ATLS practice 2026 Questions With All the Correct Answers
Question: Assessed first in trauma patient
Answer: Airway
Rationale: The "A" in the primary ABCDE survey stands for Airway with
cervical spine protection. Establishing a patent airway is the immediate
priority because without oxygen, irreversible brain damage occurs
within minutes.
Question: Degree of burn that is characterized by bone involvement
Answer: Fourth degree
Rationale: Fourth-degree burns extend through the entire skin and
subcutaneous tissue, involving underlying structures such as muscle,
tendon, and bone.
Question: Complications of head trauma
Answer: Intracerebral hematoma, extradural hematoma, brain
abscess
Rationale: Head trauma can cause bleeding within the brain
parenchyma, between the dura and skull, or lead to delayed infection.
These complications increase intracranial pressure and cause
secondary brain injury.
,Question: Most common cause of laryngotracheal stenosis
Answer: Trauma
Rationale: Trauma, particularly prolonged endotracheal intubation or
tracheostomy, is the leading cause of acquired laryngotracheal
stenosis due to mucosal ischemia and subsequent scar formation.
Question: Intervention that can help prevent development of acute
renal failure
Answer: Infusion of normal saline
Rationale: Maintaining adequate intravascular volume with isotonic
crystalloids preserves renal perfusion and prevents prerenal azotemia
from progressing to established acute kidney injury.
Question: A 26-year-old male is resuscitated with blood transfusion
after a motor vehicle collision that was complicated by a fractured
pelvis. A few hours later, the patient becomes febrile, hypotensive with
a normal CVP, and oliguric. Upon examination, the patient is found to be
bleeding from the NG tube and IV sites. Which of the following is the
most likely diagnosis?
Answer: D. Transfusion reaction
Rationale: The triad of fever, hypotension with normal CVP, and
disseminated bleeding following transfusion is classic for transfusion
reaction. Disseminated intravascular coagulation often complicates
hemolytic transfusion reactions.
,Question: Skin antiseptic
Answer: -Ethanol 70% is an effective skin antiseptic
-Acetic acid can be used to treat Gram- skin infections
-Salicylic acid is used to treat certain skin yeast infections
Rationale: Ethanol denatures bacterial proteins. Acetic acid creates an
acidic environment unfavorable for Pseudomonas. Salicylic acid has
keratolytic and antifungal properties.
Question: Class IV hemorrhage indicates what percentage blood loss?
Answer: 55%
Rationale: Class IV hemorrhage represents exsanguinating blood loss
exceeding 55% of total blood volume. Patients present with profound
hypotension, absent peripheral pulses, and unconsciousness.
Question: How does shivering affect body temperature?
Answer: Increases body temperature
Rationale: Shivering generates heat through involuntary muscle
contractions. This thermogenic mechanism increases metabolic heat
production to combat hypothermia.
Question: Class III hemorrhage indicates what percentage of blood
loss?
Answer: 35%
Rationale: Class III hemorrhage involves 30-40% blood loss. Patients
exhibit significant hypotension, tachycardia, tachypnea, and marked
, mental status changes. Immediate fluid resuscitation and blood
transfusion are required.
Question: Management of a stable patient with kidney contusion
Answer: Observation
Rationale: Hemodynamically stable patients with isolated renal
contusions are managed non-operatively with bed rest, serial
hematocrit monitoring, and imaging follow-up. Most heal spontaneously
without intervention.
Question: Associated with hypovolemic shock
Answer: -Inadequate tissue perfusion with resultant tissue hypoxia
-Blood shunting to vital organs
-Decreased circulating blood volume and decreased venous return
-Low cardiac output
-Loss of less than 20% of the blood volume is usually without symptom
except for mild tachycardia
-Patients become orthostatic with losses between 20 and 40%
-Shock is evidenced by tachycardia, hypotension, oliguria, flat neck
veins
Rationale: Hypovolemic shock results from reduced intravascular
volume. Compensatory mechanisms include peripheral
vasoconstriction, tachycardia, and shunting of blood to preserve
perfusion to the heart and brain.
