ATLS Traumatic Hematoma
Recognition Certification Test
Questions And Correct Answers
(Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A trauma patient develops a rapidly enlarging, tense swelling in the
thigh after blunt trauma. Which finding most strongly suggests a
significant traumatic hematoma?
A. Small, stable area of bruising
B. Rapidly expanding swelling with pain
C. Mild skin discoloration without tenderness
D. Chronic painless soft-tissue fullness
Answer: B. Rapidly expanding swelling with pain
Rationale: A rapidly enlarging, painful swelling is characteristic of
active bleeding into the soft tissues. The clinician should assess
circulation, distal pulses, neurologic function, and the possibility of
associated vascular injury.
2. Which mechanism most commonly produces a traumatic
hematoma?
A. Blunt or penetrating tissue injury causing vessel disruption
B. Isolated dehydration
C. Viral infection
D. Hypoglycemia
,Answer: A. Blunt or penetrating tissue injury causing vessel
disruption
Rationale: Trauma can disrupt small or large blood vessels, allowing
blood to accumulate within soft tissues or body compartments. The size
and clinical importance depend on the injured vessels, tissue
compliance, anticoagulation, and ongoing bleeding.
3. Which initial assessment is most important when a large extremity
hematoma is identified?
A. Determine the patient's dietary history
B. Assess distal perfusion and neurologic function
C. Obtain a detailed family history
D. Measure body temperature only
Answer: B. Assess distal perfusion and neurologic function
Rationale: A traumatic hematoma can compress vessels and nerves or
accompany major vascular injury. Pulses, capillary refill, motor
function, sensation, skin temperature, and limb appearance should
therefore be assessed promptly.
4. A patient with pelvic trauma has progressive abdominal distention,
tachycardia, and hypotension. Which concern should take priority?
A. Minor superficial bruising
B. Occult internal hemorrhage
C. Isolated skin abrasion
D. Delayed wound infection
Answer: B. Occult internal hemorrhage
Rationale: Pelvic and abdominal trauma can produce substantial
internal blood loss without obvious external bleeding. Hemodynamic
,deterioration should prompt immediate evaluation for life-threatening
hemorrhage and other causes of shock.
5. Which characteristic differentiates an expanding hematoma from a
stable hematoma?
A. Decreasing size
B. Increasing size over time
C. Absence of tenderness
D. Resolution of discoloration
Answer: B. Increasing size over time
Rationale: Enlargement suggests ongoing bleeding or continued
accumulation of blood. An expanding hematoma is clinically more
concerning than a stable collection and may require urgent
intervention depending on location and associated findings.
6. A patient has a thigh hematoma after a high-energy motor-vehicle
collision. Which associated condition must be actively excluded?
A. Acute limb ischemia
B. Otitis externa
C. Cataract
D. Dental caries
Answer: A. Acute limb ischemia
Rationale: High-energy extremity trauma can injure major arteries. A
hematoma may accompany arterial disruption, thrombosis,
compression, or distal embolization, making repeated vascular
examinations essential.
7. Which finding is most concerning for active arterial bleeding into a
hematoma?
, A. Slow reduction in swelling
B. Pulsatile or rapidly expanding mass
C. Stable ecchymosis
D. Mild itching
Answer: B. Pulsatile or rapidly expanding mass
Rationale: Pulsatility and rapid expansion raise concern for arterial
bleeding or a pseudoaneurysm. Such findings require urgent vascular
assessment and appropriate imaging or operative management.
8. Which hemodynamic finding can accompany a large traumatic
hematoma?
A. Hemorrhagic shock
B. Isolated hypertension in every case
C. Hyperthermia from infection
D. Respiratory alkalosis without blood loss
Answer: A. Hemorrhagic shock
Rationale: Significant blood can accumulate in soft tissues or internal
compartments. When blood loss is substantial, tachycardia,
hypotension, altered mental status, cool skin, and other manifestations
of hemorrhagic shock may occur.
9. Which physical finding may suggest that a hematoma is
compressing nearby structures?
