ATLS PRACTICE EXAM QUESTIONS
WITH 100% CORRECT DETAILED
ANSWERS
Which of the following clinical signs is the most worrisome in a patient whom elevation
of ICP is a concern?
A. Tachycardia
B. Asymmetric pupils
C. Hypothermia
D. Decreased blood pressure - Answer-B. Asymmetric pupils
Battle sign - Answer-(Mastoid ecchymosis)
Etiology: fracture of middle cranial fossa of skull
Posterior auricular = artery that causes the bruising
A patient is on mechanical ventilator and his arterial blood gas reveals a PCO2 of 38
and a pH of 7.41. What is the appropriate next step?
A. Increase oxygen
B. Observe
C. Increase rate
D. Increase tidal volume - Answer-B. Observe
A trauma patient is receiving fluids at 150 cc/hr. He received two units of blood because
his initial hemoglobin was 7.3 g. After 4 hours, his urine output is 7 cc/hr and his central
venous pressure is 3 cm of water. What is the next step in his management?
A. Start furosemide drip
B. Start dopamine at renal dose
C. Administer 500 cc of NS bolus over 1 hour
D. Decrease the rate of fluid administration - Answer-C. Administer 500 cc of NS bolus
over 1 hour
A patient is placed on a heating blanket for hypothermia. It is most important to monitor
which of the following?
A. Vital signs
B. Neurologic status
C. Sensory deficits
D. Oxygenation - Answer-A. Vital signs
Principle that most closely aligns with the oath, "Do no harm." - Answer-Nonmaleficence
,Carbon monoxide poisoning - Answer-PE: cherry red skin
Hypersensitivity is most commonly reported after use of which type of suture?
A. Nylon
B. Stainless steel wire
C. Chromic catgut
D. Silk - Answer-C. Chromic catgut
A patient suffers a gunshot wound to the abdomen. She is stable and only complains of
mild pain at the site. On examination, she has mild rebound tenderness. Her WBC
count is 10, hematocrit is 31, and hemoglobin is 13.2. What is the next step in the
management of this patient?
A. Surgery
B. Abdominal CT
C. Abdominal Ultrasound
D. Rectal exam - Answer-B. Abdominal CT
First step taken to minimize thermal burn injury - Answer-Remove source of heat
Best assessment of fluid resuscitation of adult burn patient
A. Urine output of 0.5 mL/kg/hr
B. Normalization of BP
C. Normalization of HR
D. Measuring a normal central venous pressure
E. Providing 4mL/kg/% body burned/24 hours crystalloid fluid - Answer-A. urine output
of 0.5 mL/kg/hr
Facts concerning spine trauma - Answer--5% patients with brain injury have a spine
injury
-25% patients with spine injury have a brain injury
-33% of patients with upper c-spine injuries die at the scene
Which of the following local anesthetics has the longest duration of action?
A. Procaine (Novocaine)
B. Bupivacaine (Marcaine)
C. Mepivacaine (Carbocaine)
D. Lidocaine (Xylocaine) - Answer-B. Bupivacaine (Marcaine)
When the cephalic vein cut down is done in the deltopectoral groove, the vein is usually
found between the.... - Answer-Deltoid and pectoralis muscles
What is the most important factor in preventing accidental pool drowning?
A. Pool covers
B. Fences around pools
C. Swimming lessons
D. Parental supervision - Answer-D. Parental supervision
, Characteristics of early hemorrhagic shock - Answer-Cold skin
Slow capillary refill
Confusion
NOT bradycardia
A patient is thrown out of a car. He is hemodynamically stable, asymptomatic, and the
only finding is a right sided pneumothorax. What is the best treatment for this man?
A. Aspiration of pneumothorax
B. Monitor pneumothorax
C. CT scan
D. Placement of chest tube - Answer-D. Placement of chest tube
Important landmark for location of second rib - Answer-Sternal angle
Contributes to a low score on the Glasgow coma scale - Answer-Paralysis
Low blood sugar
Use of narcotics
Pericardiocentesis is done by needle insertion through which of the intercostal spaces?
- Answer-Fifth intercostal space
After a femur fracture, which of the following is LEAST likely?
A. Severe pain
B. Expanding hematoma
C. Severe nerve injury
D. Absent distal pulses - Answer-C. Severe nerve injury
Which of the following is no longer indicated for routine treatment of shock patients?
A. Cervical spine stabilization
B. Pneumatic anti-shock garment (PASG)
C. Endotracheal intubation
D. Oxygen - Answer-B. Pneumatic anti-shock garment (PASG)
A 13 year old boy fell while riding his bicycle and hit his head. He was unconscious for 4
or 5 minutes. He vomited twice. He has no memory of the event or a headache. His
exam is entirely normal. Glasgow coma score is 15. Select the next step in
management.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation - Answer-B. CT of the head
Cerebral edema treatment - Answer-Mannitol
Head up position
WITH 100% CORRECT DETAILED
ANSWERS
Which of the following clinical signs is the most worrisome in a patient whom elevation
of ICP is a concern?
