ATLS 10th Edition Post-Test Practice Exam 200 Questions with
Rationales Updated 2026
THIS EXAM INCLUDE:
• Questions 1–50: Primary Survey, Airway, Breathing, CirculationPage 3
• Questions 51–100: Abdominal, Pelvic, Musculoskeletal, BurnsPage 13
• Questions 101–150: Head, Spine, Pediatric, GeriatricPage 23
• Questions 151–200: Extremities, Special Populations, DisasterPage 33
• Answer Key (All 200 Questions)Page 43
• Full Rationales (Questions 1–100)Page 45
• Full Rationales (Questions 101–200)Page 65
• Trauma Algorithms & Skill GuidesPage 85
,Questions 1–10: Primary Survey & Airway
1. A 28-year-old male is brought in after a motorcycle crash. He is unconscious, making
gurgling sounds. Oxygen saturation is 82% on room air. What is the immediate next
step?
A) Apply non-rebreather mask
B) Jaw thrust with suctioning
C) Orotracheal intubation
D) Cricothyroidotomy
2. Which finding indicates a definitive airway is required?
A) GCS 14
B) Respiratory rate 24
C) Extensive facial burns with hoarseness
D) Chest wall contusion
3. A patient has a suspected cervical spine injury. Which airway maneuver is safest?
A) Head tilt–chin lift
B) Jaw thrust without head extension
C) Nasopharyngeal airway only
D) Supraglottic airway
4. The most reliable sign of adequate oxygenation during bag-mask ventilation is:
A) Rise in end-tidal CO₂
B) Chest rise and fall
C) Pulse oximetry >92%
D) Normal breath sounds
5. Failed intubation after 2 attempts requires:
A) Third attempt with different blade
B) Surgical airway
,C) Laryngeal mask airway placement
D) Awake fiberoptic intubation
6. Which patient needs immediate intubation?
A) GCS 13, talking normally
B) GCS 8 with loss of gag reflex
C) GCS 10 with oxygen saturation 94%
D) GCS 15 with stridor at rest
7. Needle cricothyroidotomy provides approximately how many minutes of ventilation?
A) 5–10 minutes
B) 15–20 minutes
C) 30–45 minutes
D) 60 minutes
8. A 45-year-old with blunt neck trauma has expanding hematoma and hoarseness.
Next step:
A) Observe in ED
B) Immediate CT neck
C) Oral intubation
D) Awake fiberoptic or surgical airway
9. In a patient with apnea and no gag reflex, the preferred initial airway device is:
A) Laryngeal mask airway
B) Oropharyngeal airway with bag-mask
C) Endotracheal tube
D) Nasopharyngeal airway
10. Capnography confirmation of ETT placement shows no waveform after intubation.
What should you do?
A) Order chest X-ray
B) Remove tube and ventilate by bag-mask
, C) Auscultate both lung fields
D) Increase ventilation rate
Questions 11–20: Breathing & Ventilation
11. A stabbed patient has absent breath sounds on the right, hypotension, and
distended neck veins. Most likely diagnosis:
A) Simple pneumothorax
B) Tension pneumothorax
C) Hemothorax
D) Cardiac tamponade
12. Needle decompression for tension pneumothorax is performed at:
A) 2nd intercostal space, midclavicular line
B) 4th intercostal space, anterior axillary line
C) 5th intercostal space, midaxillary line
D) 2nd intercostal space, midaxillary line
13. Following chest tube insertion for hemothorax, initial drainage of 1500 mL blood
indicates:
A) Continue observation
B) Autotransfusion
C) Immediate thoracotomy
D) Repeat chest X-ray in 4 hours
14. A flail chest is defined as:
A) >3 rib fractures
B) Two or more adjacent ribs fractured in two or more places
C) Sternal fracture with pulmonary contusion
D) Any rib fracture with paradoxical movement
Rationales Updated 2026
THIS EXAM INCLUDE:
• Questions 1–50: Primary Survey, Airway, Breathing, CirculationPage 3
• Questions 51–100: Abdominal, Pelvic, Musculoskeletal, BurnsPage 13
• Questions 101–150: Head, Spine, Pediatric, GeriatricPage 23
• Questions 151–200: Extremities, Special Populations, DisasterPage 33
• Answer Key (All 200 Questions)Page 43
• Full Rationales (Questions 1–100)Page 45
• Full Rationales (Questions 101–200)Page 65
• Trauma Algorithms & Skill GuidesPage 85
,Questions 1–10: Primary Survey & Airway
1. A 28-year-old male is brought in after a motorcycle crash. He is unconscious, making
gurgling sounds. Oxygen saturation is 82% on room air. What is the immediate next
step?
A) Apply non-rebreather mask
B) Jaw thrust with suctioning
C) Orotracheal intubation
D) Cricothyroidotomy
2. Which finding indicates a definitive airway is required?
A) GCS 14
B) Respiratory rate 24
C) Extensive facial burns with hoarseness
D) Chest wall contusion
3. A patient has a suspected cervical spine injury. Which airway maneuver is safest?
A) Head tilt–chin lift
B) Jaw thrust without head extension
C) Nasopharyngeal airway only
D) Supraglottic airway
4. The most reliable sign of adequate oxygenation during bag-mask ventilation is:
A) Rise in end-tidal CO₂
B) Chest rise and fall
C) Pulse oximetry >92%
D) Normal breath sounds
5. Failed intubation after 2 attempts requires:
A) Third attempt with different blade
B) Surgical airway
,C) Laryngeal mask airway placement
D) Awake fiberoptic intubation
6. Which patient needs immediate intubation?
A) GCS 13, talking normally
B) GCS 8 with loss of gag reflex
C) GCS 10 with oxygen saturation 94%
D) GCS 15 with stridor at rest
7. Needle cricothyroidotomy provides approximately how many minutes of ventilation?
A) 5–10 minutes
B) 15–20 minutes
C) 30–45 minutes
D) 60 minutes
8. A 45-year-old with blunt neck trauma has expanding hematoma and hoarseness.
Next step:
A) Observe in ED
B) Immediate CT neck
C) Oral intubation
D) Awake fiberoptic or surgical airway
9. In a patient with apnea and no gag reflex, the preferred initial airway device is:
A) Laryngeal mask airway
B) Oropharyngeal airway with bag-mask
C) Endotracheal tube
D) Nasopharyngeal airway
10. Capnography confirmation of ETT placement shows no waveform after intubation.
What should you do?
A) Order chest X-ray
B) Remove tube and ventilate by bag-mask
, C) Auscultate both lung fields
D) Increase ventilation rate
Questions 11–20: Breathing & Ventilation
11. A stabbed patient has absent breath sounds on the right, hypotension, and
distended neck veins. Most likely diagnosis:
A) Simple pneumothorax
B) Tension pneumothorax
C) Hemothorax
D) Cardiac tamponade
12. Needle decompression for tension pneumothorax is performed at:
A) 2nd intercostal space, midclavicular line
B) 4th intercostal space, anterior axillary line
C) 5th intercostal space, midaxillary line
D) 2nd intercostal space, midaxillary line
13. Following chest tube insertion for hemothorax, initial drainage of 1500 mL blood
indicates:
A) Continue observation
B) Autotransfusion
C) Immediate thoracotomy
D) Repeat chest X-ray in 4 hours
14. A flail chest is defined as:
A) >3 rib fractures
B) Two or more adjacent ribs fractured in two or more places
C) Sternal fracture with pulmonary contusion
D) Any rib fracture with paradoxical movement
