ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS.
1. A 22-year-old man is hypotensive and tachycardic after a shotgun
wound to the left shoulder. His blood pressure is initially 80/40 mm Hg. After
initial fluid resuscitation his blood pressure increases to 122/84 mm Hg. His
heart rate is now 100 beats per minute and his respiratory rate is 28 breaths
per minute. A tube thoracostomy is performed for decreased left chest
breath sounds with the return of a small amount of blood and no air leak.
After chest tube insertion, the most appropriate next step is:: re-examine the
chest
2. A construction worker falls two stories from a building and sustains
bilateral calcaneal fractures. In the emergency department, he is alert, vital
signs are normal, and he is complaining of severe pain in both heels and his
lower back. Lower extremity pulses are strong and there is no other
deformity. The suspected diagnosis is most likely to be confirmed by::
complete spine x-ray series
3. Which of the following is true regarding the initial resuscitation of a
trauma patient?: Evidence of improved perfusion after fluid resuscitation could
include improvement in Glasgow Coma Scale score on reevaluation.
4. In managing a patient with a severe traumatic brain injury, the most
important initial step is to:: secure the airway
5. A previously healthy, 70-kg (154-pound) man suffers an estimated acute
blood loss of 2 liters. Which one of the following statements applies to this
patient?: An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
6. The physiological hypervolemia of pregnancy has clinical significance
in the management of the severely injured, gravid woman by:: increasing the
volume of blood loss to produce maternal hypotension
7. The best assessment of fluid resuscitation of the adult burn patient is::
urinary output of 0.5 mL/kg/hr
8. The diagnosis of shock must include:: evidence of inadequate organ
perfusion 9. A 7-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding
profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of:: direct pressure on the wound
,ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS.
10. For the patient with severe traumatic brain injury, profound hypocarbia
should be avoided to prevent:: cerebral vasoconstriction with diminished
perfusion
11. After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available.. Computed
tomography of the chest and abdomen shows an aortic injury and splenic
laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg
after CT. The next step is:: perform an exploratory laparotomy
12. Which one of the following statements regarding abdominal trauma in
the pregnant patient is TRUE?: Leakage of amniotic fluid is an indication for
hospital admission.
13. The first maneuver to improve oxygenation after chest injury is::
administer supplemental oxygen
14. A 25-year-old man, injured in a motor vehicular crash, is admitted to the
emergency department. His pupils react sluggishly and his eyes open to
pressure. He does not follow commands, but he does moan periodically. His
right arm is deformed and does not respond to pressure; however, his left
hand reaches purposefully toward the stimulus. Both legs are stiffly
extended.
His GCS score is:: 9
15. A 20-year-old woman who is at 32 weeks gestation, is stabbed in the
upper right chest. In the emergency department, her blood pressure is 80/60
mm Hg. She is gasping for breath, extremely anxious, and yelling for help.
Breath sounds are diminished in the right chest. The most appropriate first
step is to:: perform needle or finger decompression of the right chest
16. Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?: respiratory rate of 40
breaths per minute
17. The most important, immediate step in the management of an open
pneumothorax is:: placement of an occlusive dressing over the wound
18. The following are contraindications for tetanus toxoid administration::
history of neurological reaction or severe hypersensitivity to the product
19. A 56-year-old man is thrown violently against the steering wheel of his
truck during a motor vehicle crash. On arrival in the emergency department
,ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS.
he is diaphoretic and complaining of chest pain. His blood pressure is 60/40
mm Hg and his respiratory rate is 40 breaths per minute. Which of the
following best differentiates cardiac tamponade from tension pneumothorax
as the cause of his hypotension?: breath sounds
20. Bronchial intubation of the right or left mainstem bronchus can easily
occur during infant endotracheal intubation because:: The trachea is
relatively short.
21. A 23-year-old man sustains 4 stab wounds to the upper right chest
during an altercation and is brought by ambulance to a hospital that has full
surgical capabilities. His wounds are all above the nipple. He is
endotracheally intubated, closed tube thoracostomy is performed, fluid
resuscitation is initiated through 2 large-caliber IVs. FAST exam does not
reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart
rate is 160 beats per minute, and respiratory rate is 14 breaths per minute
(ventilated with 100% O2). 1500 mL of blood has drained from the right
chest. The most appropriate next step in managing this patient is to::
urgently transfer the patient to the operating room
22. A 39-year-old man is admitted to the emergency department after an
automobile collision. He is cyanotic, has insufficient respiratory effort, and
has a GCS score of 6. His full beard makes it difficult to fit the oxygen
facemask to his face. The most appropriate next step is to:: restrict cervica
motion and attempt orotracheal intubation using 2 people
23. A patient is brought to the emergency department after a motor vehicle
crash. He is conscious and there is no obvious external trauma. He arrives
at the hospital completely immobilized on a long spine board. His blood
pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. His skin
is warm. Which one of the following statements is TRUE?: Flaccidity of the
lower extremities and loss of deep tendon reflexes are expected.
