ATLS
ATLS PRACTICE TEST 2026-2027 ACTUAL EXAM 250 REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
A 22-year-old man is hypotensive and tachycardic after a
shotgun wound to the left shoulder. His blood pressure is
initially 80/40 mm Hg. After initial fluid resuscitation his blood
pressure increases to 122/84 mm Hg. His heart rate is now 100
beats per minute and his respiratory rate is 28 breaths per
minute. A tube thoracostomy is performed for decreased left
chest breath sounds with the return of a small amount of blood
and no air leak. After chest tube insertion, the most appropriate
next step is: - correct answer re-examine the chest
A construction worker falls two stories from a building and
sustains bilateral calcaneal fractures. In the emergency
department, he is alert, vital signs are normal, and he is
complaining of severe pain in both heels and his lower back.
Lower extremity pulses are strong and there is no other
,ATLS
deformity. The suspected diagnosis is most likely to be
confirmed by: - correct answer complete spine x-ray series
Which of the following is true regarding the initial resuscitation
of a trauma patient? - correct answer Evidence of improved
perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation.
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 An
ABG would demonstrate a base deficit between -6 and -10
mEq/L.
The physiological hypervolemia of pregnancy has clinical
significance in the management of the severely injured, gravid
woman by: - correct answer increasing the volume of blood loss to
produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn
patient is: - correct answer urinary output of 0.5 mL/kg/hr
,ATLS
The diagnosis 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 prevent: - correct answer cerebral
vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man
is brought to a hospital that has surgery capabilities available..
Computed tomography of the chest and abdomen shows an
aortic injury and splenic laceration with free abdominal fluid.
His blood pressure falls to 70 mm Hg after CT. The next step is: -
correct answer perform an exploratory laparotomy
Which one of the following statements regarding abdominal
trauma in the pregnant patient is TRUE? - correct answer Leakage
of amniotic fluid is an indication for hospital admission.
, ATLS
The first maneuver to improve oxygenation after chest injury is:
- correct answer administer supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is
admitted to the emergency department. His pupils react
sluggishly and his eyes open to pressure. He does not follow
commands, but he does moan periodically. His right arm is
deformed and does not respond to pressure; however, his left
hand reaches purposefully toward the stimulus. Both legs are
stiffly extended. His GCS score is: - correct answer 9
A 20-year-old woman who is at 32 weeks gestation, is stabbed
in the upper right chest. In the emergency department, her
blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are
diminished in the right chest. The most appropriate first step is
to: - correct answer perform needle or finger decompression of the
right chest
Which one of the following findings in an adult is most likely to
require immediate management during the primary survey? -
correct answer respiratory rate of 40 breaths per minute
ATLS PRACTICE TEST 2026-2027 ACTUAL EXAM 250 REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
A 22-year-old man is hypotensive and tachycardic after a
shotgun wound to the left shoulder. His blood pressure is
initially 80/40 mm Hg. After initial fluid resuscitation his blood
pressure increases to 122/84 mm Hg. His heart rate is now 100
beats per minute and his respiratory rate is 28 breaths per
minute. A tube thoracostomy is performed for decreased left
chest breath sounds with the return of a small amount of blood
and no air leak. After chest tube insertion, the most appropriate
next step is: - correct answer re-examine the chest
A construction worker falls two stories from a building and
sustains bilateral calcaneal fractures. In the emergency
department, he is alert, vital signs are normal, and he is
complaining of severe pain in both heels and his lower back.
Lower extremity pulses are strong and there is no other
,ATLS
deformity. The suspected diagnosis is most likely to be
confirmed by: - correct answer complete spine x-ray series
Which of the following is true regarding the initial resuscitation
of a trauma patient? - correct answer Evidence of improved
perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation.
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 An
ABG would demonstrate a base deficit between -6 and -10
mEq/L.
The physiological hypervolemia of pregnancy has clinical
significance in the management of the severely injured, gravid
woman by: - correct answer increasing the volume of blood loss to
produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn
patient is: - correct answer urinary output of 0.5 mL/kg/hr
,ATLS
The diagnosis 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 prevent: - correct answer cerebral
vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man
is brought to a hospital that has surgery capabilities available..
Computed tomography of the chest and abdomen shows an
aortic injury and splenic laceration with free abdominal fluid.
His blood pressure falls to 70 mm Hg after CT. The next step is: -
correct answer perform an exploratory laparotomy
Which one of the following statements regarding abdominal
trauma in the pregnant patient is TRUE? - correct answer Leakage
of amniotic fluid is an indication for hospital admission.
, ATLS
The first maneuver to improve oxygenation after chest injury is:
- correct answer administer supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is
admitted to the emergency department. His pupils react
sluggishly and his eyes open to pressure. He does not follow
commands, but he does moan periodically. His right arm is
deformed and does not respond to pressure; however, his left
hand reaches purposefully toward the stimulus. Both legs are
stiffly extended. His GCS score is: - correct answer 9
A 20-year-old woman who is at 32 weeks gestation, is stabbed
in the upper right chest. In the emergency department, her
blood pressure is 80/60 mm Hg. She is gasping for breath,
extremely anxious, and yelling for help. Breath sounds are
diminished in the right chest. The most appropriate first step is
to: - correct answer perform needle or finger decompression of the
right chest
Which one of the following findings in an adult is most likely to
require immediate management during the primary survey? -
correct answer respiratory rate of 40 breaths per minute
