ATLS PRACTICE TEST 2025-2026
ACTUAL EXAM 250 REAL QUESTIONS
AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED
ANSWERS) |
Am22-year-
oldmmanmismhypotensivemandmtachycardicmaftermamshotgunmwoundmtomthemleftmshoulder.mHismbloo
dmpressuremisminitiallym80/40mmmmHg.mAfterminitialmfluidmresuscitationmhismbloodmpressuremincreas
esmtom122/84mmmmHg.mHismheartmratemismnowm100mbeatsmpermminutemandmhismrespiratorymratemism
28mbreathsmpermminute.mAmtubemthoracostomymismperformedmformdecreasedmleftmchestmbreathmso
undsmwithmthemreturnmofmamsmallmamountmofmbloodmandmnomairmleak.mAftermchestmtubeminsertion,m
themmostmappropriatemnextmstepmis:m-mCORRECTmANSWERmre-examinemthemchest
Amconstructionmworkermfallsmtwomstoriesmfrommambuildingmandmsustainsmbilateralmcalcanealmfractu
res.mInmthememergencymdepartment,mhemismalert,mvitalmsignsmaremnormal,mandmhemismcomplainingm
ofmseverempainminmbothmheelsmandmhismlowermback.mLowermextremitympulsesmaremstrongmandmther
emismnomothermdeformity.mThemsuspectedmdiagnosismismmostmlikelymtombemconfirmedmby:m-
mCORRECTmANSWERmcompletemspinemx-raymseries
Whichmofmthemfollowingmismtruemregardingmtheminitialmresuscitationmofmamtraumampatient?m-
mCORRECTmANSWERmEvidencemofmimprovedmperfusionmaftermfluidmresuscitationmcouldmincludemim
provementminmGlasgowmComamScalemscoremonmreevaluation.
Inmmanagingmampatientmwithmamseveremtraumaticmbrainminjury,mthemmostmimportantminitialmstepmism
to:m-mCORRECTmANSWERmsecuremthemairway
Ampreviouslymhealthy,m70-kgm(154-
pound)mmanmsuffersmanmestimatedmacutembloodmlossmofm2mliters.mWhichmonemofmthemfollowingmsta
tementsmappliesmtomthismpatient?m-
mCORRECTmANSWERmAnmABGmwouldmdemonstratemambasemdeficitmbetweenm-6mandm-10mmEq/L.
,Themphysiologicalmhypervolemiamofmpregnancymhasmclinicalmsignificanceminmthemmanagementmofmt
hemseverelyminjured,mgravidmwomanmby:m-
mCORRECTmANSWERmincreasingmthemvolumemofmbloodmlossmtomproducemmaternalmhypotension
Thembestmassessmentmofmfluidmresuscitationmofmthemadultmburnmpatientmis:m-
mCORRECTmANSWERmurinarymoutputmofm0.5mmL/kg/hr
Themdiagnosismofmshockmmustminclude:m-
mCORRECTmANSWERmevidencemofminadequatemorganmperfusion
Am7-year-
oldmboymismbroughtmtomthememergencymdepartmentmbymhismparentsmseveralmminutesmaftermhemfell
mthroughmamwindow.mHemismbleedingmprofuselymfrommam6-
cmmwoundmofmhismmedialmrightmthigh.mImmediatemmanagementmofmthemwoundmshouldmconsistmof
:m-mCORRECTmANSWERmdirectmpressuremonmthemwound
Formthempatientmwithmseveremtraumaticmbrainminjury,mprofoundmhypocarbiamshouldmbemavoidedmto
mprevent:m-mCORRECTmANSWERmcerebralmvasoconstrictionmwithmdiminishedmperfusion
Aftermbeingminvolvedminmammotormvehiclemcrash,mam25-year-
oldmmanmismbroughtmtomamhospitalmthatmhasmsurgerymcapabilitiesmavailable..mComputedmtomograp
hymofmthemchestmandmabdomenmshowsmanmaorticminjurymandmsplenicmlacerationmwithmfreemabdomi
nalmfluid.mHismbloodmpressuremfallsmtom70mmmmHgmaftermCT.mThemnextmstepmis:m-
mCORRECTmANSWERmperformmanmexploratorymlaparotomy
Whichmonemofmthemfollowingmstatementsmregardingmabdominalmtraumaminmthempregnantmpatientmi
smTRUE?m-
mCORRECTmANSWERmLeakagemofmamnioticmfluidmismanmindicationmformhospitalmadmission.
