ATLS 10th Edition Test 1 ACTUAL
EXAM 2026/2027 | Complete Exam-Style
Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
Content Area Overview
This actual examination reflects the comprehensive trauma knowledge required for success on the ATLS
10th Edition Test 1. It is designed to evaluate the student's understanding of the systematic approach to
trauma care, from the primary survey to definitive management. Questions are structured to assess
recall of key principles, application of clinical algorithms to complex trauma scenarios, and analysis of
life-threatening injury patterns. This authentic question bank represents the real exams used in the
course and serves as a comprehensive resource for trauma surgeons, emergency physicians, residents,
and advanced clinical providers demonstrating mastery of ATLS content for the 2026/2027 academic
year.
SECTION 1: Primary Survey and Initial Resuscitation (ABCDEs)
(Questions 1–10)
Question 1
A 34-year-old male is brought to the emergency department after a high-speed motorcycle crash. He is
responsive to painful stimuli but not following commands. His airway is patent, but he has gurgling
respirations and vomitus in his oropharynx. The trauma team leader's first action should be:
A. Insert an oropharyngeal airway and suction the airway
B. Immediately perform rapid sequence intubation with in-line cervical stabilization
C. Logroll the patient to clear the vomitus
D. Obtain a chest x-ray before airway intervention
B. Immediately perform rapid sequence intubation with in-line cervical stabilization [CORRECT]
,The best answer is immediately perform rapid sequence intubation with in-line cervical stabilization.
This patient has a compromised airway—gurgling respirations, vomitus, and altered mental status (not
following commands) indicate he cannot protect his airway. In trauma, airway always comes first in the
primary survey. Cervical spine immobilization is maintained throughout because all trauma patients are
assumed to have a C-spine injury until proven otherwise. Suctioning is important but does not secure
the airway; the patient needs definitive airway control. This aligns with ATLS guidelines for airway
management in trauma.
Correct Answer: B
Question 2
A 28-year-old construction worker falls from a second-story scaffold and presents with absent breath
sounds on the left, tracheal deviation to the right, distended neck veins, and hypotension (BP 72/40).
The trauma team leader should perform which immediate intervention?
A. Insert a large-bore chest tube in the left 5th intercostal space
B. Perform needle decompression in the 2nd intercostal space at the midclavicular line on the left
C. Obtain an upright chest x-ray to confirm the diagnosis
D. Begin positive pressure ventilation before decompression
B. Perform needle decompression in the 2nd intercostal space at the midclavicular line on the left
[CORRECT]
This choice is correct because tension pneumothorax is a clinical diagnosis—never wait for imaging. The
classic findings include absent breath sounds, tracheal deviation away from the affected side, JVD, and
hypotension. Needle decompression with a 14-gauge needle at least 3.25 inches long in the 2nd
intercostal space, midclavicular line, on the affected side converts the tension pneumothorax to a simple
pneumothorax and is immediately life-saving. Chest tube placement follows, but decompression comes
first. This matches the systematic approach to trauma for immediate thoracic decompression.
Correct Answer: B
Question 3
A 32-year-old male has a penetrating chest injury with a visible wound producing a sucking sound during
inspiration. What is the next step?
A. Apply an occlusive dressing taped on three sides
B. Perform needle decompression
C. Insert a chest tube
, D. Perform immediate thoracotomy
E. Administer oxygen
A. Apply an occlusive dressing taped on three sides [CORRECT]
The best answer is to apply an occlusive dressing taped on three sides. An open pneumothorax (sucking
chest wound) allows air to enter the pleural space through the chest wall defect during inspiration,
collapsing the lung. A three-sided dressing acts as a one-way valve—air can escape during expiration but
cannot enter during inspiration, preventing tension pneumothorax while allowing the lung to re-expand.
A completely sealed dressing could trap air and create tension. This aligns with ATLS guidelines for open
pneumothorax management.
Correct Answer: A
Question 4
A 35-year-old female pedestrian struck by a car presents with a respiratory rate of 34, oxygen saturation
86% on room air, and paradoxical chest wall movement on the left side involving ribs 5–8. Her BP is
100/60. The most appropriate immediate management for her breathing is:
A. Immediate endotracheal intubation and mechanical ventilation
B. High-flow oxygen via non-rebreather mask and aggressive analgesia with close monitoring
C. Needle decompression of the left hemithorax
D. Chest tube insertion on the left side
B. High-flow oxygen via non-rebreather mask and aggressive analgesia with close monitoring
[CORRECT]
This choice is correct because the patient has a flail chest—paradoxical movement of a free-floating
segment due to multiple contiguous rib fractures. The real problem is usually the underlying pulmonary
contusion and pain-induced splinting, not the flail segment itself. Adequate analgesia (epidural,
intercostal nerve blocks, or IV opioids) allows deep breathing and prevents atelectasis and pneumonia.
Intubation is reserved for respiratory failure, not routine flail chest. Needle decompression and chest
tube are not indicated here. This matches ATLS guidelines for flail chest management.
