POSTEST ATLS 2025 ACTUAL EXAM PAPER
2026 QUESTIONS WITH ANSWERS GRADED
A+
⩥ Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them. Answer: D. Presence of
deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidty) and loss of reflexes.
⩥ The primary indication for transferring A patient to a higher level
trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma.
Answer: C. Resource limitations as determined by the transferring
doctor
,⩥ A young man sustains a rifle wound to the mid-abdomen. He is
brought promptly to the ED by prehospital personnel. His skin is cool
and diaphoretic, and his systolic blood pressure is 58mmHg. Warmed
crystalloid fluids are initiated without improvement in his vital signs.
The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage. Answer: A. Laparotomy because of
hemodynamic abnormality
⩥ A 42-year-old man is trapped from the waist down beneath his
overturned tractor for several hours before medical assistance arrives.
He is awake and alert until just before arriving in the ED. He is now
unconscious and responds only to painful stimuli by moaning. His pupils
are 3mm in diameter and symmetrically reactive to light. Prehospital
personnel indicate that they have not seen the patient move either of his
lower extremities. On examination in the ED, no movement of his lower
extremities are detected, even in response to painful stimuli. The most
likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
,D. Intracerebral hemorrhage
E. Bilateral compartment syndrome. Answer: E. Bilateral compartment
syndrome
⩥ A 6-year-o boy is struck by an automobile and brought to the ED. He
is lethargic, but withdraws purposefully from painful stimuli. His blood
pressure is 90mmHg systolic, heart rate 140 beats per minute and his
respiratory rate is 36 breaths per minute. The preferred route of venous
access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein.
Answer: D. Percutaneous peripheral veins in the upper extremities
⩥ A young man sustains a gunshot wound to the abdomen and is brought
promptly to the ED by prehospital personnel. His skin is cool and
diaphoretic, and he is confused. His pulse is thready and his femoral
pulse is only weakly palpable. The definitive treatment in managing this
patient is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
, E. Infuse large volumes of intravenous crystalloid solutions.. Answer: C.
Control internal hemorrhage operatively
⩥ Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the
same as in adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg
Ringers Lactate. Answer: D. The absolute volume of blood loss required
to produce shock is the same as in adults
⩥ A 33-year-old man is struck by a car travelling at 56km/h (35mph). He
has obvious fractures of the left tibia near the knee, pain in the pelvic
area, and severe dyspnea. His heart rate is 182 beats per minute, and his
respiratory rate is 48 breaths per minute with no breath sounds heard in
the left chest. A tension pneumothorax is relieved by immediate needle
decompression and tube thoracostomy. Subsequently, his heart rate
decreases to 144 beats per minute, his respirartory rate decreases to 36
breaths per minute and his blood pressure is 81/53 mmHg. Warmed
Ringers lactate is adminstered intravenously. The next priority should be
to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
2026 QUESTIONS WITH ANSWERS GRADED
A+
⩥ Which of the following physical findings suggest a cause of
hypotension other than spinal cord injury?
A. Priapism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon reflexes
E. Ability to flex forearms but not extend them. Answer: D. Presence of
deep tendon reflexes. Spinal shock refers to loss of muscle toe
(flaccidty) and loss of reflexes.
⩥ The primary indication for transferring A patient to a higher level
trauma center is:
A. Unavailibility of surgeon or operating staff
B. Multiple system injuries, including severe head injury
C. Resource limitations as determined by the transferring doctor
D. Resource limitations as determined by the hospital administration
E. Widened mediastinum on chest x-ray following blunt trauma.
Answer: C. Resource limitations as determined by the transferring
doctor
,⩥ A young man sustains a rifle wound to the mid-abdomen. He is
brought promptly to the ED by prehospital personnel. His skin is cool
and diaphoretic, and his systolic blood pressure is 58mmHg. Warmed
crystalloid fluids are initiated without improvement in his vital signs.
The next, most appropriate, step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal lavage. Answer: A. Laparotomy because of
hemodynamic abnormality
⩥ A 42-year-old man is trapped from the waist down beneath his
overturned tractor for several hours before medical assistance arrives.
He is awake and alert until just before arriving in the ED. He is now
unconscious and responds only to painful stimuli by moaning. His pupils
are 3mm in diameter and symmetrically reactive to light. Prehospital
personnel indicate that they have not seen the patient move either of his
lower extremities. On examination in the ED, no movement of his lower
extremities are detected, even in response to painful stimuli. The most
likely cause for this finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
,D. Intracerebral hemorrhage
E. Bilateral compartment syndrome. Answer: E. Bilateral compartment
syndrome
⩥ A 6-year-o boy is struck by an automobile and brought to the ED. He
is lethargic, but withdraws purposefully from painful stimuli. His blood
pressure is 90mmHg systolic, heart rate 140 beats per minute and his
respiratory rate is 36 breaths per minute. The preferred route of venous
access in this patient is:
A. Percutaneous femoral vein cannulation
B. Cutdown on the saphenous vein at the ankle
C. Intraosseous catheter placement in the proximal tibia
D. Percutaneous peripheral veins in the upper extremities
E. Central venous access via the subclavian or internal jugular vein.
Answer: D. Percutaneous peripheral veins in the upper extremities
⩥ A young man sustains a gunshot wound to the abdomen and is brought
promptly to the ED by prehospital personnel. His skin is cool and
diaphoretic, and he is confused. His pulse is thready and his femoral
pulse is only weakly palpable. The definitive treatment in managing this
patient is to:
A. Administer O-negative blood
B. Apply external warming devices
C. Control internal hemorrhage operatively
D. Apply a pneumatic antishock garment (PASG)
, E. Infuse large volumes of intravenous crystalloid solutions.. Answer: C.
Control internal hemorrhage operatively
⩥ Regarding shock in the child, which of the following is FALSE?
A. Vital signs are age-related
B. Children have greater physiologic reserves than do adults
C. Tachycardia is the primary physiologic response to hypovolemia
D. The absolute volume of blood loss required to produce shock is the
same as in adults
E. An initial fluid bolus for resuscitation should approximate 20ml/kg
Ringers Lactate. Answer: D. The absolute volume of blood loss required
to produce shock is the same as in adults
⩥ A 33-year-old man is struck by a car travelling at 56km/h (35mph). He
has obvious fractures of the left tibia near the knee, pain in the pelvic
area, and severe dyspnea. His heart rate is 182 beats per minute, and his
respiratory rate is 48 breaths per minute with no breath sounds heard in
the left chest. A tension pneumothorax is relieved by immediate needle
decompression and tube thoracostomy. Subsequently, his heart rate
decreases to 144 beats per minute, his respirartory rate decreases to 36
breaths per minute and his blood pressure is 81/53 mmHg. Warmed
Ringers lactate is adminstered intravenously. The next priority should be
to:
A. Perform external fixation of the pelvis
B. Obtain abdominal and pelvic CT-scans
