ATLS 10th Edition Post Test 1–4 Updated 2026 | Advanced Trauma Life Support
Comprehensive Study Guide, Practice Exam Questions and Answers, Exam Prep
Test Bank, Trauma Assessment Protocols, Primary and Secondary Survey Review,
Emergency Airway and Breathing Management, Shock Recognition and
Resuscitation Strategies, Injury Stabilization Principles, and Detailed Rationales
for Certification Preparation
Question 1: First step in primary survey?
A. Breathing B. Circulation C. Airway D. Disability
CORRECT ANSWER: C. Airway
Rationale: ATLS follows ABCDE.
Question 2: Most common cause of airway obstruction in unconscious
patient?
A. Blood B. Tongue C. Teeth D. Vomitus
CORRECT ANSWER: B. Tongue
Rationale: Loss of muscle tone allows tongue to fall back.
Question 3: Best initial method to open airway in trauma?
A. Head tilt-chin lift B. Jaw thrust C. Cricothyroidotomy D. Endotracheal
intubation
CORRECT ANSWER: B. Jaw thrust
Rationale: Jaw thrust minimizes cervical spine movement.
Question 4: Definitive airway definition?
A. LMA B. Combitube C. ET tube in trachea with cuff inflated D. Nasal
trumpet
CORRECT ANSWER: C. ET tube in trachea with cuff inflated
Rationale: Definitive airway is a tube placed in the trachea with cuff
inflated.
Question 5: Surgical airway contraindication age?
A. < 12 years B. < 5 years C. < 18 years D. No age limit
CORRECT ANSWER: A. < 12 years
Rationale: Needle cricothyroidotomy preferred in children < 12 due to small
anatomy.
,Question 6: Tension pneumothorax clinical sign?
A. Tracheal deviation B. Wheezing C. Stridor D. Hemoptysis
CORRECT ANSWER: A. Tracheal deviation
Rationale: Tension pneumothorax causes tracheal deviation away from
affected side.
Question 7: Tension pneumothorax initial treatment?
A. Chest tube B. Needle decompression C. Intubation D.
Pericardiocentesis
CORRECT ANSWER: B. Needle decompression
Rationale: Immediate needle decompression is required before chest tube.
Question 8: Hemothorax definition?
A. >100ml blood B. >300ml blood C. >500ml blood D. >1000ml blood
CORRECT ANSWER: B. >300ml blood
Rationale: Hemothorax is defined as >300ml of blood in pleural space.
Question 9: Massive hemothorax definition?
A. >500ml B. >1000ml C. >1500ml or 1/3 blood volume D. >2000ml
CORRECT ANSWER: C. >1500ml or 1/3 blood volume
Rationale: Massive hemothorax is >1500ml or 1/3 of patient's blood
volume.
Question 10: Massive hemothorax initial treatment?
A. Thoracotomy B. Chest tube C. Needle decompression D. Intubation
CORRECT ANSWER: B. Chest tube
Rationale: Initial treatment is tube thoracostomy to drain blood.
Question 11: Massive hemothorax indication for thoracotomy?
A. >500ml immediate B. >1000ml immediate C. >1500ml immediate or
>200ml/hr D. >2000ml immediate
CORRECT ANSWER: C. >1500ml immediate or >200ml/hr
,Rationale: Thoracotomy indicated for >1500ml immediate or >200ml/hr for
2-4 hours.
Question 12: Flail chest definition?
A. >=2 ribs in >=2 places B. >=3 ribs in >=2 places C. >=4 ribs in >=1 place
D. Sternum fracture
CORRECT ANSWER: B. >=3 ribs in >=2 places
Rationale: Flail chest is >=3 contiguous ribs fractured in >=2 places.
Question 13: Flail chest treatment?
A. Surgical fixation B. Pain control and ventilation C. Chest tube D.
Intubation
CORRECT ANSWER: B. Pain control and ventilation
Rationale: Primary treatment is adequate pain control and respiratory
support.
Question 14: Cardiac tamponade triad?
A. Cushing's triad B. Beck's triad C. Charcot's triad D. Reynolds' pentad
CORRECT ANSWER: B. Beck's triad
Rationale: Beck's triad: hypotension, JVD, muffled heart sounds.
