ADVANCED TRAUMA LIFE SUPPORT (ATLS) PROVIDER EXAM
PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES Q&A INSTANT DOWNLOAD PDF
150 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Prioritize and execute the primary and secondary surveys in trauma patients
2 Integrate physiological and anatomical findings to guide resuscitation and definitive management
3 Differentiate between life-threatening injuries requiring immediate intervention and those requiring further
diagnostic evaluation
4 Apply evidence-based, current ATLS algorithms to optimize patient outcomes
5 Advanced Trauma Life Support
6 ATLS
7 Provider Exam Practice Questions And Correct Answers
8 Verified Answers
9 Plus Rationales Q&A Instant Download Pdf
10 Foundations of Emergency Medicine / Trauma Surgery
11 Applied Emergency Medicine / Trauma Surgery
12 Advanced Emergency Medicine / Trauma Surgery
13 Emergency Medicine / Trauma Surgery Review
Page 1
,Q1 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
A patient involved in a high-speed motor vehicle collision presents with
hypotension, distended neck veins, and muffled heart sounds. After intubation
and initiation of positive-pressure ventilation, the blood pressure drops further.
Which of the following is the MOST appropriate immediate management?
A. Pericardiocentesis CORRECT
B. Bilateral needle decompression
C. Emergency department thoracotomy
D. Rapid infusion of warmed crystalloid
RATIONALE: The presentation is classic for cardiac tamponade. While pericardiocentesis can be
diagnostic and therapeutic, the definitive management is surgical. However, in a patient with
cardiac arrest or peri-arrest, an emergency department thoracotomy may be indicated. But here,
the patient is hypotensive but not in arrest, so pericardiocentesis is the immediate life-saving
procedure. Needle decompression addresses tension pneumothorax, which could also be
present, but the findings point more to tamponade. Rapid crystalloid may temporize but does not
relieve tamponade.
Q2 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
Which of the following statements BEST reflects the current ATLS
recommendation regarding the use of pelvic binders in a patient with suspected
pelvic fractures?
A. A pelvic binder should be applied only after a pelvic X-ray confirms a fracture.
B. A pelvic binder should be applied early in the resuscitation of any patient with blunt trauma
and hemodynamic instability. CORRECT
C. A pelvic binder is contraindicated in patients with an open pelvic fracture.
D. A pelvic binder should be placed at the level of the iliac crests to maximize reduction.
RATIONALE: Current ATLS guidelines recommend early application of a pelvic binder in any
blunt trauma patient with hemodynamic instability and suspected pelvic injury, even before X-ray
confirmation, to reduce pelvic volume and tamponade bleeding. It should be placed over the
greater trochanters, not the iliac crests, to be effective. Open fractures are not a contraindication,
though wound care is needed. Delaying binder placement until X-ray can worsen hemorrhage.
Page 2
,Q3 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
In the initial assessment of a trauma patient, which of the following findings
mandates immediate transfer to the operating room before performing a computed
tomography (CT) scan?
A. Glasgow Coma Scale score of 13 with a scalp laceration
B. Focused Assessment with Sonography in Trauma (FAST) showing free fluid in the right upper
quadrant CORRECT
C. Stable patient with a gunshot wound to the extremity and no vascular compromise
D. Patient with paraplegia and a palpable bladder
RATIONALE: A positive FAST in a hemodynamically unstable patient indicates intra-abdominal
hemorrhage and requires immediate laparotomy, not further imaging. A GCS of 13 with a scalp
laceration may warrant a head CT but not immediate OR. Extremity wounds without vascular
compromise can be managed in a delayed fashion. Paraplegia with a palpable bladder suggests
neurogenic bladder, not an immediate surgical indication.
Q4 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
Which of the following is the MOST appropriate initial fluid for resuscitation in a
trauma patient with hemorrhagic shock who has received 2 liters of crystalloid and
remains hypotensive?
