ATLS EXAM QUESTIONS REVIEW TEST
PAPER 2026 FULL SOLUTIONS GRADED A+
⩥ 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
⩥ Epidural hematoma
Answer: MC due to injury of Middle meningeal artery
Temporoparietal = area that has most epidural hematomas from trauma
-Can be intracranial or intraspinal (may follow LP)
,-Often associated with skull fractures
⩥ 7-year-old girl is found at the bottom of a swimming pool. Initially
she was in full arrest but after 5 minutes she showed sinus tachycardia
but no respiratory effort. Intubation was done in the field and cervical
collar placed. After transport to the emergency department she was
unresponsive with a blood pressure of 100/60 mmHg, pulse 105,
temperature 34.3C, and oxygen saturation 100%. The pupils were 3 mm
and sluggishly responsive to light. There is no response to pain. The
lungs show wheezing on the left and coarse breath sounds bilaterally.
The monitor shows sinus tachycardia. There is no rectal tone. Which of
the following should be the next step in management?
A. Cervical spine films and CT of the head B. Portable chest radiograph
C. Arterial blood gas
D. Right and left decubitus chest radiographs
Answer: A. Cervical spine films and CT of the head
⩥ Position patient should be transported in when patient complains of
neck pain and is 32 weeks pregnant
Answer: Supine on a backboard with her right hip elevated
⩥ Air embolism
Answer: PE: murmur, petechiae, desaturation
Tx: turn patient on left side in Trendelenburg position
,⩥ Fat embolism
Answer: MCC = bone fx
Clinical presentation
-Fever
-Petechial hemorrhage
-Desaturation
-Hypotension
-Altered mental status
⩥ Cauda equina syndrome
Answer: -Bilateral sciatica
-Bowel dysfunction
-Saddle sensory changes
⩥ At what point should hyper oxygenation be administered when
performing tracheal suctioning on a mechanically ventilated patient?
A. Before the procedure
B. After the procedure
C. Before and after the procedure
D. During the procedure
, Answer: C. Before and after the procedure
⩥ Nerve to muscle relationship
Answer: C5 - Deltoid
C6 - Wrist extension
C7 - Elbow extension
⩥ Most common cause of kidney injuries
Answer: Motor vehicle accidents
⩥ Crystalloid solutions
Answer: Ringer's lactate
Dextrose 5%
D5W plus 1/2 NS
NOT albumin
⩥ Indication for emergency thoracotomy
A. Pulmonary contusion
B. Flail chest
C. Hemothorax with initial blood loss of 700 cc
D. Lung collapse with an air leak
PAPER 2026 FULL SOLUTIONS GRADED A+
⩥ 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
⩥ Epidural hematoma
Answer: MC due to injury of Middle meningeal artery
Temporoparietal = area that has most epidural hematomas from trauma
-Can be intracranial or intraspinal (may follow LP)
,-Often associated with skull fractures
⩥ 7-year-old girl is found at the bottom of a swimming pool. Initially
she was in full arrest but after 5 minutes she showed sinus tachycardia
but no respiratory effort. Intubation was done in the field and cervical
collar placed. After transport to the emergency department she was
unresponsive with a blood pressure of 100/60 mmHg, pulse 105,
temperature 34.3C, and oxygen saturation 100%. The pupils were 3 mm
and sluggishly responsive to light. There is no response to pain. The
lungs show wheezing on the left and coarse breath sounds bilaterally.
The monitor shows sinus tachycardia. There is no rectal tone. Which of
the following should be the next step in management?
A. Cervical spine films and CT of the head B. Portable chest radiograph
C. Arterial blood gas
D. Right and left decubitus chest radiographs
Answer: A. Cervical spine films and CT of the head
⩥ Position patient should be transported in when patient complains of
neck pain and is 32 weeks pregnant
Answer: Supine on a backboard with her right hip elevated
⩥ Air embolism
Answer: PE: murmur, petechiae, desaturation
Tx: turn patient on left side in Trendelenburg position
,⩥ Fat embolism
Answer: MCC = bone fx
Clinical presentation
-Fever
-Petechial hemorrhage
-Desaturation
-Hypotension
-Altered mental status
⩥ Cauda equina syndrome
Answer: -Bilateral sciatica
-Bowel dysfunction
-Saddle sensory changes
⩥ At what point should hyper oxygenation be administered when
performing tracheal suctioning on a mechanically ventilated patient?
A. Before the procedure
B. After the procedure
C. Before and after the procedure
D. During the procedure
, Answer: C. Before and after the procedure
⩥ Nerve to muscle relationship
Answer: C5 - Deltoid
C6 - Wrist extension
C7 - Elbow extension
⩥ Most common cause of kidney injuries
Answer: Motor vehicle accidents
⩥ Crystalloid solutions
Answer: Ringer's lactate
Dextrose 5%
D5W plus 1/2 NS
NOT albumin
⩥ Indication for emergency thoracotomy
A. Pulmonary contusion
B. Flail chest
C. Hemothorax with initial blood loss of 700 cc
D. Lung collapse with an air leak
