ATLS 10TH EDITION 2026 POST-TEST
REVIEW GUIDE | FULL TRAUMA
LEARNING CONCEPTS & PRACTICE
THEMES || NEW VERSION
1. What is the overarching goal of the primary survey?
A) Complete diagnosis
B) Identify and treat life-threatening conditions in order of priority
C) Obtain all imaging studies
D) Perform definitive surgery
2. Which sequence correctly represents the ATLS primary survey?
A) Airway, Breathing, Circulation, Disability, Exposure
B) Airway, Circulation, Breathing, Disability, Exposure
C) Airway, Breathing, Circulation, Exposure, Disability
D) A, B, C, D, E (Airway, Breathing, Circulation, Disability, Exposure/Environment)
3. In airway management, what is the first step if obstruction is suspected?
A) Immediate cricothyroidotomy
B) Jaw-thrust maneuver
C) Orotracheal intubation
D) Nasopharyngeal airway
4. A patient with severe facial trauma is making gurgling sounds. What is the immediate
intervention?
A) Suction the oropharynx
B) Administer oxygen
C) Prepare for rapid sequence intubation
D) Perform a tracheostomy
5. When assessing breathing, what finding is an immediate threat to life?
A) Mild wheezing
B) Tension pneumothorax
C) Rib fracture
D) Bradypnea
,6. What is the first-line treatment for a tension pneumothorax identified during the
primary survey?
A) Needle decompression
B) Chest tube insertion
C) Immediate intubation
D) Thoracotomy
7. During circulation assessment, what is the most reliable indicator of significant blood
loss in an adult?
A) Tachycardia
B) Hypotension
C) Altered mental status
D) Delayed capillary refill
8. In a trauma patient with hypotension, what should be the first IV access?
A) Two large-bore peripheral IV lines
B) Central venous line
C) Intraosseous access in the sternum
D) Saphenous vein cutdown
9. A trauma patient is unresponsive with a GCS of 6. What does the "D" in the primary
survey prompt you to assess next?
A) Pupillary response and GCS
B) Blood glucose level
C) Complete neurologic exam
D) Cervical spine CT scan
10. What is the purpose of the "E" in the primary survey?
A) Ensure complete undressing and log-roll to inspect the back
B) Order all emergency lab tests
C) Perform a full physical exam
D) Transfer to CT scanner
11. When should the first chest x-ray ideally be obtained?
A) After the primary survey
B) During the primary survey as part of "Breathing" assessment
C) Only if the patient is unstable
D) After the secondary survey
,12. A patient with a penetrating chest wound has absent breath sounds on one side and
hypotension. What is the most likely diagnosis?
A) Simple pneumothorax
B) Hemothorax
C) Tension pneumothorax
D) Cardiac tamponade
13. The "Hypotensive Trauma Patient" algorithm emphasizes which approach?
A) Immediate transfusion of platelets
B) Permissive hypotension in bleeding trauma
C) Aggressive fluid resuscitation to normalize BP
D) Vasopressors as first line
14. What is the single most important predictor of outcome in trauma?
A) Number of injuries
B) Age of patient
C) Time from injury to definitive care
D) Presence of traumatic brain injury
15. What maneuver should be used initially to open the airway in a trauma patient with
suspected spine injury?
A) Head-tilt chin-lift
B) Jaw-thrust
C) Cervical collar application
D) Chin-lift only
16. What is the target systolic BP during permissive hypotension in a bleeding trauma
patient without TBI?
A) 90 mmHg
B) 110 mmHg
C) 120 mmHg
D) 80 mmHg
17. Which patient gets blood products early in the primary survey?
A) Any trauma patient with tachycardia
B) Patient responding to initial fluid bolus
C) Patient with ongoing hemorrhage and hypotension
D) Patient with isolated head injury
, 18. What is the first step in managing a flail chest?
A) Pain control and positive pressure ventilation if needed
B) Immediate surgical stabilization
C) Strapping the chest wall
D) High-flow oxygen only
19. In a patient with pelvic fracture and hypotension, what should you suspect first?
A) Intra-abdominal hemorrhage
B) Neurogenic shock
C) Cardiac contusion
D) Tension pneumothorax
20. What is the most appropriate initial imaging for a hemodynamically unstable blunt
trauma patient?
A) Full-body CT scan
B) Focused Assessment with Sonography for Trauma (FAST)
