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ATLS 10th Edition Post Test 2 Actual Exam
Questions and Answers with Rationales
2026/2027 | Advanced Trauma Life Support |
Pass Guarantee
Item ID: ATLS-10-V2-001
Scenario: A 34-year-old unrestrained driver is ejected after high-speed rollover.
EMS intubated on scene with C-collar in place. On arrival: GCS 3T, HR 148, BP
74/40, RR 14 (ventilated), SpO₂ 88 % on 100 % O₂. Breath sounds absent on left,
trachea midline, neck veins flat, pelvis unstable with 2 cm pubic diastasis. FAST is
positive in Morrison’s pouch.
Question: What is the NEXT immediate intervention according to ATLS
priorities?
Options:
A. 2 L warmed crystalloid bolus
B. Left chest decompression
C. Application of pelvic binder
D. CT head and cervical spine
(Correct Choice: B)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: B
• ATLS Algorithm Justification: Primary Survey “B” identifies life-
threatening thoracic injury before addressing circulation; absent left breath
sounds with hypoxia despite ventilation mandates immediate needle
decompression per ATLS 10th Edition.
• Distractor Analysis: A is circulatory resuscitation but does not correct the
cause of hypoxia; C is appropriate but secondary to airway/oxygenation; D
is Secondary Survey imaging and must wait until life threats are controlled.
Item ID: ATLS-10-V2-002
Scenario: A 19-year-old motorcyclist collides with guardrail at 60 mph. Helmet
cracked. On arrival: GCS 14 (E3 V5 M6), HR 126, BP 98/70, RR 32, SpO₂ 90 %
, 2
on 15 L NRBM. Chest wall crepitus right hemithorax, breath sounds decreased
right, no tracheal shift, neck veins distended.
Question: What is the MOST likely diagnosis requiring immediate action?
Options:
A. Tension pneumothorax
B. Massive hemothorax
C. Cardiac tamponade
D. Flail chest
(Correct Choice: A)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: A
• ATLS Algorithm Justification: Tension pneumothorax presents with
respiratory distress, unilateral decreased breath sounds, and can show neck
vein distension despite hypotension not yet present; immediate
decompression is mandated in Primary Survey “B”.
• Distractor Analysis: B would show hypotension earlier; C requires
penetrating mechanism or global heart shadow on FAST; D is painful but
not immediately life-threatening without respiratory failure.
Item ID: ATLS-10-V2-003
Scenario: A 28-year-old pedestrian struck by SUV at 40 mph. Alert, intoxicated.
HR 140, BP 80/60, RR 28, SpO₂ 94 %. Large open wound right thigh with arterial
spurting; FAST negative. Two 16-gauge IVs placed.
Question: What is the NEXT step in ATLS sequence?
Options:
A. Apply direct pressure & tourniquet
B. 1 L crystalloid bolus
C. CT angiogram right lower extremity
D. Type-specific blood transfusion
(Correct Choice: A)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: A
, 3
• ATLS Algorithm Justification: Primary Survey “C” dictates immediate
control of external hemorrhage before fluid resuscitation; tourniquet is
indicated for arterial bleeding not stopped by direct pressure.
• Distractor Analysis: B is secondary after bleeding controlled; C is
Secondary Survey; D is appropriate only after hemorrhage control and
continued shock.
Item ID: ATLS-10-V2-004
Scenario: A 42-year-old restrained driver in head-on collision. Airbag deployed.
Alert, complains of severe chest pain. HR 110, BP 90/60, RR 26, SpO₂ 92 %.
Paradoxical motion of right chest wall, multiple rib fractures palpable, seat -belt
sign across chest.
Question: What is the PRIORITY intervention?
Options:
A. Endotracheal intubation
B. Intercostal nerve blocks
C. Chest X-ray
D. Epidural analgesia
(Correct Choice: A)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: A
• ATLS Algorithm Justification: Flail chest with respiratory failure (SpO₂ <
94 %, increased work) requires airway control and mechanical ventilation
per ATLS 10th Edition.
• Distractor Analysis: B & D are analgesic adjuncts but do not address
oxygenation failure; C is diagnostic and Secondary Survey.
Item ID: ATLS-10-V2-005
Scenario: A 55-year-old falls 20 ft from roof. Alert, GCS 15. HR 104, BP 100/70,
RR 24, SpO₂ 95 %. Severe epigastric bruising, LUQ tenderness. FAST positive in
spleno-renal pouch; no free fluid elsewhere.
Question: What is the MOST appropriate next step?
