ATLS Pediatric Head Trauma Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1.
A 4-year-old child is brought to the trauma bay after being struck by a vehicle. He
is drowsy but arousable. What is the highest priority during the initial assessment?
A. Obtain a detailed neurologic history
B. Perform a complete secondary survey
C. Assess and protect the airway while maintaining cervical spine protection
D. Obtain magnetic resonance imaging
Answer: C. Assess and protect the airway while maintaining cervical spine
protection
Rationale: The primary survey prioritizes airway, breathing, circulation,
disability, and exposure. In a child with significant head trauma, airway
management must occur while protecting the cervical spine because associated
cervical injury may be present.
2.
Which finding most strongly suggests increased intracranial pressure in an injured
child?
,A. Mild tachycardia
B. Progressive decrease in level of consciousness
C. Isolated scalp abrasion
D. Increased appetite
Answer: B. Progressive decrease in level of consciousness
Rationale: A declining level of consciousness is an important sign of worsening
intracranial pathology and may indicate increasing intracranial pressure or
evolving intracranial hemorrhage.
3.
A 2-year-old child has a Glasgow Coma Scale score of 7 after a fall. What is the
most appropriate airway consideration?
A. Observe without intervention
B. Give oral fluids
C. Proceed with definitive airway management while protecting the cervical
spine
D. Delay airway management until computed tomography is completed
Answer: C. Proceed with definitive airway management while protecting the
cervical spine
Rationale: Severe traumatic brain injury with a markedly depressed level of
consciousness creates a significant risk of airway loss and aspiration. Definitive
airway management should not be delayed for imaging.
4.
Which statement about pediatric traumatic brain injury is most accurate?
A. Children never develop secondary brain injury
B. Children have a lower risk of cerebral edema than adults
C. Secondary brain injury can result from hypoxia, hypotension, hypercarbia, and
other physiologic disturbances
D. Hypotension is always expected after isolated head injury
,Answer: C. Secondary brain injury can result from hypoxia, hypotension,
hypercarbia, and other physiologic disturbances
Rationale: Preventing secondary brain injury is a central goal of trauma
management. Adequate oxygenation, ventilation, perfusion, and temperature
control are essential.
5.
Which mechanism is particularly concerning for traumatic brain injury in an
infant?
A. Superficial paper cut
B. Acceleration-deceleration injury
C. Minor finger injury
D. Isolated ankle sprain
Answer: B. Acceleration-deceleration injury
Rationale: Acceleration-deceleration forces can produce intracranial injury,
including subdural hemorrhage and diffuse brain injury, even when external
findings are limited.
6.
A child with head trauma has unequal pupils and progressive deterioration in
consciousness. What should the trauma team suspect?
A. Simple concussion only
B. Isolated scalp hematoma
C. Expanding intracranial mass effect with possible herniation
D. Normal post-traumatic behavior
Answer: C. Expanding intracranial mass effect with possible herniation
Rationale: Anisocoria combined with neurologic deterioration is a warning sign
of mass effect and possible transtentorial herniation. Immediate stabilization
and urgent evaluation are required.
7.
, Which Glasgow Coma Scale component evaluates the child's ability to respond to
commands?
A. Eye opening
B. Verbal response
C. Motor response
D. Pupil size
Answer: C. Motor response
Rationale: The motor component assesses purposeful movement, localization,
withdrawal, abnormal flexion, abnormal extension, and lack of motor response.
8.
A child with severe head trauma becomes hypotensive. What is the most
appropriate interpretation?
A. Hypotension is expected from isolated traumatic brain injury
B. It confirms brain herniation
C. Another cause of shock should be actively sought
D. It means intracranial pressure has decreased
Answer: C. Another cause of shock should be actively sought
Rationale: Hypotension is uncommon in isolated traumatic brain injury. Blood
loss or another cause of circulatory compromise should be investigated
promptly.
9.
Which intervention is most important for preventing secondary brain injury?
A. Allowing prolonged hypoxemia
B. Maintaining severe hyperglycemia
C. Preventing hypoxia and maintaining adequate cerebral perfusion
D. Delaying treatment until neurologic imaging is complete
Answer: C. Preventing hypoxia and maintaining adequate cerebral perfusion
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1.