C) Chest and pelvis X-ray only
D) Diagnostic peritoneal lavage
21. What is the significance of a "seatbelt sign" across the abdomen?
A) No significance
B) High risk for cervical spine injury
C) High risk for intra-abdominal injury
D) Indicates minor injury only
22. Which finding is a late sign of tension pneumothorax?
A) Tachycardia
B) Tracheal deviation
C) Decreased breath sounds
D) Hypoxia
23. In a trauma arrest from penetrating chest trauma, what procedure may be life-saving?
A) Pericardiocentesis
B) Emergency department thoracotomy
C) Rapid fluid infusion
D) Bilateral needle decompression
24. What is the target oxygen saturation in the initial phase?
A) 100%
B) ≥94%
REVIEW GUIDE | FULL TRAUMA
LEARNING CONCEPTS & PRACTICE
THEMES || NEW VERSION
1. What is the overarching goal of the primary survey?
A) Complete diagnosis
B) Identify and treat life-threatening conditions in order of priority
C) Obtain all imaging studies
D) Perform definitive surgery
2. Which sequence correctly represents the ATLS primary survey?
A) Airway, Breathing, Circulation, Disability, Exposure
B) Airway, Circulation, Breathing, Disability, Exposure
C) Airway, Breathing, Circulation, Exposure, Disability
D) A, B, C, D, E (Airway, Breathing, Circulation, Disability, Exposure/Environment)
3. In airway management, what is the first step if obstruction is suspected?
A) Immediate cricothyroidotomy
B) Jaw-thrust maneuver
C) Orotracheal intubation
D) Nasopharyngeal airway
4. A patient with severe facial trauma is making gurgling sounds. What is the immediate
intervention?
A) Suction the oropharynx
B) Administer oxygen
C) Prepare for rapid sequence intubation
D) Perform a tracheostomy
5. When assessing breathing, what finding is an immediate threat to life?
A) Mild wheezing
B) Tension pneumothorax
C) Rib fracture
D) Bradypnea
,6. What is the first-line treatment for a tension pneumothorax identified during the
primary survey?
A) Needle decompression
B) Chest tube insertion
C) Immediate intubation
D) Thoracotomy
7. During circulation assessment, what is the most reliable indicator of significant blood
loss in an adult?
A) Tachycardia
B) Hypotension
C) Altered mental status
D) Delayed capillary refill
8. In a trauma patient with hypotension, what should be the first IV access?
A) Two large-bore peripheral IV lines
B) Central venous line
C) Intraosseous access in the sternum
D) Saphenous vein cutdown
9. A trauma patient is unresponsive with a GCS of 6. What does the "D" in the primary
survey prompt you to assess next?
A) Pupillary response and GCS
B) Blood glucose level
C) Complete neurologic exam
D) Cervical spine CT scan
10. What is the purpose of the "E" in the primary survey?
A) Ensure complete undressing and log-roll to inspect the back
B) Order all emergency lab tests
C) Perform a full physical exam
D) Transfer to CT scanner
11. When should the first chest x-ray ideally be obtained?
A) After the primary survey
B) During the primary survey as part of "Breathing" assessment
C) Only if the patient is unstable
D) After the secondary survey
,12. A patient with a penetrating chest wound has absent breath sounds on one side and
hypotension. What is the most likely diagnosis?
A) Simple pneumothorax
B) Hemothorax
C) Tension pneumothorax
D) Cardiac tamponade
13. The "Hypotensive Trauma Patient" algorithm emphasizes which approach?
A) Immediate transfusion of platelets
B) Permissive hypotension in bleeding trauma
C) Aggressive fluid resuscitation to normalize BP
D) Vasopressors as first line
14. What is the single most important predictor of outcome in trauma?
A) Number of injuries
B) Age of patient
C) Time from injury to definitive care
D) Presence of traumatic brain injury
15. What maneuver should be used initially to open the airway in a trauma patient with
suspected spine injury?
A) Head-tilt chin-lift
B) Jaw-thrust
C) Cervical collar application
D) Chin-lift only
16. What is the target systolic BP during permissive hypotension in a bleeding trauma
patient without TBI?
A) 90 mmHg
B) 110 mmHg
C) 120 mmHg
D) 80 mmHg
17. Which patient gets blood products early in the primary survey?
A) Any trauma patient with tachycardia
B) Patient responding to initial fluid bolus
C) Patient with ongoing hemorrhage and hypotension
D) Patient with isolated head injury
, 18. What is the first step in managing a flail chest?
A) Pain control and positive pressure ventilation if needed
B) Immediate surgical stabilization
C) Strapping the chest wall
D) High-flow oxygen only
19. In a patient with pelvic fracture and hypotension, what should you suspect first?
A) Intra-abdominal hemorrhage
B) Neurogenic shock
C) Cardiac contusion
D) Tension pneumothorax
20. What is the most appropriate initial imaging for a hemodynamically unstable blunt
trauma patient?
A) Full-body CT scan
B) Focused Assessment with Sonography for Trauma (FAST)
C) Chest and pelvis X-ray only
D) Diagnostic peritoneal lavage
21. What is the significance of a "seatbelt sign" across the abdomen?
A) No significance
B) High risk for cervical spine injury
C) High risk for intra-abdominal injury
D) Indicates minor injury only
22. Which finding is a late sign of tension pneumothorax?
A) Tachycardia
B) Tracheal deviation
C) Decreased breath sounds
D) Hypoxia
23. In a trauma arrest from penetrating chest trauma, what procedure may be life-saving?
A) Pericardiocentesis
B) Emergency department thoracotomy
C) Rapid fluid infusion
D) Bilateral needle decompression
24. What is the target oxygen saturation in the initial phase?
A) 100%
B) ≥94%
