1|Page
ATCN FINAL ACTUAL EXAM 2026-2027
|200 QUESTIONS AND VERIFIED
ANSWERS | ALREADY A GRADED | NEW
AND REVISED
1. A trauma patient arrives with unequal pupils, hypertension,
and bradycardia. These findings MOST likely indicate:
A) Cervical spine injury
B) C) Increased intracranial pressure
C) Hypovolemia
D) Tension pneumothorax
*Italics: Cushing’s triad (hypertension, bradycardia,
irregular respirations) signals increased intracranial
pressure requiring urgent intervention.
2. The primary survey focuses on which initial priority?
A) Pain control
B) C) Airway assessment and management
C) Definitive wound closure
D) Rehabilitation planning
Airway with cervical spine protection is the first step to
ensure adequate oxygenation and ventilation.
3. Your trauma patient has absent breath sounds and tracheal
deviation to the left. What is the immediate action?
A) Insert a chest tube on the left
B) B) Needle decompression of the right chest
C) Obtain chest x-ray
,2|Page
D) Provide supplemental oxygen
These signs suggest right tension pneumothorax
requiring immediate needle decompression before
imaging.
4. A patient’s Glasgow Coma Scale score is E2 V3 M5. What
is the total score?
A) 8
B) 10
C) C) 10
D) 12
GCS components are Eye (2) + Verbal (3) + Motor (5) =
10; scores <8 indicate severe impairment.
5. Which intervention is most important for a patient with
suspected cervical spine injury?
A) Elevate head of bed
B) B) Maintain cervical spine immobilization
C) Administer analgesics
D) Initiate enteral feeding
Spinal immobilization prevents secondary neurological
injury until imaging clears the spine.
6. A trauma patient drops systolic blood pressure to 80 mmHg
after pelvic fracture. What is the priority?
A) Administer diuretics
B) B) Apply pelvic binder
C) IV antibiotic therapy
D) Hyperbaric oxygen therapy
Pelvic stabilization reduces hemorrhage from pelvic
vessels and improves hemodynamics.
7. Which fluid is preferred for initial resuscitation in
hemorrhagic shock?
A) 5% dextrose
,3|Page
B) B) Lactated Ringer’s solution
C) Albumin
D) Whole blood
Crystalloid (LR) is appropriate for initial volume
resuscitation; blood products follow based on needs.
8. A patient with penetrating trauma arrives alert but
hypotensive. What is the next action?
A) Perform head CT
B) B) Rapid transport to OR
C) Apply cervical collar
D) Full body x-ray series
Hypotension in penetrating trauma suggests internal
bleeding; surgical intervention is time-critical.
9. Which sign is most indicative of basilar skull fracture?
A) Rhinorrhea with halo sign
B) B) Periorbital ecchymosis (raccoon eyes)
C) Battle’s sign
D) All of the above
All are classic signs; raccoon eyes specifically indicate
basilar skull involvement.
10. You suspect a tension pneumothorax. What clinical
feature supports this?
A) Equal breath sounds
B) B) Hypotension with distended neck veins
C) Decreased heart rate
D) Bradycardia only
Neck vein distension and hypotension with respiratory
distress are hallmark tension pneumothorax.
11. Which lab value is most concerning for massive
hemorrhage?
A) WBC 10,000
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B) Hematocrit 40%
C) C) Lactate elevated at 4 mmol/L
D) Platelets 250,000
Elevated lactate indicates tissue hypoperfusion and shock.
12. After intubation, you should confirm tube placement
by:
A) Asking patient to speak
B) B) End-tidal CO₂ detector
C) Auscultating only left lung
D) Chest x-ray only
End-tidal CO₂ provides immediate confirmation of
tracheal intubation.
13. In pelvic trauma, what does a positive FAST exam
most likely detect?
A) Skull fracture
B) B) Intra-abdominal free fluid
C) Rib fracture
D) Pulmonary edema
FAST identifies free fluid indicating possible bleeding in
trauma.
14. A patient with flail chest will MOST likely present
with:
A) Bradycardia
B) Hypotension
C) C) Paradoxical chest movement
D) Absent breath sounds only
Flail segments move opposite to the chest wall, impairing
ventilation.
