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ATLS POST TEST MCQ Final Exam Newest Exam
Preparation With Complete Questions And Correct
Answers With Rationales | Already Graded A+||Brand
New Version!!
QUESTION 1
A 22-year-old male is brought to the emergency department after a
high-speed motor vehicle collision. He is intubated, and a left-sided
chest tube has been placed. His blood pressure is 85/50 mm Hg, heart
rate is 130 beats per minute, and oxygen saturation is 94% on 100%
oxygen. Which of the following is the most appropriate next step in
management?
A) Administer 2 liters of isotonic crystalloid rapidly
B) Perform a focused assessment with sonography for trauma (FAST)
examination
C) Obtain a CT scan of the chest
D) Prepare for an emergency thoracotomy
Answer: A) Administer 2 liters of isotonic crystalloid rapidly
Explanation: The patient is in hypotensive shock with tachycardia
following blunt trauma. The initial management of hemorrhagic shock
is the administration of warmed isotonic crystalloid at 1-2 liters. The
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FAST exam is useful but should not delay resuscitation. CT scanning is
not appropriate in an unstable patient. Emergency thoracotomy is
reserved for patients with cardiac arrest or penetrating chest trauma
with signs of life; this patient has a pulse and blood pressure, albeit low.
QUESTION 2
A 45-year-old woman is involved in a frontal collision and presents with
a “steering wheel” injury to her chest. She has paradoxical chest wall
motion on the left side. Which of the following best describes her
condition?
A) Pulmonary contusion
B) Flail chest
C) Tension pneumothorax
D) Cardiac tamponade
Answer: B) Flail chest
Explanation: Flail chest is defined as two or more adjacent rib fractures
in at least two places, leading to a segment of the chest wall that moves
paradoxically (inward during inspiration, outward during expiration).
Pulmonary contusion often accompanies flail chest. Tension
pneumothorax presents with tracheal deviation and hemodynamic
compromise. Cardiac tamponade manifests with muffled heart sounds,
hypotension, and distended neck veins.
QUESTION 3
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A 30-year-old male is stabbed in the right anterior chest. He is agitated,
with a heart rate of 120, respiratory rate of 30, and blood pressure of
90/60. On examination, breath sounds are diminished on the right, and
jugular veins are distended. What is the most appropriate immediate
intervention?
A) Needle decompression of the right chest
B) Pericardiocentesis
C) Tube thoracostomy
D) Emergency department thoracotomy
Answer: A) Needle decompression of the right chest
Explanation: The patient has signs of tension pneumothorax:
tachycardia, hypotension, distended neck veins, and diminished breath
sounds. Needle decompression (second intercostal space, midclavicular
line) is the immediate life-saving intervention, followed by tube
thoracostomy. Pericardiocentesis is for cardiac tamponade, which is less
likely in penetrating anterior chest trauma without specific signs like
muffled heart sounds. ED thoracotomy is not indicated with ongoing
signs of life.
QUESTION 4
A patient with blunt abdominal trauma has a positive FAST
examination. His blood pressure is 80/50 despite 2 liters of crystalloid.
What is the next best step?
A) Repeat FAST in 30 minutes
B) CT scan of the abdomen with contrast
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C) Immediate laparotomy
D) Angiography
Answer: C) Immediate laparotomy
Explanation: This patient has hemorrhagic shock with a positive FAST,
indicating intra-abdominal bleeding. Failure to respond to initial fluid
resuscitation (2 liters) is an indication for urgent laparotomy in blunt
trauma. CT scan is not appropriate for hemodynamically unstable
patients. Angiography is reserved for stable patients with suspected
solid organ injury.
QUESTION 5
A 55-year-old male is brought in after a fall from a height. He is
conscious and complains of back pain and bilateral lower extremity
weakness. His blood pressure is 100/70 and heart rate 95. The most
important initial step is:
A) Log roll and examine the spine
B) Apply a cervical collar and place on a spine board
C) Obtain a CT scan of the spine
D) Perform a rectal examination
Answer: B) Apply a cervical collar and place on a spine board
Explanation: All trauma patients with suspected spinal injury require
spinal immobilization (cervical collar and spine board) as the first
priority to prevent further neurologic injury. Log rolling is done carefully
ATLS POST TEST MCQ Final Exam Newest Exam
Preparation With Complete Questions And Correct
Answers With Rationales | Already Graded A+||Brand
New Version!!
