ATLS WRITTEN REVIEW A PRACTICE
EXAMINATION 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ What is the total body surface area involved in a burn to both lower
extremities?.
Answer: 36%
◍ A 40-year-old woman who was a restrained driver in a motor vehicle crash
is evaluated in the emergency department. She is hemodynamically normal
and found to be paraplegic at the level of T10. Which of the following are
true regarding her evaluation and management?.
Answer: Log rolling using 4 people is a safe approach to restrict spinal
motion when moving her.
◍ To prevent a surgical infection when is the best time to administer an
antibiotic?
A. 2-24 hrs before surgery
B. 1 hr before surgery
C. After the incision is made
D. During the procedure.
Answer: B. 1 hr before surgery
◍ Laryngeal mask is usually seated over the which structure?
A. Tonsils
B. Esophagus
C. Vallecula
D. Pyriform fossa.
Answer: D. Pyriform fossa
◍ The best assessment of fluid resuscitation of the adult burn patient is:.
, Answer: urinary output of 0.5 mL/kg/hr
◍ Can occur during massive blood transfusions.
Answer: -Dilutional thrombocytopenia-Hypocalcemia-Coagulation
abnormalitiesNOT hypokalemia
◍ 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
◍ Class I hemorrhage indicates what percentage of blood loss?.
Answer: 10%
◍ Class IV hemorrhage indicates what % blood loss.
Answer: 55%
◍ Appropriate site for insertion of a subclavian line.
Answer: -One centimeter inferior to the junctions of the middle and medial
third of the clavicle-One fingerbreadth lateral to the angle of the
clavicle-Inferior to the clavicle @ deltopectoral groove, lateral to the
midclavicular line
◍ Step in a patient diagnosed with tension pneumothorax.
Answer: 1. Needle decompression/ thoracotomy2. Chest tube
◍ What is the most common traumatic intracranial mass lesion?
A. Epidural hematoma
B. Gliocytoma
C. Subdural hematoma
D. Subarachnoid hemorrhage.
Answer: C. Subdural hematoma
◍ Which of the following is predominantly an iatrogenic complication?
A. Venous air embolism
, B. Deep venous thrombosis (DVT)
C. Venous thromboembolism
D. None of the above.
Answer: A. Venous air embolism
◍ The first maneuver to improve oxygenation after chest injury is:.
Answer: administer supplemental oxygen
◍ 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
◍ Management of a stable patient with kidney contusion.
Answer: Observation
◍ Total body surface area involved in a burn in an adult to the anterior chest
and abdomen.
Answer: 18%
◍ In a 66 year old intubated, comatose patient, what is one of the most
important information that one needs to obtain?
A. Organ donation status
B. Power of attorney
C. Lawyer
D. Driver's license.
Answer: B. Power of attorney
◍ A 33-year-old woman is involved in a head-on motor vehicle crash. It took
30 minutes to extricate her from the car. Upon arrival in the emergency
, department, her heart rate is 120 beats per minute, BP is 90/70 mm Hg,
respiratory rate is 16 breaths per minute, and her GCS score is 15.
Examination reveals bilaterally equal breath sounds, anterior chest wall
ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not
tender. Her pelvis is stable. Palpable distal pulses are found in all 4
extremities. Of the following, the most likely diagnosis is:.
Answer: cardiac tamponade
◍ What is the primary goal in the initial resuscitation of a cardiac arrest?
A. Renal perfusion
B. Limb perfusion
C. Myocardial perfusion
D. Brain perfusion.
Answer: D. Brain perfusion
◍ Cauda equina syndrome.
Answer: -Bilateral sciatica -Bowel dysfunction-Saddle sensory changes
◍ What occurs in patients developing a central herniation of the brain?
A. One sided paralysis
B. Pupillary constriction
C. Bilateral deterioration of functioning
D. Lower extremity paralysis.
Answer: C. Bilateral deterioration of functioning
◍ The diagnosis of shock must include:.
Answer: evidence of inadequate organ perfusion
◍ A trauma patient is receiving fluids at 150 cc/hr. He received two units of
blood because his initial hemoglobin was 7.3 g. After 4 hours, his urine
output is 7 cc/hr and his central venous pressure is 3 cm of water. What is
the next step in his management?
A. Start furosemide drip
B. Start dopamine at renal dose
C. Administer 500 cc of NS bolus over 1 hour
D. Decrease the rate of fluid administration.
EXAMINATION 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ What is the total body surface area involved in a burn to both lower
extremities?.
