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ATLS practice QUESTIONS AND ANSWERS A+ GRADED 100% VERIFIED 2025/2026
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ATLS practice QUESTIONS AND ANSWERS A+ GRADED 100% VERIFIED 2025/2026
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ATLS practice questions1. (*)Degree of burn that is characterized by bone involvement - ANSFourth
2. 37-year-old man is struck on the side of the head but is conscious and talkative after
the injury. No evidence of skull fracture. Several days later, he becomes increasingly
lethargic, somewhat confused, and unable to move his right side. Which type of
event has most likely occurred?
3. A. Subdural hematoma
4. B. Epidural hematoma
5. C. Carotid dissection
6. D. Brain contusion - ANSA. Subdural hematoma
7. 7-year-old girl is found at the bottom of a swimming pool. Initially she was in full
arrest but after 5 minutes she showed sinus tachycardia but no respiratory effort.
Intubation was done in the field and cervical collar placed. After transport to the
emergency department she was unresponsive with a blood pressure of 100/60
mmHg, pulse 105, temperature 34.3C, and oxygen saturation 100%. The pupils were
3 mm and sluggishly responsive to light. There is no response to pain. The lungs
show wheezing on the left and coarse breath sounds bilaterally. The monitor shows
sinus tachycardia. There is no rectal tone. Which of the following should be the next
step in management?
8. A. Cervical spine films and CT of the head B. Portable chest radiograph
9. C. Arterial blood gas
10. D. Right and left decubitus chest radiographs - ANSA. Cervical spine films and CT of
the head
11. 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.
12. A. Discharge home with concussion instructions
13. B. CT of the head
14. C. Skull films
15. D. Admit for observation - ANSB. CT of the head
16. A 17-year-old male is hit on the head with a baseball bat. He withdraws and opens
his eyes in response to deep painful stimuli. He also mumbles incomprehensibly.
What is his Glasgow coma scale score? - ANS8
17. A 18-year-old male sustains a right femur fracture and a cerebral concussion in a
motor vehicle accident. His initial blood pressure is 75/50 mmHg with a pulse of 90
beats per minute. After giving him 2 liters of Ringer lactate he stabilizes, but the
blood pressure falls when he is seen in the ER. Which of the following would be the
cause of suspected hypotension in this patient?
18. A. Subdural hematoma
19. B. Undiagnosed facial fracture
20. C. Ruptured spleen
21. D. 10% pneumothorax - ANSC. Ruptured spleen
,22. A 22-year-old man sustains a gunshot wound to the abdomen and presents with
shock. He requires multiple units of packed red blood cells during resuscitation. Later
he complains of numbness around his mouth. Physical exam reveals carpopedal
spasm and a positive Chvostek sign. An electrocardiogram demonstrates a
prolonged QT interval. Which of the following is the most appropriate treatment?
23. A. IV bicarbonate
24. B. IV furosemide
25. C. IV calcium
26. D. IV insulin - ANSC. IV calcium
27. 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?
28. A. Hemorrhagic shock
29. B. Acute adrenal insufficiency
30. C. Fat embolism syndrome
31. D. Transfusion reaction - ANSD. Transfusion reaction
32. A 28-year-old male was involved in a motor vehicle accident. He is stable. When he
is asked to sit up, the umbilicus moves up toward the neck area. What type of injury
can this indicate?
33. A. Rectus hematoma
34. B. Diastasis recti
35. C. T6-T10 spinal cord injury
36. D. Muscle spasms - ANSC. T6-T10 spinal cord injury
37. A 34-year-old with severe head trauma and elevated intracranial pressures is
intubated. Which of the following should be the target for mechanical ventilation? -
ANSSet PaCO2 between 30-35
38. 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?
39. A. Tachycardia
40. B. pulse volume
41. C. breath sounds
42. D. pulse pressure
43. E. jugular venous pressure - ANSC. breath sounds
44. A female is transported to the emergency department after a motor vehicle accident
with trauma to the left leg and back. Vital signs show temperature=37.1ºC, BP=
125/75 mm Hg, HR= 94, R=20. GCS is 15. There is paraplegia, T12 sensory level,
and decreased rectal tone. Hemoglobin is normal and stable at 1 hour. Which of the
following should be done to assess for intraperitoneal bleeding?
45. A. Diagnostic peritoneal lavage
46. B. CT of the abdomen
47. C. Abdominal ultrasound
48. D. Flat plate of the abdomen - ANSC. Abdominal ultrasound
, 49. A healthy 24-year-old is involved in a motor vehicle accident. He loses
consciousness but regains it within a few hours and appears normal to friends. He
later presents to the emergency room very lethargic, weak, and with a dilated pupil
on the left side. The patient most likely has which of the following conditions?
50. A. Acute subdural hematoma
51. B. Subarachnoid hemorrhage
52. C. Acute epidural hematoma
53. D. Intra-cerebral hemorrhage - ANSC. Acute epidural hematoma
54. A hemodynamically normal 10-year-old girl is hospitalized for observation after a
Grade III (moderately severe) splenic injury has been confirmed by computed
tomography (CT). Which of the following mandates prompt celiotomy (laparotomy)?
55. A. a serum amylase of 200
56. B. a leukocyte count of 14,000
57. C. evidence of retroperitoneal hematoma on CT scan
58. D. development of peritonitis on physical exam
59. E. a fall in the hemoglobin level from 12 g/dL to 8 g/dL over 24 hours - ANSD.
development of peritonitis on physical exam
60. A laceration of the neck superficial to the deep cervical fascia along the
sternocleidomastoid muscle at its midpoint would cause bleeding from which
structure? - ANSExternal jugular vein
61. A patient admitted with mild hypothermia is at risk to develop:
62. A. Atrial fibrillation
63. B. Ventricular tachycardia
64. C. Heart failure
65. D. Loss of their extremity - ANSA. Atrial fibrillation
66. A patient has been in a major MVA and is comatose. He has a high level of alcohol
and is hypothermic. Which of the following test can stand alone in certifying the
patient as brain dead?
67. A. Apnea test
68. B. Absence of oculocephalic and oculovestibular reflexes
69. C. Absence of blood flow on cerebral angiogram after warming
70. D. EEG - ANSC. Absence of blood flow on cerebral angiogram after warming
71. A patient injures his left arm and is found to have a transected nerve. Which is true
about this injury?
72. A. Nerves tend to recover and grow at a rate of 1 mm/day
73. B. The growing ends of the nerve can be located by EMG studies
74. C. All cut nerves should be immediately resutured
75. D. The neuromuscular junction end plates start to degenerate 2-3 weeks after the
nerve is transected - ANSA. Nerves tend to recover and grow at a rate of 1 mm/day
76. 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?
77. A. Pelvic fracture
78. B. Fracture of femur
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