ATLS POST TEST 2025-2026
22 year old male fall from 2m, large right pneumothorax. Chest tube placed, connected
to drainage. Control x-ray shows pneumothorax, third x-ray reveals pneumothorax -
ANS Tracheobronchal injury
30-year-old woman fell down four stair landing on concrete. Unconscious for 5 minutes
after the fall, full consciousness during 10 minute transport to hospital, GCS 15,
complaint is a slight headache, 30 minute later she is unresponsive with GCS 6 and left
pupil is large. - ANS Epidural hematoma
A 14 year old female is brought to the ED after falling from a horse. She is immobilized
on a long spine board with a hard collar and blocks. Cervical spine x-ray:
A. Will show cervical spine injury in more than 20% of these patients
B. Will exclude cervical spine injury if no abnormalities are found on the x-rays
C. Are not needed if she is awake, alert, neurologically normal, and has no neck pain or
midline tenderness
D. Should be performed before adressing potential breating or circulatory problems
E. May show atlanto-occipital dislocation if the Powers ratio is <1 --> 1:noraml, >1
anterior, <1 posterior - ANS C. Are not needed if she is awake, alert,
neurologically normal, and has no neck pain or midline tenderness
A 15 year old male is brought to the ED after being involved in a motor vehicle crash.
He is unconscious and was intubated at the scene by emergency personnel. Upon
arrival at the ED, the patients oxygen saturation is 92%, HR is 96 bpm and BP is 150/85
Breath sounds are decreased on the left side of the thorax. The next step is:
A. Immediate needle crycothyroidotomy
B. Reassess the position of the endotracheal tube
C. Chest tube insertion
D. Immediate needle thoracentesis
E. Obtain a chest x-ray - ANS B. Reassess the position of the endotracheal tube
A 15 year old male present following a motorcycle crash. INitial examinations reveals
normal vital signs. There is a large bruise over his epigastrium that extends to the left
flank. He has no other apparent injuries. A CT-scan of the abdomen demonstrate a
ruptured spleen surrounded by a large hematoma and fluid in the pelvis. The next step
in the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
,C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - ANS D. Surgical consult
Hemodynamisk stabil, ingen fri luft.
A 17 year old female is brought to the ED following a 2 meter fall onto concrete. She is
unresponsive and found to have a RR of 32, BP 90/60 and HR 68. The first step in
treatment is:
A. Adminstering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - ANS D. Applying oxygen and
maintaining airway
A 17-year-old helmeted motorcyclist is struck broadside by an automobile at an
intersection. He is unconscious at the scene with a blood pressure of 140/90mmHg,
heart rate of 90 beats per minute, and respiratory rate of 22 breaths per minute. His
respirations are sonorous and deep. His GCS score is 6. Immobilization of the entire
patient may include the use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar - ANS A. Air splints
A 17-year-old helmeted motorcyclist loses consciousness when he is struck broad side
by an automobile at an intersection. He arrives in the ED with a blood pressure of
140/92, pulse rate 88 beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient should include a semi-rigid
cervical collar and:
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment - ANS B. A long spine board
A 20 year old athlete is involved in a motorcycle crash. When he arrives in the ED, he
shouts that he cannot move his legs. On physical examination, there are noe
abnormalities of the chest, abdomen or pelvis. The patient has no sensation in his legs
,and cannot move them, but his arms are moving. The patients RR is 28 bpm, HR is
88bpm and BP is 80/60mmHg. He is pale and sweaty. What is the most likely cause of
this condition?
A. Neurogenic shock
B. Cardiogenic shock
C. Abdominal hemorrhage
D. Myocardial contusion
E. Hyperthermia. - ANS A. Neurogenic shock
A 20 year old male is brought to the hospital approximately 30 minutes after being
stabbed in the chest. There is 3cm wound just medial to the left nipple. His BP is 70/33
and HR is 140. Neck and arm veins are distended. Breath sounds are normal. Heart
sounds are diminshed, iv access has been established and warm crystalloid is infusing.
The next most important aspect of immediate management is:
A. CT scan of the chest
B. 12 lead ECG
C. Left tube thoracostomy
D. Begin infusion of RBCs
E. FAST exam - ANS E. FAST exam For å se etter tamponade? Normale
resp.lyder bilateralt taler mot trykkpneumothorax. EKG vil ikke gi noe informasjon.
Thoracostomy ikke indisert da det ikke er mistenkt pneumo/hemothorax. CT uaktuelt
pga hemodynamisk ustabil
A 20-year-old woman, at 32 weeks gestation, is stabbed in the upper right chest. In the
ED, her blood pressure is 80/60mmHg. 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:
A. perform tracheal intubation
B. Insert an oropharyngeal airway
C. Perform needle decompression of the right chest
D. Manually displace the gravid uterus to the left side of the abdomen
E. Initiate 2 large-caliber peripheral IV lines and crystalloid infusion - ANS C.
Perform needle decompression of the right chest
A 22 year old male is assaulted in a bar. A semi-rigid cervical collar is applied and he is
immobilized on a spine board. On initial examination, his vital signs are normal, and his
GCS is 15. Which of the following is an indication for CT in this patient with possible
minor traumatic brain injury?
