilation.
7. Needle cricothyroidotomy provides approximately how many minutes of ventilation?
A. 5-10 minutes
B. 15-20 minutes
C. 30-45 minutes
D. 60 minutes
Answer: C
Rationale: Needle cricothyroidotomy provides adequate ventilation for approximately 30-45
minutes, allowing time for a definitive surgical airway to be established.
8. A 45-year-old with blunt neck trauma has an expanding hematoma and hoarseness. Next
step:
A. Observe in ED
B. Immediate CT neck
C. Oral intubation
D. Awake fiberoptic or surgical airway
,Answer: D
Rationale: An expanding hematoma with hoarseness indicates impending airway compromise.
Awake fiberoptic intubation or surgical airway is preferred over oral intubation, which could
worsen the injury.
9. In a patient with apnea and no gag reflex, the preferred initial airway device is:
A. Laryngeal mask airway
B. Oropharyngeal airway with bag-mask
C. Endotracheal tube
D. Nasopharyngeal airway
Answer: C
Rationale: Endotracheal intubation is the preferred definitive airway in an apneic patient
without protective reflexes, providing secure airway protection and ventilation.
10. Capnography confirmation of ETT placement shows no waveform after intubation. What
should you do?
A. Order chest X-ray
B. Remove tube and ventilate by bag-mask
C. Auscultate both lung fields
D. Increase ventilation rate
Answer: B
Rationale: Absence of a capnography waveform indicates esophageal intubation. The tube
must be removed immediately and the patient ventilated by bag-mask.
11. A 24-year-old male arrives by EMS after a high-speed motorcycle crash. He is
unresponsive, snoring respirations at 8/min, and has obvious facial injuries. What is the FIRST
priority in the primary survey?
A. Insert an oropharyngeal airway and ventilate with a bag-valve-mask
B. Perform a rapid sequence intubation
C. Obtain a stat CT scan of the head and cervical spine
D. Establish two large-bore IVs and begin fluid resuscitation
Answer: A
Rationale: The primary survey follows ABCDE. Snoring respirations indicate partial upper airway
obstruction by the tongue; the immediate intervention is to open and secure the airway with a
basic adjunct and provide ventilation.
12. During the primary survey of a trauma patient, which finding requires IMMEDIATE
intervention before proceeding to the next step?
A. Tachycardia with a narrowed pulse pressure
B. Stridor and suprasternal retractions
, C. GCS of 12 with equal and reactive pupils
D. Distended abdomen with ecchymosis
Answer: B
Rationale: Stridor and suprasternal retractions indicate upper airway obstruction with
impending loss of airway patency — a life-threatening Airway (A) emergency requiring
immediate intervention.
13. What is the purpose of the secondary survey in trauma?
A. Identify life-threatening injuries
B. Perform a head-to-toe exam
C. Initiate fluid resuscitation
D. Prepare for surgery
Answer: B
Rationale: The secondary survey is a thorough head-to-toe examination performed after
stabilizing life-threatening conditions identified in the primary survey.
14. During primary and secondary survey, the patient injured by blunt trauma should be
completely immobilized until:
A. The neurologic exam has been completed
B. The patient is transferred to definitive care
C. The patient is able to indicate that he has no neck pain
D. A spinal fracture has been excluded by x-ray
Answer: D
Rationale: Spinal immobilization should be maintained until a spinal fracture has been
definitively excluded by radiographic evaluation.
15. A trauma patient has completed the primary survey and is now undergoing the secondary
survey. Which component is specifically part of the secondary survey rather than the primary
survey?
A. Assessment of airway patency
B. Evaluation of breathing effectiveness
C. AMPLE history
D. Assessment of circulation
Answer: C
Rationale: The AMPLE history (Allergies, Medications, Past medical history, Last meal, Events) is
part of the secondary survey. The primary survey focuses on ABCDE.
Section 2: Airway and Ventilatory Management (Q16–Q30)
