ATLS POST TEST EXAM PREP STUDY GUIDE
2026 PRACTICE QUESTIONS AND SOLUTIONS
GRADED A+
◉ Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them. Answer: D. Presence
of deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidty) and loss of reflexes.
◉ The primary indication for transferring A patient to a higher level
trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital
administration
,E. Widened mediastinum on chest x-ray following blunt trauma.
Answer: C. Resource limitations as determined by the transferring
doctor
◉ A young man sustains a rifle wound to the mid-abdomen. He is
brought promptly to the ED by prehospital personnel. His skin is
cool and diaphoretic, and his systolic blood pressure is 58mmHg.
Warmed crystalloid fluids are initiated without improvement in his
vital signs. The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage. Answer: A. Laparotomy because of
hemodynamic abnormality
◉ A 42-year-old man is trapped from the waist down beneath his
overturned tractor for several hours before medical assistance
arrives. He is awake and alert until just before arriving in the ED. He
is now unconscious and responds only to painful stimuli by
moaning. His pupils are 3mm in diameter and symmetrically
reactive to light. Prehospital personnel indicate that they have not
seen the patient move either of his lower extremities. On
examination in the ED, no movement of his lower extremities are
detected, even in response to painful stimuli. The most likely cause
for this finding is:
,A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome. Answer: E. Bilateral
compartment syndrome
◉ A 6-year-o boy is struck by an automobile and brought to the ED.
He is lethargic, but withdraws purposefully from painful stimuli. His
blood pressure is 90mmHg systolic, heart rate 140 beats per minute
and his respiratory rate is 36 breaths per minute. The preferred
route of venous access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein.
Answer: D. Percutaneous peripheral veins in the upper extremities
◉ A young man sustains a gunshot wound to the abdomen and is
brought promptly to the ED by prehospital personnel. His skin is
cool and diaphoretic, and he is confused. His pulse is thready and his
femoral pulse is only weakly palpable. The definitive treatment in
managing this patient is to:
, A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions.. Answer:
C. Control internal hemorrhage operatively
◉ Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is
the same as in adults
E. An initial fluid bolus for resuscitation should approximate
20ml/kg Ringers Lactate. Answer: D. The absolute volume of blood
loss required to produce shock is the same as in adults
◉ A 33-year-old man is struck by a car travelling at 56km/h
(35mph). He has obvious fractures of the left tibia near the knee,
pain in the pelvic area, and severe dyspnea. His heart rate is 182
beats per minute, and his respiratory rate is 48 breaths per minute
with no breath sounds heard in the left chest. A tension
pneumothorax is relieved by immediate needle decompression and
tube thoracostomy. Subsequently, his heart rate decreases to 144
beats per minute, his respirartory rate decreases to 36 breaths per
2026 PRACTICE QUESTIONS AND SOLUTIONS
GRADED A+
◉ Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them. Answer: D. Presence
of deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidty) and loss of reflexes.
◉ The primary indication for transferring A patient to a higher level
trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital
administration
,E. Widened mediastinum on chest x-ray following blunt trauma.
Answer: C. Resource limitations as determined by the transferring
doctor
◉ A young man sustains a rifle wound to the mid-abdomen. He is
brought promptly to the ED by prehospital personnel. His skin is
cool and diaphoretic, and his systolic blood pressure is 58mmHg.
Warmed crystalloid fluids are initiated without improvement in his
vital signs. The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage. Answer: A. Laparotomy because of
hemodynamic abnormality
◉ A 42-year-old man is trapped from the waist down beneath his
overturned tractor for several hours before medical assistance
arrives. He is awake and alert until just before arriving in the ED. He
is now unconscious and responds only to painful stimuli by
moaning. His pupils are 3mm in diameter and symmetrically
reactive to light. Prehospital personnel indicate that they have not
seen the patient move either of his lower extremities. On
examination in the ED, no movement of his lower extremities are
detected, even in response to painful stimuli. The most likely cause
for this finding is:
,A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment syndrome. Answer: E. Bilateral
compartment syndrome
◉ A 6-year-o boy is struck by an automobile and brought to the ED.
He is lethargic, but withdraws purposefully from painful stimuli. His
blood pressure is 90mmHg systolic, heart rate 140 beats per minute
and his respiratory rate is 36 breaths per minute. The preferred
route of venous access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein.
Answer: D. Percutaneous peripheral veins in the upper extremities
◉ A young man sustains a gunshot wound to the abdomen and is
brought promptly to the ED by prehospital personnel. His skin is
cool and diaphoretic, and he is confused. His pulse is thready and his
femoral pulse is only weakly palpable. The definitive treatment in
managing this patient is to:
, A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
E. Infuse large volumes of intravenous crystalloid solutions.. Answer:
C. Control internal hemorrhage operatively
◉ Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is
the same as in adults
E. An initial fluid bolus for resuscitation should approximate
20ml/kg Ringers Lactate. Answer: D. The absolute volume of blood
loss required to produce shock is the same as in adults
◉ A 33-year-old man is struck by a car travelling at 56km/h
(35mph). He has obvious fractures of the left tibia near the knee,
pain in the pelvic area, and severe dyspnea. His heart rate is 182
beats per minute, and his respiratory rate is 48 breaths per minute
with no breath sounds heard in the left chest. A tension
pneumothorax is relieved by immediate needle decompression and
tube thoracostomy. Subsequently, his heart rate decreases to 144
beats per minute, his respirartory rate decreases to 36 breaths per
