ATLS Exam 2026 2027 Questions with Verified Answers and
Correct Answers | Already Graded A+ | Exams of Nursing
Comprehensive Assessment
Updated Questions and Verified Answers | 100 Questions | 100% VERIFIED
Introduction
This comprehensive assessment measures the trauma knowledge, prioritization, and
clinical judgment required to evaluate and stabilize injured patients across the continuum
of trauma care. It spans eight core domains: Primary Survey and Airway Management;
Thoracic Trauma and Chest Injuries; Abdominal and Pelvic Trauma; Head, Neck, and Spinal
Injuries; Musculoskeletal Injuries and Soft Tissue Trauma; Burn and Pediatric Trauma;
Hemorrhage Control and Shock Management; and Triage and Mass Casualty Incidents. Each
question that follows targets a distinct sub-topic within this blueprint, from the primary
survey sequence, airway maneuvers and definitive airway indications, ventilation
assessment, and secondary survey, through tension pneumothorax, hemothorax, flail chest,
open chest wounds, tamponade, and chest tube management, solid organ and hollow viscus
injury, pelvic fracture hemorrhage control, and retroperitoneal injury recognition,
traumatic brain injury, intracranial pressure management, basilar skull fracture,
penetrating neck trauma, and spinal motion restriction, extremity fractures, compartment
syndrome, open fractures, traumatic amputation, and soft tissue management, burn
resuscitation, inhalation injury and escharotomy, pediatric physiology, injury patterns, and
pediatric transport considerations, hemorrhagic shock classes, damage control
resuscitation, transfusion complications, and reassessment, and mass casualty triage
categories, incident command, surge capability, and response review. Mastery of these
domains supports professional certification and strengthens trauma nursing clinical
execution, resuscitation quality, and patient survival.
1. The sequence of the primary survey in trauma care is:
A. Breathing, airway, disability, circulation, and exposure
B. Circulation, airway, breathing, exposure, and disability
C. Exposure, disability, circulation, breathing, and airway
D. Airway with cervical spine protection, breathing, circulation with hemorrhage
control, disability, and exposure with environmental control
Correct Answer: D. Airway with cervical spine protection, breathing, circulation
with hemorrhage control, disability, and exposure with environmental control
Rationale: Life threats are addressed in order of immediate lethality with cervical
protection maintained throughout. The other sequences reorder priorities, which delays
correction of the most rapidly fatal problems.
,2. When opening the airway of a patient with a suspected cervical spine injury, the
preferred maneuver is:
A. Head tilt with chin lift performed as the initial maneuver
B. Hyperextension of the neck to align the airway
C. Placement of the patient in the recovery position before airway management
D. Jaw thrust with manual in line immobilization of the head and neck
Correct Answer: D. Jaw thrust with manual in line immobilization of the head and
neck
Rationale: The jaw thrust minimizes cervical movement while opening the airway.
Head tilt with chin lift, neck hyperextension, and early lateral positioning risk displacing
an unstable cervical injury.
3. A trauma patient who is able to speak in full sentences and has clear phonation
most likely has:
A. A patent airway with adequate air movement at that moment, though reassessment
remains necessary
B. An airway that is fully protected for the remainder of the resuscitation
C. A definitive airway that requires no further evaluation
D. A cervical spine injury that cannot be excluded
Correct Answer: A. A patent airway with adequate air movement at that moment,
though reassessment remains necessary
Rationale: Speech indicates air movement at the time of assessment, but airway status
can deteriorate, so reassessment continues. Full protection, a definitive airway, and an
injury conclusion do not follow from phonation.
4. Which finding indicates the need for a definitive airway?
A. A Glasgow Coma Scale score of fifteen with a scalp laceration
B. A closed femur fracture with intact distal pulses
C. A Glasgow Coma Scale score of eight or less with an inability to protect the airway
D. A single episode of emesis during transport
Correct Answer: C. A Glasgow Coma Scale score of eight or less with an inability to
protect the airway
Rationale: Severe neurologic depression with loss of airway protection requires
intubation. Minor lacerations, isolated extremity fractures, and a single resolved emesis
do not by themselves require a definitive airway.
5. A contraindication to orotracheal intubation that requires an alternative approach
is:
A. A suspected cervical spine injury managed with in line immobilization
B. Massive facial trauma with distortion of the airway anatomy that prevents
visualization of the glottis
C. An oxygen saturation of ninety four percent on room air
D. A history of well controlled asthma
, Correct Answer: B. Massive facial trauma with distortion of the airway anatomy
that prevents visualization of the glottis
Rationale: Severe facial disruption may prevent direct laryngoscopy, so surgical or
other approaches are considered. Cervical precaution, mild hypoxemia, and controlled
asthma are managed within routine intubation planning.
