ATLS Practice Test 7
1. A patient with significant facial trauma is deteriorating quickly. Which is the most appropriate
immediate action for securing the airway?
a. Perform rapid sequence intubation (RSI) with in-line cervical spine stabilization
b. Attempt blind nasal intubation
c. Wait for imaging before intubating
d. Intubate only when SpO₂ drops below 90%
e. Use a supraglottic airway and defer definitive airway
2. A patient presents after a motor vehicle crash with decreased vision in the left eye. Exam shows a
teardrop-shaped pupil pointing toward a scleral laceration, subconjunctival hemorrhage 360°, and
extrusion of intraocular contents. What is the best immediate management?
a. apply a pressure dressing and send to CT scan
b. shield the eye and give broad-spectrum IV antibiotics
c. irrigate with copious saline
d. measure intraocular pressure
e. dilate the pupil for fundus exam
3. Which scenario demonstrates failure to apply ATLS principles?
a. securing the airway before imaging
b. placing a chest tube before CT scan in tension pneumothorax
c. deferring airway management until history is complete
d. initiating fluids for shock during primary survey
e. immobilizing spine before transfer
4. Which is the appropriate action during the Disability (D) step of primary survey?
a. full ophthalmic exam
b. head CT
c. Full spine films
d. GCS assessment and pupil check
e. psychiatric evaluation
5. Where should a chest tube be inserted for hemothorax or pneumothorax?
a. 2nd intercostal space, midclavicular line
b. 5th intercostal space, midaxillary line
c. 6th intercostal space, parasternal line
d. 4th intercostal space, midclavicular line
e. 8th intercostal space, posterior axillary line
1
, 6. Which of the following findings in a burn patient mandates early intubation?
a. singed nasal hairs only
b. hoarseness and stridor
c. mild facial burns without airway symptoms
d. blistering of extremities
e. carbonaceous sputum without distress
7. A victim of an explosion presents with dyspnea, hemoptysis, and decreased breath sounds on the
right. What is the most likely injury?
a. primary blast lung injury (pulmonary barotrauma)
b. secondary injury from shrapnel
c. tertiary injury from body displacement
d. quaternary injury from burns
e. rib fractures
8. In trauma patients, hypothermia contributes to the lethal triad. What is the primary effect of
hypothermia?
a. worsens myocardial contractility
b. causes hypercoagulability
c. impairs coagulation and platelet function
d. increases the oxygen demand of tissues
e. causes metabolic alkalosis
9. Following a pelvic fracture, which genitourinary injury is most likely?
a. pre-prostatic urethra
b. prostatic urethra
c. membranous urethra
d. Spongy (penile) urethra
e. bladder
10. A hemodynamically unstable adult with penetrating abdominal trauma arrives in the ED. There
is no obvious exsanguinating hemorrhage, and airway and breathing are controlled. FAST reveals
free fluid. According to ATLS principles, what is the most appropriate next step in management?
a. CT scan of the abdomen
b. diagnostic peritoneal lavage
c. laparotomy
d. observation with serial clinical exams
e. angiographic embolization
2
1. A patient with significant facial trauma is deteriorating quickly. Which is the most appropriate
immediate action for securing the airway?
a. Perform rapid sequence intubation (RSI) with in-line cervical spine stabilization
b. Attempt blind nasal intubation
c. Wait for imaging before intubating
d. Intubate only when SpO₂ drops below 90%
e. Use a supraglottic airway and defer definitive airway
2. A patient presents after a motor vehicle crash with decreased vision in the left eye. Exam shows a
teardrop-shaped pupil pointing toward a scleral laceration, subconjunctival hemorrhage 360°, and
extrusion of intraocular contents. What is the best immediate management?
a. apply a pressure dressing and send to CT scan
b. shield the eye and give broad-spectrum IV antibiotics
c. irrigate with copious saline
d. measure intraocular pressure
e. dilate the pupil for fundus exam
3. Which scenario demonstrates failure to apply ATLS principles?
a. securing the airway before imaging
b. placing a chest tube before CT scan in tension pneumothorax
c. deferring airway management until history is complete
d. initiating fluids for shock during primary survey
e. immobilizing spine before transfer
4. Which is the appropriate action during the Disability (D) step of primary survey?
a. full ophthalmic exam
b. head CT
c. Full spine films
d. GCS assessment and pupil check
e. psychiatric evaluation
5. Where should a chest tube be inserted for hemothorax or pneumothorax?
a. 2nd intercostal space, midclavicular line
b. 5th intercostal space, midaxillary line
c. 6th intercostal space, parasternal line
d. 4th intercostal space, midclavicular line
e. 8th intercostal space, posterior axillary line
1
, 6. Which of the following findings in a burn patient mandates early intubation?
a. singed nasal hairs only
b. hoarseness and stridor
c. mild facial burns without airway symptoms
d. blistering of extremities
e. carbonaceous sputum without distress
7. A victim of an explosion presents with dyspnea, hemoptysis, and decreased breath sounds on the
right. What is the most likely injury?
a. primary blast lung injury (pulmonary barotrauma)
b. secondary injury from shrapnel
c. tertiary injury from body displacement
d. quaternary injury from burns
e. rib fractures
8. In trauma patients, hypothermia contributes to the lethal triad. What is the primary effect of
hypothermia?
a. worsens myocardial contractility
b. causes hypercoagulability
c. impairs coagulation and platelet function
d. increases the oxygen demand of tissues
e. causes metabolic alkalosis
9. Following a pelvic fracture, which genitourinary injury is most likely?
a. pre-prostatic urethra
b. prostatic urethra
c. membranous urethra
d. Spongy (penile) urethra
e. bladder
10. A hemodynamically unstable adult with penetrating abdominal trauma arrives in the ED. There
is no obvious exsanguinating hemorrhage, and airway and breathing are controlled. FAST reveals
free fluid. According to ATLS principles, what is the most appropriate next step in management?
a. CT scan of the abdomen
b. diagnostic peritoneal lavage
c. laparotomy
d. observation with serial clinical exams
e. angiographic embolization
2
