ATLS PRE TEST 1 EXAM PREP 2026 PRACTICE
SOLUTION STUDY GUIDE
◉ 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
the oxygen facemask to his face. The most appropriate next step is
to: Answer: restrict cervical motion and attempt orotracheal
intubation using 2 people
,◉ A patient is brought to the emergency department after a motor
vehicle crash. He is conscious and there is no obvious external
trauma. He arrives at the hospital completely immobilized on a long
spine board. His blood pressure is 60/40 mm Hg and his heart rate
is 70 beats per minute. His skin is warm. Which one of the following
statements is TRUE? Answer: Flaccidity of the lower extremities and
loss of deep tendon reflexes are expected.
◉ Which one of the following is the most effective method for
initially treating frostbite? Answer: moist heat
◉ A 32-year-old man's right leg is trapped beneath his overturned
car for nearly 2 hours before he is extricated. On arrival in the
emergency department, his right lower extremity is cool, mottled,
insensate, and motionless. Despite normal vital signs, pulses cannot
be palpated below the right femoral artery and the muscles of the
lower extremity are firm and hard. During the management of this
patient, which of the following is most likely to improve the chances
for limb salvage? Answer: surgical consultation for right lower
extremity fasciotomy
◉ A patient arrives in the emergency department after being beaten
about the head and face with a wooden club. He is comatose and has
a palpable depressed skull fracture. His face is swollen and
ecchymotic. He has gurgling respirations and vomitus on his face
and clothing. The most appropriate step after providing
, supplemental oxygen and elevating his jaw is to: Answer: suction the
oropharynx
◉ A 22-year-old man sustains a gunshot wound to the left chest and
is transported to a small community hospital no surgical capabilities
are available. In the emergency department, a chest tube is inserted
and 700 mL of blood is evacuated. The trauma center accepts the
patient in transfer. Just before the patient is placed in the ambulance
for transfer, his blood pressure decreases to 80/68 mm Hg and his
heart rate increases to 136 beats per minute. The next step should
be to: Answer: repeat the primary survey and proceed with transfer
◉ A 64-year-old man involved in a high-speed car crash, is
resuscitated initially in a small hospital without surgical capabilities.
He has a closed head injury with a GCS score of 13. He has a widened
mediastinum on chest x-ray with fractures of left ribs 2 through 4,
but no pneumothorax. After initiating fluid resuscitation, his blood
pressure is 110/74 mm Hg, heart rate is 100 beats per minute, and
respiratory rate is 18 breaths per minute. He has gross hematuria
and a pelvic fracture. You decide to transfer this patient to a facility
capable of providing a higher level of care. The facility is 128 km (80
miles) away. Before transfer, you should first: Answer: call the
receiving hospital and speak to the surgeon on call
◉ Hemorrhage of 20% of the patient's blood volume is associated
usually with: Answer: tachycardia
SOLUTION STUDY GUIDE
◉ 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
the oxygen facemask to his face. The most appropriate next step is
to: Answer: restrict cervical motion and attempt orotracheal
intubation using 2 people
,◉ A patient is brought to the emergency department after a motor
vehicle crash. He is conscious and there is no obvious external
trauma. He arrives at the hospital completely immobilized on a long
spine board. His blood pressure is 60/40 mm Hg and his heart rate
is 70 beats per minute. His skin is warm. Which one of the following
statements is TRUE? Answer: Flaccidity of the lower extremities and
loss of deep tendon reflexes are expected.
◉ Which one of the following is the most effective method for
initially treating frostbite? Answer: moist heat
◉ A 32-year-old man's right leg is trapped beneath his overturned
car for nearly 2 hours before he is extricated. On arrival in the
emergency department, his right lower extremity is cool, mottled,
insensate, and motionless. Despite normal vital signs, pulses cannot
be palpated below the right femoral artery and the muscles of the
lower extremity are firm and hard. During the management of this
patient, which of the following is most likely to improve the chances
for limb salvage? Answer: surgical consultation for right lower
extremity fasciotomy
◉ A patient arrives in the emergency department after being beaten
about the head and face with a wooden club. He is comatose and has
a palpable depressed skull fracture. His face is swollen and
ecchymotic. He has gurgling respirations and vomitus on his face
and clothing. The most appropriate step after providing
, supplemental oxygen and elevating his jaw is to: Answer: suction the
oropharynx
◉ A 22-year-old man sustains a gunshot wound to the left chest and
is transported to a small community hospital no surgical capabilities
are available. In the emergency department, a chest tube is inserted
and 700 mL of blood is evacuated. The trauma center accepts the
patient in transfer. Just before the patient is placed in the ambulance
for transfer, his blood pressure decreases to 80/68 mm Hg and his
heart rate increases to 136 beats per minute. The next step should
be to: Answer: repeat the primary survey and proceed with transfer
◉ A 64-year-old man involved in a high-speed car crash, is
resuscitated initially in a small hospital without surgical capabilities.
He has a closed head injury with a GCS score of 13. He has a widened
mediastinum on chest x-ray with fractures of left ribs 2 through 4,
but no pneumothorax. After initiating fluid resuscitation, his blood
pressure is 110/74 mm Hg, heart rate is 100 beats per minute, and
respiratory rate is 18 breaths per minute. He has gross hematuria
and a pelvic fracture. You decide to transfer this patient to a facility
capable of providing a higher level of care. The facility is 128 km (80
miles) away. Before transfer, you should first: Answer: call the
receiving hospital and speak to the surgeon on call
◉ Hemorrhage of 20% of the patient's blood volume is associated
usually with: Answer: tachycardia
