ATLS Pretest Exam Newest Questions
and answers Updated 2024/25
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
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shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his
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blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and
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his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for
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decreased left chest breath sounds with the return of a small amount of blood and no air
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leak. After chest tube insertion, the most appropriate next step is: - re-examine the chest
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A construction worker falls two stories from a building and sustains bilateral calcaneal
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fractures. In the emergency department, he is alert, vital signs are normal, and he is
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complaining of severe pain in both heels and his lower back. Lower extremity pulses are
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strong and there is no other deformity. The suspected diagnosis is most likely to be
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confirmed by: - complete spine x-ray series
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Which of the following is true regarding the initial resuscitation of a trauma patient? -
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Evidence of improved perfusion after fluid resuscitation could include improvement in
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Glasgow Coma Scale score on reevaluation.
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In managing a patient with a severe traumatic brain injury, the most important initial step is
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to: - secure the airway
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A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2
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liters. Which one of the following statements applies to this patient? - An ABG would
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demonstrate a base deficit between -6 and -10 mEq/L.
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The physiological hypervolemia of pregnancy has clinical significance in the management
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of the severely injured, gravid woman by: - increasing the volume of blood loss to produce
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maternal hypotension
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The best assessment of fluid resuscitation of the adult burn patient is: - urinary output of
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0.5 mL/kg/hr
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ii The diagnosis of shock must include: - evidence of inadequate organ perfusion
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A 7-year-old boy is brought to the emergency department by his parents several minutes
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after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial
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right thigh. Immediate management of the wound should consist of: - direct pressure on
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the wound
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For the patient with severe traumatic brain injury, profound hypocarbia should be avoided
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to prevent: - cerebral vasoconstriction with diminished perfusion
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, After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
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that has surgery capabilities available.. Computed tomography of the chest and abdomen
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shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure
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falls to 70 mm Hg after CT. The next step is: - perform an exploratory laparotomy
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Which one of the following statements regarding abdominal trauma in the pregnant patient
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is TRUE? - Leakage of amniotic fluid is an indication for hospital admission.
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The first maneuver to improve oxygenation after chest injury is: - administer
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supplemental oxygen
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A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
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department. His pupils react sluggishly and his eyes open to pressure. He does not follow
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commands, but he does moan periodically. His right arm is deformed and does not
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respond to pressure; however, his left hand reaches purposefully toward the stimulus.
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Both legs are stiffly extended. His GCS score is: - 9
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A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In
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the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
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extremely anxious, and yelling for help. Breath sounds are diminished in the right chest.
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The most appropriate first step is to: - perform needle or finger decompression of the right
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chest
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Which one of the following findings in an adult is most likely to require immediate
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management during the primary survey? - respiratory rate of 40 breaths per minute
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The most important, immediate step in the management of an open pneumothorax is: -
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placement of an occlusive dressing over the wound
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The following are contraindications for tetanus toxoid administration: - history of
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neurological reaction or severe hypersensitivity to the product
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A 56-year-old man is thrown violently against the steering wheel of his truck during a motor
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vehicle crash. On arrival in the emergency department he is diaphoretic and complaining
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of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per
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minute. Which of the following best differentiates cardiac tamponade from tension
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pneumothorax as the cause of his hypotension? - breath sounds
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Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
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endotracheal intubation because: - The trachea is relatively short.
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A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
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and is brought by ambulance to a hospital that has full surgical capabilities. His wounds are
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all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
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performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does not
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reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160
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and answers Updated 2024/25
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left
ii ii ii ii ii ii ii ii ii ii ii ii ii
shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
blood pressure increases to 122/84 mm Hg. His heart rate is now 100 beats per minute and
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
his respiratory rate is 28 breaths per minute. A tube thoracostomy is performed for
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
decreased left chest breath sounds with the return of a small amount of blood and no air
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
leak. After chest tube insertion, the most appropriate next step is: - re-examine the chest
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A construction worker falls two stories from a building and sustains bilateral calcaneal
ii ii ii ii ii ii ii ii ii ii ii ii ii
fractures. In the emergency department, he is alert, vital signs are normal, and he is
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
complaining of severe pain in both heels and his lower back. Lower extremity pulses are
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
strong and there is no other deformity. The suspected diagnosis is most likely to be
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
confirmed by: - complete spine x-ray series
ii ii ii ii ii ii ii ii ii ii
Which of the following is true regarding the initial resuscitation of a trauma patient? -
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
Evidence of improved perfusion after fluid resuscitation could include improvement in
ii ii ii ii ii ii ii ii ii ii ii
Glasgow Coma Scale score on reevaluation.