6. Which adjunct is used to confirm and monitor endotracheal tube placement in the
trauma patient?
A. Continuous waveform capnography with auscultation and chest radiography as
supporting assessments
B. Pulse oximetry as the sole confirmation method
C. Observation of chest rise as the definitive confirmation
D. Epigastric auscultation performed alone
Correct Answer: A. Continuous waveform capnography with auscultation and
chest radiography as supporting assessments
Rationale: Waveform capnography provides continuous confirmation of tube position,
with other methods supporting the assessment. Oximetry alone, chest rise alone, and
epigastric auscultation alone are unreliable.
7. A trauma patient with gurgling respirations, vomiting, and decreasing oxygen
saturation should first be managed by:
A. Immediate surgical cricothyroidotomy before any other intervention
B. Suctioning the airway to clear blood, vomitus, or secretions while maintaining
cervical precautions
C. Administration of a neuromuscular blocking agent without airway preparation
D. Placement of the patient supine with the head elevated thirty degrees
Correct Answer: B. Suctioning the airway to clear blood, vomitus, or secretions
while maintaining cervical precautions
Rationale: Removing obstructing fluid from the airway restores ventilation and
precedes more invasive measures. Immediate surgical airway, paralysis without
preparation, and positioning alone do not address the obstruction.
8. In a trauma patient who is being ventilated with a bag valve mask, which finding
indicates inadequate ventilation?
A. A respiratory rate of sixteen breaths per minute delivered by the device
B. Oxygen saturation rising from eighty eight to ninety six percent
C. A gradual decrease in the required squeeze pressure
D. Absent or minimal chest rise with poor compliance and worsening hypoxemia
Correct Answer: D. Absent or minimal chest rise with poor compliance and
worsening hypoxemia
Rationale: Poor chest rise with declining saturation indicates that ventilation is not
reaching the lungs, prompting evaluation for obstruction, leak, or pneumothorax. Rising
saturation and reduced pressure requirement indicate improving ventilation.
, 9. Which condition must be ruled out before positive pressure ventilation is provided
to a patient with unilateral absent breath sounds?
A. Simple rib fracture, which is unaffected by ventilation
B. Pulmonary contusion, which requires no consideration before ventilation
C. Flail chest, which resolves with positive pressure alone
D. Tension pneumothorax, which would be worsened by positive pressure until
decompressed
Correct Answer: D. Tension pneumothorax, which would be worsened by positive
pressure until decompressed
Rationale: Positive pressure without decompression can worsen tension physiology
and precipitate arrest. Rib fracture, contusion, and flail chest do not require the same
sequencing consideration before ventilation.
10. The definitive airway of choice for a patient with severe laryngeal injury and
inability to intubate orally is:
A. Repeated attempts at oral intubation with a smaller tube
B. Bag valve mask ventilation continued indefinitely
C. A surgical airway such as cricothyroidotomy or tracheostomy performed by a
qualified provider
D. Placement of a supraglottic airway as the definitive solution
Correct Answer: C. A surgical airway such as cricothyroidotomy or tracheostomy
performed by a qualified provider
Rationale: Surgical access bypasses the injured larynx to secure ventilation. Repeated
oral attempts risk further injury, indefinite bagging does not secure the airway, and
supraglottic devices are temporizing rather than definitive.
11. During the exposure phase of the primary survey, the trauma team must also:
A. Delay temperature management until the secondary survey is complete
B. Remove all covering and leave the patient exposed for continuous inspection
C. Prevent hypothermia by using warm blankets, warmed fluids, and increasing the
ambient temperature
D. Restrict intravenous fluids until core temperature is measured
Correct Answer: C. Prevent hypothermia by using warm blankets, warmed fluids,
and increasing the ambient temperature
Rationale: Exposure reveals injuries but causes heat loss, so warming measures
proceed simultaneously. Delaying, leaving the patient uncovered, and withholding fluids
overlook the lethal effect of hypothermia in trauma.