Answer: 36%
◍ A 40-year-old woman who was a restrained driver in a motor vehicle crash
is evaluated in the emergency department. She is hemodynamically normal
and found to be paraplegic at the level of T10. Which of the following are
true regarding her evaluation and management?.
Answer: Log rolling using 4 people is a safe approach to restrict spinal
motion when moving her.
◍ To prevent a surgical infection when is the best time to administer an
antibiotic?
A. 2-24 hrs before surgery
B. 1 hr before surgery
C. After the incision is made
D. During the procedure.
Answer: B. 1 hr before surgery
◍ Laryngeal mask is usually seated over the which structure?
A. Tonsils
B. Esophagus
C. Vallecula
D. Pyriform fossa.
Answer: D. Pyriform fossa
◍ The best assessment of fluid resuscitation of the adult burn patient is:.
, Answer: urinary output of 0.5 mL/kg/hr
◍ Can occur during massive blood transfusions.
Answer: -Dilutional thrombocytopenia-Hypocalcemia-Coagulation
abnormalitiesNOT hypokalemia
◍ 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
◍ Class I hemorrhage indicates what percentage of blood loss?.
Answer: 10%
◍ Class IV hemorrhage indicates what % blood loss.
Answer: 55%
◍ Appropriate site for insertion of a subclavian line.
Answer: -One centimeter inferior to the junctions of the middle and medial
third of the clavicle-One fingerbreadth lateral to the angle of the
clavicle-Inferior to the clavicle @ deltopectoral groove, lateral to the
midclavicular line
◍ Step in a patient diagnosed with tension pneumothorax.
Answer: 1. Needle decompression/ thoracotomy2. Chest tube
◍ What is the most common traumatic intracranial mass lesion?
A. Epidural hematoma
B. Gliocytoma
C. Subdural hematoma
D. Subarachnoid hemorrhage.
Answer: C. Subdural hematoma
◍ Which of the following is predominantly an iatrogenic complication?
A. Venous air embolism
, B. Deep venous thrombosis (DVT)
C. Venous thromboembolism
D. None of the above.
Answer: A. Venous air embolism
◍ The first maneuver to improve oxygenation after chest injury is:.
Answer: administer supplemental oxygen
◍ 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
◍ Management of a stable patient with kidney contusion.
Answer: Observation
◍ Total body surface area involved in a burn in an adult to the anterior chest
and abdomen.
Answer: 18%
◍ In a 66 year old intubated, comatose patient, what is one of the most
important information that one needs to obtain?
A. Organ donation status
B. Power of attorney
C. Lawyer
D. Driver's license.
Answer: B. Power of attorney
◍ A 33-year-old woman is involved in a head-on motor vehicle crash. It took
30 minutes to extricate her from the car. Upon arrival in the emergency
, department, her heart rate is 120 beats per minute, BP is 90/70 mm Hg,
respiratory rate is 16 breaths per minute, and her GCS score is 15.
Examination reveals bilaterally equal breath sounds, anterior chest wall
ecchymosis, and distended neck veins. Her abdomen is flat, soft, and not
tender. Her pelvis is stable. Palpable distal pulses are found in all 4
extremities. Of the following, the most likely diagnosis is:.
Answer: cardiac tamponade
◍ What is the primary goal in the initial resuscitation of a cardiac arrest?
A. Renal perfusion
B. Limb perfusion
C. Myocardial perfusion
D. Brain perfusion.
Answer: D. Brain perfusion
◍ Cauda equina syndrome.
Answer: -Bilateral sciatica -Bowel dysfunction-Saddle sensory changes
◍ What occurs in patients developing a central herniation of the brain?
A. One sided paralysis
B. Pupillary constriction
C. Bilateral deterioration of functioning
D. Lower extremity paralysis.
Answer: C. Bilateral deterioration of functioning
◍ The diagnosis of shock must include:.
Answer: evidence of inadequate organ perfusion
◍ A trauma patient is receiving fluids at 150 cc/hr. He received two units of
blood because his initial hemoglobin was 7.3 g. After 4 hours, his urine
output is 7 cc/hr and his central venous pressure is 3 cm of water. What is
the next step in his management?
A. Start furosemide drip
B. Start dopamine at renal dose
C. Administer 500 cc of NS bolus over 1 hour
D. Decrease the rate of fluid administration.
