POST TEST ATLS FINAL PAPER 2026 FULL
STUDY GUIDE
◉ Which of the following statements is FALSE concerning Rh-
isoimmunization in the pregnant trauma patient?
A. It occurs in blunt or penetrating abdominal trauma
B. Minor degrees of fetomaternal hemorrhage produce it
C. A negative Kleihauer-Betke test excludes Rh-Isoimmunzation
D. This is not a problem in the traumatized Rh-positive pregnant
patient
E. Initiation of Rh-immunoglobulin therapy does not require proof of
fetomaternal hemorrhage. Answer: C. A negative Kleihauer-Betke
test excludes Rh-Isoimmunzation
◉ All of the following signs on the chest x-ray of a blunt injury victim
may suggest aortic rupture EXCEPT:
A. Mediastinal emphysema
B. Presence of a "pleural cap"
C. Obliteration of the aortic knob
D. Deviation of the trachea to the right
E. Depression of the left mainstem bronchus. Answer: A. Mediastinal
emphysema
,◉ Early central venous pressure monitoring during fluid
resusciation in the ED has the greatest utility in a:
A. Patient with a splenic laceration
B. Patient with a inhalation injury
C. 6 year-old child with a pelvic fracture
D. Patient with a severe cardiac contusion
E. 24-year-old man with a massive hemothorax. Answer: D. Patient
with a severe cardiac contusion
◉ A cross-table lateral x-ray of the cervical spine:
A. must precede endotracheal intubation
B. excludes serious cervical spine injury
C. Is an essential part of the primary survey
D. Is not necessary for unconscious patients with penetrating
cervical injuries
E. Is unacceptable unless 7 cervical vertebrae and the C-7 to T-1
relationship are visualized.. Answer: E. Is unacceptable unless 7
cervical vertebrae and the C-7 to T-1 relationship are visualized.
◉ A 24-year old man sustains multiple fractured ribs bilaterally as a
result of being crushed in a press at a plywood factory. Examination
in the ED reveals a flail segment of the patients thorax. Primary
resuscitation includes high-flow oxygen administration via a
nonrebreathing mask, and initiation of Ringers lactate solution. The
,patient exhibits progressive confusion, cyanosis and tachypnea.
Management at this time should consist of:
A. Intravenous sedation
B. External stabilization of the chest wall
C. Increasing the FIO2 in the inspired gas
D. Intercostal nerve blocks for pain relief
E. Endotracheal intubation and mechanical ventilation.. Answer: E.
Endotracheal intubation and mechanical ventilation
◉ Which of the following statements regarding patients with
thoracic spine injuries is TRUE?
A. Log-rolling may be destabilizing to fractures from T12 to L1
B. Adequate immobilization can be accomplished with the scoop
stretcher
C. Spinal cord injury below T10 usually spares bowel and bladder
function
D. Hyperflexion fractures in the upper thoracic spine are inherently
unstable
E. These patients rarely present with neurogenic shock in
association with cord injury.. Answer: A. Log-rolling may be
destabilizing to fractures from T12 to L1
◉ During resuscitation, which one of the following is the most
reliable as a guide to volume replacement?
, A. Heart rate
B. Hematocrit
C. Blood pressure
D. Urinary output
E. Jugular venous pressure. Answer: D. Urinary out
◉ A 24-year-old woman passenger in an automobile strikes the
wind screen with her face during a head-on collision. In the ED, she
is talking and has marked facial edema and crepitus. The highest
priority should be given to:
A. Lateral c-spine x-ray
B. Upper airway protection
C. Carotid pulse assessment
D. Management of blod loss
E. Determination of associated injuries. Answer: B. Upper airway
protection
◉ The driver of a single car crash is orotracheally intubated in the
field by prehospital personnel after they identify a closed head
injury and determine that the patient is unable to protect his airway.
In the ED, the patient demonstrate decorticate posturing bilaterally.
