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ATLS 10TH EDITION POST TEST EXAM WITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
ATLS 10th Edition Post Test — Comprehensive Test Bank
SECTION 1: INITIAL ASSESSMENT & PRIMARY SURVEY (ABCDE) (Questions 1–40)
1. What is the correct sequence of the primary survey in ATLS?
A. ABCDE: Airway, Breathing, Circulation, Disability, Exposure
B. CAB: Circulation, Airway, Breathing
C. DCBA: Disability, Circulation, Breathing, Airway
D. ABDCE: Airway, Breathing, Disability, Circulation, Exposure
Rationale: The ATLS primary survey follows a strict, prioritized sequence: Airway with cervical
spine protection, Breathing and ventilation, Circulation with hemorrhage control, Disability
(neurologic status), and Exposure/Environmental control. This sequence ensures the most
immediately life-threatening conditions are addressed first.
2. What does the "A" in the primary survey include besides assessing the airway?
A. Only looking in the mouth
B. Protection of the cervical spine by manual in-line immobilization or a rigid cervical collar
C. Administering oxygen
D. Assessing for abdominal tenderness
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Rationale: Every trauma patient is assumed to have a cervical spine injury until proven
otherwise. Airway assessment and management must be performed with simultaneous cervical
spine protection to avoid causing or worsening a spinal cord injury.
3. During the primary survey, when is a definitive airway indicated?
A. When the patient requests it
B. When there is inability to maintain a patent airway by other means, inability to protect the
airway (loss of gag reflex), or anticipated clinical deterioration
C. Only when the GCS is less than 3
D. Only when the patient is in cardiac arrest
Rationale: A definitive airway (endotracheal intubation or surgical airway) is required when the
patient cannot maintain their own airway, cannot protect it from aspiration, or when
deterioration is expected.
4. A 28-year-old male involved in a high-speed car crash is conscious but tachycardic (HR 120
bpm, BP 95/60 mmHg). What is the first step?
A. Order a full trauma CT
B. Perform primary survey
C. Administer analgesics
D. Start vasopressors
Rationale: The primary survey (ABCDE) is the first step to identify life-threatening conditions.
Prioritize ABCDE before diagnostics. Ordering imaging before stabilizing the patient delays
critical interventions.
5. A trauma patient has pale, cool extremities and a weak pulse. What is the most likely
diagnosis?
A. Cardiogenic shock
B. Hemorrhagic shock
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C. Neurogenic shock
D. Septic shock
Rationale: Pale, cool extremities and weak pulse indicate hypoperfusion from hemorrhagic
shock. Hemorrhagic shock is the most common in trauma. Assuming neurogenic shock without
spinal injury signs is a common pitfall.
6. What is the primary goal of the circulation assessment in the primary survey?
A. Assess neurological status
B. Control bleeding and assess perfusion
C. Confirm airway patency
D. Evaluate ventilatory status
Rationale: Circulation assessment focuses on controlling hemorrhage and ensuring adequate
perfusion. Rapid identification of bleeding sources is critical. Delaying hemorrhage control for
other assessments is a common pitfall.
7. A stable trauma patient has a suspected abdominal injury. What is the next diagnostic step?
A. Immediate laparotomy
B. Perform a FAST exam
C. Administer contrast IV
D. Order an abdominal X-ray
Rationale: FAST exam is the first-line tool for detecting free intraperitoneal fluid in stable
patients.
8. A 34-year-old male unrestrained driver is brought to the ED following a high-speed motor
vehicle collision. He is confused, has snoring respirations, and a GCS of 7. During the primary
survey, what is the most appropriate immediate intervention?
A. Obtain a CT scan of the head
B. Insert two large-bore peripheral IVs and begin fluid resuscitation
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C. Perform immediate orotracheal intubation with in-line spinal stabilization
D. Complete the secondary survey to identify all injuries
Rationale: The ATLS ABCDE approach mandates airway management as the first priority. This
patient has a GCS ≤ 8 with snoring respirations, indicating a compromised airway and high risk
for aspiration. Definitive airway control is required immediately.
9. Signs and symptoms of airway compromise include all of the following EXCEPT:
A. Change in voice
B. Stridor
C. Decreased pulse pressure
D. Dyspnea and agitation
Rationale: Decreased pulse pressure is a sign of hemorrhagic shock or decreased cardiac
output, not specifically airway compromise. Change in voice, stridor, and dyspnea with agitation
are all classic signs of airway compromise.
10. A 28-year-old female pedestrian struck by a vehicle arrives in the trauma bay. She is
moaning but follows commands. Her airway is patent, breathing is labored with decreased
breath sounds bilaterally, and RR is 32. After airway assessment, what is the next priority?
A. Perform a detailed neurologic examination
B. Administer 2 liters of warmed crystalloid rapidly
C. Identify and treat the cause of respiratory compromise
D. Obtain a portable chest X-ray
Rationale: After airway (A) is secured, breathing (B) is the next priority. This patient has life-
threatening respiratory compromise requiring immediate intervention. The specific cause must
be identified and treated immediately without waiting for imaging.
11. A 45-year-old male construction worker fell 20 feet from scaffolding. Primary survey
reveals: Airway patent, Breathing with RR 24 and SpO₂ 94%, Circulation with HR 96 and BP
118/76. During the "D" (Disability) assessment, which finding requires immediate attention?
