ATLS 10th Edition Post Test
Actual Questions and Answers
100% Guarantee Pass
This Exam contains:
100% Guarantee Pass.
Multiple-Choice (A–D), For Each Question.
Each Question Includes The Correct Answer
Rationale That Aligns with Atls Post Test 2025 Principles.
,────────────────────────────────────────────────────────
1. Which of the following is the recommended method for treating frostbite?
A. Vasodilators
B. Warm water immersion at approximately 40°C
C. Padding and elevation only
D. Application of heat from a hairdryer
Answer: B. Warm water immersion at approximately 40°C
Rationale:
• Rapid rewarming in a circulating water bath at 37–40°C (approx.) is the standard
of care for frostbite management.
• Use of hairdryers or dry heat is contraindicated due to the risk of uneven heating
and tissue damage.
────────────────────────────────────────────────────────
2. Which of the following physical findings suggests a cause of hypotension other
than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
Answer: D. Presence of deep tendon reflexes
Rationale:
• Spinal shock typically presents with flaccidity and loss of reflexes below the level
of injury.
• Preserved or brisk deep tendon reflexes suggest that the hypotension is not solely
due to spinal cord injury.
,────────────────────────────────────────────────────────
3. The primary indication for transferring a patient to a higher-level trauma center
is:
A. Unavailability of a surgeon or operating staff
B. Multiple system injuries (including severe head injury)
C. Resource limitations as determined by the transferring doctor
D. Widened mediastinum on chest X-ray after blunt trauma
Answer: C. Resource limitations as determined by the transferring doctor
Rationale:
• Transfer is indicated when the current facility lacks the necessary resources—
clinical expertise, specialist availability, or equipment—to manage the patient
effectively.
• The decision rests with the physician responsible for the patient’s care, based on
local capabilities.
────────────────────────────────────────────────────────
4. A young man has a gunshot wound to the mid-abdomen. He arrives hypotensive
(systolic blood pressure 58 mmHg) and does not improve despite rapid infusion of
warmed crystalloid fluids. The next most appropriate step is to:
A. Immediate laparotomy
B. Abdominal CT scan
C. Abdominal ultrasonography (FAST)
D. Diagnostic peritoneal lavage (DPL)
Answer: A. Immediate laparotomy
Rationale:
,• In the setting of penetrating abdominal trauma with persistent hypotension, the
priority is to control hemorrhage surgically.
• Diagnostic imaging (CT, FAST, DPL) is not indicated when the patient is profoundly
unstable and in obvious need of operative intervention.
────────────────────────────────────────────────────────
5. A 42-year-old man is trapped for several hours under an overturned tractor. He
was alert initially, but now is unconscious and shows no movement of his lower
extremities (even to painful stimuli). The most likely cause of this lower-extremity
finding is:
A. Pelvic fracture
B. Central cord syndrome
C. Intracerebral hemorrhage
D. Bilateral compartment syndrome
Answer: D. Bilateral compartment syndrome
Rationale:
• Prolonged entrapment can lead to crush injury and compartment syndrome in the
lower extremities.
• Absence of movement and persistent neurological deficits in both legs can be
explained by compromised tissue perfusion and increased compartment pressures.
────────────────────────────────────────────────────────
6. A 6-year-old boy is struck by an automobile and brought to the ED. He is
lethargic with a systolic BP of 90 mmHg, HR 140 bpm, and RR 36 breaths per
minute. The preferred route of venous access in this child is:
A. Percutaneous femoral vein cannulation
B. Intraosseous access in the proximal tibia
C. Percutaneous peripheral vein in the upper extremities
,D. Central venous access via the subclavian or internal jugular vein
Answer: C. Percutaneous peripheral vein in the upper extremities
Rationale:
• Peripheral intravenous (IV) access is usually quickest and safest in children if
attainable.
• Intraosseous access is an excellent alternative when peripheral IV access fails or
is not readily achieved.
────────────────────────────────────────────────────────
7. A young man with a gunshot wound to the abdomen arrives hypotensive, cool,
and diaphoretic. The definitive treatment for this hypotension is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Operatively control internal hemorrhage
D. Infuse large-volume intravenous crystalloid solutions
Answer: C. Operatively control internal hemorrhage
Rationale:
• When hypovolemia is secondary to ongoing intra-abdominal bleeding, definitive
surgical control of hemorrhage (damage control surgery) is essential.
