ATLS practice 2026/2027
Questions With All the Correct
Answers
Course
ATLS TESTS
1. What is the primary objective of the ATLS primary survey?
A. Obtain a complete medical history
B. Identify and immediately treat life-threatening injuries
C. Perform a detailed neurologic examination
D. Obtain definitive imaging
Correct Answer: B. Identify and immediately treat life-threatening injuries
Rationale: The primary survey uses a structured approach to rapidly identify and manage
immediately life-threatening conditions.
2. Which sequence represents the traditional ATLS primary survey?
A. ABCDE
B. CABDE
C. BACDE
D. EDCBA
Correct Answer: A. ABCDE
Rationale: The primary survey traditionally follows Airway with cervical spine protection,
Breathing, Circulation with hemorrhage control, Disability, and Exposure/Environmental
control.
3. A trauma patient is speaking clearly immediately after arrival. What does this finding most
strongly suggest?
A. The airway is currently patent
B. The patient has no injuries
C. The patient has adequate circulation
D. The patient has no cervical spine injury
Correct Answer: A. The airway is currently patent
,Rationale: The ability to speak indicates that air is moving through the airway at that moment.
However, ongoing airway assessment remains necessary.
4. Which finding is most concerning for impending airway obstruction?
A. Clear speech
B. Stridor
C. Normal respiratory rate
D. Warm skin
Correct Answer: B. Stridor
Rationale: Stridor suggests significant upper-airway narrowing and can indicate impending
airway compromise.
5. A trauma patient has facial burns, soot around the mouth, and progressive hoarseness.
What is the major concern?
A. Delayed airway edema
B. Isolated lower-extremity fracture
C. Simple dehydration
D. Chronic anemia
Correct Answer: A. Delayed airway edema
Rationale: Thermal or inhalational injury can cause progressive airway edema. Early recognition
and appropriate airway management are critical.
6. In a trauma patient with suspected cervical spine injury, which airway maneuver is
generally preferred initially?
A. Head-tilt/chin-lift
B. Jaw thrust while maintaining spinal precautions
C. Hyperextension of the neck
D. Forced neck rotation
Correct Answer: B. Jaw thrust while maintaining spinal precautions
Rationale: When cervical spine injury is suspected, airway maneuvers should minimize
unnecessary cervical movement.
,7. Which finding most strongly indicates inadequate ventilation?
A. Bilateral equal breath sounds
B. Severe respiratory distress with poor chest movement
C. Normal oxygenation
D. Normal mental status
Correct Answer: B. Severe respiratory distress with poor chest movement
Rationale: Poor chest excursion and severe respiratory distress suggest inadequate ventilation
and require immediate assessment and treatment.
8. A trauma patient develops severe respiratory distress, hypotension, distended neck veins,
and absent breath sounds on one side. What diagnosis should be suspected?
A. Simple rib fracture
B. Tension pneumothorax
C. Pulmonary contusion only
D. Isolated clavicle fracture
Correct Answer: B. Tension pneumothorax
Rationale: Tension pneumothorax can cause respiratory compromise and obstructive shock. It is
a clinical emergency requiring immediate treatment rather than waiting for definitive imaging.
9. What is the immediate priority when tension pneumothorax is strongly suspected in an
unstable trauma patient?
A. Wait for a chest CT
B. Immediate decompression
C. Obtain a detailed family history
D. Perform abdominal ultrasound first
Correct Answer: B. Immediate decompression
Rationale: A clinically significant tension pneumothorax requires prompt decompression
because delay can rapidly lead to cardiovascular collapse.
10. Which finding is most characteristic of an open pneumothorax?
, A. An open chest wound communicating with the atmosphere
B. Isolated abdominal tenderness
C. Bilateral leg swelling
D. Bradycardia without respiratory symptoms
Correct Answer: A. An open chest wound communicating with the atmosphere
Rationale: An open pneumothorax occurs when a chest-wall defect allows air to move between
the atmosphere and pleural space.
11. What is an appropriate initial approach to a significant open chest wound?
A. Leave it completely uncovered
B. Apply an appropriate occlusive dressing and address the underlying thoracic injury
C. Pack the wound with dry gauze only
D. Delay treatment until CT imaging
Correct Answer: B. Apply an appropriate occlusive dressing and address the underlying
thoracic injury
Rationale: An appropriate dressing helps limit air entry through the chest-wall defect while
definitive management is arranged.
12. Which injury can cause severe respiratory compromise without an obvious external chest
wound?
A. Flail chest
B. Wrist fracture
C. Isolated scalp laceration
D. Simple finger fracture
Correct Answer: A. Flail chest
Rationale: Flail chest results from multiple rib fractures creating a segment of chest wall that
moves independently and is often associated with underlying pulmonary injury.
