ATLS POST TEST Actual Exam 2026/2027 –
Complete Questions and Answers with
Detailed Rationales – Pass Guaranteed - A+
Graded
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SECTION 1: INITIAL ASSESSMENT & PRIMARY SURVEY (ABCDE) Q1 – Q9
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Question 1 of 50
A 34-year-old construction worker arrives by EMS after a 20-foot fall from scaffolding.
He is alert but anxious, with a respiratory rate of 28 and oxygen saturation of 94% on
room air. The trauma team leader begins the primary survey.
A. Start with a detailed history and head-to-toe physical examination
B. Obtain a CT scan of the head immediately because he fell from height
C. Assess airway patency, breathing, circulation, disability, and exposure in sequence ✓
CORRECT
D. Insert a Foley catheter to monitor urine output before addressing vital signs
Correct Answer: C
Rationale: The ATLS primary survey follows the ABCDE sequence to identify and treat
immediately life-threatening conditions in order of priority before moving to secondary
assessment. Obtaining CT scans or placing catheters before stabilizing airway,
breathing, and circulation violates the core principle of identifying the greatest threat to
life first. This systematic approach prevents missed injuries during the chaotic initial
minutes of trauma resuscitation.
,Question 2 of 50
A 28-year-old motorcyclist is brought to the trauma bay after a high-speed collision with
a guardrail. He is moaning but does not open his eyes to voice. His airway is patent but
he has gurgling respirations at a rate of 8.
A. Proceed to circulation assessment because the airway is patent
B. Administer supplemental oxygen via nasal cannula and reassess in 5 minutes
C. Open the airway with a jaw thrust and prepare for definitive airway management ✓
CORRECT
D. Obtain a chest x-ray before intervening on the low respiratory rate
Correct Answer: C
Rationale: A respiratory rate of 8 with gurgling respirations indicates impending
respiratory failure requiring immediate airway intervention; this patient needs a
definitive airway before proceeding to other steps. A patent airway does not guarantee
adequate ventilation or oxygenation. Delaying airway management to obtain imaging or
assess other systems risks hypoxic brain injury and cardiac arrest.
Question 3 of 50
A 45-year-old unrestrained driver is ejected from her vehicle during a rollover crash. She
arrives with a Glasgow Coma Scale of 7, snoring respirations, and a palpable radial
pulse. The trauma team is preparing to intubate.
A. Apply a cervical collar and maintain manual in-line stabilization during airway
manipulation ✓ CORRECT
B. Remove the collar to improve airway access and jaw mobility
C. Perform nasotracheal intubation because the patient is unconscious
D. Delay intubation until a CT scan confirms cervical spine clearance
Correct Answer: A
Rationale: All trauma patients with potential cervical spine injury require spinal
immobilization during airway management; manual in-line stabilization reduces neck
, movement while allowing mouth opening for orotracheal intubation. Nasotracheal
intubation is contraindicated in apneic patients and those with basilar skull fractures.
Delaying airway management for imaging is unsafe in a patient with a GCS of 7 and
compromised respirations.
Question 4 of 50
A 62-year-old pedestrian is struck by a car traveling 35 mph. He is confused, tachypneic
at 32, and hypotensive at 82/50. Breath sounds are present bilaterally but diminished on
the right. The trauma team identifies the priority intervention.
A. Obtain a chest x-ray to confirm the diagnosis before needle decompression
B. Perform immediate needle decompression of the right chest at the second
intercostal space, midclavicular line ✓ CORRECT
C. Administer 2 liters of crystalloid and reassess blood pressure
D. Insert a chest tube on the left side because tension pneumothorax often occurs
bilaterally
Correct Answer: B
Rationale: Hypotension, tachypnea, and unilateral diminished breath sounds in a trauma
patient constitute a tension pneumothorax until proven otherwise, requiring immediate
needle decompression without waiting for radiographic confirmation. Fluid
resuscitation will not correct the obstructive shock caused by mediastinal shift and
impaired venous return. Needle decompression on the wrong side would miss the
life-threatening pathology entirely.
Question 5 of 50
A 19-year-old college student is stabbed in the left upper quadrant during an altercation.
He arrives pale, diaphoretic, with a heart rate of 128 and blood pressure of 90/60. The
primary survey reveals no airway or breathing compromise.