A. Tachycardia
B. Asymmetric pupils
C. Hypothermia
D. Decreased blood pressure - Answer-B. Asymmetric pupils
Battle sign - Answer-(Mastoid ecchymosis)
Etiology: fracture of middle cranial fossa of skull
Posterior auricular = artery that causes the bruising
A patient is on mechanical ventilator and his arterial blood gas reveals a PCO2 of 38
and a pH of 7.41. What is the appropriate next step?
A. Increase oxygen
B. Observe
C. Increase rate
D. Increase tidal volume - Answer-B. Observe
A trauma patient is receiving fluids at 150 cc/hr. He received two units of blood because
his initial hemoglobin was 7.3 g. After 4 hours, his urine output is 7 cc/hr and his central
venous pressure is 3 cm of water. What is the next step in his management?
A. Start furosemide drip
B. Start dopamine at renal dose
C. Administer 500 cc of NS bolus over 1 hour
D. Decrease the rate of fluid administration - Answer-C. Administer 500 cc of NS bolus
over 1 hour
A patient is placed on a heating blanket for hypothermia. It is most important to monitor
which of the following?
A. Vital signs
B. Neurologic status
C. Sensory deficits
D. Oxygenation - Answer-A. Vital signs
Principle that most closely aligns with the oath, "Do no harm." - Answer-Nonmaleficence
,Carbon monoxide poisoning - Answer-PE: cherry red skin
Hypersensitivity is most commonly reported after use of which type of suture?
A. Nylon
B. Stainless steel wire
C. Chromic catgut
D. Silk - Answer-C. Chromic catgut
A patient suffers a gunshot wound to the abdomen. She is stable and only complains of
mild pain at the site. On examination, she has mild rebound tenderness. Her WBC
count is 10, hematocrit is 31, and hemoglobin is 13.2. What is the next step in the
management of this patient?
A. Surgery
B. Abdominal CT
C. Abdominal Ultrasound
D. Rectal exam - Answer-B. Abdominal CT
First step taken to minimize thermal burn injury - Answer-Remove source of heat
Best assessment of fluid resuscitation of adult burn patient
A. Urine output of 0.5 mL/kg/hr
B. Normalization of BP
C. Normalization of HR
D. Measuring a normal central venous pressure
E. Providing 4mL/kg/% body burned/24 hours crystalloid fluid - Answer-A. urine output
of 0.5 mL/kg/hr
Facts concerning spine trauma - Answer--5% patients with brain injury have a spine
injury
-25% patients with spine injury have a brain injury
-33% of patients with upper c-spine injuries die at the scene
Which of the following local anesthetics has the longest duration of action?
A. Procaine (Novocaine)
B. Bupivacaine (Marcaine)
C. Mepivacaine (Carbocaine)
D. Lidocaine (Xylocaine) - Answer-B. Bupivacaine (Marcaine)
When the cephalic vein cut down is done in the deltopectoral groove, the vein is usually
found between the.... - Answer-Deltoid and pectoralis muscles
What is the most important factor in preventing accidental pool drowning?
A. Pool covers
B. Fences around pools
C. Swimming lessons
D. Parental supervision - Answer-D. Parental supervision
, Characteristics of early hemorrhagic shock - Answer-Cold skin
Slow capillary refill
Confusion
NOT bradycardia
A patient is thrown out of a car. He is hemodynamically stable, asymptomatic, and the
only finding is a right sided pneumothorax. What is the best treatment for this man?
A. Aspiration of pneumothorax
B. Monitor pneumothorax
C. CT scan
D. Placement of chest tube - Answer-D. Placement of chest tube
Important landmark for location of second rib - Answer-Sternal angle
Contributes to a low score on the Glasgow coma scale - Answer-Paralysis
Low blood sugar
Use of narcotics
Pericardiocentesis is done by needle insertion through which of the intercostal spaces?
- Answer-Fifth intercostal space
After a femur fracture, which of the following is LEAST likely?
A. Severe pain
B. Expanding hematoma
C. Severe nerve injury
D. Absent distal pulses - Answer-C. Severe nerve injury
Which of the following is no longer indicated for routine treatment of shock patients?
A. Cervical spine stabilization
B. Pneumatic anti-shock garment (PASG)
C. Endotracheal intubation
D. Oxygen - Answer-B. Pneumatic anti-shock garment (PASG)
A 13 year old boy fell while riding his bicycle and hit his head. He was unconscious for 4
or 5 minutes. He vomited twice. He has no memory of the event or a headache. His
exam is entirely normal. Glasgow coma score is 15. Select the next step in
management.
A. Discharge home with concussion instructions
B. CT of the head
C. Skull films
D. Admit for observation - Answer-B. CT of the head
Cerebral edema treatment - Answer-Mannitol
Head up position
