ATLS Geriatric Trauma Resuscitation
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
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1. An 78-year-old patient is brought to the trauma bay after a motor
vehicle collision. Which physiologic characteristic of aging most
directly increases the risk of occult shock?
A. Increased resting cardiac output
B. Increased maximal heart rate
C. Reduced cardiovascular reserve
D. Increased total body water
Answer: C. Reduced cardiovascular reserve
Rationale: Older adults may have limited ability to increase cardiac
output in response to blood loss because of reduced cardiac reserve,
vascular stiffness, and impaired autonomic responsiveness. Therefore,
apparently acceptable vital signs may underestimate the severity of
shock.
2. Which age group is generally considered geriatric for trauma-
system planning?
A. 45 years and older
B. 55 years and older
C. 65 years and older
D. 80 years and older
,Answer: C. 65 years and older
Rationale: Many geriatric trauma protocols use 65 years as an
important threshold, although physiologic age, frailty, comorbidities,
medications, and functional status should also influence assessment
and management.
3. An elderly trauma patient has a heart rate of 88/min and systolic
blood pressure of 108 mmHg. Which interpretation is most
appropriate?
A. The patient cannot be in shock because the heart rate is normal
B. The patient should be considered potentially hypoperfused
C. The patient definitely has neurogenic shock
D. The patient is adequately resuscitated
Answer: B. The patient should be considered potentially
hypoperfused
Rationale: Older adults may have blunted tachycardia and altered
blood-pressure responses. A relatively modest increase in heart rate or
a systolic pressure that would appear acceptable in a younger patient
can represent clinically important physiologic compromise in an older
adult.
4. Which medication most commonly complicates hemorrhage
assessment and management in an elderly trauma patient?
A. Acetaminophen
B. Anticoagulants
C. Calcium carbonate
D. Topical emollients
Answer: B. Anticoagulants
,Rationale: Older adults frequently take anticoagulants or antiplatelet
agents. These medications can increase bleeding risk, worsen
intracranial hemorrhage, and alter the urgency and strategy of
hemostatic resuscitation.
5. During the primary survey of an elderly trauma patient, the most
appropriate initial priority is:
A. Obtain a detailed medication history before airway assessment
B. Perform the standard trauma primary survey while accounting for
geriatric physiology
C. Obtain a complete geriatric assessment before treatment
D. Delay intervention until the patient's baseline functional status is
known
Answer: B. Perform the standard trauma primary survey while
accounting for geriatric physiology
Rationale: ATLS principles remain fundamental. Airway, breathing,
circulation, disability, and exposure are addressed immediately, while
the clinician recognizes that age-related changes and comorbidities
may mask or modify physiologic signs.
6. Which finding is particularly concerning for occult hypoperfusion
in an elderly trauma patient?
A. Normal skin color alone
B. Normal heart rate alone
C. Increasing lactate or worsening base deficit
D. Mild chronic hypertension
Answer: C. Increasing lactate or worsening base deficit
Rationale: Serial lactate and base-deficit measurements can help
identify tissue hypoperfusion when conventional vital signs appear
, reassuring. Trends are often more informative than a single
measurement.
7. An elderly patient with blunt trauma has a normal systolic blood
pressure but increasing confusion. What should the trauma team
do?
A. Assume the confusion is normal aging
B. Consider hypoperfusion, hypoxia, head injury, medication effects, or
delirium
C. Discharge the patient if the blood pressure remains normal
D. Administer a sedative immediately
Answer: B. Consider hypoperfusion, hypoxia, head injury,
medication effects, or delirium
Rationale: Acute mental-status change in an older trauma patient
should never automatically be attributed to age. Delirium, intracranial
injury, hypoxia, hypoperfusion, infection, medications, and metabolic
abnormalities are important possibilities.
8. Which factor makes an older adult especially vulnerable to
traumatic injury?
A. Increased muscle mass
B. Greater bone density
C. Frailty and reduced physiologic reserve
D. Increased connective-tissue elasticity
Answer: C. Frailty and reduced physiologic reserve
Rationale: Frailty reflects diminished physiologic reserve and
increased vulnerability to stressors. A relatively minor mechanism can
therefore produce severe injury or substantial functional decline in a
frail older adult.