12. A trauma patient who becomes combative with a decreasing level of
consciousness should be evaluated first for:
A. Pain from extremity injuries as the primary cause
B. Hypoxia and hypoperfusion, since both cause altered mental status in trauma
C. Anxiety related to the trauma scene
Correct Answers | Already Graded A+ | Exams of Nursing
Comprehensive Assessment
Updated Questions and Verified Answers | 100 Questions | 100% VERIFIED
Introduction
This comprehensive assessment measures the trauma knowledge, prioritization, and
clinical judgment required to evaluate and stabilize injured patients across the continuum
of trauma care. It spans eight core domains: Primary Survey and Airway Management;
Thoracic Trauma and Chest Injuries; Abdominal and Pelvic Trauma; Head, Neck, and Spinal
Injuries; Musculoskeletal Injuries and Soft Tissue Trauma; Burn and Pediatric Trauma;
Hemorrhage Control and Shock Management; and Triage and Mass Casualty Incidents. Each
question that follows targets a distinct sub-topic within this blueprint, from the primary
survey sequence, airway maneuvers and definitive airway indications, ventilation
assessment, and secondary survey, through tension pneumothorax, hemothorax, flail chest,
open chest wounds, tamponade, and chest tube management, solid organ and hollow viscus
injury, pelvic fracture hemorrhage control, and retroperitoneal injury recognition,
traumatic brain injury, intracranial pressure management, basilar skull fracture,
penetrating neck trauma, and spinal motion restriction, extremity fractures, compartment
syndrome, open fractures, traumatic amputation, and soft tissue management, burn
resuscitation, inhalation injury and escharotomy, pediatric physiology, injury patterns, and
pediatric transport considerations, hemorrhagic shock classes, damage control
resuscitation, transfusion complications, and reassessment, and mass casualty triage
categories, incident command, surge capability, and response review. Mastery of these
domains supports professional certification and strengthens trauma nursing clinical
execution, resuscitation quality, and patient survival.
1. The sequence of the primary survey in trauma care is:
A. Breathing, airway, disability, circulation, and exposure
B. Circulation, airway, breathing, exposure, and disability
C. Exposure, disability, circulation, breathing, and airway
D. Airway with cervical spine protection, breathing, circulation with hemorrhage
control, disability, and exposure with environmental control
Correct Answer: D. Airway with cervical spine protection, breathing, circulation
with hemorrhage control, disability, and exposure with environmental control
Rationale: Life threats are addressed in order of immediate lethality with cervical
protection maintained throughout. The other sequences reorder priorities, which delays
correction of the most rapidly fatal problems.
,2. When opening the airway of a patient with a suspected cervical spine injury, the
preferred maneuver is:
A. Head tilt with chin lift performed as the initial maneuver
B. Hyperextension of the neck to align the airway
C. Placement of the patient in the recovery position before airway management
D. Jaw thrust with manual in line immobilization of the head and neck
Correct Answer: D. Jaw thrust with manual in line immobilization of the head and
neck
Rationale: The jaw thrust minimizes cervical movement while opening the airway.
Head tilt with chin lift, neck hyperextension, and early lateral positioning risk displacing
an unstable cervical injury.
3. A trauma patient who is able to speak in full sentences and has clear phonation
most likely has:
A. A patent airway with adequate air movement at that moment, though reassessment
remains necessary
B. An airway that is fully protected for the remainder of the resuscitation
C. A definitive airway that requires no further evaluation
D. A cervical spine injury that cannot be excluded
Correct Answer: A. A patent airway with adequate air movement at that moment,
though reassessment remains necessary
Rationale: Speech indicates air movement at the time of assessment, but airway status
can deteriorate, so reassessment continues. Full protection, a definitive airway, and an
injury conclusion do not follow from phonation.
4. Which finding indicates the need for a definitive airway?
A. A Glasgow Coma Scale score of fifteen with a scalp laceration
B. A closed femur fracture with intact distal pulses
C. A Glasgow Coma Scale score of eight or less with an inability to protect the airway
D. A single episode of emesis during transport
Correct Answer: C. A Glasgow Coma Scale score of eight or less with an inability to
protect the airway
Rationale: Severe neurologic depression with loss of airway protection requires
intubation. Minor lacerations, isolated extremity fractures, and a single resolved emesis
do not by themselves require a definitive airway.
5. A contraindication to orotracheal intubation that requires an alternative approach
is:
A. A suspected cervical spine injury managed with in line immobilization
B. Massive facial trauma with distortion of the airway anatomy that prevents
visualization of the glottis
C. An oxygen saturation of ninety four percent on room air
D. A history of well controlled asthma
, Correct Answer: B. Massive facial trauma with distortion of the airway anatomy
that prevents visualization of the glottis
Rationale: Severe facial disruption may prevent direct laryngoscopy, so surgical or
other approaches are considered. Cervical precaution, mild hypoxemia, and controlled
asthma are managed within routine intubation planning.