,Themfirstmmaneuvermtomimprovemoxygenationmaftermchestminjurymis:m-
mCORRECTmANSWERmadministermsupplementalmoxygen
Am25-year-
oldmman,minjuredminmammotormvehicularmcrash,mismadmittedmtomthememergencymdepartment.mHismp
upilsmreactmsluggishlymandmhismeyesmopenmtompressure.mHemdoesmnotmfollowmcommands,mbutmhemd
oesmmoanmperiodically.mHismrightmarmmismdeformedmandmdoesmnotmrespondmtompressure;mhoweve
r,mhismleftmhandmreachesmpurposefullymtowardmthemstimulus.mBothmlegsmaremstifflymextended.mHism
GCSmscoremis:m-mCORRECTmANSWERm9
Am20-year-
oldmwomanmwhomismatm32mweeksmgestation,mismstabbedminmthemuppermrightmchest.mInmthememerge
ncymdepartment,mhermbloodmpressuremism80/60mmmmHg.mShemismgaspingmformbreath,mextremelyma
nxious,mandmyellingmformhelp.mBreathmsoundsmaremdiminishedminmthemrightmchest.mThemmostmappro
priatemfirstmstepmismto:m-
mCORRECTmANSWERmperformmneedlemormfingermdecompressionmofmthemrightmchest
Whichmonemofmthemfollowingmfindingsminmanmadultmismmostmlikelymtomrequiremimmediatemmanage
mentmduringmthemprimarymsurvey?m-
mCORRECTmANSWERmrespiratorymratemofm40mbreathsmpermminute
Themmostmimportant,mimmediatemstepminmthemmanagementmofmanmopenmpneumothoraxmis:m-
mCORRECTmANSWERmplacementmofmanmocclusivemdressingmovermthemwound
Themfollowingmaremcontraindicationsmformtetanusmtoxoidmadministration:m-
mCORRECTmANSWERmhistorymofmneurologicalmreactionmormseveremhypersensitivitymtomthemproduct
Am56-year-
oldmmanmismthrownmviolentlymagainstmthemsteeringmwheelmofmhismtruckmduringmammotormvehiclemcr
ash.mOnmarrivalminmthememergencymdepartmentmhemismdiaphoreticmandmcomplainingmofmchestmpai
n.mHismbloodmpressuremism60/40mmmmHgmandmhismrespiratorymratemism40mbreathsmpermminute.mWhi
, chmofmthemfollowingmbestmdifferentiatesmcardiacmtamponademfrommtensionmpneumothoraxmasmthe
mcausemofmhismhypotension?m-mCORRECTmANSWERmbreathmsounds
Bronchialmintubationmofmthemrightmormleftmmainstemmbronchusmcanmeasilymoccurmduringminfantmen
dotrachealmintubationmbecause:m-mCORRECTmANSWERmThemtracheamismrelativelymshort.
