POSTEST ATLS EXAM 2 FINAL STUDY GUIDE
2026 SOLVED QUESTIONS WITH FULL
SOLUTIONS
◉ The response to catecholamines in an injured, hypovolemic
pregnant woman can be expected to result in:
A. Placental abruption
B. Fetal hypoxia and distress
C. Fetal/maternal dysrhytmia
D. Improved uterine blood flow
E. Increased maternal renal blood flow. Answer: B. Fetal hypoxia and
distress
◉ A 22-year-old man sustains a gunshot wound to the left chest and
is transported to a small community hospital at which surgical
capabilites are not available. In the ED, a chest tube is inserted and
700ml of blood is evacuted. The trauma center accepts the patient in
transfer. Just before the patient is placed in an ambulance for
transfer, his blood pressure decreases to 80/68mmHg and his heart
rate increases to 136 beats per minute. The next step should be to:
A. Clamp the chest tube
B. Cancel the patients transfer
C. Perform an ED thoracotomy
,D. Repeat the primary survey and proceed with transfer
E. Delay the transfer until the referring doctor can contact a thoracic
surgeon.. Answer: D. Repeat the primary survey and proceed with
transfer
◉ A young woman sustains a severe head injury as the result of a
motor vehicular crash. In the ED, her GCS is 6. Her blood pressure is
140/90 mmHg and her heart rate 80 beats per minute. She is
intubated and is being mechanically ventilated. Her pupils are 3mm
in size and equally reactive to light. There is no other apparent
injury. The most important principle to follow in early management
of her head injury is to:
A. Avoid hypotension
B. Prevent secondary brain injury
C. Agressively treat systemic hypertension
D. Reduce meatbolic requirements of the brain
E. Distinguish between intracranial hematoma and cerebral edema..
Answer: A. Avoid hypotension
◉ A 6-year-old boy walking across the street is struck by the front
bumper of a sports utility vehicle traveling at 32kph (20mph).
Which one of the following statements is TRUE?
A. A flail chest is probable
B. A symptomatic cardiac contusion is expected
,C. A pulmonary contusion may be present in the absence of rib
fractures
D. Transection of the thoracic aorta is more likely than in an adult
patient
E. Rib fractures are commonly found in children with this
mechanism of injury. Answer: C. A pulmonary contusion may be
present in the absence of rib fractures
◉ A 39-year-old man is admitted to the ED after an automobile
collision. He is cyanotic, has insufficient respiratory effort, and has a
GCS score of 6. His full beard makes it difficult to fit the oxygen
facemask to his face. The most appropriate next step is to:
A. Perform a surgical cricothyroidotomy
B. Attempt nasotracheal intubation
C. Ventilate him with a bag-mask device until c-spine injury can be
excluded
D. Attempt orotracheal intubation using 2 people and inline
stabilization of the cervical spine
E. Ventilate the patient with a bag-mask device until his beard can be
shaved for a better mask fit.. Answer: D. Attempt orotracheal
intubation using 2 people and inline stabilization of the cervical
spine
◉ A patient is brought to the ED 20 minutes after a motor vehicle
crash. He is conscious and there is no obvious external trauma. He
, arrives at the hospital completely immobilized on a long spine
board. His blood pressure is 60/40mmHg and his heart rate is 70
beats per minute. His skin is warm. Which one of the following
statements is true?
A. Vasoactive medications have no role in the patients management
B. The hypotension should be managed with volume resuscitation
alone
C. Flexion and extension views on the c-spine should be performed
early
D. Occult abdominal visceral injuries can be excluded as a cause of
hypotension
E. Flaccidity of the lower extremities and loss of deep tendon
reflexes are expected.. Answer: E. Flaccidity of the lower extremities
and loss of deep tendon reflexes are expected.