6. Which adjunct is used to confirm and monitor endotracheal tube placement in the
trauma patient?
A. Continuous waveform capnography with auscultation and chest radiography as
supporting assessments
B. Pulse oximetry as the sole confirmation method
C. Observation of chest rise as the definitive confirmation
D. Epigastric auscultation performed alone
Correct Answer: A. Continuous waveform capnography with auscultation and
chest radiography as supporting assessments
Rationale: Waveform capnography provides continuous confirmation of tube position,
with other methods supporting the assessment. Oximetry alone, chest rise alone, and
epigastric auscultation alone are unreliable.
7. A trauma patient with gurgling respirations, vomiting, and decreasing oxygen
saturation should first be managed by:
A. Immediate surgical cricothyroidotomy before any other intervention
B. Suctioning the airway to clear blood, vomitus, or secretions while maintaining
cervical precautions
C. Administration of a neuromuscular blocking agent without airway preparation
D. Placement of the patient supine with the head elevated thirty degrees
Correct Answer: B. Suctioning the airway to clear blood, vomitus, or secretions
while maintaining cervical precautions
Rationale: Removing obstructing fluid from the airway restores ventilation and
precedes more invasive measures. Immediate surgical airway, paralysis without
preparation, and positioning alone do not address the obstruction.
8. In a trauma patient who is being ventilated with a bag valve mask, which finding
indicates inadequate ventilation?
A. A respiratory rate of sixteen breaths per minute delivered by the device
B. Oxygen saturation rising from eighty eight to ninety six percent
C. A gradual decrease in the required squeeze pressure
D. Absent or minimal chest rise with poor compliance and worsening hypoxemia
Correct Answer: D. Absent or minimal chest rise with poor compliance and
worsening hypoxemia
Rationale: Poor chest rise with declining saturation indicates that ventilation is not
reaching the lungs, prompting evaluation for obstruction, leak, or pneumothorax. Rising
saturation and reduced pressure requirement indicate improving ventilation.
, 9. Which condition must be ruled out before positive pressure ventilation is provided
to a patient with unilateral absent breath sounds?
A. Simple rib fracture, which is unaffected by ventilation
B. Pulmonary contusion, which requires no consideration before ventilation
C. Flail chest, which resolves with positive pressure alone
D. Tension pneumothorax, which would be worsened by positive pressure until
decompressed
Correct Answer: D. Tension pneumothorax, which would be worsened by positive
pressure until decompressed
Rationale: Positive pressure without decompression can worsen tension physiology
and precipitate arrest. Rib fracture, contusion, and flail chest do not require the same
sequencing consideration before ventilation.
10. The definitive airway of choice for a patient with severe laryngeal injury and
inability to intubate orally is:
A. Repeated attempts at oral intubation with a smaller tube
B. Bag valve mask ventilation continued indefinitely
C. A surgical airway such as cricothyroidotomy or tracheostomy performed by a
qualified provider
D. Placement of a supraglottic airway as the definitive solution
Correct Answer: C. A surgical airway such as cricothyroidotomy or tracheostomy
performed by a qualified provider
Rationale: Surgical access bypasses the injured larynx to secure ventilation. Repeated
oral attempts risk further injury, indefinite bagging does not secure the airway, and
supraglottic devices are temporizing rather than definitive.
11. During the exposure phase of the primary survey, the trauma team must also:
A. Delay temperature management until the secondary survey is complete
B. Remove all covering and leave the patient exposed for continuous inspection
C. Prevent hypothermia by using warm blankets, warmed fluids, and increasing the
ambient temperature
D. Restrict intravenous fluids until core temperature is measured
Correct Answer: C. Prevent hypothermia by using warm blankets, warmed fluids,
and increasing the ambient temperature
Rationale: Exposure reveals injuries but causes heat loss, so warming measures
proceed simultaneously. Delaying, leaving the patient uncovered, and withholding fluids
overlook the lethal effect of hypothermia in trauma.
12. A trauma patient who becomes combative with a decreasing level of
consciousness should be evaluated first for:
A. Pain from extremity injuries as the primary cause
B. Hypoxia and hypoperfusion, since both cause altered mental status in trauma
C. Anxiety related to the trauma scene