Question 15: Cardiac tamponade diagnosis?
A. CXR B. FAST or Echo C. CT D. ECG
CORRECT ANSWER: B. FAST or Echo
Rationale: FAST or echocardiography is diagnostic for pericardial fluid.
Question 16: Cardiac tamponade treatment?
A. Chest tube B. Pericardiocentesis or thoracotomy C. IV fluids D.
Vasopressors
CORRECT ANSWER: B. Pericardiocentesis or thoracotomy
Rationale: Definitive treatment is pericardiocentesis or thoracotomy.
Question 17: Open pneumothorax initial treatment?
, A. Chest tube B. 3-sided occlusive dressing C. Intubation D. Needle
decompression
CORRECT ANSWER: B. 3-sided occlusive dressing
Rationale: Initial treatment is a 3-sided occlusive dressing to prevent
tension.
Question 18: Open pneumothorax definitive treatment?
A. Occlusive dressing B. Chest tube C. Thoracotomy D. Intubation
CORRECT ANSWER: B. Chest tube
Rationale: Definitive treatment is chest tube placement away from the
wound.
Question 19: Simple pneumothorax treatment?
A. Observe if small, else chest tube B. Needle decompression C.
Thoracotomy D. Intubation
CORRECT ANSWER: A. Observe if small, else chest tube
Rationale: Small simple pneumothoraces can be observed; larger require
chest tube.
Question 20: Tracheobronchial injury sign?
A. Hemoptysis B. Persistent air leak after chest tube C. Subcutaneous
emphysema D. Hypoxia
CORRECT ANSWER: B. Persistent air leak after chest tube
Rationale: Persistent large air leak suggests tracheobronchial injury.
Question 21: Aortic injury most common site?
A. Ascending aorta B. Aortic arch C. Aortic isthmus D. Descending aorta
CORRECT ANSWER: C. Aortic isthmus
Rationale: Aortic isthmus is the most common site of blunt aortic injury.
Question 22: Aortic injury initial diagnosis?
A. CT B. CXR (widened mediastinum) C. TEE D. MRI
CORRECT ANSWER: B. CXR (widened mediastinum)
Comprehensive Study Guide, Practice Exam Questions and Answers, Exam Prep
Test Bank, Trauma Assessment Protocols, Primary and Secondary Survey Review,
Emergency Airway and Breathing Management, Shock Recognition and
Resuscitation Strategies, Injury Stabilization Principles, and Detailed Rationales
for Certification Preparation
Question 1: First step in primary survey?
A. Breathing B. Circulation C. Airway D. Disability
CORRECT ANSWER: C. Airway
Rationale: ATLS follows ABCDE.
Question 2: Most common cause of airway obstruction in unconscious
patient?
A. Blood B. Tongue C. Teeth D. Vomitus
CORRECT ANSWER: B. Tongue
Rationale: Loss of muscle tone allows tongue to fall back.
Question 3: Best initial method to open airway in trauma?
A. Head tilt-chin lift B. Jaw thrust C. Cricothyroidotomy D. Endotracheal
intubation
CORRECT ANSWER: B. Jaw thrust
Rationale: Jaw thrust minimizes cervical spine movement.
Question 4: Definitive airway definition?
A. LMA B. Combitube C. ET tube in trachea with cuff inflated D. Nasal
trumpet
CORRECT ANSWER: C. ET tube in trachea with cuff inflated
Rationale: Definitive airway is a tube placed in the trachea with cuff
inflated.
Question 5: Surgical airway contraindication age?
A. < 12 years B. < 5 years C. < 18 years D. No age limit
CORRECT ANSWER: A. < 12 years
Rationale: Needle cricothyroidotomy preferred in children < 12 due to small
anatomy.
,Question 6: Tension pneumothorax clinical sign?
A. Tracheal deviation B. Wheezing C. Stridor D. Hemoptysis
CORRECT ANSWER: A. Tracheal deviation
Rationale: Tension pneumothorax causes tracheal deviation away from
affected side.
Question 7: Tension pneumothorax initial treatment?
A. Chest tube B. Needle decompression C. Intubation D.
Pericardiocentesis
CORRECT ANSWER: B. Needle decompression
Rationale: Immediate needle decompression is required before chest tube.