A. Blood alcohol concentration of 0,16%
B. Presence of an isolated 10cm scalp laceration
, C. Presence of a mandibular fracture
D. Presence of hemotympanum
E. History of assault - ANS D. Presence of hemotympanum
A 22 year old male present following a motorcycle crash. He complains of the inability to
move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99%
on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are
normal. His management should be:
A: 2L of iv . crystalloid and two units of pRBCs
B. 2L of iv crystalloid and vasopressors if BP does not respond
C. 2L of iv. crystalloid, mannitol and iv steroids
D. Vasopressors and laparotomy
E. 1 unit of albumin and compression stockings - ANS B. 2L of iv crystalloid and
vasopressors if BP does not respond
A 22 year old male sustains a shotgun wound to the left shoulder and chest at close
range. His BP is 80/40mmHg and his HR is 130bpm. After 2 liters of crystalloid solution
are rapidly infused, his BP increases to 122/84, and HR decreases to 100bpm. He is
tachypneic with RR of 28. On physical examination, his breath sounds are decreased at
the left upper chest with dullness on percussion. A large caliber (36 french) tube
thoracostomy is inserted in the fifth intercostal space with the return of 200ml of blood
and no air leak. The most appropriate next step is to:
A. insert a foley catheter
B. Begin to transfuse o-negative blood
C. Perform thoracotomy
D. Obtain a CT-scan of chest and abdomen
E. Repeat the physical examination of the chest - ANS E. Repeat the physical
examination of the chest
A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
awake and alert. Her heart rate is 100 beats per minute, BP 80/60mmHg, and
respiratory rate is 20 breaths per minute. A chest x-ray reveals a large left hemithorax.
A left chest tube is placed with an immediate return of 1600ml of blood. The next
management step for this patient is:
A. perform a thoracoscopy
B. Perform an arch aortogram
C. Insert a second left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ANS D. Prepare for an exploratory thoracotomy
22 year old male fall from 2m, large right pneumothorax. Chest tube placed, connected
to drainage. Control x-ray shows pneumothorax, third x-ray reveals pneumothorax -
ANS Tracheobronchal injury
30-year-old woman fell down four stair landing on concrete. Unconscious for 5 minutes
after the fall, full consciousness during 10 minute transport to hospital, GCS 15,
complaint is a slight headache, 30 minute later she is unresponsive with GCS 6 and left
pupil is large. - ANS Epidural hematoma
A 14 year old female is brought to the ED after falling from a horse. She is immobilized
on a long spine board with a hard collar and blocks. Cervical spine x-ray:
A. Will show cervical spine injury in more than 20% of these patients
B. Will exclude cervical spine injury if no abnormalities are found on the x-rays
C. Are not needed if she is awake, alert, neurologically normal, and has no neck pain or
midline tenderness
D. Should be performed before adressing potential breating or circulatory problems
E. May show atlanto-occipital dislocation if the Powers ratio is <1 --> 1:noraml, >1
anterior, <1 posterior - ANS C. Are not needed if she is awake, alert,
neurologically normal, and has no neck pain or midline tenderness
A 15 year old male is brought to the ED after being involved in a motor vehicle crash.
He is unconscious and was intubated at the scene by emergency personnel. Upon
arrival at the ED, the patients oxygen saturation is 92%, HR is 96 bpm and BP is 150/85
Breath sounds are decreased on the left side of the thorax. The next step is:
A. Immediate needle crycothyroidotomy
B. Reassess the position of the endotracheal tube
C. Chest tube insertion
D. Immediate needle thoracentesis
E. Obtain a chest x-ray - ANS B. Reassess the position of the endotracheal tube
A 15 year old male present following a motorcycle crash. INitial examinations reveals
normal vital signs. There is a large bruise over his epigastrium that extends to the left
flank. He has no other apparent injuries. A CT-scan of the abdomen demonstrate a
ruptured spleen surrounded by a large hematoma and fluid in the pelvis. The next step
in the patients management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
,C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - ANS D. Surgical consult
Hemodynamisk stabil, ingen fri luft.
