ATLS WRITTEN REVIEW A FINAL TEST
2026 QUESTIONS WITH CORRECT
ANSWERS GRADED A+
◍ 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?
A. Tachycardia
B. pulse volume
C. breath sounds
D. pulse pressure
E. jugular venous pressure.
Answer: C. breath sounds
◍ 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 C
T. The next step is:.
Answer: perform an exploratory laparotomy
◍ A 18-year-old male sustains a right femur fracture and a cerebral concussion
in a motor vehicle accident. His initial blood pressure is 75/50 mmHg with a
pulse of 90 beats per minute. After giving him 2 liters of Ringer lactate he
stabilizes, but the blood pressure falls when he is seen in the E
R. Which of the following would be the cause of suspected hypotension in
this patient?
, A. Subdural hematoma
B. Undiagnosed facial fracture
C. Ruptured spleen
D. 10% pneumothorax.
Answer: C. Ruptured spleen
◍ Air embolism.
Answer: PE: murmur, petechiae, desaturationTx: turn patient on left side in
Trendelenburg position
◍ Carbon monoxide poisoning.
Answer: PE: cherry red skin
◍ A patient suffered a slash to his right neck. The wound is over the
mid-portion of the sternocleidomastoid. There is a large hematoma and brisk
bleeding when uncovered. He is stable. What is the next step in
management?
A. Get an angiogram
B. Close the wound in the ER
C. Take him to the operating room
D. CT scan to evaluate neck structure.
Answer: C. Take him to the OR
◍ Associated with hypovolemic shock.
Answer: -Inadequate tissue perfusion with resultant tissue hypoxia-Blood
shunting to vital organs-Decreased circulating blood volume and decreased
venous return-Low cardiac output-Loss of less than 20% of the blood
volume is usually without symptom except for mild tachycardia -Patients
become orthostatic with losses between 20 and 40% -Shock is evidenced by
tachycardia, hypotension, oliguria, flat neck veins
◍ Pericardiocentesis is done by needle insertion through which of the
intercostal spaces?.
Answer: Fifth intercostal space
◍ Which of the following clinical signs is the most worrisome in a patient
, whom elevation of ICP is a concern?
A. Tachycardia
B. Asymmetric pupils
C. Hypothermia
D. Decreased blood pressure.
Answer: B. Asymmetric pupils
◍ Which statement is most accurate regarding a chest tube connected to a
water seal drainage system?
A. Bubbles in the water indicate that the chest tube is no longer needed
B. The water level should fall slightly with each spontaneous inspiration
C. The drainage system should be kept below the level of chest tube
insertion
D. The chest tube should be clamped at all times when the patient is
ambulatory.
Answer: C. The drainage system should be kept below the level of chest
tube insertion
◍ Which arterial blood gas finding is most suggestive of acute respiratory
failure?
A. PCO2= 50, PO2= 80
B. PCO2 =40, PO2=60
C. PCO2=60, PO2= 50
D. PCO2= 30, PO2=70.
Answer: C. PCO2=60, PO2= 50
◍ What is true about an unrestrained pregnant driver?
A. She is at increased risk of placenta previa
B. She is at increased risk of placental abruption
C. At 33 weeks, her fetus is well protected by an amniotic fluid cushion and
thus the pregnancy is not at risk
D. If the mother's vital signs are stable, complications are unlikely.
Answer: B. She is at increased risk of placental abruption
◍ Intervention that can help prevent development of acute renal failure.
, Answer: Infusion of normal saline
◍ How deep should the provider depress the patient's sternum during CPR in
adults?.
Answer: 2 to 3 inches
◍ Emergency decompression of the brain with a subdural hematoma should be
evacuated if there is a midline shift of what amount?
A. 1 mm
B. 2 mm
C. 5 mm
D. 10 mm.
Answer: C. 5 mm
◍ Which of the following is of no benefit for a patient who has just aspirated
during induction of anesthesia?
A. Nasogastric tube placement and suction
B. Bronchoscopy
C. Corticosteroids
D. Hydration.
Answer: C. Corticosteroids
◍ What is the most appropriate study for a patient who suffered a fall and
presents with acute cervical radiculopathy?
A. Cervical CT
B. Cervical MRI
C. Lateral C-spine radiograph
D. Myelogram.
Answer: B. Cervical MRI
◍ Which is true regarding cervical spine fractures?
A. Seen most commonly in elderly females
B. Athletic activities are the most common cause
C. Falls are the most common cause
D. Methylprednisolone should not be used in associated spinal cord injury in
the first 48 hours.
