ATLS POST TEST 2025-2026 Exam | Complete
Questions and Correct Answers | Brand New
Version!
A 47 year old house painter is brought to the hospital after falling 6 meters from a ladder
and landing straddled on a fence. Examination of his perineum reveals extensive
ecchymosis. There is blood in the external urethreal meatus. The initial diagnostic study
for evaluation of the urinary tract in this patient should be:
A. Cystoscopy
B. Cystography
C. IV pyelography
D. CT scan
E. Retrograde urethrography - __100% correct answer as E. Retrograde
urethrography
Neurogenic shock has all of the following classic characteristics except which one:
A. Hypotension
B. Vasodilatation
C. Bradycardia
D. Neurologic deficit
E. Narrowed pulse pressure - __100% correct answer as E. Narrowed pulse
pressure
Which one 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. Maneuvers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - __100% correct answer as D. Ensuring
adequate oxygenation and ventilation
Which of the following is the recommended Method for treatment frostbite?
A. Vasodilators
B. Anticigulants
C. Warm (40 degrees) water
D. Padding and elevation
E. Application of heat from a hairdryer - __100% correct answer as C. Warm (40
degrees) water
,Which of the following physical findings suggest a cause of hypotension other than
spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them - __100% correct answer as D.
Presence of deep tendon reflexes. Spinal shock refers to loss of muscle toe (flaccidty)
and loss of reflexes.
The primary indication for transferring A patient to a higher level trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma - __100% correct
answer as C. Resource limitations as determined by the transferring doctor
A young man sustains a rifle wound to the mid-abdomen. He is brought promptly to the
ED by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood
pressure is 58mmHg. Warmed crystalloid fluids are initiated without improvement in his
vital signs. The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage - __100% correct answer as A. Laparotomy
because of hemodynamic abnormality
A 42-year-old man is trapped from the waist down beneath his overturned tractor for
several hours before medical assistance arrives. He is awake and alert until just before
arriving in the ED. He is now unconscious and responds only to painful stimuli by
moaning. His pupils are 3mm in diameter and symmetrically reactive to light.
Prehospital personnel indicate that they have not seen the patient move either of his
lower extremities. On examination in the ED, no movement of his lower extremities are
detected, even in response to painful stimuli. The most likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome - __100% correct answer as E. Bilateral
compartment syndrome
A 6-year-o boy is struck by an automobile and brought to the ED. He is lethargic, but
withdraws purposefully from painful stimuli. His blood pressure is 90mmHg systolic,
,heart rate 140 beats per minute and his respiratory rate is 36 breaths per minute. The
preferred route of venous access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein - __100% correct
answer as D. Percutaneous peripheral veins in the upper extremities
A young man sustains a gunshot wound to the abdomen and is brought promptly to the
ED by prehospital personnel. His skin is cool and diaphoretic, and he is confused. His
pulse is thready and his femoral pulse is only weakly palpable. The definitive treatment
in managing this patient is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions. - __100% correct
answer as C. Control internal hemorrhage operatively
Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the same as in
adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg Ringers Lactate -
__100% correct answer as D. The absolute volume of blood loss required to
produce shock is the same as in adults
A 33-year-old man is struck by a car travelling at 56km/h (35mph). He has obvious
fractures of the left tibia near the knee, pain in the pelvic area, and severe dyspnea. His
heart rate is 182 beats per minute, and his respiratory rate is 48 breaths per minute with
no breath sounds heard in the left chest. A tension pneumothorax is relieved by
immediate needle decompression and tube thoracostomy. Subsequently, his heart rate
decreases to 144 beats per minute, his respirartory rate decreases to 36 breaths per
minute and his blood pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered
intravenously. The next priority should be to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
C. Perform arterial embolization of the pelvic vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram - __100% correct answer as D. Perform
diagnostic peritoneal lavage or FAST
, A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury,
multiple palpable left rib fractures, and bilateral femur fractures. He is intubated
orotracheally without difficulty. Initially, his ventilations are easily assisted with a bag-
mask device. It becomes more difficult to ventilate the patient over the next 5 minutes,
and his hemoglobin oxygen saturation level decreases from 98% to 89%. The most
appropriate next step is to:
