ATLS 10TH EDITION POST TEST 3 ACTUAL EXAM 2026/2027
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[Section 1: Polytrauma & Decision-Making Algorithms (Q1-10)]
Q1. A 25-year-old unrestrained driver presents after a motor vehicle collision with a
systolic BP of 80 mmHg, heart rate 132, open femur fracture, and abdominal distension.
After the primary survey, what is the priority management step?
A. Obtain a CT scan of the abdomen and pelvis
B. Proceed to the operating room for intramedullary nailing of the femur
C. Transfer to the operating room for damage control laparotomy and provisional
external fixation of the femur [CORRECT]
D. Arrange emergent angiography for possible pelvic embolization
Rationale: Hemodynamically unstable polytrauma patients require hemorrhage control
before definitive fixation; damage control laparotomy addresses life-threatening
bleeding while external fixation stabilizes the fracture without the physiologic insult of
intramedullary nailing; CT and angiography are contraindicated in instability.
Correct Answer: C
Q2. A polytrauma patient with bilateral femur and tibia fractures has a temperature of
35.1°C, pH 7.18, and lactate 4.8 mmol/L. According to Early Appropriate Care principles,
definitive fixation should be delayed until which physiologic targets are met?
A. Completion of 24 hours of broad-spectrum antibiotics
B. Temperature >35°C, pH >7.25, and lactate <2.5 mmol/L [CORRECT]
C. Availability of a dedicated orthopedic trauma operating room
D. Discharge from the intensive care unit
Rationale: Early Appropriate Care requires normalization of physiology before definitive
fixation to avoid the second hit phenomenon and subsequent ARDS or multiple organ
failure; time-based or location-based criteria do not address the patient's physiologic
readiness.
Correct Answer: B
Q3. A 34-year-old patient sustains blunt abdominal trauma, remains hemodynamically
stable, and CT reveals a grade 2 splenic laceration without contrast extravasation.
, Hemoglobin is stable at 12.4 g/dL. What is the appropriate management per ATLS 10th
Edition clinical pathways?
A. Immediate splenectomy
B. Routine angioembolization for all grade 2 injuries
C. Non-operative management with serial abdominal examinations and hemoglobin
monitoring [CORRECT]
D. Exploratory laparotomy to rule out hollow viscus injury
Rationale: ATLS 10th Edition supports non-operative management of hemodynamically
stable patients with blunt solid organ injuries up to grade 3 without active contrast
extravasation; routine surgery or embolization is not indicated in this stable patient.
Correct Answer: C
Q4. A 28-year-old sustains a stab wound to the right upper quadrant. Vital signs are
stable and there is no peritonitis on examination. What is the next appropriate step in
management?
A. Local wound exploration and discharge from the emergency department
B. Diagnostic peritoneal lavage
C. CT abdomen with intravenous contrast [CORRECT]
D. Immediate exploratory laparotomy
Rationale: In hemodynamically stable penetrating trauma without peritonitis, CT with
contrast is the preferred imaging modality to evaluate trajectory and organ injury;
immediate laparotomy is reserved for unstable patients or those with peritonitis.
Correct Answer: C
Q5. A patient with an unstable pelvic fracture (APC type II) remains hypotensive after
application of a pelvic binder and 2 units of packed red blood cells. What is the next
step in the ATLS algorithm?
A. CT pelvis to define the fracture pattern
B. Immediate application of bilateral distal femoral traction pins
C. Resuscitative endovascular balloon occlusion of the aorta or preperitoneal pelvic
packing with emergent angiography [CORRECT]
D. External fixation in the emergency department without hemorrhage control
Rationale: Unstable pelvic fractures with ongoing hemorrhage after binder application
require mechanical or angiographic hemorrhage control; CT is contraindicated in
hemodynamic instability, and external fixation alone does not address venous bleeding.
| Verified Answers | 100% Pass Guarantee | A+ Graded
[Section 1: Polytrauma & Decision-Making Algorithms (Q1-10)]
Q1. A 25-year-old unrestrained driver presents after a motor vehicle collision with a
systolic BP of 80 mmHg, heart rate 132, open femur fracture, and abdominal distension.
After the primary survey, what is the priority management step?
A. Obtain a CT scan of the abdomen and pelvis
B. Proceed to the operating room for intramedullary nailing of the femur
C. Transfer to the operating room for damage control laparotomy and provisional
external fixation of the femur [CORRECT]
D. Arrange emergent angiography for possible pelvic embolization
Rationale: Hemodynamically unstable polytrauma patients require hemorrhage control
before definitive fixation; damage control laparotomy addresses life-threatening
bleeding while external fixation stabilizes the fracture without the physiologic insult of
intramedullary nailing; CT and angiography are contraindicated in instability.
Correct Answer: C
Q2. A polytrauma patient with bilateral femur and tibia fractures has a temperature of
35.1°C, pH 7.18, and lactate 4.8 mmol/L. According to Early Appropriate Care principles,
definitive fixation should be delayed until which physiologic targets are met?
A. Completion of 24 hours of broad-spectrum antibiotics
B. Temperature >35°C, pH >7.25, and lactate <2.5 mmol/L [CORRECT]
C. Availability of a dedicated orthopedic trauma operating room
D. Discharge from the intensive care unit
Rationale: Early Appropriate Care requires normalization of physiology before definitive
fixation to avoid the second hit phenomenon and subsequent ARDS or multiple organ
failure; time-based or location-based criteria do not address the patient's physiologic
readiness.
Correct Answer: B
Q3. A 34-year-old patient sustains blunt abdominal trauma, remains hemodynamically
stable, and CT reveals a grade 2 splenic laceration without contrast extravasation.
, Hemoglobin is stable at 12.4 g/dL. What is the appropriate management per ATLS 10th
Edition clinical pathways?
A. Immediate splenectomy
B. Routine angioembolization for all grade 2 injuries
C. Non-operative management with serial abdominal examinations and hemoglobin
monitoring [CORRECT]
D. Exploratory laparotomy to rule out hollow viscus injury
Rationale: ATLS 10th Edition supports non-operative management of hemodynamically
stable patients with blunt solid organ injuries up to grade 3 without active contrast
extravasation; routine surgery or embolization is not indicated in this stable patient.
Correct Answer: C
Q4. A 28-year-old sustains a stab wound to the right upper quadrant. Vital signs are
stable and there is no peritonitis on examination. What is the next appropriate step in
management?
A. Local wound exploration and discharge from the emergency department
B. Diagnostic peritoneal lavage
C. CT abdomen with intravenous contrast [CORRECT]
D. Immediate exploratory laparotomy
Rationale: In hemodynamically stable penetrating trauma without peritonitis, CT with
contrast is the preferred imaging modality to evaluate trajectory and organ injury;
immediate laparotomy is reserved for unstable patients or those with peritonitis.
Correct Answer: C
Q5. A patient with an unstable pelvic fracture (APC type II) remains hypotensive after
application of a pelvic binder and 2 units of packed red blood cells. What is the next
step in the ATLS algorithm?
A. CT pelvis to define the fracture pattern
B. Immediate application of bilateral distal femoral traction pins
C. Resuscitative endovascular balloon occlusion of the aorta or preperitoneal pelvic
packing with emergent angiography [CORRECT]
D. External fixation in the emergency department without hemorrhage control
Rationale: Unstable pelvic fractures with ongoing hemorrhage after binder application
require mechanical or angiographic hemorrhage control; CT is contraindicated in
hemodynamic instability, and external fixation alone does not address venous bleeding.