2026 QUESTIONS WITH CORRECT
ANSWERS GRADED A+
◍ 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?
A. Tachycardia
B. pulse volume
C. breath sounds
D. pulse pressure
E. jugular venous pressure.
Answer: C. breath sounds
◍ 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 C
T. The next step is:.
Answer: perform an exploratory laparotomy
◍ A 18-year-old male sustains a right femur fracture and a cerebral concussion
in a motor vehicle accident. His initial blood pressure is 75/50 mmHg with a
pulse of 90 beats per minute. After giving him 2 liters of Ringer lactate he
stabilizes, but the blood pressure falls when he is seen in the E
R. Which of the following would be the cause of suspected hypotension in
this patient?
, A. Subdural hematoma
B. Undiagnosed facial fracture
C. Ruptured spleen
D. 10% pneumothorax.
Answer: C. Ruptured spleen
◍ Air embolism.
Answer: PE: murmur, petechiae, desaturationTx: turn patient on left side in
Trendelenburg position
◍ Carbon monoxide poisoning.
Answer: PE: cherry red skin
◍ A patient suffered a slash to his right neck. The wound is over the
mid-portion of the sternocleidomastoid. There is a large hematoma and brisk
bleeding when uncovered. He is stable. What is the next step in
management?
A. Get an angiogram
B. Close the wound in the ER
C. Take him to the operating room
D. CT scan to evaluate neck structure.
Answer: C. Take him to the OR
◍ Associated with hypovolemic shock.
Answer: -Inadequate tissue perfusion with resultant tissue hypoxia-Blood
shunting to vital organs-Decreased circulating blood volume and decreased
venous return-Low cardiac output-Loss of less than 20% of the blood
volume is usually without symptom except for mild tachycardia -Patients
become orthostatic with losses between 20 and 40% -Shock is evidenced by
tachycardia, hypotension, oliguria, flat neck veins
◍ Pericardiocentesis is done by needle insertion through which of the
intercostal spaces?.
Answer: Fifth intercostal space
◍ Which of the following clinical signs is the most worrisome in a patient
, whom elevation of ICP is a concern?
A. Tachycardia
B. Asymmetric pupils
C. Hypothermia
D. Decreased blood pressure.
Answer: B. Asymmetric pupils
◍ Which statement is most accurate regarding a chest tube connected to a
water seal drainage system?
A. Bubbles in the water indicate that the chest tube is no longer needed
B. The water level should fall slightly with each spontaneous inspiration
C. The drainage system should be kept below the level of chest tube
insertion
D. The chest tube should be clamped at all times when the patient is
ambulatory.
Answer: C. The drainage system should be kept below the level of chest
tube insertion
◍ Which arterial blood gas finding is most suggestive of acute respiratory
failure?
A. PCO2= 50, PO2= 80
B. PCO2 =40, PO2=60
C. PCO2=60, PO2= 50
D. PCO2= 30, PO2=70.
Answer: C. PCO2=60, PO2= 50
◍ What is true about an unrestrained pregnant driver?
A. She is at increased risk of placenta previa
B. She is at increased risk of placental abruption
C. At 33 weeks, her fetus is well protected by an amniotic fluid cushion and
thus the pregnancy is not at risk
D. If the mother's vital signs are stable, complications are unlikely.
Answer: B. She is at increased risk of placental abruption
◍ Intervention that can help prevent development of acute renal failure.
, Answer: Infusion of normal saline
◍ How deep should the provider depress the patient's sternum during CPR in
adults?.
Answer: 2 to 3 inches
◍ Emergency decompression of the brain with a subdural hematoma should be
evacuated if there is a midline shift of what amount?
A. 1 mm
B. 2 mm
C. 5 mm
D. 10 mm.
Answer: C. 5 mm
◍ Which of the following is of no benefit for a patient who has just aspirated
during induction of anesthesia?
A. Nasogastric tube placement and suction
B. Bronchoscopy
C. Corticosteroids
D. Hydration.
Answer: C. Corticosteroids
◍ What is the most appropriate study for a patient who suffered a fall and
presents with acute cervical radiculopathy?
A. Cervical CT
B. Cervical MRI
C. Lateral C-spine radiograph
D. Myelogram.
Answer: B. Cervical MRI
◍ Which is true regarding cervical spine fractures?
A. Seen most commonly in elderly females
B. Athletic activities are the most common cause
C. Falls are the most common cause
D. Methylprednisolone should not be used in associated spinal cord injury in
the first 48 hours.