Correct Answer: B
Question 5
A 50-year-old male involved in a motor vehicle collision presents with a heart rate of 136, BP 84/50, cool
clammy skin, and delayed capillary refill. He has received 2 liters of warmed lactated Ringer's without
EXAM 2026/2027 | Complete Exam-Style
Questions | Verified Q&A | Pass
Guaranteed - A+ Graded
Content Area Overview
This actual examination reflects the comprehensive trauma knowledge required for success on the ATLS
10th Edition Test 1. It is designed to evaluate the student's understanding of the systematic approach to
trauma care, from the primary survey to definitive management. Questions are structured to assess
recall of key principles, application of clinical algorithms to complex trauma scenarios, and analysis of
life-threatening injury patterns. This authentic question bank represents the real exams used in the
course and serves as a comprehensive resource for trauma surgeons, emergency physicians, residents,
and advanced clinical providers demonstrating mastery of ATLS content for the 2026/2027 academic
year.
SECTION 1: Primary Survey and Initial Resuscitation (ABCDEs)
(Questions 1–10)
Question 1
A 34-year-old male is brought to the emergency department after a high-speed motorcycle crash. He is
responsive to painful stimuli but not following commands. His airway is patent, but he has gurgling
respirations and vomitus in his oropharynx. The trauma team leader's first action should be:
A. Insert an oropharyngeal airway and suction the airway
B. Immediately perform rapid sequence intubation with in-line cervical stabilization
C. Logroll the patient to clear the vomitus
D. Obtain a chest x-ray before airway intervention
B. Immediately perform rapid sequence intubation with in-line cervical stabilization [CORRECT]
,The best answer is immediately perform rapid sequence intubation with in-line cervical stabilization.
This patient has a compromised airway—gurgling respirations, vomitus, and altered mental status (not
following commands) indicate he cannot protect his airway. In trauma, airway always comes first in the
primary survey. Cervical spine immobilization is maintained throughout because all trauma patients are
assumed to have a C-spine injury until proven otherwise. Suctioning is important but does not secure
the airway; the patient needs definitive airway control. This aligns with ATLS guidelines for airway
management in trauma.
Correct Answer: B
Question 2
A 28-year-old construction worker falls from a second-story scaffold and presents with absent breath
sounds on the left, tracheal deviation to the right, distended neck veins, and hypotension (BP 72/40).
The trauma team leader should perform which immediate intervention?
A. Insert a large-bore chest tube in the left 5th intercostal space
B. Perform needle decompression in the 2nd intercostal space at the midclavicular line on the left
C. Obtain an upright chest x-ray to confirm the diagnosis
D. Begin positive pressure ventilation before decompression
B. Perform needle decompression in the 2nd intercostal space at the midclavicular line on the left
[CORRECT]
This choice is correct because tension pneumothorax is a clinical diagnosis—never wait for imaging. The
classic findings include absent breath sounds, tracheal deviation away from the affected side, JVD, and
hypotension. Needle decompression with a 14-gauge needle at least 3.25 inches long in the 2nd
intercostal space, midclavicular line, on the affected side converts the tension pneumothorax to a simple
pneumothorax and is immediately life-saving. Chest tube placement follows, but decompression comes
first. This matches the systematic approach to trauma for immediate thoracic decompression.
Correct Answer: B
Question 3
A 32-year-old male has a penetrating chest injury with a visible wound producing a sucking sound during
inspiration. What is the next step?
A. Apply an occlusive dressing taped on three sides
B. Perform needle decompression
C. Insert a chest tube
, D. Perform immediate thoracotomy
E. Administer oxygen
A. Apply an occlusive dressing taped on three sides [CORRECT]
The best answer is to apply an occlusive dressing taped on three sides. An open pneumothorax (sucking
chest wound) allows air to enter the pleural space through the chest wall defect during inspiration,
collapsing the lung. A three-sided dressing acts as a one-way valve—air can escape during expiration but
cannot enter during inspiration, preventing tension pneumothorax while allowing the lung to re-expand.
A completely sealed dressing could trap air and create tension. This aligns with ATLS guidelines for open
pneumothorax management.
Correct Answer: A
Question 4
A 35-year-old female pedestrian struck by a car presents with a respiratory rate of 34, oxygen saturation
86% on room air, and paradoxical chest wall movement on the left side involving ribs 5–8. Her BP is
100/60. The most appropriate immediate management for her breathing is:
A. Immediate endotracheal intubation and mechanical ventilation
B. High-flow oxygen via non-rebreather mask and aggressive analgesia with close monitoring
C. Needle decompression of the left hemithorax
D. Chest tube insertion on the left side
B. High-flow oxygen via non-rebreather mask and aggressive analgesia with close monitoring
[CORRECT]
This choice is correct because the patient has a flail chest—paradoxical movement of a free-floating
segment due to multiple contiguous rib fractures. The real problem is usually the underlying pulmonary
contusion and pain-induced splinting, not the flail segment itself. Adequate analgesia (epidural,
intercostal nerve blocks, or IV opioids) allows deep breathing and prevents atelectasis and pneumonia.
Intubation is reserved for respiratory failure, not routine flail chest. Needle decompression and chest
tube are not indicated here. This matches ATLS guidelines for flail chest management.
Correct Answer: B
Question 5
A 50-year-old male involved in a motor vehicle collision presents with a heart rate of 136, BP 84/50, cool
clammy skin, and delayed capillary refill. He has received 2 liters of warmed lactated Ringer's without
