Page 1 of 175
ATLS 10th Edition Post Test Actual EXAM LATEST
UPDATE THIS YEAR (2026-2027) ALL 300
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
1. A 22-year-old man is brought to the emergency department after a high-speed motor vehicle
collision. He is hemodynamically unstable with a distended abdomen. After initial assessment,
what is the next priority?
A) CT scan of the abdomen
B) Focused Assessment with Sonography in Trauma (FAST)
C) Diagnostic peritoneal lavage
D) Immediate laparotomy
Answer: B The FAST exam is the preferred initial diagnostic tool in an unstable patient with
suspected abdominal injury to rapidly identify free fluid (hemorrhage) without delaying
resuscitation.
1
, Page 2 of 175
2. A 45-year-old woman falls from a height of 4 meters. She has paradoxical chest wall
movement on the left side. Which finding is most likely?
A) Simple pneumothorax
B) Flail chest
C) Cardiac tamponade
D) Tension pneumothorax
Answer: B Paradoxical chest wall movement (flail segment) indicates flail chest, defined as two
or more adjacent rib fractures with each rib fractured in two or more places, creating a free-
floating segment.
3. A 30-year-old pedestrian is struck by a car. His Glasgow Coma Scale (GCS) score is 6. What is
the first step in management?
A) CT scan of the head
B) Endotracheal intubation
C) Cervical spine immobilization
D) IV fluid bolus
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, Page 3 of 175
Answer: B A GCS ≤ 8 indicates the need for definitive airway control (endotracheal intubation)
to protect the airway and prevent aspiration, as the patient cannot protect their own airway.
4. A 60-year-old man has a gunshot wound to the right chest. Breath sounds are absent on the
right, and the trachea is deviated to the left. Blood pressure is 80/50 mm Hg. What is the most
appropriate next intervention?
A) Needle decompression of the right chest
B) Chest tube insertion on the right
C) Pericardiocentesis
D) Intubation
Answer: A Tracheal deviation away from the affected side with hypotension and absent breath
sounds is classic for tension pneumothorax; immediate needle decompression (2nd intercostal
space, midclavicular line) is life-saving.
5. In a hypotensive trauma patient with a positive FAST exam, which finding indicates the need
for immediate laparotomy?
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, Page 4 of 175
A) Free fluid in Morrison's pouch
B) Pericardial effusion
C) Pneumothorax
D) Pelvic fracture
Answer: A Free fluid in Morrison's pouch (hepatorenal space) in a hypotensive patient indicates
intra-abdominal hemorrhage; a positive FAST in an unstable patient is an indication for
immediate laparotomy.
6. A 25-year-old man sustains a stab wound to the left upper quadrant. He is hypotensive and
has a rigid abdomen. What is the best next step?
A) CT scan
B) Diagnostic peritoneal lavage
C) Laparotomy
D) Observation
4
ATLS 10th Edition Post Test Actual EXAM LATEST
UPDATE THIS YEAR (2026-2027) ALL 300
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
1. A 22-year-old man is brought to the emergency department after a high-speed motor vehicle
collision. He is hemodynamically unstable with a distended abdomen. After initial assessment,
what is the next priority?
A) CT scan of the abdomen
B) Focused Assessment with Sonography in Trauma (FAST)
C) Diagnostic peritoneal lavage
D) Immediate laparotomy
Answer: B The FAST exam is the preferred initial diagnostic tool in an unstable patient with
suspected abdominal injury to rapidly identify free fluid (hemorrhage) without delaying
resuscitation.
1
, Page 2 of 175
2. A 45-year-old woman falls from a height of 4 meters. She has paradoxical chest wall
movement on the left side. Which finding is most likely?
A) Simple pneumothorax
B) Flail chest
C) Cardiac tamponade
D) Tension pneumothorax
Answer: B Paradoxical chest wall movement (flail segment) indicates flail chest, defined as two
or more adjacent rib fractures with each rib fractured in two or more places, creating a free-
floating segment.
3. A 30-year-old pedestrian is struck by a car. His Glasgow Coma Scale (GCS) score is 6. What is
the first step in management?
A) CT scan of the head
B) Endotracheal intubation
C) Cervical spine immobilization
D) IV fluid bolus
2
, Page 3 of 175
Answer: B A GCS ≤ 8 indicates the need for definitive airway control (endotracheal intubation)
to protect the airway and prevent aspiration, as the patient cannot protect their own airway.
4. A 60-year-old man has a gunshot wound to the right chest. Breath sounds are absent on the
right, and the trachea is deviated to the left. Blood pressure is 80/50 mm Hg. What is the most
appropriate next intervention?
A) Needle decompression of the right chest
B) Chest tube insertion on the right
C) Pericardiocentesis
D) Intubation
Answer: A Tracheal deviation away from the affected side with hypotension and absent breath
sounds is classic for tension pneumothorax; immediate needle decompression (2nd intercostal
space, midclavicular line) is life-saving.
5. In a hypotensive trauma patient with a positive FAST exam, which finding indicates the need
for immediate laparotomy?
3
, Page 4 of 175
A) Free fluid in Morrison's pouch
B) Pericardial effusion
C) Pneumothorax
D) Pelvic fracture
Answer: A Free fluid in Morrison's pouch (hepatorenal space) in a hypotensive patient indicates
intra-abdominal hemorrhage; a positive FAST in an unstable patient is an indication for
immediate laparotomy.
6. A 25-year-old man sustains a stab wound to the left upper quadrant. He is hypotensive and
has a rigid abdomen. What is the best next step?
A) CT scan
B) Diagnostic peritoneal lavage
C) Laparotomy
D) Observation
4
