ATLS Post Test 1–4 | 2025/2026 Updated
Edition | 200 Questions and Answers |
Advanced Trauma Life Support Package
Deal
Section 1: Initial Assessment and Primary Survey (Q1–Q20)
1. A 24-year-old male arrives by EMS after a high-speed motorcycle
crash. He is unresponsive, snoring respirations at 8/min, and has
obvious facial injuries. What is the FIRST priority in the primary
survey?
A. Perform a rapid sequence intubation
B. Insert an oropharyngeal airway and ventilate with a bag-valve-mask
C. Obtain a stat CT scan of the head and cervical spine
D. Establish two large-bore IVs and begin fluid resuscitation
Answer: B
Rationale: The primary survey follows ABCDE. Snoring respirations
indicate partial upper airway obstruction by the tongue; the immediate
intervention is to open and secure the airway with a basic adjunct
(oropharyngeal airway) and provide ventilation with a bag-valve-mask.
Definitive airway follows initial airway patency and oxygenation.
2. During the primary survey of a trauma patient, which finding
requires IMMEDIATE intervention before proceeding to the next step?
A. Tachycardia with a narrowed pulse pressure
B. Stridor and suprasternal retractions
C. GCS of 12 with equal and reactive pupils
D. Distended abdomen with ecchymosis
,Answer: B
Rationale: Stridor and suprasternal retractions indicate upper airway
obstruction with impending loss of airway patency — a life-threatening
Airway (A) emergency requiring immediate intervention.
3. Which of the following findings necessitates a definitive airway in a
severely injured trauma patient?
A. Repeated vomiting
B. Severe maxillofacial fractures
C. Sternal fracture
D. Glasgow Coma Scale of 12
Answer: B
Rationale: Severe maxillofacial fractures threaten airway patency;
securing a definitive airway (e.g., endotracheal tube or surgical airway)
is paramount.
4. A 28-year-old male is brought to the emergency department
following a high-speed motorcycle crash. He is moaning but not
following commands. His airway is patent, but he has gurgling
respirations. According to the primary survey, what is the immediate
priority?
A. Obtain a full set of vital signs and establish IV access
B. Perform a detailed neurological examination and calculate GCS
C. Open the airway using jaw thrust while maintaining cervical spine
immobilization
D. Administer 2 liters of lactated Ringer's solution through bilateral
large-bore IVs
Answer: C
Rationale: The primary survey follows the ABCDE approach. Airway
with cervical spine protection is always the first priority. Gurgling
,respirations indicate potential airway compromise requiring immediate
intervention.
5. Which of the following signs is LEAST reliable for diagnosing
esophageal intubation?
A. Symmetrical chest wall movement
B. Presence of end-tidal CO₂ by colorimetry
C. Bilateral breath sounds
D. Endotracheal tube (ETT) tip above the carina on chest x-ray
Answer: D
Rationale: Although a chest x-ray confirms tube position after
intubation, it is less reliable in the immediate setting to rule out
esophageal placement. Real-time indicators (e.g., end-tidal CO₂ and
bilateral breath sounds) are more sensitive.
6. A 45-year-old male involved in a motor vehicle collision has a heart
rate of 120 bpm, blood pressure of 100/70 mmHg, respiratory rate of
24/min, and cool, clammy skin. He is anxious but oriented. Based on
ATLS shock classification, this patient is in:
A. Class I hemorrhagic shock with less than 15% blood loss
B. Class II hemorrhagic shock with 15–30% blood loss
C. Class III hemorrhagic shock with 30–40% blood loss
D. Class IV hemorrhagic shock with greater than 40% blood loss
Answer: B
Rationale: Class II hemorrhagic shock is characterized by 15–30% blood
loss (750–1500 mL in adults), tachycardia (100–120 bpm), normal or
slightly decreased blood pressure, increased respiratory rate, and
anxiety.
7. During the primary survey, a trauma patient is found to have a
Glasgow Coma Scale (GCS) score of 7 (E1, V2, M4). What is the
, appropriate airway management?
A. Continue supplemental oxygen via nasal cannula and monitor closely
B. Insert an oropharyngeal airway and provide bag-valve-mask
ventilation
C. Perform immediate endotracheal intubation with in-line stabilization
D. Apply a non-rebreather mask and reassess in 5 minutes
Answer: C
Rationale: A GCS of 8 or less indicates the need for definitive airway
management to protect the airway and prevent aspiration.
Endotracheal intubation with in-line stabilization is the appropriate
intervention.
8. Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
Answer: D
Rationale: Spinal shock refers to loss of muscle tone (flaccidity) and loss
of reflexes. The presence of deep tendon reflexes suggests an intact
spinal cord and points to another cause of hypotension.