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ATLS 10TH EDITION POST TEST EXAM WITH VERIFIED
ANSWERS DETAILED RATIONALES GRADED A+
ATLS 10th Edition Post Test — Comprehensive Test Bank
SECTION 1: INITIAL ASSESSMENT & PRIMARY SURVEY (ABCDE) (Questions 1–40)
1. What is the correct sequence of the primary survey in ATLS?
A. ABCDE: Airway, Breathing, Circulation, Disability, Exposure
B. CAB: Circulation, Airway, Breathing
C. DCBA: Disability, Circulation, Breathing, Airway
D. ABDCE: Airway, Breathing, Disability, Circulation, Exposure
Rationale: The ATLS primary survey follows a strict, prioritized sequence: Airway with cervical
spine protection, Breathing and ventilation, Circulation with hemorrhage control, Disability
(neurologic status), and Exposure/Environmental control. This sequence ensures the most
immediately life-threatening conditions are addressed first.
2. What does the "A" in the primary survey include besides assessing the airway?
A. Only looking in the mouth
B. Protection of the cervical spine by manual in-line immobilization or a rigid cervical collar
C. Administering oxygen
D. Assessing for abdominal tenderness
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Rationale: Every trauma patient is assumed to have a cervical spine injury until proven
otherwise. Airway assessment and management must be performed with simultaneous cervical
spine protection to avoid causing or worsening a spinal cord injury.
3. During the primary survey, when is a definitive airway indicated?
A. When the patient requests it
B. When there is inability to maintain a patent airway by other means, inability to protect the
airway (loss of gag reflex), or anticipated clinical deterioration
C. Only when the GCS is less than 3
D. Only when the patient is in cardiac arrest
Rationale: A definitive airway (endotracheal intubation or surgical airway) is required when the
patient cannot maintain their own airway, cannot protect it from aspiration, or when
deterioration is expected.
4. A 28-year-old male involved in a high-speed car crash is conscious but tachycardic (HR 120
bpm, BP 95/60 mmHg). What is the first step?
A. Order a full trauma CT
B. Perform primary survey
C. Administer analgesics
D. Start vasopressors
Rationale: The primary survey (ABCDE) is the first step to identify life-threatening conditions.
Prioritize ABCDE before diagnostics. Ordering imaging before stabilizing the patient delays
critical interventions.
5. A trauma patient has pale, cool extremities and a weak pulse. What is the most likely
diagnosis?
A. Cardiogenic shock
B. Hemorrhagic shock
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C. Neurogenic shock
D. Septic shock
Rationale: Pale, cool extremities and weak pulse indicate hypoperfusion from hemorrhagic
shock. Hemorrhagic shock is the most common in trauma. Assuming neurogenic shock without
spinal injury signs is a common pitfall.
6. What is the primary goal of the circulation assessment in the primary survey?
A. Assess neurological status
B. Control bleeding and assess perfusion
C. Confirm airway patency
D. Evaluate ventilatory status
Rationale: Circulation assessment focuses on controlling hemorrhage and ensuring adequate
perfusion. Rapid identification of bleeding sources is critical. Delaying hemorrhage control for
other assessments is a common pitfall.
7. A stable trauma patient has a suspected abdominal injury. What is the next diagnostic step?
A. Immediate laparotomy
B. Perform a FAST exam
C. Administer contrast IV
D. Order an abdominal X-ray
Rationale: FAST exam is the first-line tool for detecting free intraperitoneal fluid in stable
patients.
8. A 34-year-old male unrestrained driver is brought to the ED following a high-speed motor
vehicle collision. He is confused, has snoring respirations, and a GCS of 7. During the primary
survey, what is the most appropriate immediate intervention?
A. Obtain a CT scan of the head
B. Insert two large-bore peripheral IVs and begin fluid resuscitation
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C. Perform immediate orotracheal intubation with in-line spinal stabilization
D. Complete the secondary survey to identify all injuries
Rationale: The ATLS ABCDE approach mandates airway management as the first priority. This
patient has a GCS ≤ 8 with snoring respirations, indicating a compromised airway and high risk
for aspiration. Definitive airway control is required immediately.
9. Signs and symptoms of airway compromise include all of the following EXCEPT:
A. Change in voice
B. Stridor
C. Decreased pulse pressure
D. Dyspnea and agitation
Rationale: Decreased pulse pressure is a sign of hemorrhagic shock or decreased cardiac
output, not specifically airway compromise. Change in voice, stridor, and dyspnea with agitation
are all classic signs of airway compromise.
10. A 28-year-old female pedestrian struck by a vehicle arrives in the trauma bay. She is
moaning but follows commands. Her airway is patent, breathing is labored with decreased
breath sounds bilaterally, and RR is 32. After airway assessment, what is the next priority?
A. Perform a detailed neurologic examination
B. Administer 2 liters of warmed crystalloid rapidly
C. Identify and treat the cause of respiratory compromise
D. Obtain a portable chest X-ray
Rationale: After airway (A) is secured, breathing (B) is the next priority. This patient has life-
threatening respiratory compromise requiring immediate intervention. The specific cause must
be identified and treated immediately without waiting for imaging.
11. A 45-year-old male construction worker fell 20 feet from scaffolding. Primary survey
reveals: Airway patent, Breathing with RR 24 and SpO₂ 94%, Circulation with HR 96 and BP
118/76. During the "D" (Disability) assessment, which finding requires immediate attention?
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