ATLS POST TEST 2025-2026 UPDATES
| MULTIPLE CHOICE QUESTIONS
WITH CORRECT ANSWERS
Which one of the following statements concerning massive hemothorax is true?
A. It is usually caused by blunt thoracic trauma
B. It is commonly confused with pneumothorax
C. The diagnosis should be confirmed by upright, plain chest x-ray prior to treatment
D. The initial draining of 1000ml of blood after chest tube insertion requires immediate
thoracotomy
E. The condition should be suspected in situations with shock and unilateral absent
breath sounds - Answer-E. The condition should be suspected in situations with shock
and unilateral absent breath sounds
During primary and secondary survey, the patient injured by blunt trauma should be
completely immobilized until
A. The neurologic exam has been completed
B. The patient is transferred to definitive care
C. The patient is able to indicate that he has no neck pain
D. A spinal fracture has been excluded by x-ray
E. The patient complains of potential pressure sores due to the spine board. - Answer-
D. A spinal fracture has been excluded by x-ray
Cervical spine injury
A. Is excluded by a normal neurologic exam
B. Is not present if the patient has normal range of motion
C. Can be detected safely by careful flexion and extension of the neck
D. Can be excluded by a crosstable lateral x-ray of the c-spine
E. May be first manifested by neurologic deficit after movement of the neck - Answer-E.
May be first manifested by neurologic deficit after movement of the neck
An 18 y/o man is brought to the ED after smashing his motorcycle into a tree. He is
conscious and alert, but paralyzed in both legs and arms. His skin is pale and cold. He
complains of thirst and difficulty in breathing. His airway is clear. His BP is 60/40 and his
pulse is 140 bpm. Breath sounds are full and equal bilaterally. He should
A. Undergo exploratory celiotomy
B. Be treated for neurogenic shock
C. Be treated for hypovolemic shock
D. Undergo immediate nasotracheal intubation
E. be placed in cervical traction tongs before any other treatment is instituted - Answer-
C. Be treated for hypovolemic shock
,The principle of balanced resuscitation is:
A) Permissive hypotension and early plasma infusion
B) Equal amounts of crystalloid and colloids
C) Simultaneous management of breathing and circulation
D) Maintenance of a normal acid base balance
E) Achieving a pulse rate <90 - Answer-A) Permissive hypotension and early plasma
infusion
Healthy young male in a motor vehicle crash is brought to the emergency department
with a blood pressure of 84/60, pulse 123, GCS 10. The patient moans when his pelvis
is palpated. After initiating fluid resuscitation, the next step in management is:
A) Placement of a pelvic binder
B) Transfer to a trauma center
C) Pelvic x-ray
D) Insert urinary catheter
E) Repeat examination of pelvis - Answer-A) Placement of a pelvic binder
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 -
Answer-Tracheobronchal injury
Which one of the following is not a feature of neurogenic shock?
A. Increased venous capaitance
B. Decreased systemic vascular resistance
C. Increased cardiac output
D. Warm skin - Answer-C. Increased cardiac output
Tension pneumothorax can be caused by:
A. Flail chest
B. Cardiac tamponade
C. Clamping of a chest tube
D. All of the above - Answer-D. All of the above
Which one of the following brain stem reflexes is not assessed when assessing for brain
death?
A. Dolls eyes
B. Oculovestibular reflex
C. Gag reflex
D. Argyll Robertson pupil - Answer-D. Argyll Robertson pupil
What is the simplest way to open the airway in an unconscious patient?
A. Pull out the tongue
B. Tilt head and lift chin
C. Lift neck from behind
D. Jaw thrust - Answer-B. Tilt head and lift chin
,What is the approximate time the brain can be anoxic before developing irreversible
damage?
A. 10 min
B. 5 min
C. 2 min
D. 20 min - Answer-A. 10 min
You are treating a truama patient and attempt a definitive airway by intubation.
However, the vocal cords are not visible. What tool would be the most valuable for
achieving successful intubation?
A. Gum elastic bougie
B. Lateral cervical spine x-ray
C. Nasopharyngeal airway
D. Oxygen
E. Laryngeal mask airway - Answer-A. Gum elastic bougie
A 79 year old female is involved in a motor vehicle crash and presents to the ED. She is
on Coumadin and a beta blocker. Which of the following statements is true concerning
her management?
A. The risk of subdural hemorrhage is decreased
B. Absence of tachycardia indicates that the patient is hemodynamically normal
C. Non-operative management of abdominal injuries is more likely to be successful in
older adults than in younger patients
D. Vigorous fluid resuscitation may be associated with cardiorespiratory failure
D. epinephrine should be infused immediately for hypotension - Answer-D. Vigorous
fluid resuscitation may be associated with cardiorespiratory failure
The most common acid base disturbance encountered in injured pediatric patients is
caused by:
A. Hemorrhage
B. Changes in ventilation
C. Renal failure
D. Injudicious bicarbonate administration
E. Insufficient sodium chloride administration - Answer-B. Changes in ventilation?
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 - Answer-D. Applying oxygen and
maintaining airway
, A 25 year old male is brought to the ED following a bar fight. He has altered
consciousness, open his eyes on command, moans without forming discernible words,
and localizes to painful stimuli. Which one of the following statements concerning this
patient is true?
