ATLS MCQ TEST 1 L FINAL PAPER 2026 TEST
PAPER QUESTIONS AND SOLUTIONS GRADED
A+
◉ An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is
brought to the ED by his family. His vital signs are normal, but he
complains of left upper quadrant pain. An abdominal CT-scan reveals
a moderately severe laceration of the spleen. The receiving
institution does not have 24-hour-a-day operating room capabilities.
The most appropriate management of this patient would be to
A. Type and crossmatch for blood
B. Request consultation of a pediatrician
C. Transfer the patient to a trauma center
D. Admit the patient to the intensive care unit
E. Prepare the patient for surgery the next day. Answer: D. Admit the
patient to the intensive care unit
◉ Which of the following statements regarding injury to the central
nervous system in children is TRUE?
A. Children suffer spinal cord injury without x-ray abnormality more
commonly than adults.
B. An infant with a traumatic brain injury may become hypotensive
from cerebral edema
,C. Initial therapy for the child with traumatic brain injury includes
the administration of methylprednisolone intravenously
D. Children have more focal mass lesions as a result for traumatic
brain injury when compared to adults.
E. Young children are less tolerant of expanding intracranial mass
lesions than adults. Answer: A. Children suffer spinal cord injury
without x-ray abnormality more commonly than adults.
◉ A 17-year-old helmeted motorcyclist is struck broadside by an
automobile at an intersection. He is unconscious at the scene with a
blood pressure of 140/90mmHg, heart rate of 90 beats per minute,
and respiratory rate of 22 breaths per minute. His respirations are
sonorous and deep. His GCS score is 6. Immobilization of the entire
patient may include the use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar. Answer: A. Air splints
◉ Twenty-seven patients are seriously injured in an aircraft accident
at a local airport. The basic principle of triage should be to:
A. Treat the most severely injured patients first
B. Establish a field triage area directed by a doctor
,C. Rapidly transport all patients to the nearest appropriate hospital
D. Treat the greatest number of patients in the shortest period of
time
E. Produce the greatest number of survivors based on available
resources. Answer: E. Produce the greatest number of survivors
based on available resources
◉ An electrician is eletrocuted by a downed power line after a
thunderstorm. He apparently made contact with the wire at the level
of the right mid thigh. In the ED, his vital signs are normal and no
dysrythmia is noted on ECG. On examination, there is an exit wound
on the bottom of the right foot. His urine is positive for blood by
dipstick but not RBCs are seen microscopically. Initial management
should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic muscle
E. Admission to the ICU for observation. Answer: B. Aggressive fluid
infusion - suspected rhabdomyolyse
◉ 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. Administer an osmotic diuretic
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: B. Prevent secondary brain injury
◉ To establish a diagnosis of shock,
A. Systolic blood pressure must be below 90mmHg
B. The presence of a closed head injury should be excluded
C. Acidosis should be present by arterial blood gas analysis
D. The patient must fail to respond to intravenous fluid infusion
E. Clinical evidence of inadequate organ perfusion must be present..
Answer: E. Clinical evidence of inadequate organ perfusion must be
present.
◉ A 32-year-old is brought to the hospital unconscious with severe
facial injuries and noisy respirations after an automobile collision. In
the ED, he has no apparent injury to the anterior aspect of his neck.
He suddenly becomes apneic, and attempted ventilation with a face
mask is unsuccessful. Examination of his mouth reveals a large
PAPER QUESTIONS AND SOLUTIONS GRADED
A+
◉ An 8-year-old boy falls 4,5 meters (15 feet) from a tree and is
brought to the ED by his family. His vital signs are normal, but he
complains of left upper quadrant pain. An abdominal CT-scan reveals
a moderately severe laceration of the spleen. The receiving
institution does not have 24-hour-a-day operating room capabilities.
The most appropriate management of this patient would be to
A. Type and crossmatch for blood
B. Request consultation of a pediatrician
C. Transfer the patient to a trauma center
D. Admit the patient to the intensive care unit
E. Prepare the patient for surgery the next day. Answer: D. Admit the
patient to the intensive care unit
◉ Which of the following statements regarding injury to the central
nervous system in children is TRUE?
A. Children suffer spinal cord injury without x-ray abnormality more
commonly than adults.
B. An infant with a traumatic brain injury may become hypotensive
from cerebral edema
,C. Initial therapy for the child with traumatic brain injury includes
the administration of methylprednisolone intravenously
D. Children have more focal mass lesions as a result for traumatic
brain injury when compared to adults.
E. Young children are less tolerant of expanding intracranial mass
lesions than adults. Answer: A. Children suffer spinal cord injury
without x-ray abnormality more commonly than adults.
◉ A 17-year-old helmeted motorcyclist is struck broadside by an
automobile at an intersection. He is unconscious at the scene with a
blood pressure of 140/90mmHg, heart rate of 90 beats per minute,
and respiratory rate of 22 breaths per minute. His respirations are
sonorous and deep. His GCS score is 6. Immobilization of the entire
patient may include the use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar. Answer: A. Air splints
◉ Twenty-seven patients are seriously injured in an aircraft accident
at a local airport. The basic principle of triage should be to:
A. Treat the most severely injured patients first
B. Establish a field triage area directed by a doctor
,C. Rapidly transport all patients to the nearest appropriate hospital
D. Treat the greatest number of patients in the shortest period of
time
E. Produce the greatest number of survivors based on available
resources. Answer: E. Produce the greatest number of survivors
based on available resources
◉ An electrician is eletrocuted by a downed power line after a
thunderstorm. He apparently made contact with the wire at the level
of the right mid thigh. In the ED, his vital signs are normal and no
dysrythmia is noted on ECG. On examination, there is an exit wound
on the bottom of the right foot. His urine is positive for blood by
dipstick but not RBCs are seen microscopically. Initial management
should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic muscle
E. Admission to the ICU for observation. Answer: B. Aggressive fluid
infusion - suspected rhabdomyolyse
◉ 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. Administer an osmotic diuretic
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: B. Prevent secondary brain injury
◉ To establish a diagnosis of shock,
A. Systolic blood pressure must be below 90mmHg
B. The presence of a closed head injury should be excluded
C. Acidosis should be present by arterial blood gas analysis
D. The patient must fail to respond to intravenous fluid infusion
E. Clinical evidence of inadequate organ perfusion must be present..
Answer: E. Clinical evidence of inadequate organ perfusion must be
present.
◉ A 32-year-old is brought to the hospital unconscious with severe
facial injuries and noisy respirations after an automobile collision. In
the ED, he has no apparent injury to the anterior aspect of his neck.
He suddenly becomes apneic, and attempted ventilation with a face
mask is unsuccessful. Examination of his mouth reveals a large
