ATLS 10TH EDITION POST TEST ACTUAL
EXAM: (LATEST UPDATE 2026/2027), |
QUESTIONS & ANSWERS | 100% CORRECT |
GRADE A
ADVANCED TRAUMA LIFE SUPPORT (ATLS)
10TH EDITION
ATLS 10th Edition Post Test Questions
1. Which of the following is the recommended method for treating frostbite?
A. Vasodilators
B. Warm water immersion at approximately 40°C
C. Padding and elevation only
D. Application of heat from a hairdryer
Rationale:
Rapid rewarming in a circulating water bath at 37–40°C is the standard of care for
frostbite. Direct dry heat, such as hairdryers, is contraindicated due to uneven heating
and risk of tissue necrosis. Vasodilators are not used acutely because they do not
reverse tissue freezing. Padding and elevation are supportive measures but do not
treat the underlying ischemia. Early rewarming minimizes tissue loss and improves
functional outcomes.
2. Which of the following physical findings suggests a cause of hypotension
other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
Rationale:
Spinal shock typically presents with flaccid paralysis and absence of reflexes below the
level of injury. If deep tendon reflexes are preserved, it suggests another cause of
,hypotension, such as hemorrhage or distributive shock. Priapism and bradycardia are
classic signs of spinal shock. Diaphragmatic breathing may indicate high cervical cord
injury but does not rule out hypotension from other causes. Recognizing the source of
hypotension is critical for appropriate resuscitation.
3. The primary indication for transferring a patient to a higher-level trauma
center is:
A. Unavailability of a surgeon or operating staff
B. Multiple system injuries (including severe head injury)
C. Resource limitations as determined by the transferring doctor
D. Widened mediastinum on chest X-ray after blunt trauma
Rationale:
Patients should be transferred when the current facility lacks the resources, expertise,
or equipment to safely manage their injuries. The decision rests with the treating
physician who must consider patient needs and local capabilities. Presence of multiple
injuries or imaging findings alone does not mandate transfer if resources are sufficient.
Transfer decisions prioritize patient safety and timely access to definitive care.
4. A young man has a gunshot wound to the mid-abdomen. He arrives
hypotensive (systolic BP 58 mmHg) and does not improve despite rapid
infusion of warmed crystalloid fluids. The next most appropriate step is to:
A. Immediate laparotomy
B. Abdominal CT scan
C. Abdominal ultrasonography (FAST)
D. Diagnostic peritoneal lavage (DPL)
Rationale:
Profound hypotension in a patient with penetrating abdominal trauma indicates
ongoing hemorrhage. Immediate surgical intervention is required to control bleeding.
Imaging studies or diagnostic peritoneal lavage would delay definitive care and are not
indicated in hemodynamically unstable patients. Early operative control improves
survival in hemorrhagic shock.
5. A 42-year-old man is trapped for several hours under an overturned
tractor. He was alert initially, but now is unconscious and shows no
movement of his lower extremities (even to painful stimuli). The most likely
cause of this lower-extremity finding is:
,A. Pelvic fracture
B. Central cord syndrome
C. Intracerebral hemorrhage
D. Bilateral compartment syndrome
Rationale:
Prolonged crush injury can lead to compartment syndrome, causing ischemia and
irreversible muscle and nerve damage. Bilateral lower extremity involvement is
consistent with prolonged entrapment. Central cord syndrome primarily affects upper
extremities. Pelvic fractures can cause hemorrhage but are unlikely to cause bilateral
lower extremity paralysis without associated neurological injury. Early recognition and
fasciotomy are crucial to prevent permanent disability.
6. A 6-year-old boy is struck by an automobile and brought to the ED. He is
lethargic with a systolic BP of 90 mmHg, HR 140 bpm, and RR 36 breaths per
minute. The preferred route of venous access in this child is:
A. Percutaneous femoral vein cannulation
B. Intraosseous access in the proximal tibia
C. Percutaneous peripheral vein in the upper extremities
D. Central venous access via the subclavian or internal jugular vein
Rationale:
Peripheral IV access is the quickest and safest route if achievable in children.
Intraosseous access is an excellent alternative if peripheral veins are difficult to
cannulate. Central lines are rarely first-line in emergency pediatric resuscitation due to
higher complication rates. Timely venous access is critical for fluid resuscitation and
medication administration in pediatric trauma.
