ATLS EXAM COMPREHENSIVE EXAM SCRIPT
2026 SOLVED QUESTIONS FULL SOLUTION
◉ 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: Answer: complete spine x-ray series
◉ Which of the following is true regarding the initial resuscitation of
a trauma patient? 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: 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? 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: Answer: increasing the volume of blood loss to produce
maternal hypotension
◉ The best assessment of fluid resuscitation of the adult burn
patient is: Answer: urinary output of 0.5 mL/kg/hr
◉ The diagnosis of shock must include: 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: Answer:
direct pressure on the wound
◉ For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent: 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: Answer:
perform an exploratory laparotomy
,◉ Which one of the following statements regarding abdominal
trauma in the pregnant patient is TRUE? Answer: Leakage of
amniotic fluid is an indication for hospital admission.
◉ The first maneuver to improve oxygenation after chest injury is:
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: 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: Answer: perform
needle or finger decompression of the right chest
◉ Which one of the following findings in an adult is most likely to
require immediate management during the primary survey?
Answer: respiratory rate of 40 breaths per minute
, ◉ The most important, immediate step in the management of an
open pneumothorax is: Answer: placement of an occlusive dressing
over the wound
◉ The following are contraindications for tetanus toxoid
administration: Answer: history of neurological reaction or severe
hypersensitivity to the product
◉ A 56-year-old man is thrown violently against the steering wheel
of his truck during a motor vehicle crash. On arrival in the
emergency department he is diaphoretic and complaining of chest
pain. His blood pressure is 60/40 mm Hg and his respiratory rate is
40 breaths per minute. Which of the following best differentiates
cardiac tamponade from tension pneumothorax as the cause of his
hypotension? Answer: breath sounds
◉ Bronchial intubation of the right or left mainstem bronchus can
easily occur during infant endotracheal intubation because: Answer:
The trachea is relatively short.
◉ A 23-year-old man sustains 4 stab wounds to the upper right
chest during an altercation and is brought by ambulance to a
hospital that has full surgical capabilities. His wounds are all above
the nipple. He is endotracheally intubated, closed tube thoracostomy
is performed, fluid resuscitation is initiated through 2 large-caliber
IVs. FAST exam does not reveal intraabdominal injuries. His blood
pressure now is 60/0 mm Hg, heart rate is 160 beats per minute,
2026 SOLVED QUESTIONS FULL SOLUTION
◉ 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: Answer: complete spine x-ray series
◉ Which of the following is true regarding the initial resuscitation of
a trauma patient? 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: 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? 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: Answer: increasing the volume of blood loss to produce
maternal hypotension
◉ The best assessment of fluid resuscitation of the adult burn
patient is: Answer: urinary output of 0.5 mL/kg/hr
◉ The diagnosis of shock must include: 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: Answer:
direct pressure on the wound
◉ For the patient with severe traumatic brain injury, profound
hypocarbia should be avoided to prevent: 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: Answer:
perform an exploratory laparotomy
,◉ Which one of the following statements regarding abdominal
trauma in the pregnant patient is TRUE? Answer: Leakage of
amniotic fluid is an indication for hospital admission.
◉ The first maneuver to improve oxygenation after chest injury is:
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: 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: Answer: perform
needle or finger decompression of the right chest
◉ Which one of the following findings in an adult is most likely to
require immediate management during the primary survey?
Answer: respiratory rate of 40 breaths per minute
, ◉ The most important, immediate step in the management of an
open pneumothorax is: Answer: placement of an occlusive dressing
over the wound
◉ The following are contraindications for tetanus toxoid
administration: Answer: history of neurological reaction or severe
hypersensitivity to the product
◉ A 56-year-old man is thrown violently against the steering wheel
of his truck during a motor vehicle crash. On arrival in the
emergency department he is diaphoretic and complaining of chest
pain. His blood pressure is 60/40 mm Hg and his respiratory rate is
40 breaths per minute. Which of the following best differentiates
cardiac tamponade from tension pneumothorax as the cause of his
hypotension? Answer: breath sounds
◉ Bronchial intubation of the right or left mainstem bronchus can
easily occur during infant endotracheal intubation because: Answer:
The trachea is relatively short.
◉ A 23-year-old man sustains 4 stab wounds to the upper right
chest during an altercation and is brought by ambulance to a
hospital that has full surgical capabilities. His wounds are all above
the nipple. He is endotracheally intubated, closed tube thoracostomy
is performed, fluid resuscitation is initiated through 2 large-caliber
IVs. FAST exam does not reveal intraabdominal injuries. His blood
pressure now is 60/0 mm Hg, heart rate is 160 beats per minute,
