ATLS exam questions with correct answers
A 23-year-old man is brought immediately to the ED from the hospitals parking lot where he
was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing
and has a thready pulse. However, he is unconsious and has no detectable blood pressure.
Optimale immediate management is to:
A. Perform a FAST
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - verified answers; D.
Transfer the patient to the operating room, while initiating fluid therapy
A 22 year old male present following a motorcycle crash. He complains of the inability to
move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal
prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His
management should be:
A: 1L of iv . crystalloid and two units of pRBCs
B. 1L of iv. crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
D. Vasopressors and laparotomy
E. 1 L of cystalloid and vasopressors if blood pressure does not respond - verified answers; E. 1
L of cystalloid and vasopressors if blood pressure does not respond
Which of the following is MOST RELIABLE to confirm endotracheal intubation?
a. presence of breath sounds bilaterally
, b. absence of borborygmi in the epigatrium on ascultation
c. presence of CO2 in exhaled air via capnography
d. appearance of fog in the endotracheal tube
e. chest xray with endotracheal tube tip appearing above the carina - verified answers; e.
chest xray with endotracheal tube tip appearing above the carina
A 6 month old infant, being held in her mothers arms, is ejected on impact from a vehicle that
is struck head on by an oncoming car traveling at 64kph. The infant arrives in the ED with
multiple facial injuries, is lethargic, and is in severe respiratoy distress. Respiratory support is
not effective using a bag mask device, and her oxygen saturation is falling. Repeated attempts
at orotracheal intubation are unsuccessful. the most appropriate procedure to perform next
is:
A.Administer heliox and racemic epinephrine
B. Perform nasotracheal intubation
C.Perform surgical cricothyroidotomy
D.Repeat orotracheal intubation
E. Perform needle cricothyroidotomy with jet insufflation - verified answers; E. Perform
needle cricothyroidotomy with jet insufflation
A 28 year olf male is brought to the ED. He was involved in a fight, during which he was
beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear, resp
rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the following
should be performed during the primary survey
a. glasgow coma
b. tetanus status
c. cervical spine xray
d. blood alcohol level
e. rectal exam - verified answers; a. glasgow coma
A 23-year-old man is brought immediately to the ED from the hospitals parking lot where he
was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing
and has a thready pulse. However, he is unconsious and has no detectable blood pressure.
Optimale immediate management is to:
A. Perform a FAST
B. Initiate infusion of packed red blood cells
C. Insert a nasogastric tube and urinary catheter
D. Transfer the patient to the operating room, while initiating fluid therapy
E. Initiate fluid therapy to return his blood pressure to normotensive - verified answers; D.
Transfer the patient to the operating room, while initiating fluid therapy
A 22 year old male present following a motorcycle crash. He complains of the inability to
move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal
prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His
management should be:
A: 1L of iv . crystalloid and two units of pRBCs
B. 1L of iv. crystalloid, mannitol and iv steroids
C. 1 unit of albumin and compression stockings
D. Vasopressors and laparotomy
E. 1 L of cystalloid and vasopressors if blood pressure does not respond - verified answers; E. 1
L of cystalloid and vasopressors if blood pressure does not respond
Which of the following is MOST RELIABLE to confirm endotracheal intubation?
a. presence of breath sounds bilaterally
, b. absence of borborygmi in the epigatrium on ascultation
c. presence of CO2 in exhaled air via capnography
d. appearance of fog in the endotracheal tube
e. chest xray with endotracheal tube tip appearing above the carina - verified answers; e.
chest xray with endotracheal tube tip appearing above the carina
A 6 month old infant, being held in her mothers arms, is ejected on impact from a vehicle that
is struck head on by an oncoming car traveling at 64kph. The infant arrives in the ED with
multiple facial injuries, is lethargic, and is in severe respiratoy distress. Respiratory support is
not effective using a bag mask device, and her oxygen saturation is falling. Repeated attempts
at orotracheal intubation are unsuccessful. the most appropriate procedure to perform next
is:
A.Administer heliox and racemic epinephrine
B. Perform nasotracheal intubation
C.Perform surgical cricothyroidotomy
D.Repeat orotracheal intubation
E. Perform needle cricothyroidotomy with jet insufflation - verified answers; E. Perform
needle cricothyroidotomy with jet insufflation
A 28 year olf male is brought to the ED. He was involved in a fight, during which he was
beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear, resp
rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the following
should be performed during the primary survey
a. glasgow coma
b. tetanus status
c. cervical spine xray
d. blood alcohol level
e. rectal exam - verified answers; a. glasgow coma