A. Packed red blood cells, fresh frozen plasma, and platelets in a 1:1:1 ratio CORRECT
B. Lactated Ringer's solution
C. 3% hypertonic saline
D. Type-specific packed red blood cells only
RATIONALE: ATLS recommends early initiation of a massive transfusion protocol with blood
products in a 1:1:1 ratio for patients with hemorrhagic shock who are unresponsive to initial
crystalloid. This approach addresses coagulopathy and improves survival. Continued crystalloid
alone is insufficient. Hypertonic saline is not the primary resuscitation fluid. Type-specific red cells
alone do not correct coagulopathy.
Page 3
, Q5 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
A patient with a severe traumatic brain injury (TBI) has a Glasgow Coma Scale
score of 6. Which of the following is the MOST appropriate immediate
management?
A. Administer hypertonic saline to maintain serum sodium between 145-155 mEq/L
B. Avoid intubation until a CT scan is obtained to confirm the injury
C. Maintain systolic blood pressure above 90 mm Hg and oxygen saturation above 90%
CORRECT
D. Administer corticosteroids to reduce cerebral edema
RATIONALE: For severe TBI, ATLS emphasizes avoiding hypotension (SBP <90) and hypoxia
(SpO2 <90%) to prevent secondary brain injury. Intubation is indicated for GCS 8 to secure the
airway. Hypertonic saline may be used for herniation, but not routinely. Corticosteroids are not
recommended in TBI. Maintenance of cerebral perfusion pressure is paramount.
Q6 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
A patient with a penetrating injury to the neck presents with hoarseness,
subcutaneous emphysema, and difficulty breathing. Which of the following is the
MOST appropriate immediate step?
A. Immediate surgical exploration in the operating room
B. Cricothyroidotomy CORRECT
C. Orotracheal intubation with rapid sequence intubation
D. Computed tomography angiography of the neck
RATIONALE: The patient has signs of impending airway compromise from a laryngeal or tracheal
injury. In the presence of subcutaneous emphysema, orotracheal intubation may be hazardous
due to distortion. Cricothyroidotomy is the recommended airway technique when there is upper
airway obstruction or massive facial trauma. Surgical exploration may be needed later but not
before securing the airway. CT would delay management.
Page 4
PRACTICE QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES Q&A INSTANT DOWNLOAD PDF
150 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Prioritize and execute the primary and secondary surveys in trauma patients
2 Integrate physiological and anatomical findings to guide resuscitation and definitive management
3 Differentiate between life-threatening injuries requiring immediate intervention and those requiring further
diagnostic evaluation
4 Apply evidence-based, current ATLS algorithms to optimize patient outcomes
5 Advanced Trauma Life Support
6 ATLS
7 Provider Exam Practice Questions And Correct Answers
8 Verified Answers
9 Plus Rationales Q&A Instant Download Pdf
10 Foundations of Emergency Medicine / Trauma Surgery
11 Applied Emergency Medicine / Trauma Surgery
12 Advanced Emergency Medicine / Trauma Surgery
13 Emergency Medicine / Trauma Surgery Review
Page 1
,Q1 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
A patient involved in a high-speed motor vehicle collision presents with
hypotension, distended neck veins, and muffled heart sounds. After intubation
and initiation of positive-pressure ventilation, the blood pressure drops further.
Which of the following is the MOST appropriate immediate management?
A. Pericardiocentesis CORRECT
B. Bilateral needle decompression
C. Emergency department thoracotomy
D. Rapid infusion of warmed crystalloid
RATIONALE: The presentation is classic for cardiac tamponade. While pericardiocentesis can be
diagnostic and therapeutic, the definitive management is surgical. However, in a patient with
cardiac arrest or peri-arrest, an emergency department thoracotomy may be indicated. But here,
the patient is hypotensive but not in arrest, so pericardiocentesis is the immediate life-saving
procedure. Needle decompression addresses tension pneumothorax, which could also be
present, but the findings point more to tamponade. Rapid crystalloid may temporize but does not
relieve tamponade.
Q2 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
Which of the following statements BEST reflects the current ATLS
recommendation regarding the use of pelvic binders in a patient with suspected
pelvic fractures?