15. Hypothermia in trauma patients causes:
A) Increased clotting
B) B) Coagulopathy
ATCN FINAL ACTUAL EXAM 2026-2027
|200 QUESTIONS AND VERIFIED
ANSWERS | ALREADY A GRADED | NEW
AND REVISED
1. A trauma patient arrives with unequal pupils, hypertension,
and bradycardia. These findings MOST likely indicate:
A) Cervical spine injury
B) C) Increased intracranial pressure
C) Hypovolemia
D) Tension pneumothorax
*Italics: Cushing’s triad (hypertension, bradycardia,
irregular respirations) signals increased intracranial
pressure requiring urgent intervention.
2. The primary survey focuses on which initial priority?
A) Pain control
B) C) Airway assessment and management
C) Definitive wound closure
D) Rehabilitation planning
Airway with cervical spine protection is the first step to
ensure adequate oxygenation and ventilation.
3. Your trauma patient has absent breath sounds and tracheal
deviation to the left. What is the immediate action?
A) Insert a chest tube on the left
B) B) Needle decompression of the right chest
C) Obtain chest x-ray
,2|Page
D) Provide supplemental oxygen
These signs suggest right tension pneumothorax
requiring immediate needle decompression before
imaging.
4. A patient’s Glasgow Coma Scale score is E2 V3 M5. What
is the total score?
A) 8
B) 10
C) C) 10
D) 12
GCS components are Eye (2) + Verbal (3) + Motor (5) =
10; scores <8 indicate severe impairment.
5. Which intervention is most important for a patient with
suspected cervical spine injury?
A) Elevate head of bed
B) B) Maintain cervical spine immobilization
C) Administer analgesics
D) Initiate enteral feeding
Spinal immobilization prevents secondary neurological
injury until imaging clears the spine.
6. A trauma patient drops systolic blood pressure to 80 mmHg
after pelvic fracture. What is the priority?
A) Administer diuretics
B) B) Apply pelvic binder
C) IV antibiotic therapy
D) Hyperbaric oxygen therapy
Pelvic stabilization reduces hemorrhage from pelvic
vessels and improves hemodynamics.
7. Which fluid is preferred for initial resuscitation in
hemorrhagic shock?
A) 5% dextrose
,3|Page
B) B) Lactated Ringer’s solution
C) Albumin
D) Whole blood
Crystalloid (LR) is appropriate for initial volume
resuscitation; blood products follow based on needs.
8. A patient with penetrating trauma arrives alert but
hypotensive. What is the next action?
A) Perform head CT
B) B) Rapid transport to OR
C) Apply cervical collar
D) Full body x-ray series
Hypotension in penetrating trauma suggests internal
bleeding; surgical intervention is time-critical.
9. Which sign is most indicative of basilar skull fracture?
A) Rhinorrhea with halo sign
B) B) Periorbital ecchymosis (raccoon eyes)
C) Battle’s sign
D) All of the above
All are classic signs; raccoon eyes specifically indicate
basilar skull involvement.
10. You suspect a tension pneumothorax. What clinical
feature supports this?
A) Equal breath sounds
B) B) Hypotension with distended neck veins
C) Decreased heart rate
D) Bradycardia only
Neck vein distension and hypotension with respiratory
distress are hallmark tension pneumothorax.
11. Which lab value is most concerning for massive
hemorrhage?
A) WBC 10,000
, 4|Page
B) Hematocrit 40%
C) C) Lactate elevated at 4 mmol/L
D) Platelets 250,000
Elevated lactate indicates tissue hypoperfusion and shock.
12. After intubation, you should confirm tube placement
by:
A) Asking patient to speak
B) B) End-tidal CO₂ detector
C) Auscultating only left lung
D) Chest x-ray only
End-tidal CO₂ provides immediate confirmation of
tracheal intubation.
13. In pelvic trauma, what does a positive FAST exam
most likely detect?
A) Skull fracture
B) B) Intra-abdominal free fluid
C) Rib fracture
D) Pulmonary edema
FAST identifies free fluid indicating possible bleeding in
trauma.
14. A patient with flail chest will MOST likely present
with:
A) Bradycardia
B) Hypotension
C) C) Paradoxical chest movement
D) Absent breath sounds only
Flail segments move opposite to the chest wall, impairing
ventilation.
15. Hypothermia in trauma patients causes:
A) Increased clotting
B) B) Coagulopathy