7. A young man with a gunshot wound to the abdomen arrives hypotensive,
cool, and diaphoretic. The definitive treatment for this hypotension is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Operatively control internal hemorrhage
D. Infuse large-volume intravenous crystalloid solutions
Rationale:
Ongoing hemorrhage from penetrating trauma requires definitive surgical control.
Blood and crystalloid resuscitation alone are insufficient if bleeding continues.
Operative intervention to control hemorrhage is lifesaving and takes priority over
supportive measures. External warming is supportive but does not address the
, underlying cause. Early hemorrhage control improves survival and reduces
complications.
8. Regarding shock in a child, which of the following statements is FALSE?
A. Children have greater physiologic reserves than adults
B. Tachycardia is the primary compensatory mechanism for hypovolemia
C. The absolute blood volume required to produce shock is the same as in
adults
D. An initial fluid bolus for resuscitation is typically 20 mL/kg of Ringer’s lactate
Rationale:
Children have a smaller total blood volume, so proportionally smaller blood loss can
precipitate shock. Tachycardia is the earliest and most prominent compensatory
response. Adults can tolerate larger absolute losses before shock occurs. Standard
resuscitation guidelines recommend 20 mL/kg fluid bolus for initial management.
Recognizing these physiological differences is essential for pediatric trauma care.
9. A 33-year-old man is struck by a car at approximately 35 mph. He has a
left-sided tension pneumothorax that is decompressed, but remains
hypotensive (BP 81/53 mmHg) and tachycardic (HR 144 bpm). After
beginning fluid resuscitation, the next priority is to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT scans
C. Perform arterial embolization of pelvic vessels
D. Perform diagnostic peritoneal lavage (DPL) or FAST
Rationale:
Persistent hypotension after tension pneumothorax suggests ongoing internal
bleeding. Rapid bedside assessment using FAST or DPL can detect hemoperitoneum,
guiding urgent surgical intervention. Pelvic fixation or CT imaging delays definitive
care in unstable patients. Early detection and management of bleeding sources
improve outcomes.
10. A 42-year-old man with a closed head injury and bilateral femur fractures
is intubated without initial difficulty. Over the next 5 minutes, he becomes
harder to ventilate, and his oxygen saturation drops from 98% to 89%. The
most appropriate next step is to:
EXAM: (LATEST UPDATE 2026/2027), |
QUESTIONS & ANSWERS | 100% CORRECT |
GRADE A
ADVANCED TRAUMA LIFE SUPPORT (ATLS)
10TH EDITION
ATLS 10th Edition Post Test Questions
1. Which of the following is the recommended method for treating frostbite?
A. Vasodilators
B. Warm water immersion at approximately 40°C
C. Padding and elevation only
D. Application of heat from a hairdryer
Rationale:
Rapid rewarming in a circulating water bath at 37–40°C is the standard of care for
frostbite. Direct dry heat, such as hairdryers, is contraindicated due to uneven heating
and risk of tissue necrosis. Vasodilators are not used acutely because they do not
reverse tissue freezing. Padding and elevation are supportive measures but do not
treat the underlying ischemia. Early rewarming minimizes tissue loss and improves
functional outcomes.
2. Which of the following physical findings suggests a cause of hypotension
other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
Rationale:
Spinal shock typically presents with flaccid paralysis and absence of reflexes below the
level of injury. If deep tendon reflexes are preserved, it suggests another cause of
,hypotension, such as hemorrhage or distributive shock. Priapism and bradycardia are
classic signs of spinal shock. Diaphragmatic breathing may indicate high cervical cord
injury but does not rule out hypotension from other causes. Recognizing the source of
hypotension is critical for appropriate resuscitation.
3. The primary indication for transferring a patient to a higher-level trauma
center is:
A. Unavailability of a surgeon or operating staff
B. Multiple system injuries (including severe head injury)
C. Resource limitations as determined by the transferring doctor
D. Widened mediastinum on chest X-ray after blunt trauma
Rationale:
Patients should be transferred when the current facility lacks the resources, expertise,
or equipment to safely manage their injuries. The decision rests with the treating
physician who must consider patient needs and local capabilities. Presence of multiple
injuries or imaging findings alone does not mandate transfer if resources are sufficient.
Transfer decisions prioritize patient safety and timely access to definitive care.