◉ The following are contraindications for tetanus toxoid
administration:
A. History of neurological reaction or severe hypersensitivity to the
product
B. Local side effects
C. Muscular spasm
D. Pregnancy
E. All of the above. Answer: A. History of neurological reaction or
severe hypersensitivity to the product
2026 SOLVED QUESTIONS WITH FULL
SOLUTIONS
◉ The response to catecholamines in an injured, hypovolemic
pregnant woman can be expected to result in:
A. Placental abruption
B. Fetal hypoxia and distress
C. Fetal/maternal dysrhytmia
D. Improved uterine blood flow
E. Increased maternal renal blood flow. Answer: B. Fetal hypoxia and
distress
◉ A 22-year-old man sustains a gunshot wound to the left chest and
is transported to a small community hospital at which surgical
capabilites are not available. In the ED, a chest tube is inserted and
700ml of blood is evacuted. The trauma center accepts the patient in
transfer. Just before the patient is placed in an ambulance for
transfer, his blood pressure decreases to 80/68mmHg and his heart
rate increases to 136 beats per minute. The next step should be to:
A. Clamp the chest tube
B. Cancel the patients transfer
C. Perform an ED thoracotomy
,D. Repeat the primary survey and proceed with transfer
E. Delay the transfer until the referring doctor can contact a thoracic
surgeon.. Answer: D. Repeat the primary survey and proceed with
transfer
◉ A young woman sustains a severe head injury as the result of a
motor vehicular crash. In the ED, her GCS is 6. Her blood pressure is
140/90 mmHg and her heart rate 80 beats per minute. She is
intubated and is being mechanically ventilated. Her pupils are 3mm
in size and equally reactive to light. There is no other apparent
injury. The most important principle to follow in early management
of her head injury is to:
A. Avoid hypotension
B. Prevent secondary brain injury
C. Agressively treat systemic hypertension
D. Reduce meatbolic requirements of the brain
E. Distinguish between intracranial hematoma and cerebral edema..
Answer: A. Avoid hypotension
◉ A 6-year-old boy walking across the street is struck by the front
bumper of a sports utility vehicle traveling at 32kph (20mph).
Which one of the following statements is TRUE?
A. A flail chest is probable
B. A symptomatic cardiac contusion is expected
,C. A pulmonary contusion may be present in the absence of rib
fractures
D. Transection of the thoracic aorta is more likely than in an adult
patient
E. Rib fractures are commonly found in children with this
mechanism of injury. Answer: C. A pulmonary contusion may be
present in the absence of rib fractures
◉ A 39-year-old man is admitted to the ED after an automobile
collision. He is cyanotic, has insufficient respiratory effort, and has a
GCS score of 6. His full beard makes it difficult to fit the oxygen
facemask to his face. The most appropriate next step is to:
A. Perform a surgical cricothyroidotomy
B. Attempt nasotracheal intubation
C. Ventilate him with a bag-mask device until c-spine injury can be
excluded
D. Attempt orotracheal intubation using 2 people and inline
stabilization of the cervical spine
E. Ventilate the patient with a bag-mask device until his beard can be
shaved for a better mask fit.. Answer: D. Attempt orotracheal
intubation using 2 people and inline stabilization of the cervical
spine
◉ A patient is brought to the ED 20 minutes after a motor vehicle
crash. He is conscious and there is no obvious external trauma. He
, arrives at the hospital completely immobilized on a long spine
board. His blood pressure is 60/40mmHg and his heart rate is 70
beats per minute. His skin is warm. Which one of the following
statements is true?
A. Vasoactive medications have no role in the patients management
B. The hypotension should be managed with volume resuscitation
alone
C. Flexion and extension views on the c-spine should be performed
early
D. Occult abdominal visceral injuries can be excluded as a cause of
hypotension
E. Flaccidity of the lower extremities and loss of deep tendon
reflexes are expected.. Answer: E. Flaccidity of the lower extremities
and loss of deep tendon reflexes are expected.
◉ The following are contraindications for tetanus toxoid
administration:
A. History of neurological reaction or severe hypersensitivity to the
product
B. Local side effects
C. Muscular spasm
D. Pregnancy
E. All of the above. Answer: A. History of neurological reaction or
severe hypersensitivity to the product