A. Obtain a chest x-ray
B. Decrease the tidal volume
C. Decrease PEEP
D. Increase the rate of assisted ventilations
E. Perform needle decompression of the left chest. - __100% correct answer as A.
Obtain a chest x-ray
A 30-year-old man sustains a severely comminuted, open, distal right femur fracture in
a motorcycle crash. The wound is actively bleeding. Normal sensation is present over
the lateral aspect of the foot but decreased over the medial foot and great toe. Normal
motion of the foot is observed. Dorsalis pedis and posterior tibial pulses are easily
palpable on the left, but heard only by Doppler on the right. Immediate efforts to improve
circulation to the injured extremity should involve:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
E. Fasciotomy of all four compartments in the lower extremity - __100% correct
answer as B. Tamponade of the wound with a pressure dressing
An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the ED following
a crash. He had decreased level of consciousness at the scene, but then was alert and
conversational during transportation. Now his GCS is only 11. Which of the following
statements is TRUE?
A. Cerebral perfusion is intact
B. Intravascular volume status is normal
C. The patient is in a postictal state
D. Intra-abdominal visceral injury is unlikely
E. The patient probably has an acute epidural hematoma - __100% correct answer
as E. The patient probably has an acute epidural hematoma
A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss of
two liters. Which one of the following statements apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
C. He will have tachycardia, but no change in systolic blood pressure
D. His systolic blood pressure will be decreased with a narrowed, pulse pressure
Questions and Correct Answers | Brand New
Version!
A 47 year old house painter is brought to the hospital after falling 6 meters from a ladder
and landing straddled on a fence. Examination of his perineum reveals extensive
ecchymosis. There is blood in the external urethreal meatus. The initial diagnostic study
for evaluation of the urinary tract in this patient should be:
A. Cystoscopy
B. Cystography
C. IV pyelography
D. CT scan
E. Retrograde urethrography - __100% correct answer as E. Retrograde
urethrography
Neurogenic shock has all of the following classic characteristics except which one:
A. Hypotension
B. Vasodilatation
C. Bradycardia
D. Neurologic deficit
E. Narrowed pulse pressure - __100% correct answer as E. Narrowed pulse
pressure
Which one 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. Maneuvers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - __100% correct answer as D. Ensuring
adequate oxygenation and ventilation
Which of the following is the recommended Method for treatment frostbite?
A. Vasodilators
B. Anticigulants
C. Warm (40 degrees) water
D. Padding and elevation
E. Application of heat from a hairdryer - __100% correct answer as C. Warm (40
degrees) water
,Which of the following physical findings suggest a cause of hypotension other than
spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them - __100% correct answer as D.
Presence of deep tendon reflexes. Spinal shock refers to loss of muscle toe (flaccidty)
and loss of reflexes.
The primary indication for transferring A patient to a higher level trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma - __100% correct
answer as C. Resource limitations as determined by the transferring doctor
A young man sustains a rifle wound to the mid-abdomen. He is brought promptly to the
ED by prehospital personnel. His skin is cool and diaphoretic, and his systolic blood
pressure is 58mmHg. Warmed crystalloid fluids are initiated without improvement in his
vital signs. The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage - __100% correct answer as A. Laparotomy
because of hemodynamic abnormality
A 42-year-old man is trapped from the waist down beneath his overturned tractor for
several hours before medical assistance arrives. He is awake and alert until just before
arriving in the ED. He is now unconscious and responds only to painful stimuli by
moaning. His pupils are 3mm in diameter and symmetrically reactive to light.
