ATLS 10th Edition Post Test 1, 2, 3 & 4 Actual
Questions with Verified Answers (2026/2027),
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CATEGORIES
Initial Assessment & Primary Survey
Airway & Ventilation
Shock
Thoracic Trauma
Abdominal & Pelvic Trauma
Head, Spine, Musculoskeletal & Special Populations
STUVIAACTUALEXAM
, SECTION 1: Initial Assessment & Primary Survey
Q1
Q1. A 34-year-old restrained driver is extricated from a high-speed motor vehicle collision. On arrival the patient
is moaning, has a GCS of 9, and the airway is partially obstructed by blood. Vital signs are BP 88/54 mm Hg, HR
128, RR 6 and shallow. Which action takes absolute priority according to ATLS principles?
A. Secure a definitive airway while maintaining cervical spine protection and simultaneously supporting ventilation
and circulation.
B. Obtain a full set of laboratory studies and a CT scan of the head before any intervention.
C. Perform a detailed secondary survey including log-roll and full exposure before addressing the airway.
D. Transport immediately to the CT scanner without intervening on the airway or breathing.
Correct Answer: A
Rationale:
ATLS prioritizes the ABC approach with simultaneous life-saving interventions. A compromised airway and inadequate
ventilation must be corrected immediately while protecting the cervical spine; diagnostics do not precede airway
management.
Q2
Q2. During the primary survey of a trauma patient, the team notes unequal breath sounds and tracheal deviation
away from the side of decreased breath sounds. The patient is hypotensive. Which diagnosis and intervention are
most consistent with ATLS?
A. Simple pneumothorax managed with observation only.
B. Tension pneumothorax requiring immediate needle decompression followed by chest tube.
C. Cardiac tamponade treated first with pericardiocentesis before any thoracic intervention.
D. Hemothorax managed solely with crystalloid infusion without chest drainage.
Correct Answer: B
Rationale:
Tracheal deviation, unilateral decreased breath sounds, and hypotension indicate tension pneumothorax, which is relieved
by immediate needle decompression and subsequent tube thoracostomy. Delaying decompression for other interventions is
life-threatening.
Q3
Q3. A trauma patient has a GCS of 7, unequal pupils, and a blood pressure of 210/110 mm Hg with bradycardia.
After securing the airway, which management priority aligns with ATLS head-injury principles?
A. Allow prolonged hypotension to reduce cerebral edema.
B. Perform bilateral burr holes in the emergency department before imaging.
C. Prevent hypoxia and hypotension, elevate the head of the bed if no spine injury contraindication, and arrange
rapid transfer to a facility capable of neurosurgical care.
D. Withhold all fluids indefinitely to keep the patient 'dry'.
Correct Answer: C
Rationale:
Secondary brain injury is minimized by avoiding hypoxia and hypotension. Cushing triad suggests raised ICP; definitive care
is neurosurgical. Empiric burr holes without imaging are not standard ATLS ED practice.
ATLS 10th Edition Post Test 1, 2, 3 & 4 Actual Questions with Verified... Page 2
, Q4
Q4. In the AMPLE history portion of the secondary survey, the 'M' stands for which critical information?
A. Mechanism of injury only, already obtained from prehospital providers.
B. Maximum heart rate recorded in the field.
C. Mental status score calculated from the GCS alone.
D. Medications the patient is currently taking, including anticoagulants and antiplatelets.
Correct Answer: D
Rationale:
AMPLE = Allergies, Medications, Past medical history, Last meal, Events/Environment. Current medications, especially
anticoagulants, critically affect hemorrhage management and imaging decisions.
Q5
Q5. A patient arrives with obvious pelvic instability and hypotension after a motorcycle crash. Which immediate
action is recommended during the circulation phase of the primary survey?
A. Apply a pelvic binder or sheet to stabilize the pelvis and limit further hemorrhage while resuscitating.
B. Log-roll the patient repeatedly to inspect the back before any pelvic stabilization.
C. Perform a complete rectal examination before any circulatory support.
D. Delay vascular access until the pelvis is imaged by CT.
Correct Answer: A
Rationale:
Unstable pelvic fractures can cause massive hemorrhage. Early mechanical stabilization with a binder reduces pelvic
volume and bleeding while resuscitation continues. Repeated log-rolls and delayed access worsen shock.
Q6
Q6. Adjuncts to the primary survey include which of the following when resources and patient condition allow?
A. Immediate transfer to the operating room without any imaging in every trauma patient.
B. Pulse oximetry, ECG monitoring, urinary catheter (if not contraindicated), gastric tube, and FAST or eFAST
examination as indicated.
C. Only laboratory tests with no point-of-care ultrasound.
D. Routine bilateral chest tubes in all patients with any chest trauma.
Correct Answer: B
Rationale:
ATLS adjuncts support monitoring and rapid detection of life-threatening injuries (e.g., FAST for hemoperitoneum). They do
not replace the primary survey or delay transfer when indicated.
ATLS 10th Edition Post Test 1, 2, 3 & 4 Actual Questions with Verified... Page 3