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ATLS PRACTICE TEST 2025-2026 ACTUAL EXAM 250
REAL QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED ANSWERS)
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the
left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid
resuscitation his blood pressure increases to 122/84 mm Hg. His heart rate is
now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest breath sounds with the
return of a small amount of blood and no air leak. After chest tube insertion, the
most appropriate next step is: - CORRECT ANSWER re-examine the
chest
QUESTION : A construction worker falls two stories from a building and sustains
bilateral calcaneal fractures. In the emergency department, he is alert, vital signs
are normal, and he is complaining of severe pain in both heels and his lower
back. Lower extremity pulses are strong and there is no other deformity. The
suspected diagnosis is most likely to be confirmed by: - CORRECT
ANSWER complete spine x-ray series
QUESTION : Which of the following is true regarding the initial resuscitation of a
trauma patient? - CORRECT ANSWER Evidence of improved perfusion
after fluid resuscitation could include improvement in Glasgow Coma Scale score
on reevaluation.
QUESTION : In managing a patient with a severe traumatic brain injury, the most
important initial step is to: - CORRECT ANSWER secure the airway
2026 2027 GRADED A+
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QUESTION : A previously healthy, 70-kg (154-pound) man suffers an estimated
acute blood loss of 2 liters. Which one of the following statements applies to
this patient? - CORRECT ANSWER An ABG would demonstrate a base
deficit between -6 and -10 mEq/L.
QUESTION : The physiological hypervolemia of pregnancy has clinical
significance in the management of the severely injured, gravid woman by: -
CORRECT ANSWER increasing the volume of blood loss to produce
maternal hypotension
QUESTION : The best assessment of fluid resuscitation of the adult burn patient
is: - CORRECT ANSWER urinary output of 0.5 mL/kg/hr
QUESTION : The diagnosis of shock must include: - CORRECT ANSWER
evidence of inadequate organ perfusion
QUESTION : A 7-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding profusely
from a 6-cm wound of his medial right thigh. Immediate management of the
wound should consist of: - CORRECT ANSWER direct pressure on the
wound
QUESTION : For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent: - CORRECT ANSWER
cerebral vasoconstriction with diminished perfusion
QUESTION : After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available.. Computed
tomography of the chest and abdomen shows an aortic injury and splenic
2026 2027 GRADED A+
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laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after
CT. The next step is: - CORRECT ANSWER perform an exploratory
laparotomy
QUESTION : Which one of the following statements regarding abdominal trauma
in the pregnant patient is TRUE? - CORRECT ANSWER Leakage of
amniotic fluid is an indication for hospital admission.
QUESTION : The first maneuver to improve oxygenation after chest injury is: -
CORRECT ANSWER administer supplemental oxygen
QUESTION : A 25-year-old man, injured in a motor vehicular crash, is admitted to
the emergency department. His pupils react sluggishly and his eyes open to
pressure. He does not follow commands, but he does moan periodically. His
right arm is deformed and does not respond to pressure; however, his left hand
reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS
score is: - CORRECT ANSWER 9
QUESTION : A 20-year-old woman who is at 32 weeks gestation, is stabbed in
the upper right chest. In the emergency department, her blood pressure is 80/60
mm Hg. She is gasping for breath, extremely anxious, and yelling for help. Breath
sounds are diminished in the right chest. The most appropriate first step is to: -
CORRECT ANSWER perform needle or finger decompression of the
right chest
QUESTION : Which one of the following findings in an adult is most likely to
require immediate management during the primary survey? - CORRECT
ANSWER respiratory rate of 40 breaths per minute
2026 2027 GRADED A+
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QUESTION : The most important, immediate step in the management of an open
pneumothorax is: - CORRECT ANSWER placement of an occlusive
dressing over the wound
QUESTION : The following are contraindications for tetanus toxoid
administration: - CORRECT ANSWER history of neurological reaction or
severe hypersensitivity to the product
QUESTION : A 56-year-old man is thrown violently against the steering wheel of
his truck during a motor vehicle crash. On arrival in the emergency department
he is diaphoretic and complaining of chest pain. His blood pressure is 60/40 mm
Hg and his respiratory rate is 40 breaths per minute. Which of the following best
differentiates cardiac tamponade from tension pneumothorax as the cause of
his hypotension? - CORRECT ANSWER breath sounds
QUESTION : Bronchial intubation of the right or left mainstem bronchus can
easily occur during infant endotracheal intubation because: - CORRECT
ANSWER The trachea is relatively short.
QUESTION : A 23-year-old man sustains 4 stab wounds to the upper right chest
during an altercation and is brought by ambulance to a hospital that has full
surgical capabilities. His wounds are all above the nipple. He is endotracheally
intubated, closed tube thoracostomy is performed, fluid resuscitation is initiated
through 2 large-caliber IVs. FAST exam does not reveal intraabdominal injuries.