24. Which one of the following is the most effective method for initially
treating frostbite?: moist heat
25. A 32-year-old man's right leg is trapped beneath his overturned car for
nearly 2 hours before he is extricated. On arrival in the emergency
department, his right lower extremity is cool, mottled, insensate, and
motionless. Despite normal vital signs, pulses cannot be palpated below the
right femoral artery and the muscles of the lower extremity are firm and
, ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS.
hard. During the management of this patient, which of the following is most
likely to improve the chances for limb salvage?: surgical consultation for right
lower extremity fasciotomy
26. A patient arrives in the emergency department after being beaten about
the head and face with a wooden club. He is comatose and has a palpable
depressed skull fracture. His face is swollen and ecchymotic. He has
gurgling respirations and vomitus on his face and clothing. The most
appropriate step after providing supplemental oxygen and elevating his jaw
is to:: suction the oropharynx
27. A 22-year-old man sustains a gunshot wound to the left chest and is
transported to a small community hospital no surgical capabilities are
available. In the emergency department, a chest tube is inserted and 700 mL
of blood is evacuated. The trauma center accepts the patient in transfer.
Just before the patient is placed in the ambulance for transfer, his blood
pressure decreases to 80/68 mm Hg and his heart rate increases to 136
beats per minute. The next step should be to:: repeat the primary survey and
proceed with transfer
28. A 64-year-old man involved in a high-speed car crash, is resuscitated
initially in a small hospital without surgical capabilities. He has a closed
head injury with a GCS score of 13. He has a widened mediastinum on chest
x-ray with fractures of left ribs 2 through 4, but no pneumothorax. After
initiating fluid resuscitation, his blood pressure is 110/74 mm Hg, heart rate
is 100 beats per minute, and respiratory rate is 18 breaths per minute. He
has gross hematuria and a pelvic fracture. You decide to transfer this patient
to a facility capable of providing a higher level of care. The facility is 128 km
(80 miles) away. Before transfer, you should first:: call the receiving hospita
and speak to the surgeon on call
29. Hemorrhage of 20% of the patient's blood volume is associated usually
with:: tachycardia
30. Which one of the following statements concerning intraosseous
infusion is TRUE?: Aspiration of bone marrow confirms appropriate positioning of
the needle.
31. A young woman sustains a severe head injury as the result of a motor
vehicle crash. In the emergency department, her GCS is 6. Her blood
pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is
CORRECT DETAILED ANSWERS.
1. A 22-year-old man is hypotensive and tachycardic after a shotgun
wound to the left shoulder. His blood pressure is initially 80/40 mm Hg. After
initial fluid resuscitation his blood pressure increases to 122/84 mm Hg. His
heart rate is now 100 beats per minute and his respiratory rate is 28 breaths
per minute. A tube thoracostomy is performed for decreased left chest
breath sounds with the return of a small amount of blood and no air leak.
After chest tube insertion, the most appropriate next step is:: re-examine the
chest
2. A construction worker falls two stories from a building and sustains
bilateral calcaneal fractures. In the emergency department, he is alert, vital
signs are normal, and he is complaining of severe pain in both heels and his
lower back. Lower extremity pulses are strong and there is no other
deformity. The suspected diagnosis is most likely to be confirmed by::
complete spine x-ray series
3. Which of the following is true regarding the initial resuscitation of a
trauma patient?: Evidence of improved perfusion after fluid resuscitation could
include improvement in Glasgow Coma Scale score on reevaluation.
4. In managing a patient with a severe traumatic brain injury, the most
important initial step is to:: secure the airway
5. A previously healthy, 70-kg (154-pound) man suffers an estimated acute
blood loss of 2 liters. Which one of the following statements applies to this
patient?: An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
6. The physiological hypervolemia of pregnancy has clinical significance
in the management of the severely injured, gravid woman by:: increasing the
volume of blood loss to produce maternal hypotension
7. The best assessment of fluid resuscitation of the adult burn patient is::
urinary output of 0.5 mL/kg/hr
8. The diagnosis of shock must include:: evidence of inadequate organ
perfusion 9. A 7-year-old boy is brought to the emergency department by his
parents several minutes after he fell through a window. He is bleeding
profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of:: direct pressure on the wound
,ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS.
10. For the patient with severe traumatic brain injury, profound hypocarbia
should be avoided to prevent:: cerebral vasoconstriction with diminished
perfusion
11. After being involved in a motor vehicle crash, a 25-year-old man is
brought to a hospital that has surgery capabilities available.. Computed
tomography of the chest and abdomen shows an aortic injury and splenic
laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg
after CT. The next step is:: perform an exploratory laparotomy
12. Which one of the following statements regarding abdominal trauma in
the pregnant patient is TRUE?: Leakage of amniotic fluid is an indication for
hospital admission.
13. The first maneuver to improve oxygenation after chest injury is::
administer supplemental oxygen
14. A 25-year-old man, injured in a motor vehicular crash, is admitted to the
emergency department. His pupils react sluggishly and his eyes open to
pressure. He does not follow commands, but he does moan periodically. His
right arm is deformed and does not respond to pressure; however, his left
hand reaches purposefully toward the stimulus. Both legs are stiffly
extended.