He is being ventilated with a bag-valve device, but his breath sounds
are absent in the left hemithorax. His blood pressure is
160/80mmHg, heart rate is 70 beats per minute, and the pulse
STUDY GUIDE
◉ Which of the following statements is FALSE concerning Rh-
isoimmunization in the pregnant trauma patient?
A. It occurs in blunt or penetrating abdominal trauma
B. Minor degrees of fetomaternal hemorrhage produce it
C. A negative Kleihauer-Betke test excludes Rh-Isoimmunzation
D. This is not a problem in the traumatized Rh-positive pregnant
patient
E. Initiation of Rh-immunoglobulin therapy does not require proof of
fetomaternal hemorrhage. Answer: C. A negative Kleihauer-Betke
test excludes Rh-Isoimmunzation
◉ All of the following signs on the chest x-ray of a blunt injury victim
may suggest aortic rupture EXCEPT:
A. Mediastinal emphysema
B. Presence of a "pleural cap"
C. Obliteration of the aortic knob
D. Deviation of the trachea to the right
E. Depression of the left mainstem bronchus. Answer: A. Mediastinal
emphysema
,◉ Early central venous pressure monitoring during fluid
resusciation in the ED has the greatest utility in a:
A. Patient with a splenic laceration
B. Patient with a inhalation injury
C. 6 year-old child with a pelvic fracture
D. Patient with a severe cardiac contusion
E. 24-year-old man with a massive hemothorax. Answer: D. Patient
with a severe cardiac contusion
◉ A cross-table lateral x-ray of the cervical spine:
A. must precede endotracheal intubation
B. excludes serious cervical spine injury
C. Is an essential part of the primary survey
D. Is not necessary for unconscious patients with penetrating
cervical injuries
E. Is unacceptable unless 7 cervical vertebrae and the C-7 to T-1
relationship are visualized.. Answer: E. Is unacceptable unless 7
cervical vertebrae and the C-7 to T-1 relationship are visualized.
◉ A 24-year old man sustains multiple fractured ribs bilaterally as a
result of being crushed in a press at a plywood factory. Examination
in the ED reveals a flail segment of the patients thorax. Primary
resuscitation includes high-flow oxygen administration via a
nonrebreathing mask, and initiation of Ringers lactate solution. The
,patient exhibits progressive confusion, cyanosis and tachypnea.
Management at this time should consist of:
A. Intravenous sedation
B. External stabilization of the chest wall
C. Increasing the FIO2 in the inspired gas
D. Intercostal nerve blocks for pain relief
E. Endotracheal intubation and mechanical ventilation.. Answer: E.
Endotracheal intubation and mechanical ventilation
◉ Which of the following statements regarding patients with
thoracic spine injuries is TRUE?
A. Log-rolling may be destabilizing to fractures from T12 to L1
B. Adequate immobilization can be accomplished with the scoop
stretcher
C. Spinal cord injury below T10 usually spares bowel and bladder
function
D. Hyperflexion fractures in the upper thoracic spine are inherently
unstable
E. These patients rarely present with neurogenic shock in
association with cord injury.. Answer: A. Log-rolling may be
destabilizing to fractures from T12 to L1
◉ During resuscitation, which one of the following is the most
reliable as a guide to volume replacement?
, A. Heart rate
B. Hematocrit
C. Blood pressure
D. Urinary output
E. Jugular venous pressure. Answer: D. Urinary out
◉ A 24-year-old woman passenger in an automobile strikes the
wind screen with her face during a head-on collision. In the ED, she
is talking and has marked facial edema and crepitus. The highest
priority should be given to:
A. Lateral c-spine x-ray
B. Upper airway protection
C. Carotid pulse assessment
D. Management of blod loss
E. Determination of associated injuries. Answer: B. Upper airway
protection
◉ The driver of a single car crash is orotracheally intubated in the
field by prehospital personnel after they identify a closed head
injury and determine that the patient is unable to protect his airway.
In the ED, the patient demonstrate decorticate posturing bilaterally.
He is being ventilated with a bag-valve device, but his breath sounds
are absent in the left hemithorax. His blood pressure is
160/80mmHg, heart rate is 70 beats per minute, and the pulse