His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% O2). 1500 mL of
blood has drained from the right chest. The most appropriate next step in
managing this patient is to: - CORRECT ANSWER urgently transfer the
patient to the operating room
2026 2027 GRADED A+
ATLS PRACTICE TEST 2025-2026 ACTUAL EXAM 250
REAL QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED ANSWERS)
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the
left shoulder. His blood pressure is initially 80/40 mm Hg. After initial fluid
resuscitation his blood pressure increases to 122/84 mm Hg. His heart rate is
now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest breath sounds with the
return of a small amount of blood and no air leak. After chest tube insertion, the
most appropriate next step is: - CORRECT ANSWER re-examine the
chest
QUESTION : A construction worker falls two stories from a building and sustains
bilateral calcaneal fractures. In the emergency department, he is alert, vital signs
are normal, and he is complaining of severe pain in both heels and his lower
back. Lower extremity pulses are strong and there is no other deformity. The
suspected diagnosis is most likely to be confirmed by: - CORRECT
ANSWER complete spine x-ray series
QUESTION : Which of the following is true regarding the initial resuscitation of a
trauma patient? - CORRECT ANSWER Evidence of improved perfusion
after fluid resuscitation could include improvement in Glasgow Coma Scale score
on reevaluation.
QUESTION : In managing a patient with a severe traumatic brain injury, the most
important initial step is to: - CORRECT ANSWER secure the airway
2026 2027 GRADED A+
,2|Page
QUESTION : A previously healthy, 70-kg (154-pound) man suffers an estimated
acute blood loss of 2 liters. Which one of the following statements applies to
this patient? - CORRECT ANSWER An ABG would demonstrate a base
deficit between -6 and -10 mEq/L.
QUESTION : The physiological hypervolemia of pregnancy has clinical
significance in the management of the severely injured, gravid woman by: -
CORRECT ANSWER increasing the volume of blood loss to produce
maternal hypotension
QUESTION : The best assessment of fluid resuscitation of the adult burn patient
is: - CORRECT ANSWER urinary output of 0.5 mL/kg/hr
QUESTION : The diagnosis of shock must include: - CORRECT ANSWER
evidence of inadequate organ perfusion
QUESTION : A 7-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding profusely
from a 6-cm wound of his medial right thigh. Immediate management of the
wound should consist of: - CORRECT ANSWER direct pressure on the
wound
QUESTION : For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent: - CORRECT ANSWER
cerebral vasoconstriction with diminished perfusion
QUESTION : After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available.. Computed
tomography of the chest and abdomen shows an aortic injury and splenic
2026 2027 GRADED A+
,3|Page
laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after
CT. The next step is: - CORRECT ANSWER perform an exploratory
laparotomy
QUESTION : Which one of the following statements regarding abdominal trauma
in the pregnant patient is TRUE? - CORRECT ANSWER Leakage of
amniotic fluid is an indication for hospital admission.
QUESTION : The first maneuver to improve oxygenation after chest injury is: -
CORRECT ANSWER administer supplemental oxygen
QUESTION : A 25-year-old man, injured in a motor vehicular crash, is admitted to
the emergency department. His pupils react sluggishly and his eyes open to
pressure. He does not follow commands, but he does moan periodically. His
right arm is deformed and does not respond to pressure; however, his left hand
reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS
score is: - CORRECT ANSWER 9
QUESTION : A 20-year-old woman who is at 32 weeks gestation, is stabbed in
the upper right chest. In the emergency department, her blood pressure is 80/60
mm Hg. She is gasping for breath, extremely anxious, and yelling for help. Breath
sounds are diminished in the right chest. The most appropriate first step is to: -
CORRECT ANSWER perform needle or finger decompression of the
right chest
QUESTION : Which one of the following findings in an adult is most likely to
require immediate management during the primary survey? - CORRECT
ANSWER respiratory rate of 40 breaths per minute
2026 2027 GRADED A+
, 4|Page
QUESTION : The most important, immediate step in the management of an open
pneumothorax is: - CORRECT ANSWER placement of an occlusive
dressing over the wound
QUESTION : The following are contraindications for tetanus toxoid
administration: - CORRECT ANSWER history of neurological reaction or
severe hypersensitivity to the product
QUESTION : A 56-year-old man is thrown violently against the steering wheel of
his truck during a motor vehicle crash. On arrival in the emergency department
he is diaphoretic and complaining of chest pain. His blood pressure is 60/40 mm
Hg and his respiratory rate is 40 breaths per minute. Which of the following best
differentiates cardiac tamponade from tension pneumothorax as the cause of
his hypotension? - CORRECT ANSWER breath sounds
QUESTION : Bronchial intubation of the right or left mainstem bronchus can
easily occur during infant endotracheal intubation because: - CORRECT
ANSWER The trachea is relatively short.
QUESTION : A 23-year-old man sustains 4 stab wounds to the upper right chest
during an altercation and is brought by ambulance to a hospital that has full
surgical capabilities. His wounds are all above the nipple. He is endotracheally
intubated, closed tube thoracostomy is performed, fluid resuscitation is initiated
through 2 large-caliber IVs. FAST exam does not reveal intraabdominal injuries.
His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and
respiratory rate is 14 breaths per minute (ventilated with 100% O2). 1500 mL of
blood has drained from the right chest. The most appropriate next step in
managing this patient is to: - CORRECT ANSWER urgently transfer the
patient to the operating room
2026 2027 GRADED A+
