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ATLS 10TH EDITION — POST TEST 1–4
Comprehensive Practice Question Bank
210 Original Curriculum-Aligned Multiple-Choice Question
TABLE OF CONTENTS
Section Topic
1 Initial Assessment and Management (Primary & Secondary Survey)
2 Airway and Ventilatory Management
3 Shock and Hemorrhage Management
4 Thoracic Trauma
5 Abdominal and Pelvic Trauma
6 Head Trauma
7 Spine and Spinal Cord Trauma
8 Musculoskeletal Trauma
9 Thermal Injuries (Burns)
10 Pediatric Trauma
11 Geriatric Trauma
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Section Topic
12 Trauma in Pregnancy and Special Populations
13 Transfer to Definitive Care and Team Resource Management
SECTION 1: INITIAL ASSESSMENT AND MANAGEMENT
Question 1
Topic: Initial Assessment — Primary Survey
Learning Objective: Identify the correct sequence and components of the primary survey in
trauma assessment
Difficulty: Easy
Question :
A 45-year-old male is brought to the emergency department after a motor vehicle collision. The
trauma team leader initiates the primary survey. What is the correct order of assessment?
A. Airway, Breathing, Circulation, Disability, Exposure
B. Breathing, Airway, Circulation, Disability, Exposure
C. Circulation, Airway, Breathing, Disability, Exposure
D. Disability, Airway, Breathing, Circulation, Exposure
Correct answer: A. Airway, Breathing, Circulation, Disability, Exposure
Detailed rationale: The ATLS primary survey follows the mnemonic "ABCDE" in a specific,
prioritized sequence. Airway assessment and cervical spine protection must occur first, as
airway compromise is the most immediately life-threatening condition. Breathing and
ventilation are assessed second, followed by circulation with hemorrhage control. Disability
(neurologic status) is assessed fourth, and Exposure/Environmental control completes the
survey. This sequence ensures that life-threatening problems are identified and addressed in
order of priority.
Why the other options are incorrect:
• B: Placing Breathing before Airway is incorrect because airway obstruction must be
identified and managed before ventilation can be assessed or optimized.
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• C: Placing Circulation before Airway and Breathing is incorrect; circulatory issues are
addressed only after airway and breathing are secured.
• D: Placing Disability first is incorrect; neurologic assessment occurs after the ABCs are
addressed.
Exam tip: Remember the mnemonic "ABCDE" — Airway (with cervical spine protection) is
always first. A common error is to assess circulation before ensuring a patent airway and
adequate breathing.
Question 2
Topic: Initial Assessment — Secondary Survey
Learning Objective: Distinguish between primary and secondary survey components
Difficulty: Easy
Question :
A trauma patient has undergone a complete primary survey with no immediately life-
threatening conditions identified. The team now proceeds to the secondary survey. Which of
the following is a component of the secondary survey?
A. Assessment of airway patency
B. Needle decompression of tension pneumothorax
C. Log-roll examination of the spine
D. Application of a cervical collar
Correct answer: C. Log-roll examination of the spine
Detailed rationale: The secondary survey is a head-to-toe evaluation conducted after the
primary survey is complete and resuscitation is underway. It includes a complete history,
physical examination of all body regions, and log-roll of the patient to examine the spine and
posterior surfaces. Airway assessment, needle decompression, and cervical collar application
are all components of the primary survey, not the secondary survey.
Why the other options are incorrect:
• A: Airway assessment is part of the primary survey (the "A" in ABCDE).
• B: Needle decompression is an intervention performed during the primary survey for
tension pneumothorax (a life-threatening breathing problem).
• D: Cervical collar application occurs during the primary survey as part of airway
management with cervical spine protection.
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Exam tip: Remember: Primary survey = immediate life threats (ABCDE). Secondary survey =
complete head-to-toe examination after resuscitation has begun.
Question 3
Topic: Initial Assessment — Trauma Team Activation
Learning Objective: Identify criteria for trauma team activation based on mechanism of injury
and physiologic parameters
Difficulty: Moderate
Question :
A 28-year-old male is brought to the emergency department after a fall from a height of
approximately 20 feet (6 meters). He is alert, oriented, and hemodynamically stable. Based on
mechanism of injury alone, which of the following is the most appropriate action?
A. Perform primary survey and discharge if normal
B. Activate full trauma team response
C. Observe in the emergency department for 4 hours
D. Transfer directly to the operating room
Correct answer: B. Activate full trauma team response
Detailed rationale: Falls from a height greater than 20 feet (6 meters) are considered a high-risk
mechanism of injury and meet criteria for full trauma team activation according to ATLS
guidelines. Even in the absence of immediate physiologic abnormalities, the mechanism
predicts a high likelihood of significant injury that may not be immediately apparent. Full team
activation ensures that appropriate resources and personnel are available for a comprehensive
evaluation.
Why the other options are incorrect:
• A: Discharging a patient after a 20-foot fall without further evaluation is unsafe and does
not follow ATLS recommendations.
• C: Observation alone without trauma team evaluation is insufficient given the high-risk
mechanism.
• D: Transfer directly to the operating room is premature without complete assessment
and identification of specific surgical needs.
Exam tip: High-risk mechanisms include falls >20 feet, ejection from vehicle, death of another
occupant, pedestrian vs. vehicle, and motorcycle crashes >20 mph.
