ATLS Pretest questions and answers
2025\2026 A+ Grade
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood
pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to 122/84
mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest breath sounds with the return of a small
amount of blood and no air leak. After chest tube insertion, the most appropriate next step is: -
correct answer re-examine the chest
A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. In the
emergency department, he is alert, vital signs are normal, and he is complaining of severe pain in both
heels and his lower back. Lower extremity pulses are strong and there is no other deformity. The
suspected diagnosis is most likely to be confirmed by: -
correct answer complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? -
correct answer Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation.
In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
correct answer secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which one
of the following statements applies to this patient? -
correct answer An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
The physiological hypervolemia of pregnancy has clinical significance in the management of the severely
injured, gravid woman by: -
correct answer increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is: -
correct answer urinary output of 0.5 mL/kg/hr
, The diagnosis of shock must include: -
correct answer evidence of inadequate organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell
through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of: -
correct answer direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: -
correct answer cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has surgery
capabilities available.. Computed tomography of the chest and abdomen shows an aortic injury and
splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next step
is: -
correct answer perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? -
correct answer Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is: -
correct answer administer supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department. His
pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he does moan
periodically. His right arm is deformed and does not respond to pressure; however, his left hand reaches
purposefully toward the stimulus. Both legs are stiffly extended. His GCS score is: -
correct answer 9
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath, extremely
anxious, and yelling for help. Breath sounds are diminished in the right chest. The most appropriate first
step is to: -
correct answer perform needle or finger decompression of the right chest
2025\2026 A+ Grade
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His blood
pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to 122/84
mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per minute. A
tube thoracostomy is performed for decreased left chest breath sounds with the return of a small
amount of blood and no air leak. After chest tube insertion, the most appropriate next step is: -
correct answer re-examine the chest
A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. In the
emergency department, he is alert, vital signs are normal, and he is complaining of severe pain in both
heels and his lower back. Lower extremity pulses are strong and there is no other deformity. The
suspected diagnosis is most likely to be confirmed by: -
correct answer complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient? -
correct answer Evidence of improved perfusion after fluid resuscitation could include improvement in
Glasgow Coma Scale score on reevaluation.
In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
correct answer secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which one
of the following statements applies to this patient? -
correct answer An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
The physiological hypervolemia of pregnancy has clinical significance in the management of the severely
injured, gravid woman by: -
correct answer increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is: -
correct answer urinary output of 0.5 mL/kg/hr
, The diagnosis of shock must include: -
correct answer evidence of inadequate organ perfusion
A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell
through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of: -
correct answer direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: -
correct answer cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has surgery
capabilities available.. Computed tomography of the chest and abdomen shows an aortic injury and
splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next step
is: -
correct answer perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? -
correct answer Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is: -
correct answer administer supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department. His
pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he does moan
periodically. His right arm is deformed and does not respond to pressure; however, his left hand reaches
purposefully toward the stimulus. Both legs are stiffly extended. His GCS score is: -
correct answer 9
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath, extremely
anxious, and yelling for help. Breath sounds are diminished in the right chest. The most appropriate first
step is to: -
correct answer perform needle or finger decompression of the right chest
