,ATLS Practice Test 2025–2026: 250 Verified
Exam Questions & Clinical Answers (Real Q-
Bank with Rationale).
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His
blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to
122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per
minute. A tube thoracostomy is performed for decreased left chest breath sounds with the return of a
small amount of blood and no air leak. After chest tube insertion, the most appropriate next step is:
re-examine the chest
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:
complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient?
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow Coma
Scale score on reevaluation.
In managing a patient with a severe traumatic brain injury, the most important initial step is to:
secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which
one of the following statements applies to this patient?
An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
The physiological hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by:
increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is:
urinary output of 0.5 mL/kg/hr
The diagnosis of shock must include:
evidence of inadequate organ perfusion
,A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell
through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of:
direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent:
cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has
surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic
injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT.
The next step is:
perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE?
Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is:
administer supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department. His
pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he does
moan periodically. His right arm is deformed and does not respond to pressure; however, his left hand
reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS score is:
9
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath, extremely
anxious, and yelling for help. Breath sounds are diminished in the right chest. The most appropriate
first step is to:
perform needle or finger decompression of the right chest
Which one of the following findings in an adult is most likely to require immediate management
during the primary survey?
respiratory rate of 40 breaths per minute
The most important, immediate step in the management of an open pneumothorax is:
placement of an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration:
history of neurological reaction or severe hypersensitivity to the product
, A 56-year-old man is thrown violently against the steering wheel of his truck during a motor vehicle
crash. On arrival in the emergency department he is diaphoretic and complaining of chest pain. His
blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per minute. Which of the
following best differentiates cardiac tamponade from tension pneumothorax as the cause of his
hypotension?
breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
endotracheal intubation because:
The trachea is relatively short.
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation and is
brought by ambulance to a hospital that has full surgical capabilities. His wounds are all above the
nipple. He is endotracheally intubated, closed tube thoracostomy is performed, fluid resuscitation is
initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal injuries. His blood
pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per
minute (ventilated with 100% O2). 1500 mL of blood has drained from the right chest. The most
appropriate next step in managing this patient is to:
urgently transfer the patient to the operating room
A 39-year-old man is admitted to the emergency department after an automobile collision. He is
cyanotic, has insufficient respiratory effort, and has a GCS score of 6. His full beard makes it difficult to
fit the oxygen facemask to his face. The most appropriate next step is to:
restrict cervical motion and attempt orotracheal intubation using 2 people
A patient is brought to the emergency department after a motor vehicle crash. He is conscious and
there is no obvious external trauma. He arrives at the hospital completely immobilized on a long spine
board. His blood pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. His skin is warm.
Which one of the following statements is TRUE?
Flaccidity of the lower extremities and loss of deep tendon reflexes are expected.
Which one of the following is the most effective method for initially treating frostbite?
moist heat
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he is
extricated. On arrival in the emergency department, his right lower extremity is cool, mottled,
insensate, and motionless. Despite normal vital signs, pulses cannot be palpated below the right
femoral artery and the muscles of the lower extremity are firm and hard. During the management of
this patient, which of the following is most likely to improve the chances for limb salvage?
surgical consultation for right lower extremity fasciotomy
A patient arrives in the emergency department after being beaten about the head and face with a
wooden club. He is comatose and has a palpable depressed skull fracture. His face is swollen and
Exam Questions & Clinical Answers (Real Q-
Bank with Rationale).
A 22-year-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder. His
blood pressure is initially 80/40 mm Hg. After initial fluid resuscitation his blood pressure increases to
122/84 mm Hg. His heart rate is now 100 beats per minute and his respiratory rate is 28 breaths per
minute. A tube thoracostomy is performed for decreased left chest breath sounds with the return of a
small amount of blood and no air leak. After chest tube insertion, the most appropriate next step is:
re-examine the chest
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:
complete spine x-ray series
Which of the following is true regarding the initial resuscitation of a trauma patient?
Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow Coma
Scale score on reevaluation.
