ATLS CASE SCENARIO CDEM SELF STUDY
EXAM SCRIPT 2026 COMPLETE QUESTIONS
AND SOLUTIONS
◉ 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: Answer: perform
needle or finger decompression of the right chest
◉ Which one of the following findings in an adult is most likely to
require immediate management during the primary survey?
Answer: respiratory rate of 40 breaths per minute
◉ The most important, immediate step in the management of an
open pneumothorax is: Answer: placement of an occlusive dressing
over the wound
◉ The following are contraindications for tetanus toxoid
administration: Answer: history of neurological reaction or severe
hypersensitivity to the product
, ◉ 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? Answer: breath sounds
◉ Bronchial intubation of the right or left mainstem bronchus can
easily occur during infant endotracheal intubation because: Answer:
The trachea is relatively short.
◉ 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: Answer:
urgently transfer the patient to the operating room
◉ A 39-year-old man is admitted to the emergency department after
an automobile collision. He is cyanotic, has insufficient respiratory
effort, and has a GCS score of 6. His full beard makes it difficult to fit
EXAM SCRIPT 2026 COMPLETE QUESTIONS
AND SOLUTIONS
◉ 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: Answer: perform
needle or finger decompression of the right chest
◉ Which one of the following findings in an adult is most likely to
require immediate management during the primary survey?
Answer: respiratory rate of 40 breaths per minute
◉ The most important, immediate step in the management of an
open pneumothorax is: Answer: placement of an occlusive dressing
over the wound
◉ The following are contraindications for tetanus toxoid
administration: Answer: history of neurological reaction or severe
hypersensitivity to the product
, ◉ 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? Answer: breath sounds
◉ Bronchial intubation of the right or left mainstem bronchus can
easily occur during infant endotracheal intubation because: Answer:
The trachea is relatively short.
◉ 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: Answer:
urgently transfer the patient to the operating room
◉ A 39-year-old man is admitted to the emergency department after
an automobile collision. He is cyanotic, has insufficient respiratory
effort, and has a GCS score of 6. His full beard makes it difficult to fit
