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ATLS Clinical Scenarios & Verified Q-Bank (2025/2026) 300+ Practice Questions with Rationales for Trauma & Emergency Medicine

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This complete ATLS Q-bank contains over 300 board-level clinical questions, each paired with verified answers and concise rationales. Updated for 2025/2026, it mirrors the style of real trauma certification exams, making it ideal for students, residents, and emergency professionals. Core topics include airway management, hemorrhagic shock, neurotrauma, burns, obstetric trauma, and pediatric emergencies. You'll also find rapid decision-making logic for imaging, surgical triage, and resuscitation strategy. Includes trauma-focused algorithm tips, anatomic injury patterns, scoring systems (e.g., GCS, hemorrhage classes), and complications of common interventions. Built for fast recall and clinical accuracy, this document is perfect for ATLS prep, Step 2 CK, Step 3, EM rotations, or trauma call refreshers.

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,ATLS Clinical Scenarios & Verified Q-Bank
(2025/2026)
300+ Practice Questions with Rationales for
Trauma & Emergency Medicine
Assessed first in trauma patient

Airway

(*)Degree of burn that is characterized by bone involvement

Fourth

Complications of head trauma

Intracerebral hematoma
Extradural hematoma
Brain abscess

Most common cause of laryngotracheal stenosis

Trauma

Intervention that can help prevent development of acute renal failure

Infusion of normal saline

A 26-year-old male is resuscitated with blood transfusion after a motor vehicle collision that was
complicated by a fractured pelvis. A few hours later, the patient becomes febrile, hypotensive with a
normal CVP, and oliguric. Upon examination, the patient is found to be bleeding from the NG tube
and IV sites. Which of the following is the most likely diagnosis?
A. Hemorrhagic shock
B. Acute adrenal insufficiency
C. Fat embolism syndrome
D. Transfusion reaction

D. Transfusion reaction

Skin antiseptic

-Ethanol 70% is an effective skin antiseptic
-Acetic acid can be used to treat Gram- skin infections
-Salicylic acid is used to treat certain skin yeast infections

Class IV hemorrhage indicates what % blood loss

55%

,How does shivering affect body temperature

Increases body temperature

Class III hemorrhage indicates what % of blood loss

35%

Management of a stable patient with kidney contusion

Observation

Associated with hypovolemic shock

-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

The most effective method of monitoring the success of resuscitation during CPR?

Reactivity of pupils to light

Used to ensure correct placement of endotracheal tube

-Ultrasound
-Bilateral breath sounds
-Sustained end-tidal CO2

Total body surface area involved in a burn in an adult to the anterior chest and abdomen

18%

What is often caused by carotid massage?

Bradycardia

Step in a patient diagnosed with tension pneumothorax

1. Needle decompression/ thoracotomy
2. Chest tube

True statements regarding diaphragmatic injuries

-Blunt diaphragmatic injuries are usually associated with skeletal trauma
-Penetrating diaphragmatic injuries may be missed
-Repair of traumatic diaphragmatic injuries usually does not require prosthetic material

First priority in the treatment of an unconscious patient

Checking the pulse

, A patient involved in a road accident is brought to the emergency department in an unconscious state.
On arrival, her vitals show a temperature of 96.4 degrees Fahrenheit, a respiration rate of 24 breaths
per minute, a heart rate of 140 beats per minute, and a blood pressure of 80/40 mm Hg. She is cold,
shivering, and perspiring profusely. She has bilateral reactive pupils but she does not respond to pain.
On physical examination, she has no obvious sign of external bleeding. Which of the following cannot
be the cause of hypotension in this patient?
A. Pelvic fracture
B. Fracture of femur
C. Intracranial hemorrhage
D. Hemothorax

C. Intracranial hemorrhage

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

C. Take him to the OR

After abdominal injury, which of the following urinalysis findings would be an indication for further
testing?
A. 0-5 casts/HPF
B. 5-10 WBC/HPF
C. 10-20 RBC/HPF
D. Gross hematuria

D. Gross hematuria

A laceration of the neck superficial to the deep cervical fascia along the sternocleidomastoid muscle at
its midpoint would cause bleeding from which structure?

External jugular vein

Clinical features associated with tension pneumothorax

Unilateral decrease in breath sounds
Hyperresonance
Respiratory distress
Tachycardia
Tracheal shift
Desatruation
Decreased breath sounds
Decreased compliance
Asymmetric chest movement

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