ATLS 10th Edition Post Test 2 Actual Exam
Questions and Answers with Rationales
2026/2027 | Advanced Trauma Life Support |
Pass Guarantee
Item ID: ATLS-10-V2-001
Scenario: A 34-year-old unrestrained driver is ejected after high-speed rollover.
EMS intubated on scene with C-collar in place. On arrival: GCS 3T, HR 148, BP
74/40, RR 14 (ventilated), SpO₂ 88 % on 100 % O₂. Breath sounds absent on left,
trachea midline, neck veins flat, pelvis unstable with 2 cm pubic diastasis. FAST is
positive in Morrison’s pouch.
Question: What is the NEXT immediate intervention according to ATLS
priorities?
Options:
A. 2 L warmed crystalloid bolus
B. Left chest decompression
C. Application of pelvic binder
D. CT head and cervical spine
(Correct Choice: B)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: B
• ATLS Algorithm Justification: Primary Survey “B” identifies life-
threatening thoracic injury before addressing circulation; absent left breath
sounds with hypoxia despite ventilation mandates immediate needle
decompression per ATLS 10th Edition.
• Distractor Analysis: A is circulatory resuscitation but does not correct the
cause of hypoxia; C is appropriate but secondary to airway/oxygenation; D
is Secondary Survey imaging and must wait until life threats are controlled.
Item ID: ATLS-10-V2-002
Scenario: A 19-year-old motorcyclist collides with guardrail at 60 mph. Helmet
cracked. On arrival: GCS 14 (E3 V5 M6), HR 126, BP 98/70, RR 32, SpO₂ 90 %
, 2
on 15 L NRBM. Chest wall crepitus right hemithorax, breath sounds decreased
right, no tracheal shift, neck veins distended.
Question: What is the MOST likely diagnosis requiring immediate action?
Options:
A. Tension pneumothorax
B. Massive hemothorax
C. Cardiac tamponade
D. Flail chest
(Correct Choice: A)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: A
• ATLS Algorithm Justification: Tension pneumothorax presents with
respiratory distress, unilateral decreased breath sounds, and can show neck
vein distension despite hypotension not yet present; immediate
decompression is mandated in Primary Survey “B”.
• Distractor Analysis: B would show hypotension earlier; C requires
penetrating mechanism or global heart shadow on FAST; D is painful but
not immediately life-threatening without respiratory failure.
Item ID: ATLS-10-V2-003
Scenario: A 28-year-old pedestrian struck by SUV at 40 mph. Alert, intoxicated.
HR 140, BP 80/60, RR 28, SpO₂ 94 %. Large open wound right thigh with arterial
spurting; FAST negative. Two 16-gauge IVs placed.
Question: What is the NEXT step in ATLS sequence?
Options:
A. Apply direct pressure & tourniquet
B. 1 L crystalloid bolus
C. CT angiogram right lower extremity
D. Type-specific blood transfusion
(Correct Choice: A)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: A
, 3
• ATLS Algorithm Justification: Primary Survey “C” dictates immediate
control of external hemorrhage before fluid resuscitation; tourniquet is
indicated for arterial bleeding not stopped by direct pressure.
• Distractor Analysis: B is secondary after bleeding controlled; C is
Secondary Survey; D is appropriate only after hemorrhage control and
continued shock.
Item ID: ATLS-10-V2-004
Scenario: A 42-year-old restrained driver in head-on collision. Airbag deployed.
Alert, complains of severe chest pain. HR 110, BP 90/60, RR 26, SpO₂ 92 %.
Paradoxical motion of right chest wall, multiple rib fractures palpable, seat -belt
sign across chest.
Question: What is the PRIORITY intervention?
Options:
A. Endotracheal intubation
B. Intercostal nerve blocks
C. Chest X-ray
D. Epidural analgesia
(Correct Choice: A)
Rationale (Verified | ATLS 10th Ed. 2026/2027):
• Correct Answer: A
• ATLS Algorithm Justification: Flail chest with respiratory failure (SpO₂ <
94 %, increased work) requires airway control and mechanical ventilation
per ATLS 10th Edition.
• Distractor Analysis: B & D are analgesic adjuncts but do not address
oxygenation failure; C is diagnostic and Secondary Survey.
Item ID: ATLS-10-V2-005
Scenario: A 55-year-old falls 20 ft from roof. Alert, GCS 15. HR 104, BP 100/70,
RR 24, SpO₂ 95 %. Severe epigastric bruising, LUQ tenderness. FAST positive in
spleno-renal pouch; no free fluid elsewhere.
Question: What is the MOST appropriate next step?