• Blood and crystalloid resuscitation alone are insufficient if bleeding continues
unchecked.
────────────────────────────────────────────────────────
8. Regarding shock in a child, which of the following statements is FALSE?
A. Children have greater physiologic reserves than adults
B. Tachycardia is the primary compensatory mechanism for hypovolemia
,C. The absolute blood volume required to produce shock is the same as in adults
D. An initial fluid bolus for resuscitation is typically 20 mL/kg of Ringer’s lactate
Answer: C. The absolute blood volume required to produce shock is the same as in
adults (FALSE)
Rationale:
• Children have a smaller absolute blood volume, so a proportionally smaller
volume loss can cause shock compared to adults.
• Tachycardia is often the earliest and most prominent compensatory sign in
pediatric hypovolemia.
────────────────────────────────────────────────────────
9. A 33-year-old man is struck by a car at approximately 35 mph. He has a left-
sided tension pneumothorax that is decompressed, but remains hypotensive (BP
81/53 mmHg) and tachycardic (HR 144 bpm). After beginning fluid resuscitation,
the next priority is to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT scans
C. Perform arterial embolization of pelvic vessels
D. Perform diagnostic peritoneal lavage (DPL) or FAST
Answer: D. Perform diagnostic peritoneal lavage (DPL) or FAST
Rationale:
• Persistent hypotension after addressing a tension pneumothorax raises concern
for intra-abdominal hemorrhage or other bleeding sources.
• An immediate DPL or FAST exam can rapidly detect hemoperitoneum or
intraperitoneal bleeding that requires urgent intervention.
────────────────────────────────────────────────────────
,10. A 42-year-old man with a closed head injury and bilateral femur fractures is
intubated without initial difficulty. Over the next 5 minutes, he becomes harder to
ventilate, and his oxygen saturation drops from 98% to 89%. The most appropriate
next step is to:
A. Obtain a chest X-ray
B. Decrease the tidal volume
C. Increase the rate of assisted ventilations
D. Perform needle decompression of the left chest
Answer: A. Obtain a chest X-ray
Rationale:
• In a newly intubated trauma patient whose ventilation suddenly deteriorates,
rapid evaluation is needed.
• Common causes include endotracheal tube malposition (right mainstem or
esophageal intubation), evolving pneumothorax, or equipment failure.
• A prompt chest X-ray helps clarify tube location and detect pneumothorax if
clinical assessment is inconclusive. (If high suspicion of tension pneumothorax
exists clinically, immediate decompression precedes imaging.)
11. A 30-year-old man sustains a severely comminuted, open, distal right femur
fracture in a motorcycle crash. The wound is actively bleeding. Normal sensation is
present over the lateral aspect of the foot but decreased over the medial foot and
great toe. Normal motion of the foot is observed. Dorsalis pedis and posterior tibial
pulses are easily palpable on the left, but heard only by Doppler on the right.
Immediate efforts to improve circulation to the injured extremity should involve:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
, Answer: B. Tamponade of the wound with a pressure dressing
Rationale:
• In an actively bleeding open fracture, hemorrhage control is paramount.
• Direct pressure (tamponade) is the quickest and most effective initial measure to
control ongoing bleeding.
• Definitive fracture stabilization follows but should not delay immediate
hemorrhage control.
────────────────────────────────────────────────────────
12. An 18-year-old, unhelmeted motorcyclist is brought to the ED following a crash.
He had a decreased level of consciousness at the scene, became alert and
conversational during transport, but now his Glasgow Coma Scale (GCS) is 11.
Which of the following statements is TRUE?
A. Cerebral perfusion is intact
B. The patient is in a postictal state
C. Intra-abdominal visceral injury is unlikely
D. The patient probably has an acute epidural hematoma
Answer: D. The patient probably has an acute epidural hematoma
Rationale:
• A classic presentation for epidural hematoma includes a transient lucid interval
followed by a rapid decline in consciousness.
• Early neurosurgical evaluation and imaging are critical to prevent further
deterioration.
────────────────────────────────────────────────────────
Actual Questions and Answers
100% Guarantee Pass
This Exam contains:
100% Guarantee Pass.