9. The primary indication for transferring a patient to a higher-level
trauma center is:
A. Unavailability of a surgeon or operating room staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
Edition | 200 Questions and Answers |
Advanced Trauma Life Support Package
Deal
Section 1: Initial Assessment and Primary Survey (Q1–Q20)
1. A 24-year-old male arrives by EMS after a high-speed motorcycle
crash. He is unresponsive, snoring respirations at 8/min, and has
obvious facial injuries. What is the FIRST priority in the primary
survey?
A. Perform a rapid sequence intubation
B. Insert an oropharyngeal airway and ventilate with a bag-valve-mask
C. Obtain a stat CT scan of the head and cervical spine
D. Establish two large-bore IVs and begin fluid resuscitation
Answer: B
Rationale: The primary survey follows ABCDE. Snoring respirations
indicate partial upper airway obstruction by the tongue; the immediate
intervention is to open and secure the airway with a basic adjunct
(oropharyngeal airway) and provide ventilation with a bag-valve-mask.
Definitive airway follows initial airway patency and oxygenation.
2. During the primary survey of a trauma patient, which finding
requires IMMEDIATE intervention before proceeding to the next step?
A. Tachycardia with a narrowed pulse pressure
B. Stridor and suprasternal retractions
C. GCS of 12 with equal and reactive pupils
D. Distended abdomen with ecchymosis
,Answer: B
Rationale: Stridor and suprasternal retractions indicate upper airway
obstruction with impending loss of airway patency — a life-threatening
Airway (A) emergency requiring immediate intervention.
3. Which of the following findings necessitates a definitive airway in a
severely injured trauma patient?
A. Repeated vomiting
B. Severe maxillofacial fractures
C. Sternal fracture
D. Glasgow Coma Scale of 12
Answer: B
Rationale: Severe maxillofacial fractures threaten airway patency;
securing a definitive airway (e.g., endotracheal tube or surgical airway)
is paramount.
4. A 28-year-old male is brought to the emergency department
following a high-speed motorcycle crash. He is moaning but not
following commands. His airway is patent, but he has gurgling
respirations. According to the primary survey, what is the immediate
priority?
A. Obtain a full set of vital signs and establish IV access
B. Perform a detailed neurological examination and calculate GCS
C. Open the airway using jaw thrust while maintaining cervical spine
immobilization
D. Administer 2 liters of lactated Ringer's solution through bilateral
large-bore IVs
Answer: C
Rationale: The primary survey follows the ABCDE approach. Airway
with cervical spine protection is always the first priority. Gurgling
,respirations indicate potential airway compromise requiring immediate
intervention.
5. Which of the following signs is LEAST reliable for diagnosing
esophageal intubation?
A. Symmetrical chest wall movement
B. Presence of end-tidal CO₂ by colorimetry
C. Bilateral breath sounds
D. Endotracheal tube (ETT) tip above the carina on chest x-ray
Answer: D
Rationale: Although a chest x-ray confirms tube position after
intubation, it is less reliable in the immediate setting to rule out
esophageal placement. Real-time indicators (e.g., end-tidal CO₂ and
bilateral breath sounds) are more sensitive.
6. A 45-year-old male involved in a motor vehicle collision has a heart
rate of 120 bpm, blood pressure of 100/70 mmHg, respiratory rate of
24/min, and cool, clammy skin. He is anxious but oriented. Based on
ATLS shock classification, this patient is in:
A. Class I hemorrhagic shock with less than 15% blood loss
B. Class II hemorrhagic shock with 15–30% blood loss
C. Class III hemorrhagic shock with 30–40% blood loss
D. Class IV hemorrhagic shock with greater than 40% blood loss
Answer: B
Rationale: Class II hemorrhagic shock is characterized by 15–30% blood
loss (750–1500 mL in adults), tachycardia (100–120 bpm), normal or
slightly decreased blood pressure, increased respiratory rate, and
anxiety.
7. During the primary survey, a trauma patient is found to have a
Glasgow Coma Scale (GCS) score of 7 (E1, V2, M4). What is the
, appropriate airway management?
A. Continue supplemental oxygen via nasal cannula and monitor closely
B. Insert an oropharyngeal airway and provide bag-valve-mask
ventilation
C. Perform immediate endotracheal intubation with in-line stabilization
D. Apply a non-rebreather mask and reassess in 5 minutes
Answer: C
Rationale: A GCS of 8 or less indicates the need for definitive airway
management to protect the airway and prevent aspiration.
Endotracheal intubation with in-line stabilization is the appropriate
intervention.
8. Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
Answer: D
Rationale: Spinal shock refers to loss of muscle tone (flaccidity) and loss
of reflexes. The presence of deep tendon reflexes suggests an intact
spinal cord and points to another cause of hypotension.
9. The primary indication for transferring a patient to a higher-level
trauma center is:
A. Unavailability of a surgeon or operating room staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
