ATLS 10th Edition Post Test 2025:
Actual Questions & Verified Answers |
100% Guaranteed Pass
Question 1: A 35-year-old male presents to the emergency department after a motor vehicle
collision. He is unresponsive with a GCS of 6. What is the FIRST step in the primary survey?
A. Assess for external hemorrhage B. Open the airway with a jaw-thrust maneuver C. Obtain
intravenous access D. Perform a FAST exam
Correct Answer: B Rationale: The first step in the primary survey is to assess and secure
the airway. A GCS of 6 indicates a severely compromised airway, and a jaw-thrust maneuver
is the safest initial method to open the airway without manipulating the cervical spine. Assessing
hemorrhage (A) and obtaining IV access (C) are important but secondary to airway
management. A FAST exam (D) is part of the secondary survey.
Question 2: A 28-year-old female is brought in after a motorcycle accident. She is tachypneic
with a respiratory rate of 32 breaths per minute and absent breath sounds on the right side of her
chest. What is the MOST likely diagnosis?
A. Simple pneumothorax B. Tension pneumothorax C. Hemothorax D. Pulmonary contusion
Correct Answer: B Rationale: Tachypnea and absent breath sounds on one side are
classic signs of a tension pneumothorax, which is a life-threatening condition requiring
immediate decompression. A simple pneumothorax (A) would not cause tachypnea of this
severity. Hemothorax (C) would present with dullness to percussion, and pulmonary contusion
(D) would not cause absent breath sounds.
Question 3: A 45-year-old male presents with a stab wound to the chest. He is hypotensive with
a blood pressure of 80/50 mmHg and has distended neck veins. What is the IMMEDIATE
intervention?
A. Chest X-ray B. Needle thoracostomy C. Intubation D. IV fluid resuscitation
,Correct Answer: B Rationale: The patient’s presentation is consistent with a tension
pneumothorax, which requires immediate needle thoracostomy to relieve the pressure and
restore venous return. A chest X-ray (A) would delay life-saving treatment. Intubation (C) and IV
fluid resuscitation (D) are secondary to addressing the tension pneumothorax.
Question 4: A 50-year-old male is brought in after a fall from a height. He is hypotensive with a
blood pressure of 70/40 mmHg and has a distended abdomen. What is the MOST likely source
of his hypotension?
A. Neurogenic shock B. Hemorrhagic shock C. Septic shock D. Cardiogenic shock
Correct Answer: B Rationale: The patient’s hypotension and distended abdomen suggest
intra-abdominal bleeding, leading to hemorrhagic shock. Neurogenic shock (A) would
present with bradycardia and warm extremities. Septic shock (C) and cardiogenic shock (D) are
less likely in this trauma scenario.
Question 5: A 30-year-old female presents with a gunshot wound to the thigh. She is
hemodynamically unstable with a blood pressure of 80/50 mmHg. What is the FIRST step in
managing her hemorrhage?
A. Apply a tourniquet B. Apply direct pressure C. Administer tranexamic acid (TXA) D. Obtain a
CT angiogram
Correct Answer: B Rationale: The first step in managing external hemorrhage is to apply
direct pressure to the wound. A tourniquet (A) is used if direct pressure fails. TXA (C) is
administered after hemorrhage control, and a CT angiogram (D) is not the first step in an
unstable patient.
Question 6: A 6-year-old child is brought in after a pedestrian versus automobile accident. He is
tachycardic with a heart rate of 150 bpm and has a distended abdomen. What is the MOST
appropriate initial fluid bolus?
A. 5 mL/kg of crystalloid B. 10 mL/kg of crystalloid C. 20 mL/kg of crystalloid D. 1 unit of packed
red blood cells
Correct Answer: C Rationale: In pediatric trauma, the initial fluid bolus is 20 mL/kg of
crystalloid to address hypovolemic shock. Smaller volumes (A, B) are inadequate for initial
resuscitation. Blood products (D) are typically administered after crystalloid resuscitation if the
child remains unstable.
,Question 7: A 60-year-old male presents after a ground-level fall. He is on warfarin and has a
large scalp hematoma. His INR is 4.5. What is the MOST appropriate management for his
anticoagulation?