Multiple-Choice (A–D), For Each Question.
Each Question Includes The Correct Answer
Rationale That Aligns with Atls Post Test 2025 Principles.
,────────────────────────────────────────────────────────
1. Which of the following is the recommended method for treating frostbite?
A. Vasodilators
B. Warm water immersion at approximately 40°C
C. Padding and elevation only
D. Application of heat from a hairdryer
Answer: B. Warm water immersion at approximately 40°C
Rationale:
• Rapid rewarming in a circulating water bath at 37–40°C (approx.) is the standard
of care for frostbite management.
• Use of hairdryers or dry heat is contraindicated due to the risk of uneven heating
and tissue damage.
────────────────────────────────────────────────────────
2. Which of the following physical findings suggests a cause of hypotension other
than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
Answer: D. Presence of deep tendon reflexes
Rationale:
• Spinal shock typically presents with flaccidity and loss of reflexes below the level
of injury.
• Preserved or brisk deep tendon reflexes suggest that the hypotension is not solely
due to spinal cord injury.
,────────────────────────────────────────────────────────
3. The primary indication for transferring a patient to a higher-level trauma center
is:
A. Unavailability of a surgeon or operating staff
B. Multiple system injuries (including severe head injury)
C. Resource limitations as determined by the transferring doctor
D. Widened mediastinum on chest X-ray after blunt trauma
Answer: C. Resource limitations as determined by the transferring doctor
Rationale:
• Transfer is indicated when the current facility lacks the necessary resources—
clinical expertise, specialist availability, or equipment—to manage the patient
effectively.
• The decision rests with the physician responsible for the patient’s care, based on
local capabilities.
────────────────────────────────────────────────────────
4. A young man has a gunshot wound to the mid-abdomen. He arrives hypotensive
(systolic blood pressure 58 mmHg) and does not improve despite rapid infusion of
warmed crystalloid fluids. The next most appropriate step is to:
A. Immediate laparotomy
B. Abdominal CT scan
C. Abdominal ultrasonography (FAST)
D. Diagnostic peritoneal lavage (DPL)
Answer: A. Immediate laparotomy
Rationale:
,• In the setting of penetrating abdominal trauma with persistent hypotension, the
priority is to control hemorrhage surgically.
• Diagnostic imaging (CT, FAST, DPL) is not indicated when the patient is profoundly
unstable and in obvious need of operative intervention.
────────────────────────────────────────────────────────
5. A 42-year-old man is trapped for several hours under an overturned tractor. He
was alert initially, but now is unconscious and shows no movement of his lower
extremities (even to painful stimuli). The most likely cause of this lower-extremity
finding is:
A. Pelvic fracture
B. Central cord syndrome
C. Intracerebral hemorrhage
D. Bilateral compartment syndrome
Answer: D. Bilateral compartment syndrome
Rationale:
• Prolonged entrapment can lead to crush injury and compartment syndrome in the
lower extremities.
• Absence of movement and persistent neurological deficits in both legs can be
explained by compromised tissue perfusion and increased compartment pressures.
────────────────────────────────────────────────────────
6. A 6-year-old boy is struck by an automobile and brought to the ED. He is
lethargic with a systolic BP of 90 mmHg, HR 140 bpm, and RR 36 breaths per
minute. The preferred route of venous access in this child is:
A. Percutaneous femoral vein cannulation
B. Intraosseous access in the proximal tibia
C. Percutaneous peripheral vein in the upper extremities
,D. Central venous access via the subclavian or internal jugular vein
Answer: C. Percutaneous peripheral vein in the upper extremities
Rationale:
• Peripheral intravenous (IV) access is usually quickest and safest in children if
attainable.
• Intraosseous access is an excellent alternative when peripheral IV access fails or
is not readily achieved.
────────────────────────────────────────────────────────
7. A young man with a gunshot wound to the abdomen arrives hypotensive, cool,
and diaphoretic. The definitive treatment for this hypotension is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Operatively control internal hemorrhage
D. Infuse large-volume intravenous crystalloid solutions
Answer: C. Operatively control internal hemorrhage
Rationale:
• When hypovolemia is secondary to ongoing intra-abdominal bleeding, definitive
surgical control of hemorrhage (damage control surgery) is essential.