Complete Questions and Answers with
Detailed Rationales – Pass Guaranteed - A+
Graded
══════════════════════════════════════
SECTION 1: INITIAL ASSESSMENT & PRIMARY SURVEY (ABCDE) Q1 – Q9
══════════════════════════════════════
Question 1 of 50
A 34-year-old construction worker arrives by EMS after a 20-foot fall from scaffolding.
He is alert but anxious, with a respiratory rate of 28 and oxygen saturation of 94% on
room air. The trauma team leader begins the primary survey.
A. Start with a detailed history and head-to-toe physical examination
B. Obtain a CT scan of the head immediately because he fell from height
C. Assess airway patency, breathing, circulation, disability, and exposure in sequence ✓
CORRECT
D. Insert a Foley catheter to monitor urine output before addressing vital signs
Correct Answer: C
Rationale: The ATLS primary survey follows the ABCDE sequence to identify and treat
immediately life-threatening conditions in order of priority before moving to secondary
assessment. Obtaining CT scans or placing catheters before stabilizing airway,
breathing, and circulation violates the core principle of identifying the greatest threat to
life first. This systematic approach prevents missed injuries during the chaotic initial
minutes of trauma resuscitation.
,Question 2 of 50
A 28-year-old motorcyclist is brought to the trauma bay after a high-speed collision with
a guardrail. He is moaning but does not open his eyes to voice. His airway is patent but
he has gurgling respirations at a rate of 8.
A. Proceed to circulation assessment because the airway is patent
B. Administer supplemental oxygen via nasal cannula and reassess in 5 minutes
C. Open the airway with a jaw thrust and prepare for definitive airway management ✓
CORRECT
D. Obtain a chest x-ray before intervening on the low respiratory rate
Correct Answer: C
Rationale: A respiratory rate of 8 with gurgling respirations indicates impending
respiratory failure requiring immediate airway intervention; this patient needs a
definitive airway before proceeding to other steps. A patent airway does not guarantee
adequate ventilation or oxygenation. Delaying airway management to obtain imaging or
assess other systems risks hypoxic brain injury and cardiac arrest.
Question 3 of 50
A 45-year-old unrestrained driver is ejected from her vehicle during a rollover crash. She
arrives with a Glasgow Coma Scale of 7, snoring respirations, and a palpable radial
pulse. The trauma team is preparing to intubate.
A. Apply a cervical collar and maintain manual in-line stabilization during airway
manipulation ✓ CORRECT
B. Remove the collar to improve airway access and jaw mobility
C. Perform nasotracheal intubation because the patient is unconscious
D. Delay intubation until a CT scan confirms cervical spine clearance
Correct Answer: A
Rationale: All trauma patients with potential cervical spine injury require spinal
immobilization during airway management; manual in-line stabilization reduces neck
, movement while allowing mouth opening for orotracheal intubation. Nasotracheal
intubation is contraindicated in apneic patients and those with basilar skull fractures.
Delaying airway management for imaging is unsafe in a patient with a GCS of 7 and
compromised respirations.
Question 4 of 50
A 62-year-old pedestrian is struck by a car traveling 35 mph. He is confused, tachypneic
at 32, and hypotensive at 82/50. Breath sounds are present bilaterally but diminished on
the right. The trauma team identifies the priority intervention.
A. Obtain a chest x-ray to confirm the diagnosis before needle decompression
B. Perform immediate needle decompression of the right chest at the second
intercostal space, midclavicular line ✓ CORRECT
C. Administer 2 liters of crystalloid and reassess blood pressure
D. Insert a chest tube on the left side because tension pneumothorax often occurs
bilaterally
Correct Answer: B
Rationale: Hypotension, tachypnea, and unilateral diminished breath sounds in a trauma
patient constitute a tension pneumothorax until proven otherwise, requiring immediate
needle decompression without waiting for radiographic confirmation. Fluid
resuscitation will not correct the obstructive shock caused by mediastinal shift and
impaired venous return. Needle decompression on the wrong side would miss the
life-threatening pathology entirely.
Question 5 of 50
A 19-year-old college student is stabbed in the left upper quadrant during an altercation.
He arrives pale, diaphoretic, with a heart rate of 128 and blood pressure of 90/60. The
primary survey reveals no airway or breathing compromise.