A. Progressive neurologic deficit
B. Improved sensation
C. Increased distal warmth
D. Decreased swelling
Answer: A. Progressive neurologic deficit
Recognition Certification Test
Questions And Correct Answers
(Verified Answers) Plus Rationales
2026 Q&A | Instant Download Pdf
1. A trauma patient develops a rapidly enlarging, tense swelling in the
thigh after blunt trauma. Which finding most strongly suggests a
significant traumatic hematoma?
A. Small, stable area of bruising
B. Rapidly expanding swelling with pain
C. Mild skin discoloration without tenderness
D. Chronic painless soft-tissue fullness
Answer: B. Rapidly expanding swelling with pain
Rationale: A rapidly enlarging, painful swelling is characteristic of
active bleeding into the soft tissues. The clinician should assess
circulation, distal pulses, neurologic function, and the possibility of
associated vascular injury.
2. Which mechanism most commonly produces a traumatic
hematoma?
A. Blunt or penetrating tissue injury causing vessel disruption
B. Isolated dehydration
C. Viral infection
D. Hypoglycemia
,Answer: A. Blunt or penetrating tissue injury causing vessel
disruption
Rationale: Trauma can disrupt small or large blood vessels, allowing
blood to accumulate within soft tissues or body compartments. The size
and clinical importance depend on the injured vessels, tissue
compliance, anticoagulation, and ongoing bleeding.
3. Which initial assessment is most important when a large extremity
hematoma is identified?
A. Determine the patient's dietary history
B. Assess distal perfusion and neurologic function
C. Obtain a detailed family history
D. Measure body temperature only
Answer: B. Assess distal perfusion and neurologic function
Rationale: A traumatic hematoma can compress vessels and nerves or
accompany major vascular injury. Pulses, capillary refill, motor
function, sensation, skin temperature, and limb appearance should
therefore be assessed promptly.
4. A patient with pelvic trauma has progressive abdominal distention,
tachycardia, and hypotension. Which concern should take priority?
A. Minor superficial bruising
B. Occult internal hemorrhage
C. Isolated skin abrasion
D. Delayed wound infection
Answer: B. Occult internal hemorrhage
Rationale: Pelvic and abdominal trauma can produce substantial
internal blood loss without obvious external bleeding. Hemodynamic
,deterioration should prompt immediate evaluation for life-threatening
hemorrhage and other causes of shock.
5. Which characteristic differentiates an expanding hematoma from a
stable hematoma?
A. Decreasing size
B. Increasing size over time
C. Absence of tenderness
D. Resolution of discoloration
Answer: B. Increasing size over time
Rationale: Enlargement suggests ongoing bleeding or continued
accumulation of blood. An expanding hematoma is clinically more
concerning than a stable collection and may require urgent
intervention depending on location and associated findings.
6. A patient has a thigh hematoma after a high-energy motor-vehicle
collision. Which associated condition must be actively excluded?
A. Acute limb ischemia
B. Otitis externa
C. Cataract
D. Dental caries
Answer: A. Acute limb ischemia
Rationale: High-energy extremity trauma can injure major arteries. A
hematoma may accompany arterial disruption, thrombosis,
compression, or distal embolization, making repeated vascular
examinations essential.
7. Which finding is most concerning for active arterial bleeding into a
hematoma?
, A. Slow reduction in swelling
B. Pulsatile or rapidly expanding mass
C. Stable ecchymosis
D. Mild itching
Answer: B. Pulsatile or rapidly expanding mass
Rationale: Pulsatility and rapid expansion raise concern for arterial
bleeding or a pseudoaneurysm. Such findings require urgent vascular
assessment and appropriate imaging or operative management.
8. Which hemodynamic finding can accompany a large traumatic
hematoma?
A. Hemorrhagic shock
B. Isolated hypertension in every case
C. Hyperthermia from infection
D. Respiratory alkalosis without blood loss
Answer: A. Hemorrhagic shock
Rationale: Significant blood can accumulate in soft tissues or internal
compartments. When blood loss is substantial, tachycardia,
hypotension, altered mental status, cool skin, and other manifestations
of hemorrhagic shock may occur.
9. Which physical finding may suggest that a hematoma is
compressing nearby structures?
A. Progressive neurologic deficit
B. Improved sensation
C. Increased distal warmth
D. Decreased swelling
Answer: A. Progressive neurologic deficit
