ATLS 10TH EDITION POST TEST PRACTICE QUESTIONS & ANSWERS
ADVANCED TRAUMA LIFE SUPPORT - COMPREHENSIVE STUDY GUIDE
SECTION 1: PRIMARY SURVEY & RESUSCITATION
Question 1
A 28-year-old male is brought to the emergency department after a high-speed motor vehicle collision.
He is unresponsive. What is the FIRST priority in his management?
A) Obtain intravenous access and begin fluid resuscitation
B) Perform a focused abdominal sonography for trauma (FAST) examination
C) Establish and maintain a patent airway while protecting the cervical spine
D) Assess neurological status using the Glasgow Coma Scale
E) Apply a cervical collar and perform log-roll examination
CORRECT ANSWER:C
Explanation:
The ATLS primary survey follows the ABCDE sequence:
A - Airway maintenance with cervical spine protection
B - Breathing and ventilation
C - Circulation with hemorrhage control
D - Disability/neurological status
E - Exposure and environmental control
Airway is ALWAYS the first priority. Without a patent airway, all other interventions are futile. In an
unresponsive patient, airway compromise is life-threatening and must be addressed immediately.
Cervical spine protection is performed simultaneously with airway management in trauma patients.
,Key Teaching Point: The "A" in ABCDE does not mean airway alone — it means Airway WITH cervical
spine protection. These two actions occur simultaneously.
Question 2
During the primary survey of a trauma patient, you identify life-threatening conditions in which order
should they be addressed?
A) Neurological deficits → Airway problems → Hemorrhage → Breathing issues
B) Airway obstruction → Breathing problems → Circulatory failure → Neurological deficits
C) Hemorrhage → Airway obstruction → Breathing problems → Neurological deficits
D) Breathing problems → Airway obstruction → Circulatory failure → Neurological deficits
E) Circulatory failure → Airway obstruction → Breathing problems → Neurological deficits
CORRECT ANSWER:B
Explanation:
The ATLS primary survey sequence is strictly hierarchical:
Airway — obstruction kills fastest (minutes)
Breathing — inadequate ventilation/oxygenation
Circulation — hemorrhage control and perfusion
Disability — neurological assessment
Exposure — complete examination
Each problem identified during the primary survey is addressed IMMEDIATELY before moving to the
next step. This is a critical concept — you do not complete the entire primary survey before treating;
you treat as you go.
Key Teaching Point: Life-threatening conditions are treated as they are identified during the primary
survey, not after the entire survey is complete.
,Question 3
A 35-year-old woman is brought in after a motorcycle accident. Her GCS is 14, respiratory rate is 28/min,
blood pressure is 90/60 mmHg, and she has obvious deformity of the right femur. During the primary
survey, which finding requires IMMEDIATE intervention?
A) GCS of 14
B) Respiratory rate of 28/min
C) Blood pressure of 90/60 mmHg
D) Right femur deformity
E) Both B and C
CORRECT ANSWER:C
Explanation:
While all findings are concerning:
GCS 14 — slightly decreased but not immediately life-threatening
RR 28/min — tachypnea is concerning but she is breathing
BP 90/60 — this represents hypotension, indicating Class III-IV hemorrhagic shock requiring IMMEDIATE
intervention
Femur deformity — addressed in secondary survey unless associated with vascular compromise
The hypotension (BP 90/60) in a trauma patient indicates hemorrhagic shock until proven otherwise.
This requires immediate vascular access, fluid resuscitation, and identification/control of hemorrhage
source.
Remember: Systolic BP <90 mmHg in adults = hypotension in trauma setting
Question 4
Which of the following BEST describes the concept of "treat as you go" during the ATLS primary survey?
, A) Complete the entire primary survey before initiating any treatment
B) Identify and treat life-threatening conditions immediately as they are discovered
C) Prioritize treatment of the most visually dramatic injuries first
D) Delay treatment until the secondary survey is complete
E) Begin treatment only after all diagnostic studies are obtained
CORRECT ANSWER:B
Explanation:
A fundamental ATLS principle is that life-threatening conditions are treated AS they are identified, not
after the complete survey. This means:
If airway obstruction is found → secure airway immediately
If tension pneumothorax is identified → decompress immediately
If massive hemorrhage is identified → control immediately
This approach prevents deaths that would occur if treatment were delayed until the survey was
complete. The primary survey is dynamic and simultaneous — multiple team members may address
different components concurrently.
Key Teaching Point: Do NOT move to "B" until the "A" problem is addressed. Do NOT move to "C" until
"B" is addressed, and so on.