• Blood and crystalloid resuscitation alone are insufficient if bleeding continues
unchecked.
────────────────────────────────────────────────────────
8. Regarding shock in a child, which of the following statements is FALSE?
A. Children have greater physiologic reserves than adults
B. Tachycardia is the primary compensatory mechanism for hypovolemia
,C. The absolute blood volume required to produce shock is the same as in adults
D. An initial fluid bolus for resuscitation is typically 20 mL/kg of Ringer’s lactate
Answer: C. The absolute blood volume required to produce shock is the same as in
adults (FALSE)
Rationale:
• Children have a smaller absolute blood volume, so a proportionally smaller
volume loss can cause shock compared to adults.
• Tachycardia is often the earliest and most prominent compensatory sign in
pediatric hypovolemia.
────────────────────────────────────────────────────────
9. A 33-year-old man is struck by a car at approximately 35 mph. He has a left-
sided tension pneumothorax that is decompressed, but remains hypotensive (BP
81/53 mmHg) and tachycardic (HR 144 bpm). After beginning fluid resuscitation,
the next priority is to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT scans
C. Perform arterial embolization of pelvic vessels
D. Perform diagnostic peritoneal lavage (DPL) or FAST
Answer: D. Perform diagnostic peritoneal lavage (DPL) or FAST
Rationale:
• Persistent hypotension after addressing a tension pneumothorax raises concern
for intra-abdominal hemorrhage or other bleeding sources.
• An immediate DPL or FAST exam can rapidly detect hemoperitoneum or
intraperitoneal bleeding that requires urgent intervention.
────────────────────────────────────────────────────────
,10. A 42-year-old man with a closed head injury and bilateral femur fractures is
intubated without initial difficulty. Over the next 5 minutes, he becomes harder to
ventilate, and his oxygen saturation drops from 98% to 89%. The most appropriate
next step is to:
A. Obtain a chest X-ray
B. Decrease the tidal volume
C. Increase the rate of assisted ventilations
D. Perform needle decompression of the left chest
Answer: A. Obtain a chest X-ray
Rationale:
• In a newly intubated trauma patient whose ventilation suddenly deteriorates,
rapid evaluation is needed.
• Common causes include endotracheal tube malposition (right mainstem or
esophageal intubation), evolving pneumothorax, or equipment failure.
• A prompt chest X-ray helps clarify tube location and detect pneumothorax if
clinical assessment is inconclusive. (If high suspicion of tension pneumothorax
exists clinically, immediate decompression precedes imaging.)
11. A 30-year-old man sustains a severely comminuted, open, distal right femur
fracture in a motorcycle crash. The wound is actively bleeding. Normal sensation is
present over the lateral aspect of the foot but decreased over the medial foot and
great toe. Normal motion of the foot is observed. Dorsalis pedis and posterior tibial
pulses are easily palpable on the left, but heard only by Doppler on the right.
Immediate efforts to improve circulation to the injured extremity should involve:
A. Immediate angiography
B. Tamponade of the wound with a pressure dressing
C. Wound exploration and removal of bony fragments
D. Realignment of the fracture segments with a traction splint
, Answer: B. Tamponade of the wound with a pressure dressing
Rationale:
• In an actively bleeding open fracture, hemorrhage control is paramount.
• Direct pressure (tamponade) is the quickest and most effective initial measure to
control ongoing bleeding.
• Definitive fracture stabilization follows but should not delay immediate
hemorrhage control.
────────────────────────────────────────────────────────
12. An 18-year-old, unhelmeted motorcyclist is brought to the ED following a crash.
He had a decreased level of consciousness at the scene, became alert and
conversational during transport, but now his Glasgow Coma Scale (GCS) is 11.
Which of the following statements is TRUE?
A. Cerebral perfusion is intact
B. The patient is in a postictal state
C. Intra-abdominal visceral injury is unlikely
D. The patient probably has an acute epidural hematoma
Answer: D. The patient probably has an acute epidural hematoma
Rationale:
• A classic presentation for epidural hematoma includes a transient lucid interval
followed by a rapid decline in consciousness.
• Early neurosurgical evaluation and imaging are critical to prevent further
deterioration.
────────────────────────────────────────────────────────