4. A young man has a gunshot wound to the mid-abdomen. He arrives
hypotensive (systolic BP 58 mmHg) and does not improve despite rapid
infusion of warmed crystalloid fluids. The next most appropriate step is to:
A. Immediate laparotomy
B. Abdominal CT scan
C. Abdominal ultrasonography (FAST)
D. Diagnostic peritoneal lavage (DPL)
Rationale:
Profound hypotension in a patient with penetrating abdominal trauma indicates
ongoing hemorrhage. Immediate surgical intervention is required to control bleeding.
Imaging studies or diagnostic peritoneal lavage would delay definitive care and are not
indicated in hemodynamically unstable patients. Early operative control improves
survival in hemorrhagic shock.
5. A 42-year-old man is trapped for several hours under an overturned
tractor. He was alert initially, but now is unconscious and shows no
movement of his lower extremities (even to painful stimuli). The most likely
cause of this lower-extremity finding is:
,A. Pelvic fracture
B. Central cord syndrome
C. Intracerebral hemorrhage
D. Bilateral compartment syndrome
Rationale:
Prolonged crush injury can lead to compartment syndrome, causing ischemia and
irreversible muscle and nerve damage. Bilateral lower extremity involvement is
consistent with prolonged entrapment. Central cord syndrome primarily affects upper
extremities. Pelvic fractures can cause hemorrhage but are unlikely to cause bilateral
lower extremity paralysis without associated neurological injury. Early recognition and
fasciotomy are crucial to prevent permanent disability.
6. A 6-year-old boy is struck by an automobile and brought to the ED. He is
lethargic with a systolic BP of 90 mmHg, HR 140 bpm, and RR 36 breaths per
minute. The preferred route of venous access in this child is:
A. Percutaneous femoral vein cannulation
B. Intraosseous access in the proximal tibia
C. Percutaneous peripheral vein in the upper extremities
D. Central venous access via the subclavian or internal jugular vein
Rationale:
Peripheral IV access is the quickest and safest route if achievable in children.
Intraosseous access is an excellent alternative if peripheral veins are difficult to
cannulate. Central lines are rarely first-line in emergency pediatric resuscitation due to
higher complication rates. Timely venous access is critical for fluid resuscitation and
medication administration in pediatric trauma.
7. A young man with a gunshot wound to the abdomen arrives hypotensive,
cool, and diaphoretic. The definitive treatment for this hypotension is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Operatively control internal hemorrhage
D. Infuse large-volume intravenous crystalloid solutions
Rationale:
Ongoing hemorrhage from penetrating trauma requires definitive surgical control.
Blood and crystalloid resuscitation alone are insufficient if bleeding continues.
Operative intervention to control hemorrhage is lifesaving and takes priority over
supportive measures. External warming is supportive but does not address the
, underlying cause. Early hemorrhage control improves survival and reduces
complications.
8. Regarding shock in a child, which of the following statements is FALSE?
A. Children have greater physiologic reserves than adults
B. Tachycardia is the primary compensatory mechanism for hypovolemia
C. The absolute blood volume required to produce shock is the same as in
adults
D. An initial fluid bolus for resuscitation is typically 20 mL/kg of Ringer’s lactate
Rationale:
Children have a smaller total blood volume, so proportionally smaller blood loss can
precipitate shock. Tachycardia is the earliest and most prominent compensatory
response. Adults can tolerate larger absolute losses before shock occurs. Standard
resuscitation guidelines recommend 20 mL/kg fluid bolus for initial management.
Recognizing these physiological differences is essential for pediatric trauma care.
9. A 33-year-old man is struck by a car at approximately 35 mph. He has a
left-sided tension pneumothorax that is decompressed, but remains
hypotensive (BP 81/53 mmHg) and tachycardic (HR 144 bpm). After
beginning fluid resuscitation, the next priority is to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT scans
C. Perform arterial embolization of pelvic vessels
D. Perform diagnostic peritoneal lavage (DPL) or FAST
Rationale:
Persistent hypotension after tension pneumothorax suggests ongoing internal
bleeding. Rapid bedside assessment using FAST or DPL can detect hemoperitoneum,
guiding urgent surgical intervention. Pelvic fixation or CT imaging delays definitive
care in unstable patients. Early detection and management of bleeding sources
improve outcomes.
10. A 42-year-old man with a closed head injury and bilateral femur fractures
is intubated without initial difficulty. Over the next 5 minutes, he becomes
harder to ventilate, and his oxygen saturation drops from 98% to 89%. The
most appropriate next step is to:
