ATLS POST TEST 4 LATEST VERSIONS 2025 REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS |AGRADE
A 22 year old male is brought by ambulance to a small community hospital after falling from the top of
an 8 foot ladder. Initially, he was found to have a large right pneumothorax. A chest tube was inserted
and connected to an underwater seal drainage collection system with negative pressure. A repeat CXR
demonstrates a residual, large right pneumothorax. After transferring the patient to a verified trauma
center, a third chest x-ray reveals a persistent right pneumothorax. The chest tube appears to be
functioning and in good position. He remains hemodynamically normal with no signs of respiratory
distress. The most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury - correct answer -E. Tracheobronchial injury
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray - correct answer -D. oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Which of the following signs necessitates the need for a definitive airway in severe trauma patient?
A. facial lacerations
B. repeated vomiting
,ATLS POST TEST 4 LATEST VERSIONS 2025 REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS |AGRADE
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12 - correct answer -C. Severe maxillofacial trauma
Twenty seven people are severely injured in an aircraft crash at a local airport. The principles of triage
include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources - correct answer -E. Produce
the greatest number of survivors based on available resources
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas - correct answer -A. Cerebral
contusions may coalesce to form an intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He has one bullet wound just below the right
clavicle and another just below the costal margin in the right posterior axillary line. His blood pressure is
110/60, heart rate of 90, and respiratory rate of 34. After ensuring a patent airway and inserting 2 large
caliber IV lines, the next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
, ATLS POST TEST 4 LATEST VERSIONS 2025 REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS |AGRADE
E. Perform diagnostic peritoneal lavage - correct answer -A. Obtain a portable chest x-ray need
more info on chest, not abdomen
Which of the following should be performed FIRST in any patient whose injuries may include multiple
closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - correct answer -D. Ensuring adequate oxygenation and
ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His BP is 80/40
and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases to 122/84 and HR
decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds are decreased at the left
upper chest with dullness on percussion. A large caliber tube thoracostomy is inserted into the fifth
intercostal space with the return of 200 mL of blood and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest - correct answer -E. Repeat the physical exam of the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle decompression
followed by tube
Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
QUESTIONS AND CORRECT ANSWERS |AGRADE
A 22 year old male is brought by ambulance to a small community hospital after falling from the top of
an 8 foot ladder. Initially, he was found to have a large right pneumothorax. A chest tube was inserted
and connected to an underwater seal drainage collection system with negative pressure. A repeat CXR
demonstrates a residual, large right pneumothorax. After transferring the patient to a verified trauma
center, a third chest x-ray reveals a persistent right pneumothorax. The chest tube appears to be
functioning and in good position. He remains hemodynamically normal with no signs of respiratory
distress. The most likely cause for the persistent right pneumothorax is:
A. Flail chest
B. Diaphragmatic injury
C. Pulmonary contusion
D. Esophageal perforation
E. Tracheobronchial injury - correct answer -E. Tracheobronchial injury
Which of the following is LEAST reliable for diagnosing ESOPHAGEAL intubation?
A. symmetrical chest wall movement
B. end-tidal CO2
C. bilateral breath sounds
D. oxygen saturation >92%
E. ETT above carina on chest x-ray - correct answer -D. oxygen saturation >92%
-> if it says ESOPHAGEAL, go with this answer
Which of the following signs necessitates the need for a definitive airway in severe trauma patient?
A. facial lacerations
B. repeated vomiting
,ATLS POST TEST 4 LATEST VERSIONS 2025 REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS |AGRADE
C. severe maxillofacial trauma
D. sternal fracture
E. GCS 12 - correct answer -C. Severe maxillofacial trauma
Twenty seven people are severely injured in an aircraft crash at a local airport. The principles of triage
include:
A. establish a triage site within the internal perimeter of the crash site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest hospital
D. treat the greatest number of patients in the shortest period of time
E. produce the greatest number of survivors based on available resources - correct answer -E. Produce
the greatest number of survivors based on available resources
Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
E. The associated brain damage is more severe in epidural hematomas - correct answer -A. Cerebral
contusions may coalesce to form an intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
An 18 year old male is brought to the ED after being shot. He has one bullet wound just below the right
clavicle and another just below the costal margin in the right posterior axillary line. His blood pressure is
110/60, heart rate of 90, and respiratory rate of 34. After ensuring a patent airway and inserting 2 large
caliber IV lines, the next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
, ATLS POST TEST 4 LATEST VERSIONS 2025 REAL EXAM 160
QUESTIONS AND CORRECT ANSWERS |AGRADE
E. Perform diagnostic peritoneal lavage - correct answer -A. Obtain a portable chest x-ray need
more info on chest, not abdomen
Which of the following should be performed FIRST in any patient whose injuries may include multiple
closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome - correct answer -D. Ensuring adequate oxygenation and
ventilation
(ABC's)
A 22 year old male sustains a shotgun wound to the shoulder and chest at close range. His BP is 80/40
and HR 130. After 2 L of crystalloid solution are rapidly infused, his BP increases to 122/84 and HR
decreases to 100. He is tachypneic with RR of 28. On PE, his breath sounds are decreased at the left
upper chest with dullness on percussion. A large caliber tube thoracostomy is inserted into the fifth
intercostal space with the return of 200 mL of blood and no air leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest - correct answer -E. Repeat the physical exam of the chest
decreased breath sounds w/dullness -> hemothorax, need tube to drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension pneumonia, need needle decompression
followed by tube
Which one of the following statements concerning spine and spinal cord trauma is TRUE?
A. A normal lateral C spine film excludes injury
