ATLS EXAM QUESTIONS AND ANSWERS 2024/25
UPDATE ALL ANSWERS CORRECT
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 ANSWERS 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 deformity. The
suspected diagnosis is most likely to be confirmed by: - CORRECT ANSWERS
complete spine x-ray series
What is true regarding the initial resuscitation of a trauma patient? - CORRECT
ANSWERS 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 ANSWERS secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood
loss of 2 liters. What applies to this patient? - CORRECT ANSWERS 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 ANSWERS
increasing the volume of blood loss to produce maternal hypotension.
,The best assessment of fluid resuscitation of the adult burn patient is: -
CORRECT ANSWERS urinary output of 0.5 mL/kg/hr
The diagnosis of shock must include: - CORRECT ANSWERS 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 ANSWERS direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should
be avoided to prevent: - CORRECT ANSWERS 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 ANSWERS perform an exploratory laparotomy
What statements regarding abdominal trauma in the pregnant patient is TRUE?
- CORRECT ANSWERS Leakage of amniotic fluid is an indication for hospital
admission.
The first maneuver to improve oxygenation after chest injury is: - CORRECT
ANSWERS 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 ANSWERS 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 ANSWERS perform needle or finger decompression of the right chest
What findings in an adult is most likely to require immediate management
during the primary survey? - CORRECT ANSWERS respiratory rate of 40 breaths
per minute
The most important, immediate step in the management of an open
pneumothorax is: - CORRECT ANSWERS placement of an occlusive dressing
over the wound
The following are contraindications for tetanus toxoid administration: -
CORRECT ANSWERS history of neurological reaction or severe hypersensitivity
to the product
A 56-year-old man is thrown violently against the steering wheel of his truck
during a motor vehicle crash. On arrival in the emergency department he is
diaphoretic and complaining of chest pain. His blood pressure is 60/40 mm Hg
and his respiratory rate is 40 breaths per minute. What best differentiates
cardiac tamponade from tension pneumothorax as the cause of his
hypotension? - CORRECT ANSWERS breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur
during infant endotracheal intubation because: - CORRECT ANSWERS The
trachea is relatively short.
A 23-year-old man sustains 4 stab wounds to the upper right chest during an
altercation and is brought by ambulance to a hospital that has full surgical
capabilities. His wounds are all above the nipple. He is endotracheally
intubated, closed tube thoracostomy is performed, fluid resuscitation is
, initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal
injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per
minute, and respiratory rate is 14 breaths per minute (ventilated with 100%
O2). 1500 mL of blood has drained from the right chest. The most appropriate
next step in managing this patient is to: - CORRECT ANSWERS urgently transfer
the patient to the operating room
A 39-year-old man is admitted to the emergency department after an
automobile collision. He is cyanotic, has insufficient respiratory effort, and has
a GCS score of 6. His full beard makes it difficult to fit the oxygen facemask to
his face. The most appropriate next step is to: - CORRECT ANSWERS restrict
cervical motion and attempt orotracheal intubation using 2 people
A patient is brought to the emergency department after a motor vehicle crash.
He is conscious and there is no obvious external trauma. He arrives at the
hospital completely immobilized on a long spine board. His blood pressure is
60/40 mm Hg and his heart rate is 70 beats per minute. His skin is warm. What
do you expect to see with the patient? - CORRECT ANSWERS Flaccidity of the
lower extremities and loss of deep tendon reflexes are expected.
What is the most effective method for initially treating frostbite? - CORRECT
ANSWERS Moist heat
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2
hours before he is extricated. On arrival in the emergency department, his right
lower extremity is cool, mottled, insensate, and motionless. Despite normal
vital signs, pulses cannot be palpated below the right femoral artery and the
muscles of the lower extremity are firm and hard. During the management of
this patient, what is most likely to improve the chances for limb salvage? -
CORRECT ANSWERS surgical consultation for right lower extremity fasciotomy
A patient arrives in the emergency department after being beaten about the
head and face with a wooden club. He is comatose and has a palpable
depressed skull fracture. His face is swollen and ecchymotic. He has gurgling
respirations and vomitus on his face and clothing. The most appropriate step
UPDATE ALL ANSWERS CORRECT
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 ANSWERS 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 deformity. The
suspected diagnosis is most likely to be confirmed by: - CORRECT ANSWERS
complete spine x-ray series
What is true regarding the initial resuscitation of a trauma patient? - CORRECT
ANSWERS 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 ANSWERS secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood
loss of 2 liters. What applies to this patient? - CORRECT ANSWERS 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 ANSWERS
increasing the volume of blood loss to produce maternal hypotension.
