ADVANCED TRAUMA LIFE SUPPORT (ATLS) ACTUAL PRACTICE EXAM 2025-26 QUESTIONS WITH ANSWERS

What systematic approach should be used when preforming a primary survey
providing a step by step approach to assess and treat trauma patients?
ABCDE Approach
Airway (+ C-spine)
Breathing and ventilation
Circulation
Disability
Exposure
What scales and scoring systems can be used to map a patient's neurological
status/condition?
- Glasgow coma scale (GCS)
- APVU score
What components are included in a Glasgow coma scale?
- eye opening
- motor response
- verbal response
What are the general eye opening responses (4) used for a GCS?
1 = no response
2 = to pain
3 = to speech
4 = spontaneously open
What are the general motor responses (6) used for a GCS?
1 = no response
2 = extension response to pain
3 = abnormal flexion response to pain
4 = normal flexion response to pain
5 = moves to localized pain
6 = obeys commands
What are the general verbal responses (5) used for a GCS?
1 = no response
2 = sounds
3 = words
4 = confused
5 = orientated
A patient with a GCS </= to a score of what is considered to be in a coma?
</= 8
What surveys should be completed on a patient with advanced trauma?

,1. ABCDE Approach
2. If completed #1 and appropriate responses, continue with complete examination
3. Repeat ABCDE Approach and secondary survey (step 2) one day after admission,
including eval of any interventions
What is the AVPU score?
neurological evaluation
What are the components of the AVPU score?
A = awake and alert
V = responds only to verbal stimulus
P = responds only to pain stimulus
U = unresponsive
How many classifications are there for hemorrhagic shock?
4
What are different components used to classify hemorrhagic shock?
- Blood loss in mL and %
- HR
- BP
- Pulse pressure
- RR
- Urine protection
- CNS/mental status
What amount of blood loss is classified as class I hemorrhagic shock?
mL = < 750
% = < 15%
What amount of blood loss is classified as class II hemorrhagic shock?
mL = 750-1500
% = 15-30%
What amount of blood loss is classified as class III hemorrhagic shock?
mL = 1500-2000
% = 30-40%
What amount of blood loss is classified as class IV hemorrhagic shock?
mL = > 2000
% = > 40%
What HR is classified as class I hemorrhagic shock?
< 100
What HR is classified as class II hemorrhagic shock?
> 100
What HR is classified as class III hemorrhagic shock?
> 120
What HR is classified as class IV hemorrhagic shock?
> 140
What class of hemorrhagic shock does BP start to decrease?
Class III
What class of hemorrhagic shock does pulse pressure start to decrease?
Class II
What is the RR for class I hemorrhagic shock?

, 14-20 bpm
What is the RR for class II hemorrhagic shock?
20-30 bpm
What is the RR for class III hemorrhagic shock?
30-40 bpm
What is the RR for class IV hemorrhagic shock?
> 35 bpm
What is the urine production (ml/hr) for class I hemorrhagic shock?
> 30
What is the urine production (ml/hr) for class II hemorrhagic shock?
20-30
What is the urine production (ml/hr) for class III hemorrhagic shock?
5-15
What is the urine production (ml/hr) for class IV hemorrhagic shock?
Negligible
What is the central nervous system/mental status for class I hemorrhagic shock?
slightly anxious
What is the central nervous system/mental status for class II hemorrhagic shock?
mildly anxious
What is the central nervous system/mental status for class III hemorrhagic
shock?
anxious, confused
What is the central nervous system/mental status for class IV hemorrhagic
shock?
confused, lethargic
What is the physical exam portion of looking at the airway and c-spine?
- check if still breathing
- is airway clear - can they talk? audible breathing (stridor, snoring)
- inspect mouth (foreign body, blood, vomit)
What diagnostic tests/imaging are involved in looking at the c-spine/assessing
airway?
- maxillofacial CT
- c-spine CT
- C-spine xray in kids
What is the proposed treatment for airway?
- head tilt/chin life (need to consider cervical injury -> jaw thrust, no head tilt)
- 15L/100% O2 mask 0> oropharyngeal airway -> orotacheal intubation ->
cricothyrotomy
What needs to be monitored after intubation?
CO2
what are possible causes of instability when evaluating someone's airway/c-
spine?
- aspiration of blood/vomit
- atone of the tongue due to unconsciousness
- c-spine injury
- maxillofacial fractures