ATLS COMPREHENSIVE STUDY GUIDE 2026
FULL ANSWERS GRADED A+
⩥ Class I hemorrhage indicates what percentage of blood loss? Answer:
10%
⩥ Which is not a clinical component of the Glasgow Coma Score?
A. Eye movement
B. Sensation
C. Verbal response
D. Extremity movement. Answer: B. Sensation
⩥ How should epinephrine should be injected for treatment of
anaphylaxis? Answer: Intramuscularly (IM) into vastus lateralis
⩥ How would a patient with a change in mental status would be triaged
using the simple triage and rapid treatment (START)?
A. Delayed
B. Immediate
C. Minor
D. Critical. Answer: B. Immediate
,⩥ 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
⩥ In head trauma, the majority of patients with post-traumatic CSF
otorrhea:
A. Need surgery
B. Should be started on antibiotics
C. Heal spontaneously
D. Develop meningitis Answer: C. Heal spontaneously
⩥ Uncal herniation Answer: PE: Biot breathing, dilated and fixed pupil
(out and down)
Nerves affected: 3rd, 4th, parasympathetic input
⩥ Laryngeal mask is usually seated over the which structure?
A. Tonsils
B. Esophagus
C. Vallecula
,D. Pyriform fossa Answer: D. Pyriform fossa
⩥ Patterns of injury seen in spinal cord trauma Answer: -Central cord
syndrome
-Anterior cord syndrome
-Brown-Sequard syndrome
⩥ Should be avoided in patient with suspected nasal fracture Answer:
Nasal intubation
⩥ What is the best way to evaluate a cardiac contusion?
A. CT scan of the chest
B. Echocardiogram
C. ECG monitoring x 24 hours
D. Cardiac enzymes Answer: C. ECG monitoring x 24 hours
⩥ Cerebral contusions Answer: May happen opposite to the point of
impact
⩥ An 18-year-old is thrown off his motorbike on a slippery road. At the
scene, what is the first priority in the management of this patient?
A. Assess vital signs
B. Stabilize cervical spine
, C. Assess airway
D. Start IV fluids Answer: C. Assess airway
⩥ Normal adult respiratory rate Answer: 12-20 breaths per minute
⩥ Scapular fracture Answer: -Usually requires a tremendous force to
fracture
-May be uneasily visible on plain xray
-Treatment requires prolonged immobilization
-Usually associated with other chest injuries
⩥ A patient suffers a stab wound to the chest. In the emergency room, he
is found to have an 80 percent pneumothorax with a midline shift of the
trachea to the contralateral chest. There is evidence of circulatory and
respiratory dysfunction. What is the next step in the management of this
patient?
A. Endotracheal tube
B. Fluid bolus
C. Epinephrine
D. 20 gauge needle Answer: D. 20 gauge needle
⩥ Flail chest Answer: Mediastinum is pulled toward affected side during
expiration
FULL ANSWERS GRADED A+
⩥ Class I hemorrhage indicates what percentage of blood loss? Answer:
10%
⩥ Which is not a clinical component of the Glasgow Coma Score?
A. Eye movement
B. Sensation
C. Verbal response
D. Extremity movement. Answer: B. Sensation
⩥ How should epinephrine should be injected for treatment of
anaphylaxis? Answer: Intramuscularly (IM) into vastus lateralis
⩥ How would a patient with a change in mental status would be triaged
using the simple triage and rapid treatment (START)?
A. Delayed
B. Immediate
C. Minor
D. Critical. Answer: B. Immediate
,⩥ 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
⩥ In head trauma, the majority of patients with post-traumatic CSF
otorrhea:
A. Need surgery
B. Should be started on antibiotics
C. Heal spontaneously
D. Develop meningitis Answer: C. Heal spontaneously
⩥ Uncal herniation Answer: PE: Biot breathing, dilated and fixed pupil
(out and down)
Nerves affected: 3rd, 4th, parasympathetic input
⩥ Laryngeal mask is usually seated over the which structure?
A. Tonsils
B. Esophagus
C. Vallecula
,D. Pyriform fossa Answer: D. Pyriform fossa
⩥ Patterns of injury seen in spinal cord trauma Answer: -Central cord
syndrome
-Anterior cord syndrome
-Brown-Sequard syndrome
⩥ Should be avoided in patient with suspected nasal fracture Answer:
Nasal intubation
⩥ What is the best way to evaluate a cardiac contusion?
A. CT scan of the chest
B. Echocardiogram
C. ECG monitoring x 24 hours
D. Cardiac enzymes Answer: C. ECG monitoring x 24 hours
⩥ Cerebral contusions Answer: May happen opposite to the point of
impact
⩥ An 18-year-old is thrown off his motorbike on a slippery road. At the
scene, what is the first priority in the management of this patient?
A. Assess vital signs
B. Stabilize cervical spine
, C. Assess airway
D. Start IV fluids Answer: C. Assess airway
⩥ Normal adult respiratory rate Answer: 12-20 breaths per minute
⩥ Scapular fracture Answer: -Usually requires a tremendous force to
fracture
-May be uneasily visible on plain xray
-Treatment requires prolonged immobilization
-Usually associated with other chest injuries
⩥ A patient suffers a stab wound to the chest. In the emergency room, he
is found to have an 80 percent pneumothorax with a midline shift of the
trachea to the contralateral chest. There is evidence of circulatory and
respiratory dysfunction. What is the next step in the management of this
patient?
A. Endotracheal tube
B. Fluid bolus
C. Epinephrine
D. 20 gauge needle Answer: D. 20 gauge needle
⩥ Flail chest Answer: Mediastinum is pulled toward affected side during
expiration