,The best assessment of fluid resuscitation of the adult burn patient is: -
CORRECT ANSWERS urinary output of 0.5 mL/kg/hr
The diagnosis of shock must include: - CORRECT ANSWERS 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 ANSWERS direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should
be avoided to prevent: - CORRECT ANSWERS 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 ANSWERS perform an exploratory laparotomy
What statements regarding abdominal trauma in the pregnant patient is TRUE?
- CORRECT ANSWERS Leakage of amniotic fluid is an indication for hospital
admission.
The first maneuver to improve oxygenation after chest injury is: - CORRECT
ANSWERS 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 ANSWERS 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 ANSWERS perform needle or finger decompression of the right chest
What findings in an adult is most likely to require immediate management
during the primary survey? - CORRECT ANSWERS respiratory rate of 40 breaths
per minute
The most important, immediate step in the management of an open
pneumothorax is: - CORRECT ANSWERS placement of an occlusive dressing
over the wound
The following are contraindications for tetanus toxoid administration: -
CORRECT ANSWERS history of neurological reaction or severe hypersensitivity
to the product
A 56-year-old man is thrown violently against the steering wheel of his truck
during a motor vehicle crash. On arrival in the emergency department he is
diaphoretic and complaining of chest pain. His blood pressure is 60/40 mm Hg
and his respiratory rate is 40 breaths per minute. What best differentiates
cardiac tamponade from tension pneumothorax as the cause of his
hypotension? - CORRECT ANSWERS breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur
during infant endotracheal intubation because: - CORRECT ANSWERS The
trachea is relatively short.
A 23-year-old man sustains 4 stab wounds to the upper right chest during an
altercation and is brought by ambulance to a hospital that has full surgical
capabilities. His wounds are all above the nipple. He is endotracheally
intubated, closed tube thoracostomy is performed, fluid resuscitation is
, initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal
injuries. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per
minute, and respiratory rate is 14 breaths per minute (ventilated with 100%
O2). 1500 mL of blood has drained from the right chest. The most appropriate
next step in managing this patient is to: - CORRECT ANSWERS urgently transfer
the patient to the operating room
A 39-year-old man is admitted to the emergency department after an
automobile collision. He is cyanotic, has insufficient respiratory effort, and has
a GCS score of 6. His full beard makes it difficult to fit the oxygen facemask to
his face. The most appropriate next step is to: - CORRECT ANSWERS restrict
cervical motion and attempt orotracheal intubation using 2 people
A patient is brought to the emergency department after a motor vehicle crash.
He is conscious and there is no obvious external trauma. He arrives at the
hospital completely immobilized on a long spine board. His blood pressure is
60/40 mm Hg and his heart rate is 70 beats per minute. His skin is warm. What
do you expect to see with the patient? - CORRECT ANSWERS Flaccidity of the
lower extremities and loss of deep tendon reflexes are expected.
What is the most effective method for initially treating frostbite? - CORRECT
ANSWERS Moist heat
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2
hours before he is extricated. On arrival in the emergency department, his right
lower extremity is cool, mottled, insensate, and motionless. Despite normal
vital signs, pulses cannot be palpated below the right femoral artery and the
muscles of the lower extremity are firm and hard. During the management of
this patient, what is most likely to improve the chances for limb salvage? -
CORRECT ANSWERS surgical consultation for right lower extremity fasciotomy
A patient arrives in the emergency department after being beaten about the
head and face with a wooden club. He is comatose and has a palpable
depressed skull fracture. His face is swollen and ecchymotic. He has gurgling
respirations and vomitus on his face and clothing. The most appropriate step
