ATLS 10th Edition Post Test Study Guide
2025: 200+ Verified Questions &
Answers | Guaranteed Pass
Question 1: A 35-year-old male presents to the ED after a motor vehicle collision. He is
unresponsive, with a GCS of 6. What is the FIRST step in the primary survey? A. Assess
breathing B. Assess circulation C. Open the airway D. Control external hemorrhage
Correct Answer: C Rationale: The primary survey follows the ABCDE sequence. The first
step is to open the airway (A = Airway) to ensure patency and prevent hypoxia. Assessing
breathing (A) and circulation (B) come after securing the airway. Controlling hemorrhage (D) is
part of circulation (C) but is not the first step.
Question 2: During the primary survey of a trauma patient, you note the absence of breath
sounds on the left side and tracheal deviation to the right. What is the MOST likely diagnosis? A.
Simple pneumothorax B. Tension pneumothorax C. Hemothorax D. Pulmonary contusion
Correct Answer: B Rationale: Tension pneumothorax presents with absent breath sounds
on the affected side and tracheal deviation away from the affected side due to increasing
intrathoracic pressure. Simple pneumothorax (A) does not cause tracheal deviation. Hemothorax
(C) may cause dullness to percussion but not tracheal deviation. Pulmonary contusion (D) does
not cause tracheal deviation.
Question 3: A patient presents with a stab wound to the chest and signs of shock. The FAST
exam shows fluid in the pericardial sac. What is the MOST appropriate next intervention? A.
Chest tube insertion B. Pericardiocentesis C. Exploratory laparotomy D. Intubation
Correct Answer: B Rationale: Fluid in the pericardial sac on FAST exam suggests cardiac
tamponade , which requires pericardiocentesis to relieve the tamponade physiology. Chest
tube insertion (A) is for pneumothorax/hemothorax. Exploratory laparotomy (C) is for abdominal
trauma. Intubation (D) is for airway management, not tamponade.
,Question 4: A 22-year-old male presents with a gunshot wound to the abdomen. He is
hypotensive with a distended abdomen. What is the MOST appropriate next step? A. CT scan of
the abdomen B. Exploratory laparotomy C. Diagnostic peritoneal lavage D. FAST exam
Correct Answer: B Rationale: In a hypotensive patient with a penetrating abdominal
wound and peritonitis, the priority is exploratory laparotomy to control hemorrhage. CT
scan (A) is inappropriate in unstable patients. Diagnostic peritoneal lavage (C) and FAST exam
(D) are diagnostic tools but do not definitively treat the patient.
Question 5: A patient with a head injury has a GCS of 13. What is the MOST appropriate initial
imaging study? A. Skull X-ray B. Non-contrast CT head C. MRI brain D. Angiography
Correct Answer: B Rationale: A non-contrast CT head is the initial imaging study of
choice for traumatic brain injury to assess for hemorrhage, contusions, or mass effect. Skull
X-ray (A) is insufficient. MRI (C) is not used acutely due to time constraints. Angiography (D) is
for vascular injuries.
Question 6: A 40-year-old male is involved in a high-speed MVC. He is alert, but his blood
pressure is 80/40 mmHg, and his heart rate is 130 bpm. What is the MOST likely cause of his
hypotension? A. Neurogenic shock B. Hypovolemic shock C. Cardiogenic shock D. Septic shock
Correct Answer: B Rationale: Hypovolemic shock is the most common cause of
hypotension in trauma, typically due to hemorrhage. Neurogenic shock (A) would present with
bradycardia and warm extremities. Cardiogenic shock (C) is rare in trauma unless cardiac injury
is present. Septic shock (D) is not acute in trauma.
Question 7: A patient with a pelvic fracture is hypotensive. What is the FIRST intervention? A.
Apply a pelvic binder B. Administer 2 L of crystalloid C. Perform a FAST exam D. Insert a chest
tube
Correct Answer: A Rationale: In pelvic fractures with hypotension, the first intervention is
to apply a pelvic binder to stabilize the pelvis and reduce bleeding. Fluid resuscitation (B) is
secondary. FAST exam (C) is diagnostic but not therapeutic. Chest tube (D) is for thoracic
injuries.
Question 8: A 5-year-old child presents after a fall. He is lethargic with a GCS of 12. What is the
MOST important consideration in his assessment? A. Cervical spine injury B. Intracranial
hemorrhage C. Hypovolemic shock D. Pneumothorax
, Correct Answer: B Rationale: In pediatric trauma, head injuries are the leading cause of
death. A GCS of 12 indicates a significant risk of intracranial hemorrhage . Cervical spine
injury (A) is important but less likely to cause lethargy. Hypovolemic shock (C) and
pneumothorax (D) are less likely without other signs.