A. Administer vitamin K B. Administer prothrombin complex concentrate (PCC) C. Administer
fresh frozen plasma (FFP) D. Observe and repeat INR in 6 hours
Correct Answer: B Rationale: In a patient on warfarin with an elevated INR and evidence of
bleeding, prothrombin complex concentrate (PCC) is the fastest and most effective way to
reverse anticoagulation. Vitamin K (A) takes hours to days to work. FFP (C) requires larger
volumes and takes longer to administer. Observation (D) is inappropriate in the setting of active
bleeding.
Question 8: A 25-year-old male presents with a gunshot wound to the chest. He is hypotensive
with a blood pressure of 70/40 mmHg and has muffled heart sounds. What is the MOST likely
diagnosis?
A. Tension pneumothorax B. Cardiac tamponade C. Hemothorax D. Aortic dissection
Correct Answer: B Rationale: The triad of hypotension, muffled heart sounds, and
distended neck veins is classic for cardiac tamponade (Beck’s triad). Tension pneumothorax
(A) would present with absent breath sounds and tracheal deviation. Hemothorax (C) would
present with dullness to percussion. Aortic dissection (D) is unlikely in this context.
Question 9: A 40-year-old female presents with a crush injury to her pelvis. She is hypotensive
with a blood pressure of 80/50 mmHg. What is the FIRST step in management?
A. Administer IV fluids B. Apply a pelvic binder C. Perform a FAST exam D. Obtain a CT scan of
the pelvis
Correct Answer: B Rationale: In a patient with a pelvic fracture and hypotension, the first
step is to apply a pelvic binder to stabilize the pelvis and reduce bleeding from the pelvic
venous plexus. IV fluids (A) are important but secondary to hemorrhage control. A FAST exam
(C) and CT scan (D) are useful but not the first steps.
Question 10: A 3-year-old child is brought in after a fall from a height. He is alert but refuses to
move his right arm. On examination, he has tenderness over the right clavicle. What is the
MOST likely diagnosis?
, A. Clavicle fracture B. Shoulder dislocation C. Humerus fracture D. Rotator cuff injury
Correct Answer: A Rationale: In a pediatric patient with tenderness over the clavicle after a
fall, a clavicle fracture is the most likely diagnosis. Shoulder dislocation (B) and humerus
fracture (C) are less common in this age group. Rotator cuff injury (D) is rare in children.
Question 11: A 35-year-old male presents with a stab wound to the neck. He is
hemodynamically stable but has an expanding hematoma. What is the NEXT step in
management?
A. CT angiography of the neck B. Exploratory surgery C. Observation and serial exams D.
Administer intravenous antibiotics
Correct Answer: B Rationale: An expanding hematoma in a patient with a neck stab wound
indicates ongoing bleeding, likely from a vascular injury. Exploratory surgery is required to
control the bleeding. CT angiography (A) may be useful in stable patients but is not the priority
here. Observation (C) is inappropriate in the setting of active bleeding. Antibiotics (D) are
secondary to controlling the hemorrhage.
Question 12: A 50-year-old male is brought in after a house fire. He has circumferential burns to
his chest and is wheezing. His SpO₂ is 88% on room air. What is the IMMEDIATE next step?
A. Administer 100% oxygen via non-rebreather mask B. Perform endotracheal intubation C.
Administer nebulized albuterol D. Perform escharotomy
Correct Answer: B Rationale: The patient’s circumferential burns to the chest and
wheezing indicate potential airway compromise due to inhalation injury and restrictive burns.
Endotracheal intubation is the immediate next step to secure the airway before swelling or
respiratory failure occurs. Oxygen (A) is important but does not secure the airway. Nebulized
albuterol (C) is not sufficient for securing the airway. Escharotomy (D) is indicated for
circumferential burns to prevent compartment syndrome but is secondary to airway
management.
Question 13: A 20-year-old male presents with a gunshot wound to the thigh. He is
hemodynamically stable, but the wound is actively bleeding. What is the FIRST step in
management?