Question 8: Hemothorax definition?
A. >100ml blood B. >300ml blood C. >500ml blood D. >1000ml blood
CORRECT ANSWER: B. >300ml blood
Rationale: Hemothorax is defined as >300ml of blood in pleural space.
Question 9: Massive hemothorax definition?
A. >500ml B. >1000ml C. >1500ml or 1/3 blood volume D. >2000ml
CORRECT ANSWER: C. >1500ml or 1/3 blood volume
Rationale: Massive hemothorax is >1500ml or 1/3 of patient's blood
volume.
Question 10: Massive hemothorax initial treatment?
A. Thoracotomy B. Chest tube C. Needle decompression D. Intubation
CORRECT ANSWER: B. Chest tube
Rationale: Initial treatment is tube thoracostomy to drain blood.
Question 11: Massive hemothorax indication for thoracotomy?
A. >500ml immediate B. >1000ml immediate C. >1500ml immediate or
>200ml/hr D. >2000ml immediate
CORRECT ANSWER: C. >1500ml immediate or >200ml/hr
,Rationale: Thoracotomy indicated for >1500ml immediate or >200ml/hr for
2-4 hours.
Question 12: Flail chest definition?
A. >=2 ribs in >=2 places B. >=3 ribs in >=2 places C. >=4 ribs in >=1 place
D. Sternum fracture
CORRECT ANSWER: B. >=3 ribs in >=2 places
Rationale: Flail chest is >=3 contiguous ribs fractured in >=2 places.
Question 13: Flail chest treatment?
A. Surgical fixation B. Pain control and ventilation C. Chest tube D.
Intubation
CORRECT ANSWER: B. Pain control and ventilation
Rationale: Primary treatment is adequate pain control and respiratory
support.
Question 14: Cardiac tamponade triad?
A. Cushing's triad B. Beck's triad C. Charcot's triad D. Reynolds' pentad
CORRECT ANSWER: B. Beck's triad
Rationale: Beck's triad: hypotension, JVD, muffled heart sounds.
Question 15: Cardiac tamponade diagnosis?
A. CXR B. FAST or Echo C. CT D. ECG
CORRECT ANSWER: B. FAST or Echo
Rationale: FAST or echocardiography is diagnostic for pericardial fluid.
Question 16: Cardiac tamponade treatment?
A. Chest tube B. Pericardiocentesis or thoracotomy C. IV fluids D.
Vasopressors
CORRECT ANSWER: B. Pericardiocentesis or thoracotomy
Rationale: Definitive treatment is pericardiocentesis or thoracotomy.
Question 17: Open pneumothorax initial treatment?
, A. Chest tube B. 3-sided occlusive dressing C. Intubation D. Needle
decompression
CORRECT ANSWER: B. 3-sided occlusive dressing
Rationale: Initial treatment is a 3-sided occlusive dressing to prevent
tension.
Question 18: Open pneumothorax definitive treatment?
A. Occlusive dressing B. Chest tube C. Thoracotomy D. Intubation
CORRECT ANSWER: B. Chest tube
Rationale: Definitive treatment is chest tube placement away from the
wound.
Question 19: Simple pneumothorax treatment?
A. Observe if small, else chest tube B. Needle decompression C.
Thoracotomy D. Intubation
CORRECT ANSWER: A. Observe if small, else chest tube
Rationale: Small simple pneumothoraces can be observed; larger require
chest tube.
Question 20: Tracheobronchial injury sign?
A. Hemoptysis B. Persistent air leak after chest tube C. Subcutaneous
emphysema D. Hypoxia
CORRECT ANSWER: B. Persistent air leak after chest tube
Rationale: Persistent large air leak suggests tracheobronchial injury.
Question 21: Aortic injury most common site?
A. Ascending aorta B. Aortic arch C. Aortic isthmus D. Descending aorta
CORRECT ANSWER: C. Aortic isthmus
Rationale: Aortic isthmus is the most common site of blunt aortic injury.
Question 22: Aortic injury initial diagnosis?
A. CT B. CXR (widened mediastinum) C. TEE D. MRI
CORRECT ANSWER: B. CXR (widened mediastinum)
