ATLS POST TEST 4 LATEST VERSIONS REAL EXAM
160 QUESTIONS AND CORRECT ANSWERS |A+ GRADE
"A trauma patient presents to your emergency department with inspiratory stridor and a suspected c-
spine injury. Oxygen saturation is 88% on high-flow oxygen via a nonrebreathing mask. The most
appropriate next step is to: - CORRECT ANSWER restrict cervical motion and establish a definitive
airway"
"A 22-year-old female athlete is stabbed in her left chest at the third interspace in the anterior axillary
line. On admission to the emergency department and 15 minutes after the incident, she is awake and
alert. Her heart rate is 100 beats per minute, blood pressure 80/60 mm Hg, and respiratory rate 20 breaths
per minute. A chest x-ray reveals a large left hemothorax. A left chest tube is placed with an immediate
return of 1600 mL of blood. The next management step for this patient is: - CORRECT ANSWER prepare
for an exploratory thoracotomy"
"The most effective method of monitoring the success of resuscitation during CPR? - CORRECT ANSWER
Reactivity of pupils to light"
"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 - CORRECT ANSWER C. Take him to the OR"
"Which of the following is the least preferred method of administering IV fluids?
A. Cubital veins
B. Cephalic veins
C. Subclavian veins
D. Saphenous vein - CORRECT ANSWER Subclavian veins"
"A patient is found unconscious after a fire in his bedroom. He is found to have severe burns around his
face. What is the first aspect of treatment?
A. Tetanus toxoid
B. Cover the wound
C. Airway
D. Obtain blood work - CORRECT ANSWER C. Airway"
"Which is true regarding cervical spine fractures?
A. Seen most commonly in elderly females
1|Page
,B. Athletic activities are the most common cause
C. Falls are the most common cause
D. Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours - CORRECT
ANSWER D. Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours"
"The laryngeal mask airway is contraindicated in patients with what condition?
A. Spine injury
B. Head trauma
C. Giving birth
D. Propensity to aspirate - CORRECT ANSWER D. Propensity to aspirate"
"What does a carotid pulse indicate?
A. A functioning pump for blood flow
B. The circulating blood volume is reaching end organs
C. Diastolic blood pressure
D. None of the above - CORRECT ANSWER B. The circulating blood volume is reaching end organs"
“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: - CORRECT
ANSWER 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: - CORRECT ANSWER complete spine x-ray series"
"In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
CORRECT ANSWER secure the airway"
"The physiological hypervolemia of pregnancy has clinical significance in the management of the severely
injured, gravid woman by: - CORRECT ANSWER increasing the volume of blood loss to produce maternal
hypotension"
"The best assessment of fluid resuscitation of the adult burn patient is: - CORRECT ANSWER urinary
output of 0.5 mL/kg/hr"
"The diagnosis of shock must include: - CORRECT ANSWER evidence of inadequate organ perfusion"
2|Page
,"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: - CORRECT ANSWER direct pressure on the wound"
"For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: -
CORRECT ANSWER cerebral vasoconstriction with diminished perfusion"
"Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? -
CORRECT ANSWER Leakage of amniotic fluid is an indication for hospital admission."
"The first maneuver to improve oxygenation after chest injury is: - CORRECT ANSWER 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: - CORRECT ANSWER
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: - CORRECT
ANSWER 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? - CORRECT ANSWER respiratory rate of 40 breaths per minute"
"The most important, immediate step in the management of an open pneumothorax is: - CORRECT
ANSWER placement of an occlusive dressing over the wound"
"The following are contraindications for tetanus toxoid administration: - CORRECT ANSWER 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? -
CORRECT ANSWER breath sounds"
"Bronchial intubation of the right or left mainstem bronchus can easily occur during infant endotracheal
intubation because: - CORRECT ANSWER The trachea is relatively short."
3|Page
, "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: - CORRECT ANSWER 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: - CORRECT ANSWER 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? - CORRECT ANSWER 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? - CORRECT
ANSWER 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? - CORRECT ANSWER 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
ecchymotic. He has gurgling respirations and vomitus on his face and clothing. The most appropriate step
after providing supplemental oxygen and elevating his jaw is to: - CORRECT ANSWER suction the
oropharynx"
"A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small community
hospital no surgical capabilities are available. In the emergency department, a chest tube is inserted and
700 mL of blood is evacuated. The trauma center accepts the patient in transfer. Just before the patient
is placed in the ambulance for transfer, his blood pressure decreases to 80/68 mm Hg and his heart rate
increases to 136 beats per minute. The next step should be to: - CORRECT ANSWER repeat the primary
survey and proceed with transfer"
"A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small hospital without
surgical capabilities. He has a closed head injury with a GCS score of 13. He has a widened mediastinum
4|Page
160 QUESTIONS AND CORRECT ANSWERS |A+ GRADE
"A trauma patient presents to your emergency department with inspiratory stridor and a suspected c-
spine injury. Oxygen saturation is 88% on high-flow oxygen via a nonrebreathing mask. The most
appropriate next step is to: - CORRECT ANSWER restrict cervical motion and establish a definitive
airway"
"A 22-year-old female athlete is stabbed in her left chest at the third interspace in the anterior axillary
line. On admission to the emergency department and 15 minutes after the incident, she is awake and
alert. Her heart rate is 100 beats per minute, blood pressure 80/60 mm Hg, and respiratory rate 20 breaths
per minute. A chest x-ray reveals a large left hemothorax. A left chest tube is placed with an immediate
return of 1600 mL of blood. The next management step for this patient is: - CORRECT ANSWER prepare
for an exploratory thoracotomy"
"The most effective method of monitoring the success of resuscitation during CPR? - CORRECT ANSWER
Reactivity of pupils to light"
"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 - CORRECT ANSWER C. Take him to the OR"
"Which of the following is the least preferred method of administering IV fluids?