A. Apply a tourniquet B. Apply direct pressure C. Administer intravenous fluids D. Obtain a CT
angiogram
Actual Questions & Verified Answers |
100% Guaranteed Pass
Question 1: A 35-year-old male presents to the emergency department after a motor vehicle
collision. He is unresponsive with a GCS of 6. What is the FIRST step in the primary survey?
A. Assess for external hemorrhage B. Open the airway with a jaw-thrust maneuver C. Obtain
intravenous access D. Perform a FAST exam
Correct Answer: B Rationale: The first step in the primary survey is to assess and secure
the airway. A GCS of 6 indicates a severely compromised airway, and a jaw-thrust maneuver
is the safest initial method to open the airway without manipulating the cervical spine. Assessing
hemorrhage (A) and obtaining IV access (C) are important but secondary to airway
management. A FAST exam (D) is part of the secondary survey.
Question 2: A 28-year-old female is brought in after a motorcycle accident. She is tachypneic
with a respiratory rate of 32 breaths per minute and absent breath sounds on the right side of her
chest. What is the MOST likely diagnosis?
A. Simple pneumothorax B. Tension pneumothorax C. Hemothorax D. Pulmonary contusion
Correct Answer: B Rationale: Tachypnea and absent breath sounds on one side are
classic signs of a tension pneumothorax, which is a life-threatening condition requiring
immediate decompression. A simple pneumothorax (A) would not cause tachypnea of this
severity. Hemothorax (C) would present with dullness to percussion, and pulmonary contusion
(D) would not cause absent breath sounds.
Question 3: A 45-year-old male presents with a stab wound to the chest. He is hypotensive with
a blood pressure of 80/50 mmHg and has distended neck veins. What is the IMMEDIATE
intervention?
A. Chest X-ray B. Needle thoracostomy C. Intubation D. IV fluid resuscitation
,Correct Answer: B Rationale: The patient’s presentation is consistent with a tension
pneumothorax, which requires immediate needle thoracostomy to relieve the pressure and
restore venous return. A chest X-ray (A) would delay life-saving treatment. Intubation (C) and IV
fluid resuscitation (D) are secondary to addressing the tension pneumothorax.
Question 4: A 50-year-old male is brought in after a fall from a height. He is hypotensive with a
blood pressure of 70/40 mmHg and has a distended abdomen. What is the MOST likely source
of his hypotension?
A. Neurogenic shock B. Hemorrhagic shock C. Septic shock D. Cardiogenic shock
Correct Answer: B Rationale: The patient’s hypotension and distended abdomen suggest
intra-abdominal bleeding, leading to hemorrhagic shock. Neurogenic shock (A) would
present with bradycardia and warm extremities. Septic shock (C) and cardiogenic shock (D) are
less likely in this trauma scenario.
Question 5: A 30-year-old female presents with a gunshot wound to the thigh. She is
hemodynamically unstable with a blood pressure of 80/50 mmHg. What is the FIRST step in
managing her hemorrhage?
A. Apply a tourniquet B. Apply direct pressure C. Administer tranexamic acid (TXA) D. Obtain a
CT angiogram
Correct Answer: B Rationale: The first step in managing external hemorrhage is to apply
direct pressure to the wound. A tourniquet (A) is used if direct pressure fails. TXA (C) is
administered after hemorrhage control, and a CT angiogram (D) is not the first step in an
unstable patient.
Question 6: A 6-year-old child is brought in after a pedestrian versus automobile accident. He is
tachycardic with a heart rate of 150 bpm and has a distended abdomen. What is the MOST
appropriate initial fluid bolus?
A. 5 mL/kg of crystalloid B. 10 mL/kg of crystalloid C. 20 mL/kg of crystalloid D. 1 unit of packed
red blood cells
Correct Answer: C Rationale: In pediatric trauma, the initial fluid bolus is 20 mL/kg of
crystalloid to address hypovolemic shock. Smaller volumes (A, B) are inadequate for initial
resuscitation. Blood products (D) are typically administered after crystalloid resuscitation if the
child remains unstable.
,Question 7: A 60-year-old male presents after a ground-level fall. He is on warfarin and has a
large scalp hematoma. His INR is 4.5. What is the MOST appropriate management for his
anticoagulation?
