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ATLS POST TEST 2025 UPDATED
ACTUAL EXAM WITH CORRECT
SOLUTIONS.
A 22 year old male is brought by ambulance to a small
community hospital after falling from the top of an 8 foot ladder.
Initially, he was found to have a large right pneumothorax. A
chest tube was inserted and connected to an underwater seal
drainage collection system with negative pressure. A repeat
CXR demonstrates a residual, large right pneumothorax. After
transferring the patient to a verified trauma center, a third chest
x-ray reveals a persistent right pneumothorax. The chest tube
appears to be functioning and in good position. He remains
hemodynamically normal with no signs of respiratory distress.
The most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury - correct answer- E.
Tracheobronchial injury
Which of the following is LEAST reliable for diagnosing
ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
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D. oxygen saturation >92%
E. ETT above carina on chest x-ray - correct answer- D.
oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Which of the following signs necessitates the need for a
definitive airway in severe trauma patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12 - correct answer- C. Severe maxillofacial trauma
Twenty seven people are severely injured in an aircraft crash at
a local airport. The principles of triage include:
A. establish a triage site within the internal perimeter of the
crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of
time
E. produce the greatest number of survivors based on available
resources - correct answer- E. Produce the greatest number of
survivors based on available resources
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Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral
hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle
meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural
hematomas - correct answer- A. Cerebral contusions may
coalesce to form an intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He
has one bullet wound just below the right clavicle and another
just below the costal margin in the right posterior axillary line.
His blood pressure is 110/60, heart rate of 90, and respiratory
rate of 34. After ensuring a patent airway and inserting 2 large
caliber IV lines, the next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage - correct answer- A.
Obtain a portable chest x-ray
need more info on chest, not abdomen
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Which of the following should be performed FIRST in any
patient whose injuries may include multiple closed extremity
fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - correct answer- D.
Ensuring adequate oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder
and chest at close range. His BP is 80/40 and HR 130. After 2 L
of crystalloid solution are rapidly infused, his BP increases to
122/84 and HR decreases to 100. He is tachypneic with RR of
28. On PE, his breath sounds are decreased at the left upper
chest with dullness on percussion. A large caliber tube
thoracostomy is inserted into the fifth intercostal space with the
return of 200 mL of blood and no air leak. The most appropriate
next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
ATLS POST TEST 2025 UPDATED
ACTUAL EXAM WITH CORRECT
SOLUTIONS.
A 22 year old male is brought by ambulance to a small
community hospital after falling from the top of an 8 foot ladder.
Initially, he was found to have a large right pneumothorax. A
chest tube was inserted and connected to an underwater seal
drainage collection system with negative pressure. A repeat
CXR demonstrates a residual, large right pneumothorax. After
transferring the patient to a verified trauma center, a third chest
x-ray reveals a persistent right pneumothorax. The chest tube
appears to be functioning and in good position. He remains
hemodynamically normal with no signs of respiratory distress.
The most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury - correct answer- E.
Tracheobronchial injury
Which of the following is LEAST reliable for diagnosing
ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
,2 | Page
D. oxygen saturation >92%
E. ETT above carina on chest x-ray - correct answer- D.
oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Which of the following signs necessitates the need for a
definitive airway in severe trauma patient?
A. facial lacerations
B. repeated vomiting
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12 - correct answer- C. Severe maxillofacial trauma
Twenty seven people are severely injured in an aircraft crash at
a local airport. The principles of triage include:
A. establish a triage site within the internal perimeter of the
crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of
time
E. produce the greatest number of survivors based on available
resources - correct answer- E. Produce the greatest number of
survivors based on available resources
,3 | Page
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral
hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle
meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural
hematomas - correct answer- A. Cerebral contusions may
coalesce to form an intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He
has one bullet wound just below the right clavicle and another
just below the costal margin in the right posterior axillary line.
His blood pressure is 110/60, heart rate of 90, and respiratory
rate of 34. After ensuring a patent airway and inserting 2 large
caliber IV lines, the next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage - correct answer- A.
Obtain a portable chest x-ray
need more info on chest, not abdomen
, 4 | Page
Which of the following should be performed FIRST in any
patient whose injuries may include multiple closed extremity
fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - correct answer- D.
Ensuring adequate oxygenation and ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder
and chest at close range. His BP is 80/40 and HR 130. After 2 L
of crystalloid solution are rapidly infused, his BP increases to
122/84 and HR decreases to 100. He is tachypneic with RR of
28. On PE, his breath sounds are decreased at the left upper
chest with dullness on percussion. A large caliber tube
thoracostomy is inserted into the fifth intercostal space with the
return of 200 mL of blood and no air leak. The most appropriate
next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