A 4-year-old child is brought to the trauma bay after being struck by a vehicle. He
is drowsy but arousable. What is the highest priority during the initial assessment?
A. Obtain a detailed neurologic history
B. Perform a complete secondary survey
C. Assess and protect the airway while maintaining cervical spine protection
D. Obtain magnetic resonance imaging
Answer: C. Assess and protect the airway while maintaining cervical spine
protection
Rationale: The primary survey prioritizes airway, breathing, circulation,
disability, and exposure. In a child with significant head trauma, airway
management must occur while protecting the cervical spine because associated
cervical injury may be present.
2.
Which finding most strongly suggests increased intracranial pressure in an injured
child?
,A. Mild tachycardia
B. Progressive decrease in level of consciousness
C. Isolated scalp abrasion
D. Increased appetite
Answer: B. Progressive decrease in level of consciousness
Rationale: A declining level of consciousness is an important sign of worsening
intracranial pathology and may indicate increasing intracranial pressure or
evolving intracranial hemorrhage.
3.
A 2-year-old child has a Glasgow Coma Scale score of 7 after a fall. What is the
most appropriate airway consideration?
A. Observe without intervention
B. Give oral fluids
C. Proceed with definitive airway management while protecting the cervical
spine
D. Delay airway management until computed tomography is completed
Answer: C. Proceed with definitive airway management while protecting the
cervical spine
Rationale: Severe traumatic brain injury with a markedly depressed level of
consciousness creates a significant risk of airway loss and aspiration. Definitive
airway management should not be delayed for imaging.
4.
Which statement about pediatric traumatic brain injury is most accurate?
A. Children never develop secondary brain injury
B. Children have a lower risk of cerebral edema than adults
C. Secondary brain injury can result from hypoxia, hypotension, hypercarbia, and
other physiologic disturbances
D. Hypotension is always expected after isolated head injury
,Answer: C. Secondary brain injury can result from hypoxia, hypotension,
hypercarbia, and other physiologic disturbances
Rationale: Preventing secondary brain injury is a central goal of trauma
management. Adequate oxygenation, ventilation, perfusion, and temperature
control are essential.
5.
Which mechanism is particularly concerning for traumatic brain injury in an
infant?
A. Superficial paper cut
B. Acceleration-deceleration injury
C. Minor finger injury
D. Isolated ankle sprain
Answer: B. Acceleration-deceleration injury
Rationale: Acceleration-deceleration forces can produce intracranial injury,
including subdural hemorrhage and diffuse brain injury, even when external
findings are limited.
6.
A child with head trauma has unequal pupils and progressive deterioration in
consciousness. What should the trauma team suspect?
A. Simple concussion only
B. Isolated scalp hematoma
C. Expanding intracranial mass effect with possible herniation
D. Normal post-traumatic behavior
Answer: C. Expanding intracranial mass effect with possible herniation
Rationale: Anisocoria combined with neurologic deterioration is a warning sign
of mass effect and possible transtentorial herniation. Immediate stabilization
and urgent evaluation are required.
7.
, Which Glasgow Coma Scale component evaluates the child's ability to respond to
commands?
A. Eye opening
B. Verbal response
C. Motor response
D. Pupil size
Answer: C. Motor response
Rationale: The motor component assesses purposeful movement, localization,
withdrawal, abnormal flexion, abnormal extension, and lack of motor response.
8.
A child with severe head trauma becomes hypotensive. What is the most
appropriate interpretation?
A. Hypotension is expected from isolated traumatic brain injury
B. It confirms brain herniation
C. Another cause of shock should be actively sought
D. It means intracranial pressure has decreased
Answer: C. Another cause of shock should be actively sought
Rationale: Hypotension is uncommon in isolated traumatic brain injury. Blood
loss or another cause of circulatory compromise should be investigated
promptly.
9.
Which intervention is most important for preventing secondary brain injury?
A. Allowing prolonged hypoxemia
B. Maintaining severe hyperglycemia
C. Preventing hypoxia and maintaining adequate cerebral perfusion
D. Delaying treatment until neurologic imaging is complete
Answer: C. Preventing hypoxia and maintaining adequate cerebral perfusion