His GCS score is:: 9
15. A 20-year-old woman who is at 32 weeks gestation, is stabbed in the
upper right chest. In the emergency department, her blood pressure is 80/60
mm Hg. She is gasping for breath, extremely anxious, and yelling for help.
Breath sounds are diminished in the right chest. The most appropriate first
step is to:: perform needle or finger decompression of the right chest
16. Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?: respiratory rate of 40
breaths per minute
17. The most important, immediate step in the management of an open
pneumothorax is:: placement of an occlusive dressing over the wound
18. The following are contraindications for tetanus toxoid administration::
history of neurological reaction or severe hypersensitivity to the product
19. A 56-year-old man is thrown violently against the steering wheel of his
truck during a motor vehicle crash. On arrival in the emergency department
,ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS.
he is diaphoretic and complaining of chest pain. His blood pressure is 60/40
mm Hg and his respiratory rate is 40 breaths per minute. Which of the
following best differentiates cardiac tamponade from tension pneumothorax
as the cause of his hypotension?: breath sounds
20. Bronchial intubation of the right or left mainstem bronchus can easily
occur during infant endotracheal intubation because:: The trachea is
relatively short.
21. A 23-year-old man sustains 4 stab wounds to the upper right chest
during an altercation and is brought by ambulance to a hospital that has full
surgical capabilities. His wounds are all above the nipple. He is
endotracheally intubated, closed tube thoracostomy is performed, fluid
resuscitation is initiated through 2 large-caliber IVs. FAST exam does not
reveal intraabdominal injuries. His blood pressure now is 60/0 mm Hg, heart
rate is 160 beats per minute, and respiratory rate is 14 breaths per minute
(ventilated with 100% O2). 1500 mL of blood has drained from the right
chest. The most appropriate next step in managing this patient is to::
urgently transfer the patient to the operating room
22. A 39-year-old man is admitted to the emergency department after an
automobile collision. He is cyanotic, has insufficient respiratory effort, and
has a GCS score of 6. His full beard makes it difficult to fit the oxygen
facemask to his face. The most appropriate next step is to:: restrict cervica
motion and attempt orotracheal intubation using 2 people
23. A patient is brought to the emergency department after a motor vehicle
crash. He is conscious and there is no obvious external trauma. He arrives
at the hospital completely immobilized on a long spine board. His blood
pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. His skin
is warm. Which one of the following statements is TRUE?: Flaccidity of the
lower extremities and loss of deep tendon reflexes are expected.
24. Which one of the following is the most effective method for initially
treating frostbite?: moist heat
25. A 32-year-old man's right leg is trapped beneath his overturned car for
nearly 2 hours before he is extricated. On arrival in the emergency
department, his right lower extremity is cool, mottled, insensate, and
motionless. Despite normal vital signs, pulses cannot be palpated below the
right femoral artery and the muscles of the lower extremity are firm and
, ATLS PRACTICE TEST 2024-2025 ACTUAL EXAM 250 REAL QUESTIONS AND
CORRECT DETAILED ANSWERS.
hard. During the management of this patient, which of the following is most
likely to improve the chances for limb salvage?: surgical consultation for right
lower extremity fasciotomy
26. A patient arrives in the emergency department after being beaten about
the head and face with a wooden club. He is comatose and has a palpable
depressed skull fracture. His face is swollen and ecchymotic. He has
gurgling respirations and vomitus on his face and clothing. The most
appropriate step after providing supplemental oxygen and elevating his jaw
is to:: suction the oropharynx
27. A 22-year-old man sustains a gunshot wound to the left chest and is
transported to a small community hospital no surgical capabilities are
available. In the emergency department, a chest tube is inserted and 700 mL
of blood is evacuated. The trauma center accepts the patient in transfer.
Just before the patient is placed in the ambulance for transfer, his blood
pressure decreases to 80/68 mm Hg and his heart rate increases to 136
beats per minute. The next step should be to:: repeat the primary survey and
proceed with transfer
28. A 64-year-old man involved in a high-speed car crash, is resuscitated
initially in a small hospital without surgical capabilities. He has a closed
head injury with a GCS score of 13. He has a widened mediastinum on chest
x-ray with fractures of left ribs 2 through 4, but no pneumothorax. After
initiating fluid resuscitation, his blood pressure is 110/74 mm Hg, heart rate
is 100 beats per minute, and respiratory rate is 18 breaths per minute. He
has gross hematuria and a pelvic fracture. You decide to transfer this patient
to a facility capable of providing a higher level of care. The facility is 128 km
(80 miles) away. Before transfer, you should first:: call the receiving hospita
and speak to the surgeon on call
29. Hemorrhage of 20% of the patient's blood volume is associated usually
with:: tachycardia
30. Which one of the following statements concerning intraosseous
infusion is TRUE?: Aspiration of bone marrow confirms appropriate positioning of
the needle.
31. A young woman sustains a severe head injury as the result of a motor
vehicle crash. In the emergency department, her GCS is 6. Her blood
pressure is 140/90 mm Hg and her heart rate is 80 beats per minute. She is
