ATLS Pediatric Abdominal Injury
Management Exam Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
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1.
A 7-year-old child is brought to the emergency department after being struck by a
vehicle. The child has abdominal tenderness and tachycardia. Which principle is
most important when initially evaluating pediatric abdominal trauma?
A. Abdominal tenderness reliably indicates major intra-abdominal bleeding
B. Children maintain normal blood pressure until late shock
C. Computed tomography should be performed before resuscitation
D. Children may compensate for blood loss and deteriorate suddenly
Answer: D. Children may compensate for blood loss and deteriorate suddenly
Rationale: Children can maintain blood pressure through increased heart rate
and vascular resistance despite significant blood loss. Hypotension is a late and
ominous sign of pediatric hemorrhagic shock.
2.
,A 5-year-old child has blunt abdominal trauma after a motor vehicle collision.
Which organ is particularly vulnerable to injury because of its relatively large size
and less protective body habitus?
A. Pancreas
B. Liver
C. Bladder
D. Colon
Answer: B. Liver
Rationale: The liver is relatively large in children and extends below the costal
margin, making it susceptible to blunt abdominal injury.
3.
A child with blunt abdominal trauma is tachycardic, pale, and cool but has a
normal blood pressure. What is the most appropriate interpretation?
A. The child has no significant blood loss
B. The child has isolated anxiety
C. The child may already have compensated hemorrhagic shock
D. Hypotension must occur before treatment is initiated
Answer: C. The child may already have compensated hemorrhagic shock
Rationale: Pediatric patients can preserve blood pressure despite substantial
blood loss. Tachycardia, poor perfusion, and altered mental status may precede
hypotension.
4.
Which mechanism is particularly concerning for pancreatic injury in a child?
A. Fall onto an outstretched hand
B. Low-energy twisting injury
,C. Handlebar impact to the upper abdomen
D. Isolated scalp impact
Answer: C. Handlebar impact to the upper abdomen
Rationale: Bicycle-handlebar injuries can compress the pancreas against the
vertebral column, producing pancreatic contusion or ductal injury.
5.
A child with blunt abdominal trauma has progressive abdominal distention,
tachycardia, and pallor. What should be suspected first?
A. Simple abdominal wall contusion
B. Intra-abdominal hemorrhage
C. Isolated gastroenteritis
D. Uncomplicated constipation
Answer: B. Intra-abdominal hemorrhage
Rationale: Abdominal distention combined with signs of shock after trauma
raises concern for significant intra-abdominal bleeding.
6.
Which finding is most concerning for hollow-viscus injury after blunt abdominal
trauma?
A. Mild isolated flank bruising
B. Stable heart rate
C. Free intraperitoneal air
D. Normal abdominal examination
Answer: C. Free intraperitoneal air
, Rationale: Free intraperitoneal air following trauma strongly suggests
perforation of a hollow abdominal viscus and requires urgent surgical
evaluation.
7.
A child with blunt abdominal trauma has bruising across the abdomen
corresponding to a seat belt. This finding should raise concern for:
A. Isolated skin injury
B. Rib fracture only
C. Intra-abdominal and lumbar spine injuries
D. Isolated extremity injury
Answer: C. Intra-abdominal and lumbar spine injuries
Rationale: A seat-belt sign is associated with intestinal, mesenteric, pancreatic,
and lumbar spine injuries and warrants careful evaluation.
8.
A hemodynamically unstable child has suspected intra-abdominal hemorrhage.
What is the priority?
A. Obtain a complete abdominal CT scan
B. Wait for laboratory confirmation
C. Control hemorrhage while continuing resuscitation
D. Perform diagnostic endoscopy
Answer: C. Control hemorrhage while continuing resuscitation
Rationale: In an unstable trauma patient, definitive hemorrhage control takes
priority over time-consuming diagnostic studies.
9.
Management Exam Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1.
A 7-year-old child is brought to the emergency department after being struck by a
vehicle. The child has abdominal tenderness and tachycardia. Which principle is
most important when initially evaluating pediatric abdominal trauma?
A. Abdominal tenderness reliably indicates major intra-abdominal bleeding
B. Children maintain normal blood pressure until late shock
C. Computed tomography should be performed before resuscitation
D. Children may compensate for blood loss and deteriorate suddenly
Answer: D. Children may compensate for blood loss and deteriorate suddenly
Rationale: Children can maintain blood pressure through increased heart rate
and vascular resistance despite significant blood loss. Hypotension is a late and
ominous sign of pediatric hemorrhagic shock.
2.
,A 5-year-old child has blunt abdominal trauma after a motor vehicle collision.
Which organ is particularly vulnerable to injury because of its relatively large size
and less protective body habitus?
A. Pancreas
B. Liver
C. Bladder
D. Colon
Answer: B. Liver
Rationale: The liver is relatively large in children and extends below the costal
margin, making it susceptible to blunt abdominal injury.
3.
A child with blunt abdominal trauma is tachycardic, pale, and cool but has a
normal blood pressure. What is the most appropriate interpretation?
A. The child has no significant blood loss
B. The child has isolated anxiety
C. The child may already have compensated hemorrhagic shock
D. Hypotension must occur before treatment is initiated
Answer: C. The child may already have compensated hemorrhagic shock
Rationale: Pediatric patients can preserve blood pressure despite substantial
blood loss. Tachycardia, poor perfusion, and altered mental status may precede
hypotension.
4.
Which mechanism is particularly concerning for pancreatic injury in a child?
A. Fall onto an outstretched hand
B. Low-energy twisting injury
,C. Handlebar impact to the upper abdomen
D. Isolated scalp impact
Answer: C. Handlebar impact to the upper abdomen
Rationale: Bicycle-handlebar injuries can compress the pancreas against the
vertebral column, producing pancreatic contusion or ductal injury.
5.
A child with blunt abdominal trauma has progressive abdominal distention,
tachycardia, and pallor. What should be suspected first?
A. Simple abdominal wall contusion
B. Intra-abdominal hemorrhage
C. Isolated gastroenteritis
D. Uncomplicated constipation
Answer: B. Intra-abdominal hemorrhage
Rationale: Abdominal distention combined with signs of shock after trauma
raises concern for significant intra-abdominal bleeding.
6.
Which finding is most concerning for hollow-viscus injury after blunt abdominal
trauma?
A. Mild isolated flank bruising
B. Stable heart rate
C. Free intraperitoneal air
D. Normal abdominal examination
Answer: C. Free intraperitoneal air
, Rationale: Free intraperitoneal air following trauma strongly suggests
perforation of a hollow abdominal viscus and requires urgent surgical
evaluation.
7.
A child with blunt abdominal trauma has bruising across the abdomen
corresponding to a seat belt. This finding should raise concern for:
A. Isolated skin injury
B. Rib fracture only
C. Intra-abdominal and lumbar spine injuries
D. Isolated extremity injury
Answer: C. Intra-abdominal and lumbar spine injuries
Rationale: A seat-belt sign is associated with intestinal, mesenteric, pancreatic,
and lumbar spine injuries and warrants careful evaluation.
8.
A hemodynamically unstable child has suspected intra-abdominal hemorrhage.
What is the priority?
A. Obtain a complete abdominal CT scan
B. Wait for laboratory confirmation
C. Control hemorrhage while continuing resuscitation
D. Perform diagnostic endoscopy
Answer: C. Control hemorrhage while continuing resuscitation
Rationale: In an unstable trauma patient, definitive hemorrhage control takes
priority over time-consuming diagnostic studies.
9.