Question 9: A patient with a gunshot wound to the chest has a blood pressure of 70/40 mmHg.
What is the MOST appropriate initial fluid resuscitation? A. 1 L of normal saline B. 2 L of lactated
Ringer’s C. 1 unit of O-negative blood D. 1 unit of packed red blood cells
Correct Answer: C Rationale: In hypotensive trauma patients with suspected
hemorrhage , O-negative blood is the initial fluid of choice if available, as it is universally
compatible. Crystalloid (A, B) is secondary. Packed red blood cells (D) require cross-matching.
Question 10: A patient with a femoral fracture is in hemorrhagic shock. What is the MOST
appropriate intervention? A. Tourniquet application B. Splinting the femur C. Administering
tranexamic acid D. Inserting a central line
Correct Answer: A Rationale: In hemorrhagic shock from a femoral fracture , a tourniquet
is the fastest way to control bleeding. Splinting (B) is important but secondary. Tranexamic
acid (C) is adjunctive. Central line insertion (D) is for fluid access, not hemorrhage control.
Question 11: A patient with a flail chest is hypotensive and hypoxic. What is the FIRST
intervention? A. Intubation and mechanical ventilation B. Chest tube insertion C. Needle
decompression D. Pain control
Correct Answer: A Rationale: In flail chest with hypoxia and hypotension, intubation and
mechanical ventilation are prioritized to stabilize the airway and improve oxygenation. Chest
tube (B) is for pneumothorax/hemothorax. Needle decompression (C) is for tension
pneumothorax. Pain control (D) is secondary.
Question 12: A patient with a head injury has a GCS of 8. What is the MOST appropriate airway
management? A. Nasopharyngeal airway B. Oropharyngeal airway C. Endotracheal intubation D.
Cricothyrotomy
Correct Answer: C Rationale: A GCS of 8 indicates severe traumatic brain injury, requiring
definitive airway control with endotracheal intubation. Nasopharyngeal (A) and
oropharyngeal (B) airways are temporary. Cricothyrotomy (D) is a last resort if intubation fails.
2025: 200+ Verified Questions &
Answers | Guaranteed Pass
Question 1: A 35-year-old male presents to the ED after a motor vehicle collision. He is
unresponsive, with a GCS of 6. What is the FIRST step in the primary survey? A. Assess
breathing B. Assess circulation C. Open the airway D. Control external hemorrhage
Correct Answer: C Rationale: The primary survey follows the ABCDE sequence. The first
step is to open the airway (A = Airway) to ensure patency and prevent hypoxia. Assessing
breathing (A) and circulation (B) come after securing the airway. Controlling hemorrhage (D) is
part of circulation (C) but is not the first step.
Question 2: During the primary survey of a trauma patient, you note the absence of breath
sounds on the left side and tracheal deviation to the right. What is the MOST likely diagnosis? A.
Simple pneumothorax B. Tension pneumothorax C. Hemothorax D. Pulmonary contusion
Correct Answer: B Rationale: Tension pneumothorax presents with absent breath sounds
on the affected side and tracheal deviation away from the affected side due to increasing
intrathoracic pressure. Simple pneumothorax (A) does not cause tracheal deviation. Hemothorax
(C) may cause dullness to percussion but not tracheal deviation. Pulmonary contusion (D) does
not cause tracheal deviation.
Question 3: A patient presents with a stab wound to the chest and signs of shock. The FAST
exam shows fluid in the pericardial sac. What is the MOST appropriate next intervention? A.
Chest tube insertion B. Pericardiocentesis C. Exploratory laparotomy D. Intubation
Correct Answer: B Rationale: Fluid in the pericardial sac on FAST exam suggests cardiac
tamponade , which requires pericardiocentesis to relieve the tamponade physiology. Chest
tube insertion (A) is for pneumothorax/hemothorax. Exploratory laparotomy (C) is for abdominal
trauma. Intubation (D) is for airway management, not tamponade.
,Question 4: A 22-year-old male presents with a gunshot wound to the abdomen. He is
hypotensive with a distended abdomen. What is the MOST appropriate next step? A. CT scan of
the abdomen B. Exploratory laparotomy C. Diagnostic peritoneal lavage D. FAST exam
Correct Answer: B Rationale: In a hypotensive patient with a penetrating abdominal
wound and peritonitis, the priority is exploratory laparotomy to control hemorrhage. CT
scan (A) is inappropriate in unstable patients. Diagnostic peritoneal lavage (C) and FAST exam
(D) are diagnostic tools but do not definitively treat the patient.