ATLS 10TH EDITION — POST TEST 1–4
Comprehensive Practice Question Bank
210 Original Curriculum-Aligned Multiple-Choice Question
TABLE OF CONTENTS
Section Topic
1 Initial Assessment and Management (Primary & Secondary Survey)
2 Airway and Ventilatory Management
3 Shock and Hemorrhage Management
4 Thoracic Trauma
5 Abdominal and Pelvic Trauma
6 Head Trauma
7 Spine and Spinal Cord Trauma
8 Musculoskeletal Trauma
9 Thermal Injuries (Burns)
10 Pediatric Trauma
11 Geriatric Trauma
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Section Topic
12 Trauma in Pregnancy and Special Populations
13 Transfer to Definitive Care and Team Resource Management
SECTION 1: INITIAL ASSESSMENT AND MANAGEMENT
Question 1
Topic: Initial Assessment — Primary Survey
Learning Objective: Identify the correct sequence and components of the primary survey in
trauma assessment
Difficulty: Easy
Question :
A 45-year-old male is brought to the emergency department after a motor vehicle collision. The
trauma team leader initiates the primary survey. What is the correct order of assessment?
A. Airway, Breathing, Circulation, Disability, Exposure
B. Breathing, Airway, Circulation, Disability, Exposure
C. Circulation, Airway, Breathing, Disability, Exposure
D. Disability, Airway, Breathing, Circulation, Exposure
Correct answer: A. Airway, Breathing, Circulation, Disability, Exposure
Detailed rationale: The ATLS primary survey follows the mnemonic "ABCDE" in a specific,
prioritized sequence. Airway assessment and cervical spine protection must occur first, as
airway compromise is the most immediately life-threatening condition. Breathing and
ventilation are assessed second, followed by circulation with hemorrhage control. Disability
(neurologic status) is assessed fourth, and Exposure/Environmental control completes the
survey. This sequence ensures that life-threatening problems are identified and addressed in
order of priority.
Why the other options are incorrect:
• B: Placing Breathing before Airway is incorrect because airway obstruction must be
identified and managed before ventilation can be assessed or optimized.
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• C: Placing Circulation before Airway and Breathing is incorrect; circulatory issues are
addressed only after airway and breathing are secured.
• D: Placing Disability first is incorrect; neurologic assessment occurs after the ABCs are
addressed.
Exam tip: Remember the mnemonic "ABCDE" — Airway (with cervical spine protection) is
always first. A common error is to assess circulation before ensuring a patent airway and
adequate breathing.
Question 2
Topic: Initial Assessment — Secondary Survey
Learning Objective: Distinguish between primary and secondary survey components
Difficulty: Easy
Question :
A trauma patient has undergone a complete primary survey with no immediately life-
threatening conditions identified. The team now proceeds to the secondary survey. Which of
the following is a component of the secondary survey?
A. Assessment of airway patency
B. Needle decompression of tension pneumothorax
C. Log-roll examination of the spine
D. Application of a cervical collar
Correct answer: C. Log-roll examination of the spine
Detailed rationale: The secondary survey is a head-to-toe evaluation conducted after the
primary survey is complete and resuscitation is underway. It includes a complete history,
physical examination of all body regions, and log-roll of the patient to examine the spine and
posterior surfaces. Airway assessment, needle decompression, and cervical collar application
are all components of the primary survey, not the secondary survey.
Why the other options are incorrect:
• A: Airway assessment is part of the primary survey (the "A" in ABCDE).
• B: Needle decompression is an intervention performed during the primary survey for
tension pneumothorax (a life-threatening breathing problem).
• D: Cervical collar application occurs during the primary survey as part of airway
management with cervical spine protection.
, Page 4 of 170
Exam tip: Remember: Primary survey = immediate life threats (ABCDE). Secondary survey =
complete head-to-toe examination after resuscitation has begun.
Question 3
Topic: Initial Assessment — Trauma Team Activation
Learning Objective: Identify criteria for trauma team activation based on mechanism of injury
and physiologic parameters
Difficulty: Moderate
Question :
A 28-year-old male is brought to the emergency department after a fall from a height of
approximately 20 feet (6 meters). He is alert, oriented, and hemodynamically stable. Based on
mechanism of injury alone, which of the following is the most appropriate action?
A. Perform primary survey and discharge if normal
B. Activate full trauma team response
C. Observe in the emergency department for 4 hours
D. Transfer directly to the operating room
Correct answer: B. Activate full trauma team response
Detailed rationale: Falls from a height greater than 20 feet (6 meters) are considered a high-risk
mechanism of injury and meet criteria for full trauma team activation according to ATLS
guidelines. Even in the absence of immediate physiologic abnormalities, the mechanism
predicts a high likelihood of significant injury that may not be immediately apparent. Full team
activation ensures that appropriate resources and personnel are available for a comprehensive
evaluation.
Why the other options are incorrect:
• A: Discharging a patient after a 20-foot fall without further evaluation is unsafe and does
not follow ATLS recommendations.
• C: Observation alone without trauma team evaluation is insufficient given the high-risk
mechanism.
• D: Transfer directly to the operating room is premature without complete assessment
and identification of specific surgical needs.
Exam tip: High-risk mechanisms include falls >20 feet, ejection from vehicle, death of another
occupant, pedestrian vs. vehicle, and motorcycle crashes >20 mph.