Question 5
A trauma patient arrives with a systolic blood pressure of 70 mmHg. After 1 liter of crystalloid, BP rises
to 110 mmHg. Twenty minutes later, BP drops again to 80 mmHg. This response pattern is BEST
described as:
A) Rapid responder
B) Transient responder
C) Non-responder
D) Delayed responder
ADVANCED TRAUMA LIFE SUPPORT - COMPREHENSIVE STUDY GUIDE
SECTION 1: PRIMARY SURVEY & RESUSCITATION
Question 1
A 28-year-old male is brought to the emergency department after a high-speed motor vehicle collision.
He is unresponsive. What is the FIRST priority in his management?
A) Obtain intravenous access and begin fluid resuscitation
B) Perform a focused abdominal sonography for trauma (FAST) examination
C) Establish and maintain a patent airway while protecting the cervical spine
D) Assess neurological status using the Glasgow Coma Scale
E) Apply a cervical collar and perform log-roll examination
CORRECT ANSWER:C
Explanation:
The ATLS primary survey follows the ABCDE sequence:
A - Airway maintenance with cervical spine protection
B - Breathing and ventilation
C - Circulation with hemorrhage control
D - Disability/neurological status
E - Exposure and environmental control
Airway is ALWAYS the first priority. Without a patent airway, all other interventions are futile. In an
unresponsive patient, airway compromise is life-threatening and must be addressed immediately.
Cervical spine protection is performed simultaneously with airway management in trauma patients.
,Key Teaching Point: The "A" in ABCDE does not mean airway alone — it means Airway WITH cervical
spine protection. These two actions occur simultaneously.
Question 2
During the primary survey of a trauma patient, you identify life-threatening conditions in which order
should they be addressed?
A) Neurological deficits → Airway problems → Hemorrhage → Breathing issues
B) Airway obstruction → Breathing problems → Circulatory failure → Neurological deficits
C) Hemorrhage → Airway obstruction → Breathing problems → Neurological deficits
D) Breathing problems → Airway obstruction → Circulatory failure → Neurological deficits
E) Circulatory failure → Airway obstruction → Breathing problems → Neurological deficits
CORRECT ANSWER:B
Explanation:
The ATLS primary survey sequence is strictly hierarchical:
Airway — obstruction kills fastest (minutes)
Breathing — inadequate ventilation/oxygenation
Circulation — hemorrhage control and perfusion
Disability — neurological assessment
Exposure — complete examination
Each problem identified during the primary survey is addressed IMMEDIATELY before moving to the
next step. This is a critical concept — you do not complete the entire primary survey before treating;
you treat as you go.
Key Teaching Point: Life-threatening conditions are treated as they are identified during the primary
survey, not after the entire survey is complete.
,Question 3
A 35-year-old woman is brought in after a motorcycle accident. Her GCS is 14, respiratory rate is 28/min,
blood pressure is 90/60 mmHg, and she has obvious deformity of the right femur. During the primary
survey, which finding requires IMMEDIATE intervention?
A) GCS of 14
B) Respiratory rate of 28/min
C) Blood pressure of 90/60 mmHg
D) Right femur deformity
E) Both B and C
CORRECT ANSWER:C
Explanation:
While all findings are concerning:
GCS 14 — slightly decreased but not immediately life-threatening
RR 28/min — tachypnea is concerning but she is breathing
BP 90/60 — this represents hypotension, indicating Class III-IV hemorrhagic shock requiring IMMEDIATE
intervention
Femur deformity — addressed in secondary survey unless associated with vascular compromise
The hypotension (BP 90/60) in a trauma patient indicates hemorrhagic shock until proven otherwise.
This requires immediate vascular access, fluid resuscitation, and identification/control of hemorrhage
source.
Remember: Systolic BP <90 mmHg in adults = hypotension in trauma setting
Question 4
Which of the following BEST describes the concept of "treat as you go" during the ATLS primary survey?
, A) Complete the entire primary survey before initiating any treatment
B) Identify and treat life-threatening conditions immediately as they are discovered
C) Prioritize treatment of the most visually dramatic injuries first
D) Delay treatment until the secondary survey is complete
E) Begin treatment only after all diagnostic studies are obtained
CORRECT ANSWER:B
Explanation:
A fundamental ATLS principle is that life-threatening conditions are treated AS they are identified, not
after the complete survey. This means:
If airway obstruction is found → secure airway immediately
If tension pneumothorax is identified → decompress immediately
If massive hemorrhage is identified → control immediately
This approach prevents deaths that would occur if treatment were delayed until the survey was
complete. The primary survey is dynamic and simultaneous — multiple team members may address
different components concurrently.
Key Teaching Point: Do NOT move to "B" until the "A" problem is addressed. Do NOT move to "C" until
"B" is addressed, and so on.
Question 5
A trauma patient arrives with a systolic blood pressure of 70 mmHg. After 1 liter of crystalloid, BP rises
to 110 mmHg. Twenty minutes later, BP drops again to 80 mmHg. This response pattern is BEST
described as:
A) Rapid responder
B) Transient responder
C) Non-responder
D) Delayed responder