QUESTION 1
A 22-year-old male is brought to the emergency department after a
high-speed motor vehicle collision. He is intubated, and a left-sided
chest tube has been placed. His blood pressure is 85/50 mm Hg, heart
rate is 130 beats per minute, and oxygen saturation is 94% on 100%
oxygen. Which of the following is the most appropriate next step in
management?
A) Administer 2 liters of isotonic crystalloid rapidly
B) Perform a focused assessment with sonography for trauma (FAST)
examination
C) Obtain a CT scan of the chest
D) Prepare for an emergency thoracotomy
Answer: A) Administer 2 liters of isotonic crystalloid rapidly
Explanation: The patient is in hypotensive shock with tachycardia
following blunt trauma. The initial management of hemorrhagic shock
is the administration of warmed isotonic crystalloid at 1-2 liters. The
,2|Page
FAST exam is useful but should not delay resuscitation. CT scanning is
not appropriate in an unstable patient. Emergency thoracotomy is
reserved for patients with cardiac arrest or penetrating chest trauma
with signs of life; this patient has a pulse and blood pressure, albeit low.
QUESTION 2
A 45-year-old woman is involved in a frontal collision and presents with
a “steering wheel” injury to her chest. She has paradoxical chest wall
motion on the left side. Which of the following best describes her
condition?
A) Pulmonary contusion
B) Flail chest
C) Tension pneumothorax
D) Cardiac tamponade
Answer: B) Flail chest
Explanation: Flail chest is defined as two or more adjacent rib fractures
in at least two places, leading to a segment of the chest wall that moves
paradoxically (inward during inspiration, outward during expiration).
Pulmonary contusion often accompanies flail chest. Tension
pneumothorax presents with tracheal deviation and hemodynamic
compromise. Cardiac tamponade manifests with muffled heart sounds,
hypotension, and distended neck veins.
QUESTION 3
,3|Page
A 30-year-old male is stabbed in the right anterior chest. He is agitated,
with a heart rate of 120, respiratory rate of 30, and blood pressure of
90/60. On examination, breath sounds are diminished on the right, and
jugular veins are distended. What is the most appropriate immediate
intervention?
A) Needle decompression of the right chest
B) Pericardiocentesis
C) Tube thoracostomy
D) Emergency department thoracotomy
Answer: A) Needle decompression of the right chest
Explanation: The patient has signs of tension pneumothorax:
tachycardia, hypotension, distended neck veins, and diminished breath
sounds. Needle decompression (second intercostal space, midclavicular
line) is the immediate life-saving intervention, followed by tube
thoracostomy. Pericardiocentesis is for cardiac tamponade, which is less
likely in penetrating anterior chest trauma without specific signs like
muffled heart sounds. ED thoracotomy is not indicated with ongoing
signs of life.
QUESTION 4
A patient with blunt abdominal trauma has a positive FAST
examination. His blood pressure is 80/50 despite 2 liters of crystalloid.
What is the next best step?
A) Repeat FAST in 30 minutes
B) CT scan of the abdomen with contrast
, 4|Page
C) Immediate laparotomy
D) Angiography
Answer: C) Immediate laparotomy
Explanation: This patient has hemorrhagic shock with a positive FAST,
indicating intra-abdominal bleeding. Failure to respond to initial fluid
resuscitation (2 liters) is an indication for urgent laparotomy in blunt
trauma. CT scan is not appropriate for hemodynamically unstable
patients. Angiography is reserved for stable patients with suspected
solid organ injury.
QUESTION 5
A 55-year-old male is brought in after a fall from a height. He is
conscious and complains of back pain and bilateral lower extremity
weakness. His blood pressure is 100/70 and heart rate 95. The most
important initial step is:
A) Log roll and examine the spine
B) Apply a cervical collar and place on a spine board
C) Obtain a CT scan of the spine
D) Perform a rectal examination
Answer: B) Apply a cervical collar and place on a spine board
Explanation: All trauma patients with suspected spinal injury require
spinal immobilization (cervical collar and spine board) as the first
priority to prevent further neurologic injury. Log rolling is done carefully