13. What is a major cause of hypoxia in patients with significant flail chest?
A. Pulmonary contusion
B. Isolated skin abrasion
Questions With All the Correct
Answers
Course
ATLS TESTS
1. What is the primary objective of the ATLS primary survey?
A. Obtain a complete medical history
B. Identify and immediately treat life-threatening injuries
C. Perform a detailed neurologic examination
D. Obtain definitive imaging
Correct Answer: B. Identify and immediately treat life-threatening injuries
Rationale: The primary survey uses a structured approach to rapidly identify and manage
immediately life-threatening conditions.
2. Which sequence represents the traditional ATLS primary survey?
A. ABCDE
B. CABDE
C. BACDE
D. EDCBA
Correct Answer: A. ABCDE
Rationale: The primary survey traditionally follows Airway with cervical spine protection,
Breathing, Circulation with hemorrhage control, Disability, and Exposure/Environmental
control.
3. A trauma patient is speaking clearly immediately after arrival. What does this finding most
strongly suggest?
A. The airway is currently patent
B. The patient has no injuries
C. The patient has adequate circulation
D. The patient has no cervical spine injury
Correct Answer: A. The airway is currently patent
,Rationale: The ability to speak indicates that air is moving through the airway at that moment.
However, ongoing airway assessment remains necessary.
4. Which finding is most concerning for impending airway obstruction?
A. Clear speech
B. Stridor
C. Normal respiratory rate
D. Warm skin
Correct Answer: B. Stridor
Rationale: Stridor suggests significant upper-airway narrowing and can indicate impending
airway compromise.
5. A trauma patient has facial burns, soot around the mouth, and progressive hoarseness.
What is the major concern?
A. Delayed airway edema
B. Isolated lower-extremity fracture
C. Simple dehydration
D. Chronic anemia
Correct Answer: A. Delayed airway edema
Rationale: Thermal or inhalational injury can cause progressive airway edema. Early recognition
and appropriate airway management are critical.
6. In a trauma patient with suspected cervical spine injury, which airway maneuver is
generally preferred initially?
A. Head-tilt/chin-lift
B. Jaw thrust while maintaining spinal precautions
C. Hyperextension of the neck
D. Forced neck rotation
Correct Answer: B. Jaw thrust while maintaining spinal precautions
Rationale: When cervical spine injury is suspected, airway maneuvers should minimize
unnecessary cervical movement.
,7. Which finding most strongly indicates inadequate ventilation?
A. Bilateral equal breath sounds
B. Severe respiratory distress with poor chest movement
C. Normal oxygenation
D. Normal mental status
Correct Answer: B. Severe respiratory distress with poor chest movement
Rationale: Poor chest excursion and severe respiratory distress suggest inadequate ventilation
and require immediate assessment and treatment.
8. A trauma patient develops severe respiratory distress, hypotension, distended neck veins,
and absent breath sounds on one side. What diagnosis should be suspected?
A. Simple rib fracture
B. Tension pneumothorax
C. Pulmonary contusion only
D. Isolated clavicle fracture
Correct Answer: B. Tension pneumothorax
Rationale: Tension pneumothorax can cause respiratory compromise and obstructive shock. It is
a clinical emergency requiring immediate treatment rather than waiting for definitive imaging.
9. What is the immediate priority when tension pneumothorax is strongly suspected in an
unstable trauma patient?
A. Wait for a chest CT
B. Immediate decompression
C. Obtain a detailed family history
D. Perform abdominal ultrasound first
Correct Answer: B. Immediate decompression
Rationale: A clinically significant tension pneumothorax requires prompt decompression
because delay can rapidly lead to cardiovascular collapse.
10. Which finding is most characteristic of an open pneumothorax?
, A. An open chest wound communicating with the atmosphere
B. Isolated abdominal tenderness
C. Bilateral leg swelling
D. Bradycardia without respiratory symptoms
Correct Answer: A. An open chest wound communicating with the atmosphere
Rationale: An open pneumothorax occurs when a chest-wall defect allows air to move between
the atmosphere and pleural space.
11. What is an appropriate initial approach to a significant open chest wound?
A. Leave it completely uncovered
B. Apply an appropriate occlusive dressing and address the underlying thoracic injury
C. Pack the wound with dry gauze only
D. Delay treatment until CT imaging
Correct Answer: B. Apply an appropriate occlusive dressing and address the underlying
thoracic injury
Rationale: An appropriate dressing helps limit air entry through the chest-wall defect while
definitive management is arranged.
12. Which injury can cause severe respiratory compromise without an obvious external chest
wound?
A. Flail chest
B. Wrist fracture
C. Isolated scalp laceration
D. Simple finger fracture
Correct Answer: A. Flail chest
Rationale: Flail chest results from multiple rib fractures creating a segment of chest wall that
moves independently and is often associated with underlying pulmonary injury.
13. What is a major cause of hypoxia in patients with significant flail chest?
A. Pulmonary contusion
B. Isolated skin abrasion