Prehospital personnel indicate that they have not seen the patient move either of his
lower extremities. On examination in the ED, no movement of his lower extremities are
detected, even in response to painful stimuli. The most likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome - __100% correct answer as E. Bilateral
compartment syndrome
A 6-year-o boy is struck by an automobile and brought to the ED. He is lethargic, but
withdraws purposefully from painful stimuli. His blood pressure is 90mmHg systolic,
,heart rate 140 beats per minute and his respiratory rate is 36 breaths per minute. The
preferred route of venous access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein - __100% correct
answer as D. Percutaneous peripheral veins in the upper extremities
A young man sustains a gunshot wound to the abdomen and is brought promptly to the
ED by prehospital personnel. His skin is cool and diaphoretic, and he is confused. His
pulse is thready and his femoral pulse is only weakly palpable. The definitive treatment
in managing this patient is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions. - __100% correct
answer as C. Control internal hemorrhage operatively
Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the same as in
adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg Ringers Lactate -
__100% correct answer as D. The absolute volume of blood loss required to
produce shock is the same as in adults
A 33-year-old man is struck by a car travelling at 56km/h (35mph). He has obvious
fractures of the left tibia near the knee, pain in the pelvic area, and severe dyspnea. His
heart rate is 182 beats per minute, and his respiratory rate is 48 breaths per minute with
no breath sounds heard in the left chest. A tension pneumothorax is relieved by
immediate needle decompression and tube thoracostomy. Subsequently, his heart rate
decreases to 144 beats per minute, his respirartory rate decreases to 36 breaths per
minute and his blood pressure is 81/53 mmHg. Warmed Ringers lactate is adminstered
intravenously. The next priority should be to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
C. Perform arterial embolization of the pelvic vessel
D. Perform diagnostic peritoneal lavage or FAST
E. Perform a urethrogram and cystogram - __100% correct answer as D. Perform
diagnostic peritoneal lavage or FAST
, A 42-year-old man, injured in a motor vehicle crash, suffers a closed head injury,
multiple palpable left rib fractures, and bilateral femur fractures. He is intubated
orotracheally without difficulty. Initially, his ventilations are easily assisted with a bag-
mask device. It becomes more difficult to ventilate the patient over the next 5 minutes,
and his hemoglobin oxygen saturation level decreases from 98% to 89%. The most
appropriate next step is to:
A. Obtain a chest x-ray
B. Decrease the tidal volume
C. Decrease PEEP
D. Increase the rate of assisted ventilations
E. Perform needle decompression of the left chest. - __100% correct answer as A.
Obtain a chest x-ray
A 30-year-old man sustains a severely comminuted, open, distal right femur fracture in
a motorcycle crash. The wound is actively bleeding. Normal sensation is present over
the lateral aspect of the foot but decreased over the medial foot and great toe. Normal
motion of the foot is observed. Dorsalis pedis and posterior tibial pulses are easily
palpable on the left, but heard only by Doppler on the right. Immediate efforts to improve
circulation to the injured extremity should involve:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
E. Fasciotomy of all four compartments in the lower extremity - __100% correct
answer as B. Tamponade of the wound with a pressure dressing
An 18-yeard-old, unhelmeted motorcyclist is brought by ambulance to the ED following
a crash. He had decreased level of consciousness at the scene, but then was alert and
conversational during transportation. Now his GCS is only 11. Which of the following
statements is TRUE?
A. Cerebral perfusion is intact
B. Intravascular volume status is normal
C. The patient is in a postictal state
D. Intra-abdominal visceral injury is unlikely
E. The patient probably has an acute epidural hematoma - __100% correct answer
as E. The patient probably has an acute epidural hematoma
A previously healthy, 70kg (175 pound) man suffers an estimated acute blood loss of
two liters. Which one of the following statements apply to this patient?
A. His pulse pressure will be widened
B. His urinary output will be at the lower limits of normal
C. He will have tachycardia, but no change in systolic blood pressure
D. His systolic blood pressure will be decreased with a narrowed, pulse pressure
