ATLS® PRACTICE TEST AND STUDY GUIDE
2026: 250 PRACTICE QUESTIONS AND
DETAILED ANSWER RATIONALES
ADVANCED TRAUMA LIFE SUPPORT
CERTIFICATION EXAM REVIEW
Which of the following is no longer indicated for routine treatment of shock
patients?
A. Cervical spine stabilization
B. Pneumatic anti-shock garment (PASG)
C. Endotracheal intubation
D. Oxygen - CORRECT ANSWER -B. Pneumatic anti-shock garment (PASG)
A 13 year old boy fell while riding his bicycle and hit his head. He was
unconscious for 4 or 5 minutes. He vomited twice. He has no memory of
the event or a headache. His exam is entirely normal. Glasgow coma score
is 15. Select the next step in management.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation - CORRECT ANSWER -B. CT of the head
Cerebral edema treatment - CORRECT ANSWER -Mannitol
Head up position
,Hyperventilation
Sellick maneuver - CORRECT ANSWER -Minimizes the chances of
regurgitation during intubation
Which of the following is predominantly an iatrogenic complication?
A. Venous air embolism
B. Deep venous thrombosis (DVT)
C. Venous thromboembolism
D. None of the above - CORRECT ANSWER -A. Venous air embolism
Normal capillary refill time - CORRECT ANSWER -2 seconds
Which of the following cannot be administered via endotracheal (ET) tube?
A. Atropine
B. Atenolol
C. Epinephrine
D. Lidocaine - CORRECT ANSWER -B. Atenolol
Can be added to lidocaine to reduce the burning sensation when
administered - CORRECT ANSWER -Sodium bicarbonate
Nerve + sensory relationships - CORRECT ANSWER -C6 - Thumb
C7 - Middle finger
,C8 - Little finger
True regarding the initial resuscitation of a trauma patient - CORRECT
ANSWER -Evidence of improved perfusion after fluid resuscitation could
include improvement of GCS on reevaluation
For the patient with severe traumatic brain injury, profound hypocarbia
should be avoided to prevent: - CORRECT ANSWER -cerebral
vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought
to a hospital that has surgery capabilities available.. Computed tomography
of the chest and abdomen shows an aortic injury and splenic laceration
with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT.
The next step is: - CORRECT ANSWER -perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the
pregnant patient is TRUE?
A. The fetus is in jeopardy only with major abdominal trauma.
B. Leakage of amniotic fluid is an indication for hospital admission.
C. Indications for peritoneal lavage are different from those in the
nonpregnant patient.
D. With penetrating trauma, injury to the mother's abdominal hollow
viscus is more common in late than in early pregnancy.
E. The secondary survey follows a different pattern from that of the
nonpregnant patient. - CORRECT ANSWER -B. Leakage of amniotic fluid is
an indication for hospital admission.
, Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?
A. distended abdomen
B. Glasgow Coma Scale score of 11
C. temperature of 36.5°C (97.8°F)
D. deforming of the right thigh
E. Respiratory rate of 40 breaths per minute - CORRECT ANSWER -E.
Respiratory rate of 40 breaths per minute
The most important, immediate step in the management of an open
pneumothorax is:
A. endotracheal intubation
B. operation to close the wound
C. placing a chest tube through the chest wound
D. placement of an occlusive dressing over the wound
E. initiation of 2, large-caliber IVs with crystalloid solutionE. - CORRECT
ANSWER -D. placement of an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration:
A. history of neurological reaction or severe hypersensitivity to the product
B. local side effects
C. muscular spasms
D. pregnancy
E. all of the above - CORRECT ANSWER -A. history of neurological reaction
or severe hypersensitivity to the product
2026: 250 PRACTICE QUESTIONS AND
DETAILED ANSWER RATIONALES
ADVANCED TRAUMA LIFE SUPPORT
CERTIFICATION EXAM REVIEW
Which of the following is no longer indicated for routine treatment of shock
patients?
A. Cervical spine stabilization
B. Pneumatic anti-shock garment (PASG)
C. Endotracheal intubation
D. Oxygen - CORRECT ANSWER -B. Pneumatic anti-shock garment (PASG)
A 13 year old boy fell while riding his bicycle and hit his head. He was
unconscious for 4 or 5 minutes. He vomited twice. He has no memory of
the event or a headache. His exam is entirely normal. Glasgow coma score
is 15. Select the next step in management.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation - CORRECT ANSWER -B. CT of the head
Cerebral edema treatment - CORRECT ANSWER -Mannitol
Head up position
,Hyperventilation
Sellick maneuver - CORRECT ANSWER -Minimizes the chances of
regurgitation during intubation
Which of the following is predominantly an iatrogenic complication?
A. Venous air embolism
B. Deep venous thrombosis (DVT)
C. Venous thromboembolism
D. None of the above - CORRECT ANSWER -A. Venous air embolism
Normal capillary refill time - CORRECT ANSWER -2 seconds
Which of the following cannot be administered via endotracheal (ET) tube?
A. Atropine
B. Atenolol
C. Epinephrine
D. Lidocaine - CORRECT ANSWER -B. Atenolol
Can be added to lidocaine to reduce the burning sensation when
administered - CORRECT ANSWER -Sodium bicarbonate
Nerve + sensory relationships - CORRECT ANSWER -C6 - Thumb
C7 - Middle finger
,C8 - Little finger
True regarding the initial resuscitation of a trauma patient - CORRECT
ANSWER -Evidence of improved perfusion after fluid resuscitation could
include improvement of GCS on reevaluation
For the patient with severe traumatic brain injury, profound hypocarbia
should be avoided to prevent: - CORRECT ANSWER -cerebral
vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought
to a hospital that has surgery capabilities available.. Computed tomography
of the chest and abdomen shows an aortic injury and splenic laceration
with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT.
The next step is: - CORRECT ANSWER -perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the
pregnant patient is TRUE?
A. The fetus is in jeopardy only with major abdominal trauma.
B. Leakage of amniotic fluid is an indication for hospital admission.
C. Indications for peritoneal lavage are different from those in the
nonpregnant patient.
D. With penetrating trauma, injury to the mother's abdominal hollow
viscus is more common in late than in early pregnancy.
E. The secondary survey follows a different pattern from that of the
nonpregnant patient. - CORRECT ANSWER -B. Leakage of amniotic fluid is
an indication for hospital admission.
, Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?
A. distended abdomen
B. Glasgow Coma Scale score of 11
C. temperature of 36.5°C (97.8°F)
D. deforming of the right thigh
E. Respiratory rate of 40 breaths per minute - CORRECT ANSWER -E.
Respiratory rate of 40 breaths per minute
The most important, immediate step in the management of an open
pneumothorax is:
A. endotracheal intubation
B. operation to close the wound
C. placing a chest tube through the chest wound
D. placement of an occlusive dressing over the wound
E. initiation of 2, large-caliber IVs with crystalloid solutionE. - CORRECT
ANSWER -D. placement of an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration:
A. history of neurological reaction or severe hypersensitivity to the product
B. local side effects
C. muscular spasms
D. pregnancy
E. all of the above - CORRECT ANSWER -A. history of neurological reaction
or severe hypersensitivity to the product
