Updated 2025/2026 | 200 Real Exam
Q&A
Exam
This comprehensive 2025/2026 resource includes all four ATLS Post Tests (1–4),
featuring a total of 200 scenario-based multiple-choice questions (50 per test) with
100% verified correct answers. Aligned with the American College of Surgeons (ACS)
ATLS 10th Edition guidelines, it is designed for trauma surgeons, emergency physicians,
and healthcare professionals pursuing certification or recertification. The material
focuses on high-impact trauma decision-making during the "golden hour," and reflects
key updates such as revised massive transfusion protocols, cervical spine clearance, and
TXA administration.
ATLS POST TEST 1 – 10th Edition (2025/2026)
Sample Questions (Airway, Breathing, Primary Survey)
Q1
A 32-year-old male arrives after a high-speed MVC. He is agitated, has
gurgling respirations, RR 10/min, SpO₂ 86% on room air, and blood in the
oropharynx. What is the next best step?
,A. Obtain CT cervical spine
B. Apply non-rebreather oxygen
C. Perform rapid sequence intubation
D. Insert nasopharyngeal airway
Correct Answer
C. Perform rapid sequence intubation
Rationale
This patient has airway compromise (gurgling, blood, hypoxia). ATLS
dictates airway with cervical spine protection FIRST. Supplemental
oxygen alone is insufficient, and adjuncts are contraindicated with blood
and decreased mental status. Definitive airway is required immediately.
Q2
Which finding mandates immediate airway intervention in trauma?
A. Hoarseness
B. Facial fractures
C. GCS of 8
D. Tachypnea
Correct Answer
C. GCS of 8
Rationale
ATLS rule: “GCS ≤ 8 = intubate.” This reflects inability to protect the
airway. Other findings may raise concern but are not absolute indications.
,Q3
During primary survey, absent breath sounds are noted on the right with
hypotension and JVD. What is the most appropriate immediate action?
A. Chest X-ray
B. Needle decompression
C. Intubation
D. IV fluids
Correct Answer
B. Needle decompression
Rationale
This is tension pneumothorax, a clinical diagnosis. Imaging delays are
contraindicated. Immediate needle decompression saves life.
Q4
A trauma patient is hypotensive with cool clammy skin and narrow pulse
pressure. What type of shock is most likely?
A. Neurogenic
B. Septic
C. Cardiogenic
D. Hemorrhagic
Correct Answer
D. Hemorrhagic
, Rationale
In trauma, shock = hemorrhage until proven otherwise. Neurogenic
shock presents with hypotension and bradycardia with warm skin.
Q5
Which IV access is preferred initially in adult trauma?
A. Central venous catheter
B. PICC line
C. Two large-bore peripheral IVs
D. Intraosseous access
Correct Answer
C. Two large-bore peripheral IVs
Rationale
ATLS prioritizes rapid volume delivery. Large-bore peripheral IVs are
fastest and most effective. IO is second-line.
Q6
According to ATLS 10th Edition, TXA should be given:
A. To all trauma patients
B. Only after CT confirms bleeding
C. Within 3 hours in patients with major hemorrhage
D. Only if INR is elevated