ATLS EXAM 2024-2025 175 QUESTIONS and ANSWERS
A 36-year-old woman is beaten about the head and face and is brought to the local community hospital
in full spinal immobilization. Her BP is 13088, HR 70/minutes, and RR 18/minute. Pulse oximetry
indicated 98% while she was given 100% O2 via a non rebreather mask. Her airway is clear. She has
marked swellings on her face and several lacerations of her scalp that are not actively bleeding. She
does not respond to verbal stimuli, but localizes to painful stiumuli and opens her eyes. She moves all
ANSWER- D. Transfer the patient to a neurosurgeon without performing a CT-scan
For the trauma patient with cerebral edema, hypercarbia should be avoided to prevent:
A. metabolic acidosis
B. Respiratory acidosis
C. Cerebral vasodilatation
D. Neurogenic pulmonary edema
E. Reciprocal high level of PaCO2 -ANSWER- C. Cerebral vasodilatation
A 29 y/o male is brought to the ED after being involved in a motor vehicular collision when his car struck
a bridge abutment. He is intoxicated, has GCS 13 and complains of abdominal pain. His BP was 80mmHg
systolic by palpation on admission, but rapidly increased to 110/70 with the administration of IV fluid.
His heart rate is 120/minute. The chest x-ray show loss of aortic know, widening of mediastinum, no rib
fracture and no hemopneumothorax. Contrast angiography:
A. Is not indicated
B. Shoul -ANSWER- D. Is not necessary if the CT-scan of the chest is normal
Important screening x-rays to obtain in the multiple system trauma patient are:
A. Skull, chest and abdomen
B. Chest, abdomen and pelvis
C. Skull cervical spine and pelvis
,D. Cervical spine, chest and pelvis
E. Cervical spine, chest and abdomen -ANSWER- D. Cervical spine, chest and pelvis
Which of the following is NORMAL in pregnancy?
A. increased residual lung volume
B. Decreased plasma volume
C. Decreased total RBC mass
D. Widened symphysis pubis
E. -ANSWER- D. Widened symphysis pubis
A 34-year-old man is brought to the ED after being pinned to the wall of building by a cement truck. He
is in obvious shock, and has deformities and marked swelling of both thighs. Although no open wound
are present, his shock:
A. Cannot be explained without concomitant pelvic fracture
B. Signifies a loss of approximately 15%
C. Is consistent with blood loss from bilateral femoral fracture
D. Will likely be reversed if appropriate traction splint are applied
E. Cannot be explained by his observe -ANSWER- C. Is consistent with blood loss from bilateral
femoral fracture
Prior to passage of urinary catheter in a man, it is essential to:
A. Examine the abdomen
B. Determine pelvic stability
C. Examine the rectum and perineum
D. Perform a retrograde urethrogram
E. Know the history and mechanism of injury -ANSWER- C. Examine the rectum and perineum
The best guide for adequate fluid resuscitation of the burn patient is:
,A. Adequate urinary output
B. Reversal of systemic acidosis
C. Normalization of the heart rate
D. A normal central venous pressure
E. 4ml/kg/percent body burn/24 hours -ANSWER- A. Adequate urinary output
All of the following statement regarding pulse oxymetry are true EXCEPT
A. excessive surrounding room light can interfere with the accuracy of the reading
B. Significant levels of dysfunctional hemoglobin can affect the accuracy of the reading
C. It provides a continuous measurement of the partial pressure of oxygen
D. It is dependent on differential light absorption by oxygenated and deoxygenated hemoglobin
E. It provides a continuous, non-invasiv measurement of pulse rate that is updated with -ANSWER-
C. It provides a continuous measurement of the partial pressure of oxygen
Bronchial intubation at the right or left mainstem bronchus can easily occuring during infant
endotracheal intubation because
A. The trachea is relatively short
B. The distance from the lips to the larynx is relatively short
C. The use of tubes without cuffs allow the tube to slip easily
D. The mainstem bronchi are less angulated in their relation to the trachea
E. Do litte friction exist between endotracheal tube and the wall of the trachea. -ANSWER- A. The
trachea is relatively short
, A 52 y/o woman sustaining 50% total body surface burns in an explosion. She has burns around the
chest and both upper arms. Adequate resuscitation is initiated. She is nasotracheally intubated and is
being mechanically ventilated. Her CarboxyHb level is 10%. Her arterial blood gas reveals PaO2 of
40mmHg, PaCo2 of 60mmHg and pH of 7,25. Appropriate immediate management at the time is to
A. Ensure adequate tissue perfusion
B. Increase the rate of fluid resuscitation
C. Add PEEP
D. Reassess for the -ANSWER- ?A. Ensure adequate tissue perfusion
All of the following suggest urethral injury EXCEPT
A. scrotal hematoma
B. Blood in rectal lumen
C. Blod in external urethral meatus
D. High riding prostate on rectal exam
E. Absence of a palpable prostate on rectal exam -ANSWER- E. Absence of a palpable prostate on
rectal exam
Which one of the following is recommended method for threating frostbite?
A. Moist heat
B. Early amputation
C. Padding and elevation
D. Vasodilators and heparin
E. Topical application of silversulphadiazine -ANSWER- A. Moist heat
A 32-year-old mans right leg is trapped beneath his overturned car for nearly two hours before he is
extricated. On arrival in the ED, both lower extremities are cool, mottled, insensate and motionless.
Despite normal vital signs, pulses cannot be palpated below the femoral vessels and the muscles of the
lower extremities are firm and hard. During the initial management of this patient, which of the followin
is most likely to improve chances for limb salvage?