In managing a patient with a severe traumatic brain injury, the most important initial step is to:
secure the airway
A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which
one of the following statements applies to this patient?
An ABG would demonstrate a base deficit between -6 and -10 mEq/L.
The physiological hypervolemia of pregnancy has clinical significance in the management of the
severely injured, gravid woman by:
increasing the volume of blood loss to produce maternal hypotension
The best assessment of fluid resuscitation of the adult burn patient is:
urinary output of 0.5 mL/kg/hr
The diagnosis of shock must include:
evidence of inadequate organ perfusion
,A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell
through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate
management of the wound should consist of:
direct pressure on the wound
For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent:
cerebral vasoconstriction with diminished perfusion
After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has
surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic
injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT.
The next step is:
perform an exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE?
Leakage of amniotic fluid is an indication for hospital admission.
The first maneuver to improve oxygenation after chest injury is:
administer supplemental oxygen
A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department. His
pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he does
moan periodically. His right arm is deformed and does not respond to pressure; however, his left hand
reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS score is:
9
A 20-year-old woman who is at 32 weeks gestation, is stabbed in the upper right chest. In the
emergency department, her blood pressure is 80/60 mm Hg. She is gasping for breath, extremely
anxious, and yelling for help. Breath sounds are diminished in the right chest. The most appropriate
first step is to:
perform needle or finger decompression of the right chest
Which one of the following findings in an adult is most likely to require immediate management
during the primary survey?
respiratory rate of 40 breaths per minute
The most important, immediate step in the management of an open pneumothorax is:
placement of an occlusive dressing over the wound
The following are contraindications for tetanus toxoid administration:
history of neurological reaction or severe hypersensitivity to the product
, A 56-year-old man is thrown violently against the steering wheel of his truck during a motor vehicle
crash. On arrival in the emergency department he is diaphoretic and complaining of chest pain. His
blood pressure is 60/40 mm Hg and his respiratory rate is 40 breaths per minute. Which of the
following best differentiates cardiac tamponade from tension pneumothorax as the cause of his
hypotension?
breath sounds
Bronchial intubation of the right or left mainstem bronchus can easily occur during infant
endotracheal intubation because:
The trachea is relatively short.
A 23-year-old man sustains 4 stab wounds to the upper right chest during an altercation and is
brought by ambulance to a hospital that has full surgical capabilities. His wounds are all above the
nipple. He is endotracheally intubated, closed tube thoracostomy is performed, fluid resuscitation is
initiated through 2 large-caliber IVs. FAST exam does not reveal intraabdominal injuries. His blood
pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per
minute (ventilated with 100% O2). 1500 mL of blood has drained from the right chest. The most
appropriate next step in managing this patient is to:
urgently transfer the patient to the operating room
A 39-year-old man is admitted to the emergency department after an automobile collision. He is
cyanotic, has insufficient respiratory effort, and has a GCS score of 6. His full beard makes it difficult to
fit the oxygen facemask to his face. The most appropriate next step is to:
restrict cervical motion and attempt orotracheal intubation using 2 people
A patient is brought to the emergency department after a motor vehicle crash. He is conscious and
there is no obvious external trauma. He arrives at the hospital completely immobilized on a long spine
board. His blood pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. His skin is warm.
Which one of the following statements is TRUE?
Flaccidity of the lower extremities and loss of deep tendon reflexes are expected.
Which one of the following is the most effective method for initially treating frostbite?
moist heat
A 32-year-old man's right leg is trapped beneath his overturned car for nearly 2 hours before he is
extricated. On arrival in the emergency department, his right lower extremity is cool, mottled,
insensate, and motionless. Despite normal vital signs, pulses cannot be palpated below the right
femoral artery and the muscles of the lower extremity are firm and hard. During the management of
this patient, which of the following is most likely to improve the chances for limb salvage?
surgical consultation for right lower extremity fasciotomy
A patient arrives in the emergency department after being beaten about the head and face with a
wooden club. He is comatose and has a palpable depressed skull fracture. His face is swollen and