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A | Instant
Download Pdf
1. An 78-year-old patient is brought to the trauma bay after a motor
vehicle collision. Which physiologic characteristic of aging most
directly increases the risk of occult shock?
A. Increased resting cardiac output
B. Increased maximal heart rate
C. Reduced cardiovascular reserve
D. Increased total body water
Answer: C. Reduced cardiovascular reserve
Rationale: Older adults may have limited ability to increase cardiac
output in response to blood loss because of reduced cardiac reserve,
vascular stiffness, and impaired autonomic responsiveness. Therefore,
apparently acceptable vital signs may underestimate the severity of
shock.
2. Which age group is generally considered geriatric for trauma-
system planning?
A. 45 years and older
B. 55 years and older
C. 65 years and older
D. 80 years and older
,Answer: C. 65 years and older
Rationale: Many geriatric trauma protocols use 65 years as an
important threshold, although physiologic age, frailty, comorbidities,
medications, and functional status should also influence assessment
and management.
3. An elderly trauma patient has a heart rate of 88/min and systolic
blood pressure of 108 mmHg. Which interpretation is most
appropriate?
A. The patient cannot be in shock because the heart rate is normal
B. The patient should be considered potentially hypoperfused
C. The patient definitely has neurogenic shock
D. The patient is adequately resuscitated
Answer: B. The patient should be considered potentially
hypoperfused
Rationale: Older adults may have blunted tachycardia and altered
blood-pressure responses. A relatively modest increase in heart rate or
a systolic pressure that would appear acceptable in a younger patient
can represent clinically important physiologic compromise in an older
adult.
4. Which medication most commonly complicates hemorrhage
assessment and management in an elderly trauma patient?
A. Acetaminophen
B. Anticoagulants
C. Calcium carbonate
D. Topical emollients
Answer: B. Anticoagulants
,Rationale: Older adults frequently take anticoagulants or antiplatelet
agents. These medications can increase bleeding risk, worsen
intracranial hemorrhage, and alter the urgency and strategy of
hemostatic resuscitation.
5. During the primary survey of an elderly trauma patient, the most
appropriate initial priority is:
A. Obtain a detailed medication history before airway assessment
B. Perform the standard trauma primary survey while accounting for
geriatric physiology
C. Obtain a complete geriatric assessment before treatment
D. Delay intervention until the patient's baseline functional status is
known
Answer: B. Perform the standard trauma primary survey while
accounting for geriatric physiology
Rationale: ATLS principles remain fundamental. Airway, breathing,
circulation, disability, and exposure are addressed immediately, while
the clinician recognizes that age-related changes and comorbidities
may mask or modify physiologic signs.
6. Which finding is particularly concerning for occult hypoperfusion
in an elderly trauma patient?
A. Normal skin color alone
B. Normal heart rate alone
C. Increasing lactate or worsening base deficit
D. Mild chronic hypertension
Answer: C. Increasing lactate or worsening base deficit
Rationale: Serial lactate and base-deficit measurements can help
identify tissue hypoperfusion when conventional vital signs appear
, reassuring. Trends are often more informative than a single
measurement.
7. An elderly patient with blunt trauma has a normal systolic blood
pressure but increasing confusion. What should the trauma team
do?
A. Assume the confusion is normal aging
B. Consider hypoperfusion, hypoxia, head injury, medication effects, or
delirium
C. Discharge the patient if the blood pressure remains normal
D. Administer a sedative immediately
Answer: B. Consider hypoperfusion, hypoxia, head injury,
medication effects, or delirium
Rationale: Acute mental-status change in an older trauma patient
should never automatically be attributed to age. Delirium, intracranial
injury, hypoxia, hypoperfusion, infection, medications, and metabolic
abnormalities are important possibilities.
8. Which factor makes an older adult especially vulnerable to
traumatic injury?
A. Increased muscle mass
B. Greater bone density
C. Frailty and reduced physiologic reserve
D. Increased connective-tissue elasticity
Answer: C. Frailty and reduced physiologic reserve
Rationale: Frailty reflects diminished physiologic reserve and
increased vulnerability to stressors. A relatively minor mechanism can
therefore produce severe injury or substantial functional decline in a
frail older adult.
