ATLS Practice Test 8
1. A resuscitation team fails to recognize worsening shock because each member is focused only on
their specific task. What best describes this failure?
a. Task fixation due to cognitive overload
b. Poor leadership delegation
c. Inadequate resource allocation
d. Lack of structured briefing
e. Failure of situational awareness
2. A 17-year-old male with severe TBI (GCS 5, fixed left pupil) arrives at a rural emergency
department. Intubation is successful, and vital signs are stable on ventilator support. CT scan
confirms a large subdural hematoma. The nearest neurosurgical facility is 4 hours away. Which of
the following is the priority during transfer preparation?
a. Hyperventilate to PaCO₂ <25 mmHg before transfer
b. Ensure sedation and paralysis for transport
c. Insert an ICP monitor to guide resuscitation
d. Administer mannitol or hypertonic saline as indicated
e. Delay transfer to place arterial and central venous lines
3. A 35-year-old construction worker falls 6 meters. He has bilateral calcaneal fractures. What
additional injury should be suspected?
a. Cervical spine fracture
b. Thoracic aortic injury
c. Lumbar spine fracture
d. Pelvic fracture
e. Liver rupture
4. A 37-year-old man after blunt trauma has a GCS of 7. Which statement is most accurate?
a. Definitive airway control is indicated
b. Intubation should be delayed until CT scan is complete
c. Only supplemental O₂ is required
d. Observation with serial neurological checks is appropriate
e. Hyperventilation is the first-line of therapy
5. A 29-year-old man presents after a stab wound to the left chest. He is tachycardic and
hypotensive. Chest tube is placed, draining 1,600 mL of blood immediately. What is the most
appropriate next step?
1
, a. Continue tube thoracostomy and observe output
b. Autotransfuse the blood and continue resuscitation
c. Urgent thoracotomy
d. CT scan of the chest
e. eFAST examination of the chest and abdomen
6. A 70-year-old man presents after a fall with rib fractures. He is on chronic opioids for back pain.
After initial resuscitation, he is hypoventilating with hypoxemia. What is the most important next
management priority?
a. Intubate immediately and transfer to ICU
b. Optimize multimodal pain control to facilitate pulmonary toilet
c. Start high-dose opioids to control pain
d. Administer prophylactic antibiotics for pneumonia prevention
e. Discharge if he maintains oxygen saturation >90% on room air
7. A 76-year-old woman presents with head trauma after a ground-level fall. She is alert and has no
focal neurological deficits. She is on apixaban for atrial fibrillation. CT shows a small subdural
hematoma. What is the next best step?
a. Discharge home with close family observation
b. Admit for observation and initiate anticoagulant reversal
c. Repeat CT scan in 24 hours without admission
d. Begin prophylactic hyperventilation to lower ICP
e. Schedule elective neurosurgical follow-up in 2 weeks
8. Which of the following best reflects adequate resuscitation in trauma patients?
a. Return of normal urine output (>0.5 mL/kg/hr)
b. Normal blood pressure
c. Resolution of tachycardia
d. Normal hematocrit
e. Normal ketones
9. A 45-year-old woman sustains burns to her entire right arm and entire back. Using the Rule of
Nines, what is the %TBSA burned?
a. 9%
b. 18%
c. 27%
d. 36%
e. 45%
2
1. A resuscitation team fails to recognize worsening shock because each member is focused only on
their specific task. What best describes this failure?
a. Task fixation due to cognitive overload
b. Poor leadership delegation
c. Inadequate resource allocation
d. Lack of structured briefing
e. Failure of situational awareness
2. A 17-year-old male with severe TBI (GCS 5, fixed left pupil) arrives at a rural emergency
department. Intubation is successful, and vital signs are stable on ventilator support. CT scan
confirms a large subdural hematoma. The nearest neurosurgical facility is 4 hours away. Which of
the following is the priority during transfer preparation?
a. Hyperventilate to PaCO₂ <25 mmHg before transfer
b. Ensure sedation and paralysis for transport
c. Insert an ICP monitor to guide resuscitation
d. Administer mannitol or hypertonic saline as indicated
e. Delay transfer to place arterial and central venous lines
3. A 35-year-old construction worker falls 6 meters. He has bilateral calcaneal fractures. What
additional injury should be suspected?
a. Cervical spine fracture
b. Thoracic aortic injury
c. Lumbar spine fracture
d. Pelvic fracture
e. Liver rupture
4. A 37-year-old man after blunt trauma has a GCS of 7. Which statement is most accurate?
a. Definitive airway control is indicated
b. Intubation should be delayed until CT scan is complete
c. Only supplemental O₂ is required
d. Observation with serial neurological checks is appropriate
e. Hyperventilation is the first-line of therapy
5. A 29-year-old man presents after a stab wound to the left chest. He is tachycardic and
hypotensive. Chest tube is placed, draining 1,600 mL of blood immediately. What is the most
appropriate next step?
1
, a. Continue tube thoracostomy and observe output
b. Autotransfuse the blood and continue resuscitation
c. Urgent thoracotomy
d. CT scan of the chest
e. eFAST examination of the chest and abdomen
6. A 70-year-old man presents after a fall with rib fractures. He is on chronic opioids for back pain.
After initial resuscitation, he is hypoventilating with hypoxemia. What is the most important next
management priority?
a. Intubate immediately and transfer to ICU
b. Optimize multimodal pain control to facilitate pulmonary toilet
c. Start high-dose opioids to control pain
d. Administer prophylactic antibiotics for pneumonia prevention
e. Discharge if he maintains oxygen saturation >90% on room air
7. A 76-year-old woman presents with head trauma after a ground-level fall. She is alert and has no
focal neurological deficits. She is on apixaban for atrial fibrillation. CT shows a small subdural
hematoma. What is the next best step?
a. Discharge home with close family observation
b. Admit for observation and initiate anticoagulant reversal
c. Repeat CT scan in 24 hours without admission
d. Begin prophylactic hyperventilation to lower ICP
e. Schedule elective neurosurgical follow-up in 2 weeks
8. Which of the following best reflects adequate resuscitation in trauma patients?
a. Return of normal urine output (>0.5 mL/kg/hr)
b. Normal blood pressure
c. Resolution of tachycardia
d. Normal hematocrit
e. Normal ketones
9. A 45-year-old woman sustains burns to her entire right arm and entire back. Using the Rule of
Nines, what is the %TBSA burned?
a. 9%
b. 18%
c. 27%
d. 36%
e. 45%
2