ii ii ii ii ii ii
In managing a patient with a severe traumatic brain injury, the most important initial step is
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
to: - secure the airway
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A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2
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liters. Which one of the following statements applies to this patient? - An ABG would
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demonstrate a base deficit between -6 and -10 mEq/L.
ii ii ii ii ii ii ii ii ii
The physiological hypervolemia of pregnancy has clinical significance in the management
ii ii ii ii ii ii ii ii ii ii ii
of the severely injured, gravid woman by: - increasing the volume of blood loss to produce
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
maternal hypotension
ii ii
The best assessment of fluid resuscitation of the adult burn patient is: - urinary output of
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
0.5 mL/kg/hr
ii ii
ii The diagnosis of shock must include: - evidence of inadequate organ perfusion
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A 7-year-old boy is brought to the emergency department by his parents several minutes
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after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
right thigh. Immediate management of the wound should consist of: - direct pressure on
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
the wound
ii ii
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided
ii ii ii ii ii ii ii ii ii ii ii ii ii
to prevent: - cerebral vasoconstriction with diminished perfusion
ii ii ii ii ii ii ii ii ii ii ii
, After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
that has surgery capabilities available.. Computed tomography of the chest and abdomen
ii ii ii ii ii ii ii ii ii ii ii ii
shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
falls to 70 mm Hg after CT. The next step is: - perform an exploratory laparotomy
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
Which one of the following statements regarding abdominal trauma in the pregnant patient
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is TRUE? - Leakage of amniotic fluid is an indication for hospital admission.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
The first maneuver to improve oxygenation after chest injury is: - administer
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
supplemental oxygen
ii ii
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
department. His pupils react sluggishly and his eyes open to pressure. He does not follow
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
commands, but he does moan periodically. His right arm is deformed and does not
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
respond to pressure; however, his left hand reaches purposefully toward the stimulus.
ii ii ii ii ii ii ii ii ii ii ii ii
Both legs are stiffly extended. His GCS score is: - 9
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A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
the emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath,
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
extremely anxious, and yelling for help. Breath sounds are diminished in the right chest.
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
The most appropriate first step is to: - perform needle or finger decompression of the right
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
chest
ii
Which one of the following findings in an adult is most likely to require immediate
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
management during the primary survey? - respiratory rate of 40 breaths per minute
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
The most important, immediate step in the management of an open pneumothorax is: -
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
placement of an occlusive dressing over the wound
ii ii ii ii ii ii ii ii
The following are contraindications for tetanus toxoid administration: - history of
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
neurological reaction or severe hypersensitivity to the product
ii ii ii ii ii ii ii ii
A 56-year-old man is thrown violently against the steering wheel of his truck during a motor
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
vehicle crash. On arrival in the emergency department he is diaphoretic and complaining
ii ii ii ii ii ii ii ii ii ii ii ii ii
of chest pain. His blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
minute. Which of the following best differentiates cardiac tamponade from tension
ii ii ii ii ii ii ii ii ii ii ii
pneumothorax as the cause of his hypotension? - breath sounds
ii ii ii ii ii ii ii ii ii ii ii ii ii
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
ii ii ii ii ii ii ii ii ii ii ii ii ii ii
endotracheal intubation because: - The trachea is relatively short.
ii ii ii ii ii ii ii ii ii ii ii ii
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
and is brought by ambulance to a hospital that has full surgical capabilities. His wounds are
ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii ii
all above the nipple. He is endotracheally intubated, closed tube thoracostomy is
ii ii ii ii ii ii ii ii ii ii ii ii
performed, fluid resuscitation is initiated through 2 large-caliber IVs. FAST exam does not
ii ii ii ii ii ii ii ii ii ii ii ii ii
reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160
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