ATLS Post Test | 10th Edition | Updated
2025/2026 | 75 Verified MCQs with 100%
Correct Answers | Advanced Trauma Life
Support | Graded A+
E. The associated brain damage is more severe in epidural hematomas - answersA.
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 - answersA. Obtain a portable chest x-ray
need more info on chest, not abdomen
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 - answersD. 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
,E. Repeat the physical exam of the chest - answersE. Repeat the physical exam of the
chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle
decompression followed by tube
Which one of the following statements concerning spine and spinal cord trauma is
TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine
injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be
made in the primary survey - answersB. A vertebral injury is unlikely in the absence of
physical findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is
unresponsive and found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST
step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - answersD. Applying oxygen and
maintaining airway
First = ABCs
Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure - answersE. Decreased pulse pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a ladder
and landing straddled on a fence. Examination of his perineum reveals extensive
ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study
for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography - answersE. retrograde urethrography
, -> any ecchymosis, needs to be done before catheter!
A 30 year old male presents after a MVC. Vitals are RR 18, HR 88, BP 130/72, GCS
13. Laparatomy is indicated when:
A. There is a distinct seat belt sign over the abdomen
B. The CT demonstrates a grade 4 hepatic injury
C. There is evidence of extraperitoneal bladder injury
D. CT demonstrates retroperitoneal air
E. The abdomen is distended with localized rihgt upper quadrant tenderness -
answersD. CT demonstrates retroperitoneal air
-> air, peritonitis (tenderness, rigidity), unstable vital signs
A 20 year old male is brought to the hospital approximately 30 minutes after being
stabbed in the chest. There is 3 cm wound just medial to the left nipple. BP is 70/33 and
HR is 140. Neck and arm veins are distended. Breath sounds are normal. Heart sounds
are diminished, IV access is established and warm crystalloid is infusing. The next most
important aspect of immediate management is:
A. CT Chest
B. EKG
C. Left tube thoracostomy
D. RBC infusion
E. FAST exam - answersE. FAST exam
Tamponade: muffled heart sounds, JVD, and hypotension -> FAST cardiac exam
Will require pericardiocentesis
Neurogenic shock has all of the following characteristics except which one?
A. hypotension
B. vasodilation
C. bradycardia
D. neurologic deficit
E. narrowed pulse pressure - answersE. narrowed pulse pressure
always the answer :)
A 30 year old male sustains a gunshot wound to the right lower chest, midway between
the nipple and the costal margin. He is brought by ambulance to a hospital with full
surgical capabilities. In the ED, he is endotracheally intubated, 2 L of crystalloid is
infused rapidly, and a closed tube thoracostomy is performed with the return of 200 mL
of blood. A CXR reveals correct placement of the chest tube and a small residual
hemothorax. His BP is now 70/50 and HR 140. The most appropriate next step is:
A. Insert a second chest tube
B. Obtain CT Abd
C. Perform a thoracotomy in the ED
D. Perform a laporotomy in the OR
E. Perform a FAST exam - answersE. Perform a FAST exam
-> needs more CHEST exploration not abdomen, so FAST of chest
2025/2026 | 75 Verified MCQs with 100%
Correct Answers | Advanced Trauma Life
Support | Graded A+
E. The associated brain damage is more severe in epidural hematomas - answersA.
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 - answersA. Obtain a portable chest x-ray
need more info on chest, not abdomen
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 - answersD. 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
,E. Repeat the physical exam of the chest - answersE. Repeat the physical exam of the
chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle
decompression followed by tube
Which one of the following statements concerning spine and spinal cord trauma is
TRUE?
A. A normal lateral C spine film excludes injury
B. A vertebral injury is unlikely in the absence of physical findings of a cord injury
C. A patient with a suspected spine injury requires immobilization on a short spine
D. Diaphragmatic breathing in an unconscious patient who has fallen is a sign of spine
injury
E. Determination of whether a spinal cord lesion is complete or incomplete must be
made in the primary survey - answersB. A vertebral injury is unlikely in the absence of
physical findings of a cord injury
A 17 year old female is brought to the ED following a 6 feet fall onto concrete. She is
unresponsive and found to have a RR of 32, BP of 90/60, and HR of 68. The FIRST
step in treatment is:
A. Administering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - answersD. Applying oxygen and
maintaining airway
First = ABCs
Signs and symptoms of airway compromise include all of the following except:
A. Change in voice
B. Stridor
C. Tachypea
D. Dyspnea and agitation
E. Decreased pulse pressure - answersE. Decreased pulse pressure
A 47 year old house painter is brought to the hospital after falling 20 feet from a ladder
and landing straddled on a fence. Examination of his perineum reveals extensive
ecchymosis. There is blood in the external urethral meatus. The initial diagnostic study
for the evaluation of the urinary tract should be:
A. cystoscopy
B. cystography
C. intravenous pyelography
D. CT scan
E. retrograde urethrography - answersE. retrograde urethrography
, -> any ecchymosis, needs to be done before catheter!
A 30 year old male presents after a MVC. Vitals are RR 18, HR 88, BP 130/72, GCS
13. Laparatomy is indicated when:
A. There is a distinct seat belt sign over the abdomen
B. The CT demonstrates a grade 4 hepatic injury
C. There is evidence of extraperitoneal bladder injury
D. CT demonstrates retroperitoneal air
E. The abdomen is distended with localized rihgt upper quadrant tenderness -
answersD. CT demonstrates retroperitoneal air
-> air, peritonitis (tenderness, rigidity), unstable vital signs
A 20 year old male is brought to the hospital approximately 30 minutes after being
stabbed in the chest. There is 3 cm wound just medial to the left nipple. BP is 70/33 and
HR is 140. Neck and arm veins are distended. Breath sounds are normal. Heart sounds
are diminished, IV access is established and warm crystalloid is infusing. The next most
important aspect of immediate management is:
A. CT Chest
B. EKG
C. Left tube thoracostomy
D. RBC infusion
E. FAST exam - answersE. FAST exam
Tamponade: muffled heart sounds, JVD, and hypotension -> FAST cardiac exam
Will require pericardiocentesis
Neurogenic shock has all of the following characteristics except which one?
A. hypotension
B. vasodilation
C. bradycardia
D. neurologic deficit
E. narrowed pulse pressure - answersE. narrowed pulse pressure
always the answer :)
A 30 year old male sustains a gunshot wound to the right lower chest, midway between
the nipple and the costal margin. He is brought by ambulance to a hospital with full
surgical capabilities. In the ED, he is endotracheally intubated, 2 L of crystalloid is
infused rapidly, and a closed tube thoracostomy is performed with the return of 200 mL
of blood. A CXR reveals correct placement of the chest tube and a small residual
hemothorax. His BP is now 70/50 and HR 140. The most appropriate next step is:
A. Insert a second chest tube
B. Obtain CT Abd
C. Perform a thoracotomy in the ED
D. Perform a laporotomy in the OR
E. Perform a FAST exam - answersE. Perform a FAST exam
-> needs more CHEST exploration not abdomen, so FAST of chest