Am23-year-
oldmmanmsustainsm4mstabmwoundsmtomthemuppermrightmchestmduringmanmaltercationmandmismbrough
tmbymambulancemtomamhospitalmthatmhasmfullmsurgicalmcapabilities.mHismwoundsmaremallmabovemthem
nipple.mHemismendotracheallymintubated,mclosedmtubemthoracostomymismperformed,mfluidmresuscit
ationmisminitiatedmthroughm2mlarge-
calibermIVs.mFASTmexammdoesmnotmrevealmintraabdominalminjuries.mHismbloodmpressuremnowmism60
/0mmmmHg,mheartmratemism160mbeatsmpermminute,mandmrespiratorymratemism14mbreathsmpermminute
m(ventilatedmwithm100%mO2).m1500mmLmofmbloodmhasmdrainedmfrommthemrightmchest.mThemmostmap
propriatemnextmstepminmmanagingmthismpatientmismto:m-
mCORRECTmANSWERmurgentlymtransfermthempatientmtomthemoperatingmroom
Am39-year-
oldmmanmismadmittedmtomthememergencymdepartmentmaftermanmautomobilemcollision.mHemismcyano
tic,mhasminsufficientmrespiratorymeffort,mandmhasmamGCSmscoremofm6.mHismfullmbeardmmakesmitmdiffic
ultmtomfitmthemoxygenmfacemaskmtomhismface.mThemmostmappropriatemnextmstepmismto:m-
mCORRECTmANSWERmrestrictmcervicalmmotionmandmattemptmorotrachealmintubationmusingm2mpeop
le
Ampatientmismbroughtmtomthememergencymdepartmentmaftermammotormvehiclemcrash.mHemismconscio
usmandmtheremismnomobviousmexternalmtrauma.mHemarrivesmatmthemhospitalmcompletelymimmobilize
dmonmamlongmspinemboard.mHismbloodmpressuremism60/40mmmmHgmandmhismheartmratemism70mbeatsmp
ermminute.mHismskinmismwarm.mWhichmonemofmthemfollowingmstatementsmismTRUE?m-
mCORRECTmANSWERmFlacciditymofmthemlowermextremitiesmandmlossmofmdeepmtendonmreflexesmarem
expected.
Whichmonemofmthemfollowingmismthemmostmeffectivemmethodmforminitiallymtreatingmfrostbite?m-
mCORRECTmANSWERmmoistmheat
ACTUAL EXAM 250 REAL QUESTIONS
AND CORRECT DETAILED ANSWERS
WITH RATIONALES (100% VERIFIED
ANSWERS) |
Am22-year-
oldmmanmismhypotensivemandmtachycardicmaftermamshotgunmwoundmtomthemleftmshoulder.mHismbloo
dmpressuremisminitiallym80/40mmmmHg.mAfterminitialmfluidmresuscitationmhismbloodmpressuremincreas
esmtom122/84mmmmHg.mHismheartmratemismnowm100mbeatsmpermminutemandmhismrespiratorymratemism
28mbreathsmpermminute.mAmtubemthoracostomymismperformedmformdecreasedmleftmchestmbreathmso
undsmwithmthemreturnmofmamsmallmamountmofmbloodmandmnomairmleak.mAftermchestmtubeminsertion,m
themmostmappropriatemnextmstepmis:m-mCORRECTmANSWERmre-examinemthemchest
Amconstructionmworkermfallsmtwomstoriesmfrommambuildingmandmsustainsmbilateralmcalcanealmfractu
res.mInmthememergencymdepartment,mhemismalert,mvitalmsignsmaremnormal,mandmhemismcomplainingm
ofmseverempainminmbothmheelsmandmhismlowermback.mLowermextremitympulsesmaremstrongmandmther
emismnomothermdeformity.mThemsuspectedmdiagnosismismmostmlikelymtombemconfirmedmby:m-
mCORRECTmANSWERmcompletemspinemx-raymseries
Whichmofmthemfollowingmismtruemregardingmtheminitialmresuscitationmofmamtraumampatient?m-
mCORRECTmANSWERmEvidencemofmimprovedmperfusionmaftermfluidmresuscitationmcouldmincludemim
provementminmGlasgowmComamScalemscoremonmreevaluation.