Question 5: A patient with a head injury has a GCS of 13. What is the MOST appropriate initial
imaging study? A. Skull X-ray B. Non-contrast CT head C. MRI brain D. Angiography
Correct Answer: B Rationale: A non-contrast CT head is the initial imaging study of
choice for traumatic brain injury to assess for hemorrhage, contusions, or mass effect. Skull
X-ray (A) is insufficient. MRI (C) is not used acutely due to time constraints. Angiography (D) is
for vascular injuries.
Question 6: A 40-year-old male is involved in a high-speed MVC. He is alert, but his blood
pressure is 80/40 mmHg, and his heart rate is 130 bpm. What is the MOST likely cause of his
hypotension? A. Neurogenic shock B. Hypovolemic shock C. Cardiogenic shock D. Septic shock
Correct Answer: B Rationale: Hypovolemic shock is the most common cause of
hypotension in trauma, typically due to hemorrhage. Neurogenic shock (A) would present with
bradycardia and warm extremities. Cardiogenic shock (C) is rare in trauma unless cardiac injury
is present. Septic shock (D) is not acute in trauma.
Question 7: A patient with a pelvic fracture is hypotensive. What is the FIRST intervention? A.
Apply a pelvic binder B. Administer 2 L of crystalloid C. Perform a FAST exam D. Insert a chest
tube
Correct Answer: A Rationale: In pelvic fractures with hypotension, the first intervention is
to apply a pelvic binder to stabilize the pelvis and reduce bleeding. Fluid resuscitation (B) is
secondary. FAST exam (C) is diagnostic but not therapeutic. Chest tube (D) is for thoracic
injuries.
Question 8: A 5-year-old child presents after a fall. He is lethargic with a GCS of 12. What is the
MOST important consideration in his assessment? A. Cervical spine injury B. Intracranial
hemorrhage C. Hypovolemic shock D. Pneumothorax
, Correct Answer: B Rationale: In pediatric trauma, head injuries are the leading cause of
death. A GCS of 12 indicates a significant risk of intracranial hemorrhage . Cervical spine
injury (A) is important but less likely to cause lethargy. Hypovolemic shock (C) and
pneumothorax (D) are less likely without other signs.
Question 9: A patient with a gunshot wound to the chest has a blood pressure of 70/40 mmHg.
What is the MOST appropriate initial fluid resuscitation? A. 1 L of normal saline B. 2 L of lactated
Ringer’s C. 1 unit of O-negative blood D. 1 unit of packed red blood cells
Correct Answer: C Rationale: In hypotensive trauma patients with suspected
hemorrhage , O-negative blood is the initial fluid of choice if available, as it is universally
compatible. Crystalloid (A, B) is secondary. Packed red blood cells (D) require cross-matching.
Question 10: A patient with a femoral fracture is in hemorrhagic shock. What is the MOST
appropriate intervention? A. Tourniquet application B. Splinting the femur C. Administering
tranexamic acid D. Inserting a central line
Correct Answer: A Rationale: In hemorrhagic shock from a femoral fracture , a tourniquet
is the fastest way to control bleeding. Splinting (B) is important but secondary. Tranexamic
acid (C) is adjunctive. Central line insertion (D) is for fluid access, not hemorrhage control.
Question 11: A patient with a flail chest is hypotensive and hypoxic. What is the FIRST
intervention? A. Intubation and mechanical ventilation B. Chest tube insertion C. Needle
decompression D. Pain control
Correct Answer: A Rationale: In flail chest with hypoxia and hypotension, intubation and
mechanical ventilation are prioritized to stabilize the airway and improve oxygenation. Chest
tube (B) is for pneumothorax/hemothorax. Needle decompression (C) is for tension
pneumothorax. Pain control (D) is secondary.
Question 12: A patient with a head injury has a GCS of 8. What is the MOST appropriate airway
management? A. Nasopharyngeal airway B. Oropharyngeal airway C. Endotracheal intubation D.
Cricothyrotomy
Correct Answer: C Rationale: A GCS of 8 indicates severe traumatic brain injury, requiring
definitive airway control with endotracheal intubation. Nasopharyngeal (A) and
oropharyngeal (B) airways are temporary. Cricothyrotomy (D) is a last resort if intubation fails.
