ATLS WRITTEN REVIEW A CERTIFICATION
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◍ 37-year-old man is struck on the side of the head but is conscious and
talkative after the injury. No evidence of skull fracture. Several days later,
he becomes increasingly lethargic, somewhat confused, and unable to move
his right side. Which type of event has most likely occurred?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion.
Answer: Subdural hematoma
◍ A patient involved in a road accident is brought to the emergency
department in an unconscious state. On arrival, her vitals show a
temperature of 96.4 degrees Fahrenheit, RR 24, HR 140, and BP 80/40 mm
Hg. She is cold, shivering, and perspiring profusely. She has bilateral
reactive pupils but she does not respond to pain. On physical exam, she has
no obvious sign of external bleeding. Which of the following cannot be the
cause of hypotension in this patient?
A. Pelvic fracture
B. Fracture of femur
C. Intracranial hemorrhage
D. Hemothorax.
Answer: Intracranial hemorrhage
◍ What is the main bleeding source in a subdural hematoma?
A. Capillary
B. Venous
, C. Arterial
D. Mix type.
Answer: Venous
◍ Class IV hemorrhage indicates what % blood loss.
Answer: >40%
◍ How deep should the provider depress the patient's sternum during CPR in
adults?.
Answer: 2 to 3 inches
◍ A patient sustains blunt trauma to the back and left leg. Vital signs in the ED
show temperature 36 degrees C, BP 120/80 mm Hg,HR 92, RR 19, GCS 15.
There is bilateral lower extremity paraplegia, T12 sensory level, and
decreased rectal tone. Hemoglobin is 14.2 and the same in one hour. Which
of the following tests is best for diagnosing an intraperitoneal bleed?
A. Abdominal ultrasound
B. Laparotomy
C. KUB
D. Diagnostic peritoneal lavage.
Answer: Abdominal ultrasound
◍ A 33-year-old woman is involved in a head-on MV
A. It took 30 minutes to extricate her from the car. Upon arrival to the ED,
her HR is 120, BP is 90/70 mm Hg, RR 16, and her GCS is 15. Exam
reveals bilaterally equal breath sounds, anterior chest wall ecchymosis, and
distended neck veins. Her abdomen is flat, soft, and not tender. Her pelvis is
stable. Palpable distal pulses are found in all 4 extremities. The most likely
diagnosis is:.
Answer: cardiac tamponade
◍ Management of a stable patient with kidney contusion.
Answer: Observation
◍ A patient is hit by a car and has severe injuries to his extremities. He is
immediately brought to the ER by EM
, S. Evaluation reveals that he has multiple organ injuries. He has an open,
gaping wound which measures 2 x 2 cm, just below the right knee. The leg
appears dislocated and ecchymotic. However, pulses are present in the distal
extremity. He does not complain of any paresthesias. X-ray reveals that
there is a fracture of the tibia. The trauma team is called. As their arrival is
awaited, which of the following should NOT be done to help manage this
patient?
A. Obtain culture and close wound using a sterile technique
B. Don't reduce the dislocation
C. Give tetanus toxoid/booster shot
D. Give antibiotics.
Answer: Obtain culture and close wound using a sterile technique
◍ Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?
A. distended abdomen
B. Glasgow Coma Scale score of 11
C. temperature of 36.5°C (97.8°F)
D. deforming of the right thigh
E. Respiratory rate of 40 breaths per minute.
Answer: Respiratory rate of 40 breaths per minute
◍ Class III hemorrhage indicates what % of blood loss.
Answer: 31-40%
◍ Which one of the following is the most effective method for initially treating
frostbite?
A. moist heat
B. early amputation
C. padding and elevation
D. vasodilators and heparin
E. topical application of silver sulfadiazine.
Answer: moist heat
◍ Central venous pressure is reflective of:.
, Answer: Pressure of blood returning to the heart
◍ Neuromuscular blocking agent that works by depolarization.
Answer: Succinylcholine
◍ Confirmatory test that is a reliable indicator of brain death:
A. Apnea test with a pCO2 less than 40
B. Electromyography
C. 4-vessel cerebral angiography
D. CT scan of the brain.
Answer: 4-vessel cerebral angiography
◍ Most common cause of kidney injuries.
Answer: Motor vehicle accidents
◍ Foot drop is caused by which of the following?
A. Common peroneal nerve lesion
B. Superficial peroneal nerve lesion
C. Sciatic nerve
D. Femoral nerve.
Answer: Common peroneal nerve lesion
◍ Following a minor motor vehicle accident, a patient is experiencing pain and
stiffness in her neck. Upon physical exam, she is able to rotate her neck
greater than 55 degrees and denies paresthesias in the extremities. Which of
the following is the next best step for this patient?
A. Exercise therapy
B. NSAIDs and rest
C. Neck x-rays
D. Narcotics.
Answer: NSAIDs and rest
◍ Most common EMS pediatric calls.
Answer: - Seizures- Respiratory problems- Trauma
◍ Which of the following patients with head trauma does not require
admission?