A. Apply skeletal traction
A 36-year-old woman is beaten about the head and face and is brought to the local community hospital
in full spinal immobilization. Her BP is 13088, HR 70/minutes, and RR 18/minute. Pulse oximetry
indicated 98% while she was given 100% O2 via a non rebreather mask. Her airway is clear. She has
marked swellings on her face and several lacerations of her scalp that are not actively bleeding. She
does not respond to verbal stimuli, but localizes to painful stiumuli and opens her eyes. She moves all
ANSWER- D. Transfer the patient to a neurosurgeon without performing a CT-scan
For the trauma patient with cerebral edema, hypercarbia should be avoided to prevent:
A. metabolic acidosis
B. Respiratory acidosis
C. Cerebral vasodilatation
D. Neurogenic pulmonary edema
E. Reciprocal high level of PaCO2 -ANSWER- C. Cerebral vasodilatation
A 29 y/o male is brought to the ED after being involved in a motor vehicular collision when his car struck
a bridge abutment. He is intoxicated, has GCS 13 and complains of abdominal pain. His BP was 80mmHg
systolic by palpation on admission, but rapidly increased to 110/70 with the administration of IV fluid.
His heart rate is 120/minute. The chest x-ray show loss of aortic know, widening of mediastinum, no rib
fracture and no hemopneumothorax. Contrast angiography:
A. Is not indicated
B. Shoul -ANSWER- D. Is not necessary if the CT-scan of the chest is normal
Important screening x-rays to obtain in the multiple system trauma patient are:
A. Skull, chest and abdomen
B. Chest, abdomen and pelvis
C. Skull cervical spine and pelvis
,D. Cervical spine, chest and pelvis
E. Cervical spine, chest and abdomen -ANSWER- D. Cervical spine, chest and pelvis
Which of the following is NORMAL in pregnancy?
A. increased residual lung volume
B. Decreased plasma volume
C. Decreased total RBC mass
D. Widened symphysis pubis
E. -ANSWER- D. Widened symphysis pubis
A 34-year-old man is brought to the ED after being pinned to the wall of building by a cement truck. He
is in obvious shock, and has deformities and marked swelling of both thighs. Although no open wound
are present, his shock:
A. Cannot be explained without concomitant pelvic fracture
B. Signifies a loss of approximately 15%
C. Is consistent with blood loss from bilateral femoral fracture
D. Will likely be reversed if appropriate traction splint are applied
E. Cannot be explained by his observe -ANSWER- C. Is consistent with blood loss from bilateral
femoral fracture
Prior to passage of urinary catheter in a man, it is essential to:
A. Examine the abdomen
B. Determine pelvic stability
C. Examine the rectum and perineum
D. Perform a retrograde urethrogram
E. Know the history and mechanism of injury -ANSWER- C. Examine the rectum and perineum
The best guide for adequate fluid resuscitation of the burn patient is:
,A. Adequate urinary output
B. Reversal of systemic acidosis
C. Normalization of the heart rate
D. A normal central venous pressure
E. 4ml/kg/percent body burn/24 hours -ANSWER- A. Adequate urinary output
All of the following statement regarding pulse oxymetry are true EXCEPT
A. excessive surrounding room light can interfere with the accuracy of the reading
B. Significant levels of dysfunctional hemoglobin can affect the accuracy of the reading
C. It provides a continuous measurement of the partial pressure of oxygen
D. It is dependent on differential light absorption by oxygenated and deoxygenated hemoglobin
E. It provides a continuous, non-invasiv measurement of pulse rate that is updated with -ANSWER-
C. It provides a continuous measurement of the partial pressure of oxygen
Bronchial intubation at the right or left mainstem bronchus can easily occuring during infant
endotracheal intubation because
A. The trachea is relatively short
B. The distance from the lips to the larynx is relatively short
C. The use of tubes without cuffs allow the tube to slip easily
D. The mainstem bronchi are less angulated in their relation to the trachea
E. Do litte friction exist between endotracheal tube and the wall of the trachea. -ANSWER- A. The
trachea is relatively short
, A 52 y/o woman sustaining 50% total body surface burns in an explosion. She has burns around the
chest and both upper arms. Adequate resuscitation is initiated. She is nasotracheally intubated and is
being mechanically ventilated. Her CarboxyHb level is 10%. Her arterial blood gas reveals PaO2 of
40mmHg, PaCo2 of 60mmHg and pH of 7,25. Appropriate immediate management at the time is to
A. Ensure adequate tissue perfusion
B. Increase the rate of fluid resuscitation
C. Add PEEP
D. Reassess for the -ANSWER- ?A. Ensure adequate tissue perfusion
All of the following suggest urethral injury EXCEPT
A. scrotal hematoma
B. Blood in rectal lumen
C. Blod in external urethral meatus
D. High riding prostate on rectal exam
E. Absence of a palpable prostate on rectal exam -ANSWER- E. Absence of a palpable prostate on
rectal exam
Which one of the following is recommended method for threating frostbite?
A. Moist heat
B. Early amputation
C. Padding and elevation
D. Vasodilators and heparin
E. Topical application of silversulphadiazine -ANSWER- A. Moist heat
A 32-year-old mans right leg is trapped beneath his overturned car for nearly two hours before he is
extricated. On arrival in the ED, both lower extremities are cool, mottled, insensate and motionless.
Despite normal vital signs, pulses cannot be palpated below the femoral vessels and the muscles of the
lower extremities are firm and hard. During the initial management of this patient, which of the followin
is most likely to improve chances for limb salvage?
A. Apply skeletal traction