Inmmanagingmampatientmwithmamseveremtraumaticmbrainminjury,mthemmostmimportantminitialmstepmism
to:m-mCORRECTmANSWERmsecuremthemairway
Ampreviouslymhealthy,m70-kgm(154-
pound)mmanmsuffersmanmestimatedmacutembloodmlossmofm2mliters.mWhichmonemofmthemfollowingmsta
tementsmappliesmtomthismpatient?m-
mCORRECTmANSWERmAnmABGmwouldmdemonstratemambasemdeficitmbetweenm-6mandm-10mmEq/L.
,Themphysiologicalmhypervolemiamofmpregnancymhasmclinicalmsignificanceminmthemmanagementmofmt
hemseverelyminjured,mgravidmwomanmby:m-
mCORRECTmANSWERmincreasingmthemvolumemofmbloodmlossmtomproducemmaternalmhypotension
Thembestmassessmentmofmfluidmresuscitationmofmthemadultmburnmpatientmis:m-
mCORRECTmANSWERmurinarymoutputmofm0.5mmL/kg/hr
Themdiagnosismofmshockmmustminclude:m-
mCORRECTmANSWERmevidencemofminadequatemorganmperfusion
Am7-year-
oldmboymismbroughtmtomthememergencymdepartmentmbymhismparentsmseveralmminutesmaftermhemfell
mthroughmamwindow.mHemismbleedingmprofuselymfrommam6-
cmmwoundmofmhismmedialmrightmthigh.mImmediatemmanagementmofmthemwoundmshouldmconsistmof
:m-mCORRECTmANSWERmdirectmpressuremonmthemwound
Formthempatientmwithmseveremtraumaticmbrainminjury,mprofoundmhypocarbiamshouldmbemavoidedmto
mprevent:m-mCORRECTmANSWERmcerebralmvasoconstrictionmwithmdiminishedmperfusion
Aftermbeingminvolvedminmammotormvehiclemcrash,mam25-year-
oldmmanmismbroughtmtomamhospitalmthatmhasmsurgerymcapabilitiesmavailable..mComputedmtomograp
hymofmthemchestmandmabdomenmshowsmanmaorticminjurymandmsplenicmlacerationmwithmfreemabdomi
nalmfluid.mHismbloodmpressuremfallsmtom70mmmmHgmaftermCT.mThemnextmstepmis:m-
mCORRECTmANSWERmperformmanmexploratorymlaparotomy
Whichmonemofmthemfollowingmstatementsmregardingmabdominalmtraumaminmthempregnantmpatientmi
smTRUE?m-
mCORRECTmANSWERmLeakagemofmamnioticmfluidmismanmindicationmformhospitalmadmission.
,Themfirstmmaneuvermtomimprovemoxygenationmaftermchestminjurymis:m-
mCORRECTmANSWERmadministermsupplementalmoxygen
Am25-year-
oldmman,minjuredminmammotormvehicularmcrash,mismadmittedmtomthememergencymdepartment.mHismp
upilsmreactmsluggishlymandmhismeyesmopenmtompressure.mHemdoesmnotmfollowmcommands,mbutmhemd
oesmmoanmperiodically.mHismrightmarmmismdeformedmandmdoesmnotmrespondmtompressure;mhoweve
r,mhismleftmhandmreachesmpurposefullymtowardmthemstimulus.mBothmlegsmaremstifflymextended.mHism
GCSmscoremis:m-mCORRECTmANSWERm9
Am20-year-
oldmwomanmwhomismatm32mweeksmgestation,mismstabbedminmthemuppermrightmchest.mInmthememerge
ncymdepartment,mhermbloodmpressuremism80/60mmmmHg.mShemismgaspingmformbreath,mextremelyma
nxious,mandmyellingmformhelp.mBreathmsoundsmaremdiminishedminmthemrightmchest.mThemmostmappro
priatemfirstmstepmismto:m-
mCORRECTmANSWERmperformmneedlemormfingermdecompressionmofmthemrightmchest