A 17 year old female is brought to the ED following a 2 meter fall onto concrete. She is
unresponsive and found to have a RR of 32, BP 90/60 and HR 68. The first step in
treatment is:
A. Adminstering vasopressors
B. Establishing IV access for drug-assisted intubation
C. Seeking the cause of her decreased level of consciousness
D. Applying oxygen and maintaining airway
E. Excluding hemorrhage as a cause of shock - ANS D. Applying oxygen and
maintaining airway
A 17-year-old helmeted motorcyclist is struck broadside by an automobile at an
intersection. He is unconscious at the scene with a blood pressure of 140/90mmHg,
heart rate of 90 beats per minute, and respiratory rate of 22 breaths per minute. His
respirations are sonorous and deep. His GCS score is 6. Immobilization of the entire
patient may include the use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar - ANS A. Air splints
A 17-year-old helmeted motorcyclist loses consciousness when he is struck broad side
by an automobile at an intersection. He arrives in the ED with a blood pressure of
140/92, pulse rate 88 beats per minute, a respiratory rate of 18 breaths per minue, and
a GCS of 7. Appropriate initial immobilization of this patient should include a semi-rigid
cervical collar and:
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment - ANS B. A long spine board
A 20 year old athlete is involved in a motorcycle crash. When he arrives in the ED, he
shouts that he cannot move his legs. On physical examination, there are noe
abnormalities of the chest, abdomen or pelvis. The patient has no sensation in his legs
,and cannot move them, but his arms are moving. The patients RR is 28 bpm, HR is
88bpm and BP is 80/60mmHg. He is pale and sweaty. What is the most likely cause of
this condition?
A. Neurogenic shock
B. Cardiogenic shock
C. Abdominal hemorrhage
D. Myocardial contusion
E. Hyperthermia. - ANS A. Neurogenic shock
A 20 year old male is brought to the hospital approximately 30 minutes after being
stabbed in the chest. There is 3cm wound just medial to the left nipple. His BP is 70/33
and HR is 140. Neck and arm veins are distended. Breath sounds are normal. Heart
sounds are diminshed, iv access has been established and warm crystalloid is infusing.
The next most important aspect of immediate management is:
A. CT scan of the chest
B. 12 lead ECG
C. Left tube thoracostomy
D. Begin infusion of RBCs
E. FAST exam - ANS E. FAST exam For å se etter tamponade? Normale
resp.lyder bilateralt taler mot trykkpneumothorax. EKG vil ikke gi noe informasjon.
Thoracostomy ikke indisert da det ikke er mistenkt pneumo/hemothorax. CT uaktuelt
pga hemodynamisk ustabil
A 20-year-old woman, at 32 weeks gestation, is stabbed in the upper right chest. In the
ED, her blood pressure is 80/60mmHg. 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:
A. perform tracheal intubation
B. Insert an oropharyngeal airway
C. Perform needle decompression of the right chest
D. Manually displace the gravid uterus to the left side of the abdomen
E. Initiate 2 large-caliber peripheral IV lines and crystalloid infusion - ANS C.
Perform needle decompression of the right chest
A 22 year old male is assaulted in a bar. A semi-rigid cervical collar is applied and he is
immobilized on a spine board. On initial examination, his vital signs are normal, and his
GCS is 15. Which of the following is an indication for CT in this patient with possible
minor traumatic brain injury?
A. Blood alcohol concentration of 0,16%
B. Presence of an isolated 10cm scalp laceration
, C. Presence of a mandibular fracture
D. Presence of hemotympanum
E. History of assault - ANS D. Presence of hemotympanum
A 22 year old male present following a motorcycle crash. He complains of the inability to
move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99%
on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are
normal. His management should be:
A: 2L of iv . crystalloid and two units of pRBCs
B. 2L of iv crystalloid and vasopressors if BP does not respond
C. 2L of iv. crystalloid, mannitol and iv steroids
D. Vasopressors and laparotomy
E. 1 unit of albumin and compression stockings - ANS B. 2L of iv crystalloid and
vasopressors if BP does not respond
A 22 year old male sustains a shotgun wound to the left shoulder and chest at close
range. His BP is 80/40mmHg and his HR is 130bpm. After 2 liters of crystalloid solution
are rapidly infused, his BP increases to 122/84, and HR decreases to 100bpm. He is
tachypneic with RR of 28. On physical examination, his breath sounds are decreased at
the left upper chest with dullness on percussion. A large caliber (36 french) tube
thoracostomy is inserted in the fifth intercostal space with the return of 200ml of blood
and no air leak. The most appropriate next step is to:
A. insert a foley catheter
B. Begin to transfuse o-negative blood
C. Perform thoracotomy
D. Obtain a CT-scan of chest and abdomen
E. Repeat the physical examination of the chest - ANS E. Repeat the physical
examination of the chest
A 22-year-old female athlete is stabbed in her left chest at the third interspace in the
anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
awake and alert. Her heart rate is 100 beats per minute, BP 80/60mmHg, and
respiratory rate is 20 breaths per minute. A chest x-ray reveals a large left hemithorax.
A left chest tube is placed with an immediate return of 1600ml of blood. The next
management step for this patient is:
A. perform a thoracoscopy
B. Perform an arch aortogram
C. Insert a second left chest tube
D. Prepare for an exploratory thoracotomy
E. Perform a chest CT - ANS D. Prepare for an exploratory thoracotomy