A. Hyperoxia should be avoided
B. CT scanning is an important part of neurological assessment
C. Mandatory intubation to protect his airway is required
D. His GCS suggest severe head injury
E. His level of consciousness can be solely attributed to elevated blood alcohol. -
Answer-B. CT scanning is an important part of neurological assessment
Han har GCS på 10-11, således passer det ikke med svaralternativ D som tilsvarer
GCS <9. Ettersom GCS er >8 passer heller ikke svaralternativ C. E er feil da det ikke
kan gi så lav GCS
Which one of the following statements regarding genitourinary injuries is true?
A. Urethral injuries are associated with pelvic fractures
B. All patients with microscopic hematuria require evaluation of genitourinary tract
C. Patient presenting with gross hematuria and shock will have a major renal injury as
the source of hemorrhage
D. Intraperitoneal bladder injuries are usually managed definitively with a urinary
catether
E. Urinary catheters should be placed in all patients with pelvic fractures during the
primary survey - Answer-A. Urethral injuries are associated with pelvic fractures
B er feil - det er pasienter med makroskopisk hematuri og/eller pas. med mikroskopisk
hematuri og sjokk som det er aktuelt å gjøre CT av. C kan være riktig, men kan ikke si
det sikkert at det er nyrene som er blødningskilden. D er feil - ekstraperitoneal
blæreskade behandles med kateter, og E er feil da man først må undersøke for
uretraskade
Cardiac tamponade:
A. Requires surgical intervention
B. Is defintively managed by needle pericardiocentesis
C. Is easily diagnosed by discovery of Becks triad in the ED
D. Is indicated by Kussmaul breathing
E. Is most common with blunt thoracic trauma and anterior rib fractures - Answer-A.
Requires surgical intervention
A 6 month old infant, being held in her mothers arms, is ejected on impact from a
vehicle that is struck head on by an oncoming car traveling at 65kph. The infant arrives
in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress.
Respiratory support is not effective using a bag mask device, and her oxygen saturation
is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most
appropriate procedure to perform next is:
A. perform needle cricothyroidotomy with jet insufflation
B. Administer heliox and racemic epinephrine
| MULTIPLE CHOICE QUESTIONS
WITH CORRECT ANSWERS
Which one of the following statements concerning massive hemothorax is true?
A. It is usually caused by blunt thoracic trauma
B. It is commonly confused with pneumothorax
C. The diagnosis should be confirmed by upright, plain chest x-ray prior to treatment
D. The initial draining of 1000ml of blood after chest tube insertion requires immediate
thoracotomy
E. The condition should be suspected in situations with shock and unilateral absent
breath sounds - Answer-E. The condition should be suspected in situations with shock
and unilateral absent breath sounds
During primary and secondary survey, the patient injured by blunt trauma should be
completely immobilized until
A. The neurologic exam has been completed
B. The patient is transferred to definitive care
C. The patient is able to indicate that he has no neck pain
D. A spinal fracture has been excluded by x-ray
E. The patient complains of potential pressure sores due to the spine board. - Answer-
D. A spinal fracture has been excluded by x-ray
Cervical spine injury
A. Is excluded by a normal neurologic exam
B. Is not present if the patient has normal range of motion
C. Can be detected safely by careful flexion and extension of the neck
D. Can be excluded by a crosstable lateral x-ray of the c-spine
E. May be first manifested by neurologic deficit after movement of the neck - Answer-E.
May be first manifested by neurologic deficit after movement of the neck
An 18 y/o man is brought to the ED after smashing his motorcycle into a tree. He is
conscious and alert, but paralyzed in both legs and arms. His skin is pale and cold. He
complains of thirst and difficulty in breathing. His airway is clear. His BP is 60/40 and his
pulse is 140 bpm. Breath sounds are full and equal bilaterally. He should
A. Undergo exploratory celiotomy
B. Be treated for neurogenic shock
C. Be treated for hypovolemic shock
D. Undergo immediate nasotracheal intubation
E. be placed in cervical traction tongs before any other treatment is instituted - Answer-
C. Be treated for hypovolemic shock
,The principle of balanced resuscitation is:
A) Permissive hypotension and early plasma infusion
B) Equal amounts of crystalloid and colloids
C) Simultaneous management of breathing and circulation
D) Maintenance of a normal acid base balance
E) Achieving a pulse rate <90 - Answer-A) Permissive hypotension and early plasma
infusion
Healthy young male in a motor vehicle crash is brought to the emergency department
with a blood pressure of 84/60, pulse 123, GCS 10. The patient moans when his pelvis
is palpated. After initiating fluid resuscitation, the next step in management is:
A) Placement of a pelvic binder
B) Transfer to a trauma center
C) Pelvic x-ray
D) Insert urinary catheter
E) Repeat examination of pelvis - Answer-A) Placement of a pelvic binder
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 -
Answer-Tracheobronchal injury
Which one of the following is not a feature of neurogenic shock?