A. A pelvic binder should be applied only after a pelvic X-ray confirms a fracture.
B. A pelvic binder should be applied early in the resuscitation of any patient with blunt trauma
and hemodynamic instability. CORRECT
C. A pelvic binder is contraindicated in patients with an open pelvic fracture.
D. A pelvic binder should be placed at the level of the iliac crests to maximize reduction.
RATIONALE: Current ATLS guidelines recommend early application of a pelvic binder in any
blunt trauma patient with hemodynamic instability and suspected pelvic injury, even before X-ray
confirmation, to reduce pelvic volume and tamponade bleeding. It should be placed over the
greater trochanters, not the iliac crests, to be effective. Open fractures are not a contraindication,
though wound care is needed. Delaying binder placement until X-ray can worsen hemorrhage.
Page 2
,Q3 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
In the initial assessment of a trauma patient, which of the following findings
mandates immediate transfer to the operating room before performing a computed
tomography (CT) scan?
A. Glasgow Coma Scale score of 13 with a scalp laceration
B. Focused Assessment with Sonography in Trauma (FAST) showing free fluid in the right upper
quadrant CORRECT
C. Stable patient with a gunshot wound to the extremity and no vascular compromise
D. Patient with paraplegia and a palpable bladder
RATIONALE: A positive FAST in a hemodynamically unstable patient indicates intra-abdominal
hemorrhage and requires immediate laparotomy, not further imaging. A GCS of 13 with a scalp
laceration may warrant a head CT but not immediate OR. Extremity wounds without vascular
compromise can be managed in a delayed fashion. Paraplegia with a palpable bladder suggests
neurogenic bladder, not an immediate surgical indication.
Q4 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
Which of the following is the MOST appropriate initial fluid for resuscitation in a
trauma patient with hemorrhagic shock who has received 2 liters of crystalloid and
remains hypotensive?
A. Packed red blood cells, fresh frozen plasma, and platelets in a 1:1:1 ratio CORRECT
B. Lactated Ringer's solution
C. 3% hypertonic saline
D. Type-specific packed red blood cells only
RATIONALE: ATLS recommends early initiation of a massive transfusion protocol with blood
products in a 1:1:1 ratio for patients with hemorrhagic shock who are unresponsive to initial
crystalloid. This approach addresses coagulopathy and improves survival. Continued crystalloid
alone is insufficient. Hypertonic saline is not the primary resuscitation fluid. Type-specific red cells
alone do not correct coagulopathy.
Page 3
, Q5 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
A patient with a severe traumatic brain injury (TBI) has a Glasgow Coma Scale
score of 6. Which of the following is the MOST appropriate immediate
management?
A. Administer hypertonic saline to maintain serum sodium between 145-155 mEq/L
B. Avoid intubation until a CT scan is obtained to confirm the injury
C. Maintain systolic blood pressure above 90 mm Hg and oxygen saturation above 90%
CORRECT
D. Administer corticosteroids to reduce cerebral edema
RATIONALE: For severe TBI, ATLS emphasizes avoiding hypotension (SBP <90) and hypoxia
(SpO2 <90%) to prevent secondary brain injury. Intubation is indicated for GCS 8 to secure the
airway. Hypertonic saline may be used for herniation, but not routinely. Corticosteroids are not
recommended in TBI. Maintenance of cerebral perfusion pressure is paramount.
Q6 PRIORITIZE AND EXECUTE THE PRIMARY AND SECONDARY SURVEYS IN TRAUMA
PATIENTS
A patient with a penetrating injury to the neck presents with hoarseness,
subcutaneous emphysema, and difficulty breathing. Which of the following is the
MOST appropriate immediate step?
A. Immediate surgical exploration in the operating room
B. Cricothyroidotomy CORRECT
C. Orotracheal intubation with rapid sequence intubation
D. Computed tomography angiography of the neck
RATIONALE: The patient has signs of impending airway compromise from a laryngeal or tracheal
injury. In the presence of subcutaneous emphysema, orotracheal intubation may be hazardous
due to distortion. Cricothyroidotomy is the recommended airway technique when there is upper
airway obstruction or massive facial trauma. Surgical exploration may be needed later but not
before securing the airway. CT would delay management.
Page 4