A. Administer vitamin K B. Administer prothrombin complex concentrate (PCC) C. Administer
fresh frozen plasma (FFP) D. Observe and repeat INR in 6 hours
Correct Answer: B Rationale: In a patient on warfarin with an elevated INR and evidence of
bleeding, prothrombin complex concentrate (PCC) is the fastest and most effective way to
reverse anticoagulation. Vitamin K (A) takes hours to days to work. FFP (C) requires larger
volumes and takes longer to administer. Observation (D) is inappropriate in the setting of active
bleeding.
Question 8: A 25-year-old male presents with a gunshot wound to the chest. He is hypotensive
with a blood pressure of 70/40 mmHg and has muffled heart sounds. What is the MOST likely
diagnosis?
A. Tension pneumothorax B. Cardiac tamponade C. Hemothorax D. Aortic dissection
Correct Answer: B Rationale: The triad of hypotension, muffled heart sounds, and
distended neck veins is classic for cardiac tamponade (Beck’s triad). Tension pneumothorax
(A) would present with absent breath sounds and tracheal deviation. Hemothorax (C) would
present with dullness to percussion. Aortic dissection (D) is unlikely in this context.
Question 9: A 40-year-old female presents with a crush injury to her pelvis. She is hypotensive
with a blood pressure of 80/50 mmHg. What is the FIRST step in management?
A. Administer IV fluids B. Apply a pelvic binder C. Perform a FAST exam D. Obtain a CT scan of
the pelvis
Correct Answer: B Rationale: In a patient with a pelvic fracture and hypotension, the first
step is to apply a pelvic binder to stabilize the pelvis and reduce bleeding from the pelvic
venous plexus. IV fluids (A) are important but secondary to hemorrhage control. A FAST exam
(C) and CT scan (D) are useful but not the first steps.
Question 10: A 3-year-old child is brought in after a fall from a height. He is alert but refuses to
move his right arm. On examination, he has tenderness over the right clavicle. What is the
MOST likely diagnosis?
, A. Clavicle fracture B. Shoulder dislocation C. Humerus fracture D. Rotator cuff injury
Correct Answer: A Rationale: In a pediatric patient with tenderness over the clavicle after a
fall, a clavicle fracture is the most likely diagnosis. Shoulder dislocation (B) and humerus
fracture (C) are less common in this age group. Rotator cuff injury (D) is rare in children.
Question 11: A 35-year-old male presents with a stab wound to the neck. He is
hemodynamically stable but has an expanding hematoma. What is the NEXT step in
management?
A. CT angiography of the neck B. Exploratory surgery C. Observation and serial exams D.
Administer intravenous antibiotics
Correct Answer: B Rationale: An expanding hematoma in a patient with a neck stab wound
indicates ongoing bleeding, likely from a vascular injury. Exploratory surgery is required to
control the bleeding. CT angiography (A) may be useful in stable patients but is not the priority
here. Observation (C) is inappropriate in the setting of active bleeding. Antibiotics (D) are
secondary to controlling the hemorrhage.
Question 12: A 50-year-old male is brought in after a house fire. He has circumferential burns to
his chest and is wheezing. His SpO₂ is 88% on room air. What is the IMMEDIATE next step?
A. Administer 100% oxygen via non-rebreather mask B. Perform endotracheal intubation C.
Administer nebulized albuterol D. Perform escharotomy
Correct Answer: B Rationale: The patient’s circumferential burns to the chest and
wheezing indicate potential airway compromise due to inhalation injury and restrictive burns.
Endotracheal intubation is the immediate next step to secure the airway before swelling or
respiratory failure occurs. Oxygen (A) is important but does not secure the airway. Nebulized
albuterol (C) is not sufficient for securing the airway. Escharotomy (D) is indicated for
circumferential burns to prevent compartment syndrome but is secondary to airway
management.
Question 13: A 20-year-old male presents with a gunshot wound to the thigh. He is
hemodynamically stable, but the wound is actively bleeding. What is the FIRST step in
management?
A. Apply a tourniquet B. Apply direct pressure C. Administer intravenous fluids D. Obtain a CT
angiogram