A. Increased venous capaitance
B. Decreased systemic vascular resistance
C. Increased cardiac output
D. Warm skin - Answer-C. Increased cardiac output
Tension pneumothorax can be caused by:
A. Flail chest
B. Cardiac tamponade
C. Clamping of a chest tube
D. All of the above - Answer-D. All of the above
Which one of the following brain stem reflexes is not assessed when assessing for brain
death?
A. Dolls eyes
B. Oculovestibular reflex
C. Gag reflex
D. Argyll Robertson pupil - Answer-D. Argyll Robertson pupil
What is the simplest way to open the airway in an unconscious patient?
A. Pull out the tongue
B. Tilt head and lift chin
C. Lift neck from behind
D. Jaw thrust - Answer-B. Tilt head and lift chin
,What is the approximate time the brain can be anoxic before developing irreversible
damage?
A. 10 min
B. 5 min
C. 2 min
D. 20 min - Answer-A. 10 min
You are treating a truama patient and attempt a definitive airway by intubation.
However, the vocal cords are not visible. What tool would be the most valuable for
achieving successful intubation?
A. Gum elastic bougie
B. Lateral cervical spine x-ray
C. Nasopharyngeal airway
D. Oxygen
E. Laryngeal mask airway - Answer-A. Gum elastic bougie
A 79 year old female is involved in a motor vehicle crash and presents to the ED. She is
on Coumadin and a beta blocker. Which of the following statements is true concerning
her management?
A. The risk of subdural hemorrhage is decreased
B. Absence of tachycardia indicates that the patient is hemodynamically normal
C. Non-operative management of abdominal injuries is more likely to be successful in
older adults than in younger patients
D. Vigorous fluid resuscitation may be associated with cardiorespiratory failure
D. epinephrine should be infused immediately for hypotension - Answer-D. Vigorous
fluid resuscitation may be associated with cardiorespiratory failure
The most common acid base disturbance encountered in injured pediatric patients is
caused by:
A. Hemorrhage
B. Changes in ventilation
C. Renal failure
D. Injudicious bicarbonate administration
E. Insufficient sodium chloride administration - Answer-B. Changes in ventilation?
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 - Answer-D. Applying oxygen and
maintaining airway
, A 25 year old male is brought to the ED following a bar fight. He has altered
consciousness, open his eyes on command, moans without forming discernible words,
and localizes to painful stimuli. Which one of the following statements concerning this
patient is true?
A. Hyperoxia should be avoided
B. CT scanning is an important part of neurological assessment
C. Mandatory intubation to protect his airway is required
D. His GCS suggest severe head injury
E. His level of consciousness can be solely attributed to elevated blood alcohol. -
Answer-B. CT scanning is an important part of neurological assessment
Han har GCS på 10-11, således passer det ikke med svaralternativ D som tilsvarer
GCS <9. Ettersom GCS er >8 passer heller ikke svaralternativ C. E er feil da det ikke
kan gi så lav GCS
Which one of the following statements regarding genitourinary injuries is true?
A. Urethral injuries are associated with pelvic fractures
B. All patients with microscopic hematuria require evaluation of genitourinary tract
C. Patient presenting with gross hematuria and shock will have a major renal injury as
the source of hemorrhage
D. Intraperitoneal bladder injuries are usually managed definitively with a urinary
catether
E. Urinary catheters should be placed in all patients with pelvic fractures during the
primary survey - Answer-A. Urethral injuries are associated with pelvic fractures
B er feil - det er pasienter med makroskopisk hematuri og/eller pas. med mikroskopisk
hematuri og sjokk som det er aktuelt å gjøre CT av. C kan være riktig, men kan ikke si
det sikkert at det er nyrene som er blødningskilden. D er feil - ekstraperitoneal
blæreskade behandles med kateter, og E er feil da man først må undersøke for
uretraskade
Cardiac tamponade:
A. Requires surgical intervention
B. Is defintively managed by needle pericardiocentesis
C. Is easily diagnosed by discovery of Becks triad in the ED
D. Is indicated by Kussmaul breathing
E. Is most common with blunt thoracic trauma and anterior rib fractures - Answer-A.
Requires surgical intervention
A 6 month old infant, being held in her mothers arms, is ejected on impact from a
vehicle that is struck head on by an oncoming car traveling at 65kph. The infant arrives
in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress.
Respiratory support is not effective using a bag mask device, and her oxygen saturation
is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most
appropriate procedure to perform next is:
A. perform needle cricothyroidotomy with jet insufflation
B. Administer heliox and racemic epinephrine
