ATLS 10TH EDITION SHOCK & RESUSCITATION PRACTICE EXAM – CLINICAL CALCULATIONS & CASE QUESTIONS Calculations + Scenarios Hemorrhagic Shock, Estimated Blood Loss, Vital Signs, Resuscitation, Fluid/Blood Therapy

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ATLS 10TH EDITION SHOCK & RESUSCITATION PRACTICE
EXAM – CLINICAL CALCULATIONS & CASE QUESTIONS
Calculations + Scenarios Hemorrhagic Shock, Estimated
Blood Loss, Vital Signs, Resuscitation, Fluid/Blood Therapy


Trauma / Hemorrhagic Shock / Resuscitation / Clinical / Nursing



Exam coverage :
❖ Section 1 (Q1–15): ATLS shock classification, estimated blood
loss, and base deficit correlation.
❖ Section 2 (Q16–30): Initial assessment, hemorrhage control,
and xABCDE prioritization.
❖ Section 3 (Q31–50): Fluid resuscitation, blood product
therapy, massive transfusion, and TXA.
❖ Section 4 (Q51–70): Special populations, including geriatric,
pediatric, pregnant, and comorbid patients.
❖ Section 5 (Q71–85): Monitoring and endpoints of
resuscitation, including base deficit, lactate, and urine
output.
❖ Section 6 (Q86–100): Complications and pitfalls of shock
resuscitation.

Section 1: Foundations of Shock & Hemorrhage
Classification (Questions 1–15)

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Question 1
A 35-year-old male is brought to the emergency department
after a high-speed motorcycle collision. His heart rate is 128
bpm, blood pressure is 118/76 mmHg, respiratory rate is
24/min, and urine output is 25 mL/hr. Based on the ATLS 10th
Edition shock classification, which class of hemorrhage does
this patient most likely represent?
A. Class I
B. Class II
C. Class III
D. Class IV
CORRECT ANSWER: B ✅
RATIONALE: This patient has an elevated heart rate (128 bpm)
with a normal blood pressure and decreased pulse pressure,
which corresponds to Class II hemorrhage (15–30% blood loss).
Option A (Class I) is incorrect because Class I presents with
normal heart rate and blood pressure. Option C (Class III) is
incorrect because Class III typically presents with hypotension
(systolic BP decreased) and a further increase in heart rate.
Option D (Class IV) is incorrect because Class IV presents with
marked hypotension and severe tachycardia.
Question 2
A 28-year-old female is involved in a motor vehicle crash. Her
estimated blood loss is calculated at 1,800 mL. Given an
estimated total blood volume of 5,000 mL, what percentage of
blood loss does this represent, and what is the corresponding
ATLS hemorrhage class?
A. 26%, Class II
B. 36%, Class III
C. 46%, Class IV

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D. 16%, Class I
CORRECT ANSWER: B ✅
RATIONALE: Percentage blood loss = (1,800 ÷ 5,000) × 100 =
36%. According to ATLS 10th Edition, Class III hemorrhage
corresponds to 31–40% blood loss. Option A is incorrect
because Class II is 15–30%. Option C is incorrect because
Class IV is >40%. Option D is incorrect because Class I is <15%.
Question 3
A trauma patient has a base deficit of -8 mEq/L. According to
the ATLS 10th Edition shock classification table, which class of
hemorrhage does this finding most likely correspond to?
A. Class I
B. Class II
C. Class III
D. Class IV
CORRECT ANSWER: C ✅
RATIONALE: The ATLS 10th Edition classification table
indicates that a base deficit of -6 to -10 mEq/L corresponds to
Class III hemorrhage. Option A is incorrect because Class I has
a base deficit of 0 to -2 mEq/L. Option B is incorrect because
Class II has a base deficit of -2 to -6 mEq/L. Option D is
incorrect because Class IV has a base deficit of -10 mEq/L or
less.
Question 4
A 45-year-old male presents with a gunshot wound to the
abdomen. His vital signs are: heart rate 142 bpm, blood
pressure 78/40 mmHg, respiratory rate 32/min, and GCS 13.
According to ATLS 10th Edition, which class of hemorrhagic
shock does this represent?

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A. Class I
B. Class II
C. Class III
D. Class IV
CORRECT ANSWER: D ✅
RATIONALE: This patient has marked hypotension (systolic BP
<90 mmHg), severe tachycardia, tachypnea, and altered mental
status, which are consistent with Class IV hemorrhage (>40%
blood loss). Option A is incorrect because Class I presents with
normal vital signs. Option B is incorrect because Class II
presents with normal blood pressure. Option C is incorrect
because Class III presents with hypotension but typically less
severe tachycardia and mental status changes than Class IV.
Question 5
A trauma patient has an estimated blood loss of 800 mL. What
percentage of total blood volume does this represent in an
average adult with a blood volume of 5,000 mL, and what ATLS
class does this correspond to?
A. 16%, Class II
B. 10%, Class I
C. 20%, Class II
D. 8%, Class I
CORRECT ANSWER: A ✅
RATIONALE: Percentage blood loss = (800 ÷ 5,000) × 100 = 16%.
According to ATLS 10th Edition, Class II hemorrhage
corresponds to 15–30% blood loss. Option B is incorrect
because Class I is <15%. Option C is incorrect because the
calculation yields 16%, not 20%. Option D is incorrect because
8% is Class I, not 16%.