Question: Assessed first in trauma patient
Answer: Airway
Rationale: The "A" in the primary ABCDE survey stands for Airway with
cervical spine protection. Establishing a patent airway is the immediate
priority because without oxygen, irreversible brain damage occurs
within minutes.
Question: Degree of burn that is characterized by bone involvement
Answer: Fourth degree
Rationale: Fourth-degree burns extend through the entire skin and
subcutaneous tissue, involving underlying structures such as muscle,
tendon, and bone.
Question: Complications of head trauma
Answer: Intracerebral hematoma, extradural hematoma, brain
abscess
Rationale: Head trauma can cause bleeding within the brain
parenchyma, between the dura and skull, or lead to delayed infection.
These complications increase intracranial pressure and cause
secondary brain injury.
,Question: Most common cause of laryngotracheal stenosis
Answer: Trauma
Rationale: Trauma, particularly prolonged endotracheal intubation or
tracheostomy, is the leading cause of acquired laryngotracheal
stenosis due to mucosal ischemia and subsequent scar formation.
Question: Intervention that can help prevent development of acute
renal failure
Answer: Infusion of normal saline
Rationale: Maintaining adequate intravascular volume with isotonic
crystalloids preserves renal perfusion and prevents prerenal azotemia
from progressing to established acute kidney injury.
Question: A 26-year-old male is resuscitated with blood transfusion
after a motor vehicle collision that was complicated by a fractured
pelvis. A few hours later, the patient becomes febrile, hypotensive with
a normal CVP, and oliguric. Upon examination, the patient is found to be
bleeding from the NG tube and IV sites. Which of the following is the
most likely diagnosis?
Answer: D. Transfusion reaction
Rationale: The triad of fever, hypotension with normal CVP, and
disseminated bleeding following transfusion is classic for transfusion
reaction. Disseminated intravascular coagulation often complicates
hemolytic transfusion reactions.
,Question: Skin antiseptic
Answer: -Ethanol 70% is an effective skin antiseptic
-Acetic acid can be used to treat Gram- skin infections
-Salicylic acid is used to treat certain skin yeast infections
Rationale: Ethanol denatures bacterial proteins. Acetic acid creates an
acidic environment unfavorable for Pseudomonas. Salicylic acid has
keratolytic and antifungal properties.
Question: Class IV hemorrhage indicates what percentage blood loss?
Answer: 55%
Rationale: Class IV hemorrhage represents exsanguinating blood loss
exceeding 55% of total blood volume. Patients present with profound
hypotension, absent peripheral pulses, and unconsciousness.
Question: How does shivering affect body temperature?
Answer: Increases body temperature
Rationale: Shivering generates heat through involuntary muscle
contractions. This thermogenic mechanism increases metabolic heat
production to combat hypothermia.
Question: Class III hemorrhage indicates what percentage of blood
loss?
Answer: 35%
Rationale: Class III hemorrhage involves 30-40% blood loss. Patients
exhibit significant hypotension, tachycardia, tachypnea, and marked
, mental status changes. Immediate fluid resuscitation and blood
transfusion are required.
Question: Management of a stable patient with kidney contusion
Answer: Observation
Rationale: Hemodynamically stable patients with isolated renal
contusions are managed non-operatively with bed rest, serial
hematocrit monitoring, and imaging follow-up. Most heal spontaneously
without intervention.
Question: Associated with hypovolemic shock
Answer: -Inadequate tissue perfusion with resultant tissue hypoxia
-Blood shunting to vital organs
-Decreased circulating blood volume and decreased venous return
-Low cardiac output
-Loss of less than 20% of the blood volume is usually without symptom
except for mild tachycardia
-Patients become orthostatic with losses between 20 and 40%
-Shock is evidenced by tachycardia, hypotension, oliguria, flat neck
veins
Rationale: Hypovolemic shock results from reduced intravascular
volume. Compensatory mechanisms include peripheral
vasoconstriction, tachycardia, and shunting of blood to preserve
perfusion to the heart and brain.