SCRIPT 2026 QUESTIONS WITH SOLUTIONS
GRADED A+
◍ 37-year-old man is struck on the side of the head but is conscious and
talkative after the injury. No evidence of skull fracture. Several days later,
he becomes increasingly lethargic, somewhat confused, and unable to move
his right side. Which type of event has most likely occurred?
A. Subdural hematoma
B. Epidural hematoma
C. Carotid dissection
D. Brain contusion.
Answer: Subdural hematoma
◍ A patient involved in a road accident is brought to the emergency
department in an unconscious state. On arrival, her vitals show a
temperature of 96.4 degrees Fahrenheit, RR 24, HR 140, and BP 80/40 mm
Hg. She is cold, shivering, and perspiring profusely. She has bilateral
reactive pupils but she does not respond to pain. On physical exam, she has
no obvious sign of external bleeding. Which of the following cannot be the
cause of hypotension in this patient?
A. Pelvic fracture
B. Fracture of femur
C. Intracranial hemorrhage
D. Hemothorax.
Answer: Intracranial hemorrhage
◍ What is the main bleeding source in a subdural hematoma?
A. Capillary
B. Venous
, C. Arterial
D. Mix type.
Answer: Venous
◍ Class IV hemorrhage indicates what % blood loss.
Answer: >40%
◍ How deep should the provider depress the patient's sternum during CPR in
adults?.
Answer: 2 to 3 inches
◍ A patient sustains blunt trauma to the back and left leg. Vital signs in the ED
show temperature 36 degrees C, BP 120/80 mm Hg,HR 92, RR 19, GCS 15.
There is bilateral lower extremity paraplegia, T12 sensory level, and
decreased rectal tone. Hemoglobin is 14.2 and the same in one hour. Which
of the following tests is best for diagnosing an intraperitoneal bleed?
A. Abdominal ultrasound
B. Laparotomy
C. KUB
D. Diagnostic peritoneal lavage.
Answer: Abdominal ultrasound
◍ A 33-year-old woman is involved in a head-on MV
A. It took 30 minutes to extricate her from the car. Upon arrival to the ED,
her HR is 120, BP is 90/70 mm Hg, RR 16, and her GCS is 15. Exam
reveals bilaterally equal breath sounds, anterior chest wall ecchymosis, and
distended neck veins. Her abdomen is flat, soft, and not tender. Her pelvis is
stable. Palpable distal pulses are found in all 4 extremities. The most likely
diagnosis is:.
Answer: cardiac tamponade
◍ Management of a stable patient with kidney contusion.
Answer: Observation
◍ A patient is hit by a car and has severe injuries to his extremities. He is
immediately brought to the ER by EM
, S. Evaluation reveals that he has multiple organ injuries. He has an open,
gaping wound which measures 2 x 2 cm, just below the right knee. The leg
appears dislocated and ecchymotic. However, pulses are present in the distal
extremity. He does not complain of any paresthesias. X-ray reveals that
there is a fracture of the tibia. The trauma team is called. As their arrival is
awaited, which of the following should NOT be done to help manage this
patient?
A. Obtain culture and close wound using a sterile technique
B. Don't reduce the dislocation
C. Give tetanus toxoid/booster shot
D. Give antibiotics.
Answer: Obtain culture and close wound using a sterile technique
◍ Which one of the following findings in an adult is most likely to require
immediate management during the primary survey?
A. distended abdomen
B. Glasgow Coma Scale score of 11
C. temperature of 36.5°C (97.8°F)
D. deforming of the right thigh
E. Respiratory rate of 40 breaths per minute.
Answer: Respiratory rate of 40 breaths per minute
◍ Class III hemorrhage indicates what % of blood loss.
Answer: 31-40%
◍ Which one of the following is the most effective method for initially treating
frostbite?
A. moist heat
B. early amputation
C. padding and elevation
D. vasodilators and heparin
E. topical application of silver sulfadiazine.
Answer: moist heat
◍ Central venous pressure is reflective of:.
, Answer: Pressure of blood returning to the heart
◍ Neuromuscular blocking agent that works by depolarization.
Answer: Succinylcholine
◍ Confirmatory test that is a reliable indicator of brain death:
A. Apnea test with a pCO2 less than 40
B. Electromyography
C. 4-vessel cerebral angiography
D. CT scan of the brain.
Answer: 4-vessel cerebral angiography
◍ Most common cause of kidney injuries.
Answer: Motor vehicle accidents
◍ Foot drop is caused by which of the following?
A. Common peroneal nerve lesion
B. Superficial peroneal nerve lesion
C. Sciatic nerve
D. Femoral nerve.
Answer: Common peroneal nerve lesion
◍ Following a minor motor vehicle accident, a patient is experiencing pain and
stiffness in her neck. Upon physical exam, she is able to rotate her neck
greater than 55 degrees and denies paresthesias in the extremities. Which of
the following is the next best step for this patient?
A. Exercise therapy
B. NSAIDs and rest
C. Neck x-rays
D. Narcotics.
Answer: NSAIDs and rest
◍ Most common EMS pediatric calls.
Answer: - Seizures- Respiratory problems- Trauma
◍ Which of the following patients with head trauma does not require
admission?