Whichmonemofmthemfollowingmfindingsminmanmadultmismmostmlikelymtomrequiremimmediatemmanage
mentmduringmthemprimarymsurvey?m-
mCORRECTmANSWERmrespiratorymratemofm40mbreathsmpermminute
Themmostmimportant,mimmediatemstepminmthemmanagementmofmanmopenmpneumothoraxmis:m-
mCORRECTmANSWERmplacementmofmanmocclusivemdressingmovermthemwound
Themfollowingmaremcontraindicationsmformtetanusmtoxoidmadministration:m-
mCORRECTmANSWERmhistorymofmneurologicalmreactionmormseveremhypersensitivitymtomthemproduct
Am56-year-
oldmmanmismthrownmviolentlymagainstmthemsteeringmwheelmofmhismtruckmduringmammotormvehiclemcr
ash.mOnmarrivalminmthememergencymdepartmentmhemismdiaphoreticmandmcomplainingmofmchestmpai
n.mHismbloodmpressuremism60/40mmmmHgmandmhismrespiratorymratemism40mbreathsmpermminute.mWhi
, chmofmthemfollowingmbestmdifferentiatesmcardiacmtamponademfrommtensionmpneumothoraxmasmthe
mcausemofmhismhypotension?m-mCORRECTmANSWERmbreathmsounds
Bronchialmintubationmofmthemrightmormleftmmainstemmbronchusmcanmeasilymoccurmduringminfantmen
dotrachealmintubationmbecause:m-mCORRECTmANSWERmThemtracheamismrelativelymshort.
Am23-year-
oldmmanmsustainsm4mstabmwoundsmtomthemuppermrightmchestmduringmanmaltercationmandmismbrough
tmbymambulancemtomamhospitalmthatmhasmfullmsurgicalmcapabilities.mHismwoundsmaremallmabovemthem
nipple.mHemismendotracheallymintubated,mclosedmtubemthoracostomymismperformed,mfluidmresuscit
ationmisminitiatedmthroughm2mlarge-
calibermIVs.mFASTmexammdoesmnotmrevealmintraabdominalminjuries.mHismbloodmpressuremnowmism60
/0mmmmHg,mheartmratemism160mbeatsmpermminute,mandmrespiratorymratemism14mbreathsmpermminute
m(ventilatedmwithm100%mO2).m1500mmLmofmbloodmhasmdrainedmfrommthemrightmchest.mThemmostmap
propriatemnextmstepminmmanagingmthismpatientmismto:m-
mCORRECTmANSWERmurgentlymtransfermthempatientmtomthemoperatingmroom
Am39-year-
oldmmanmismadmittedmtomthememergencymdepartmentmaftermanmautomobilemcollision.mHemismcyano
tic,mhasminsufficientmrespiratorymeffort,mandmhasmamGCSmscoremofm6.mHismfullmbeardmmakesmitmdiffic
ultmtomfitmthemoxygenmfacemaskmtomhismface.mThemmostmappropriatemnextmstepmismto:m-
mCORRECTmANSWERmrestrictmcervicalmmotionmandmattemptmorotrachealmintubationmusingm2mpeop
le
Ampatientmismbroughtmtomthememergencymdepartmentmaftermammotormvehiclemcrash.mHemismconscio
usmandmtheremismnomobviousmexternalmtrauma.mHemarrivesmatmthemhospitalmcompletelymimmobilize
dmonmamlongmspinemboard.mHismbloodmpressuremism60/40mmmmHgmandmhismheartmratemism70mbeatsmp
ermminute.mHismskinmismwarm.mWhichmonemofmthemfollowingmstatementsmismTRUE?m-
mCORRECTmANSWERmFlacciditymofmthemlowermextremitiesmandmlossmofmdeepmtendonmreflexesmarem
expected.
Whichmonemofmthemfollowingmismthemmostmeffectivemmethodmforminitiallymtreatingmfrostbite?m-
mCORRECTmANSWERmmoistmheat
