ATLS EXAMINATION STUDY GUIDE 2026
COMPLETE QUESTIONS AND ANSWERS
◉ Reason epinephrine is added to local anesthetics.
Answer: Prolongs its action
◉ Used to treat high ICP.
Answer: Control BG
Hyperventilation (pCO2 30-35)
Elevate head of bed
Mannitol (osmotic diuretic)
Furosemide (loop diur.)
◉ Earliest symptom of local anesthetic toxicity.
Answer: Tongue and circumoral numbness
◉ 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 ER. 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
◉ An unrestrained driver involved in a high speed MVA is
transported by paramedics with c-spine precautions. GCS score is 7,
but there is no obvious trauma. Respirations are shallow, and BVM is
not providing adequate ventilation. Extremities are cool, and the
pulses are thready. Prior to rapid sequence intubation, what should
be done?
A. Brief neurologic examination
B. Immediate chin lift and jaw thrust maneuver
C. Assess all vital signs
D. Administer 4-5 quick tidal volume breaths with an FIO2 of 100%
using a bag mask ventilatory device.
Answer: D. Administer 4-5 quick tidal volume breaths with an FIO2
of 100% using a bag mask ventilatory device
◉ Which of the following is indicative of a kidney injury?
A. Ascites
B. Flank tenderness
C. Hematuria
,D. Hematemesis.
Answer: C. Hematuria
◉ Can occur during massive blood transfusions.
Answer: -Dilutional thrombocytopenia
-Hypocalcemia
-Coagulation abnormalities
NOT hypokalemia
◉ Which of the following most likely will result in a favorable
outcome in pediatric drowning?
A. Spontaneous circulation established in the ER
B. Core temperature in the ER <33ºC C. Return of spontaneous
circulation at the scene of the drowning
D. Reactive pupils at the scene of the drowning.
Answer: C. Return of spontaneous circulation at the scene of the
drowning
◉ Underlying pathophysiology of a decrease in urine output.
Answer: Compromised organ perfusion
, ◉ 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
◉ Battle sign.
Answer: (Mastoid ecchymosis)
Etiology: fracture of middle cranial fossa of skull
Posterior auricular = artery that causes the bruising
◉ A patient is on mechanical ventilator and his arterial blood gas
reveals a PCO2 of 38 and a pH of 7.41. What is the appropriate next
step?
A. Increase oxygen
B. Observe
C. Increase rate
D. Increase tidal volume.
COMPLETE QUESTIONS AND ANSWERS
◉ Reason epinephrine is added to local anesthetics.
Answer: Prolongs its action
◉ Used to treat high ICP.
Answer: Control BG
Hyperventilation (pCO2 30-35)
Elevate head of bed
Mannitol (osmotic diuretic)
Furosemide (loop diur.)
◉ Earliest symptom of local anesthetic toxicity.
Answer: Tongue and circumoral numbness
◉ 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 ER. 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
◉ An unrestrained driver involved in a high speed MVA is
transported by paramedics with c-spine precautions. GCS score is 7,
but there is no obvious trauma. Respirations are shallow, and BVM is
not providing adequate ventilation. Extremities are cool, and the
pulses are thready. Prior to rapid sequence intubation, what should
be done?
A. Brief neurologic examination
B. Immediate chin lift and jaw thrust maneuver
C. Assess all vital signs
D. Administer 4-5 quick tidal volume breaths with an FIO2 of 100%
using a bag mask ventilatory device.
Answer: D. Administer 4-5 quick tidal volume breaths with an FIO2
of 100% using a bag mask ventilatory device
◉ Which of the following is indicative of a kidney injury?
A. Ascites
B. Flank tenderness
C. Hematuria
,D. Hematemesis.
Answer: C. Hematuria
◉ Can occur during massive blood transfusions.
Answer: -Dilutional thrombocytopenia
-Hypocalcemia
-Coagulation abnormalities
NOT hypokalemia
◉ Which of the following most likely will result in a favorable
outcome in pediatric drowning?
A. Spontaneous circulation established in the ER
B. Core temperature in the ER <33ºC C. Return of spontaneous
circulation at the scene of the drowning
D. Reactive pupils at the scene of the drowning.
Answer: C. Return of spontaneous circulation at the scene of the
drowning
◉ Underlying pathophysiology of a decrease in urine output.
Answer: Compromised organ perfusion
, ◉ 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
◉ Battle sign.
Answer: (Mastoid ecchymosis)
Etiology: fracture of middle cranial fossa of skull
Posterior auricular = artery that causes the bruising
◉ A patient is on mechanical ventilator and his arterial blood gas
reveals a PCO2 of 38 and a pH of 7.41. What is the appropriate next
step?
A. Increase oxygen
B. Observe
C. Increase rate
D. Increase tidal volume.