A. Cubital veins
B. Cephalic veins
C. Subclavian veins
D. Saphenous vein - CORRECT ANSWER Subclavian veins"
"A patient is found unconscious after a fire in his bedroom. He is found to have severe burns around his
face. What is the first aspect of treatment?
A. Tetanus toxoid
B. Cover the wound
C. Airway
D. Obtain blood work - CORRECT ANSWER C. Airway"
"Which is true regarding cervical spine fractures?
A. Seen most commonly in elderly females
1|Page
,B. Athletic activities are the most common cause
C. Falls are the most common cause
D. Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours - CORRECT
ANSWER D. Methylprednisolone should not be used in associated spinal cord injury in the first 48 hours"
"The laryngeal mask airway is contraindicated in patients with what condition?
A. Spine injury
B. Head trauma
C. Giving birth
D. Propensity to aspirate - CORRECT ANSWER D. Propensity to aspirate"
"What does a carotid pulse indicate?
A. A functioning pump for blood flow
B. The circulating blood volume is reaching end organs
C. Diastolic blood pressure
D. None of the above - CORRECT ANSWER B. The circulating blood volume is reaching end organs"
“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: - CORRECT
ANSWER 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: - CORRECT ANSWER complete spine x-ray series"
"In managing a patient with a severe traumatic brain injury, the most important initial step is to: -
CORRECT ANSWER secure the airway"
"The physiological hypervolemia of pregnancy has clinical significance in the management of the severely
injured, gravid woman by: - CORRECT ANSWER increasing the volume of blood loss to produce maternal
hypotension"
"The best assessment of fluid resuscitation of the adult burn patient is: - CORRECT ANSWER urinary
output of 0.5 mL/kg/hr"
"The diagnosis of shock must include: - CORRECT ANSWER evidence of inadequate organ perfusion"
2|Page
,"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: - CORRECT ANSWER direct pressure on the wound"
"For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: -
CORRECT ANSWER cerebral vasoconstriction with diminished perfusion"
"Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? -
CORRECT ANSWER Leakage of amniotic fluid is an indication for hospital admission."
"The first maneuver to improve oxygenation after chest injury is: - CORRECT ANSWER 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: - CORRECT ANSWER
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: - CORRECT
ANSWER 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? - CORRECT ANSWER respiratory rate of 40 breaths per minute"
"The most important, immediate step in the management of an open pneumothorax is: - CORRECT
ANSWER placement of an occlusive dressing over the wound"
"The following are contraindications for tetanus toxoid administration: - CORRECT ANSWER 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? -
CORRECT ANSWER breath sounds"
"Bronchial intubation of the right or left mainstem bronchus can easily occur during infant endotracheal
intubation because: - CORRECT ANSWER The trachea is relatively short."
3|Page
, "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: - CORRECT ANSWER 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: - CORRECT ANSWER 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? - CORRECT ANSWER 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? - CORRECT
ANSWER 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? - CORRECT ANSWER 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
ecchymotic. He has gurgling respirations and vomitus on his face and clothing. The most appropriate step
after providing supplemental oxygen and elevating his jaw is to: - CORRECT ANSWER suction the
oropharynx"
"A 22-year-old man sustains a gunshot wound to the left chest and is transported to a small community
hospital no surgical capabilities are available. In the emergency department, a chest tube is inserted and
700 mL of blood is evacuated. The trauma center accepts the patient in transfer. Just before the patient
is placed in the ambulance for transfer, his blood pressure decreases to 80/68 mm Hg and his heart rate
increases to 136 beats per minute. The next step should be to: - CORRECT ANSWER repeat the primary
survey and proceed with transfer"
"A 64-year-old man involved in a high-speed car crash, is resuscitated initially in a small hospital without
surgical capabilities. He has a closed head injury with a GCS score of 13. He has a widened mediastinum
4|Page
