CORRECT DETAILED ANSWERS 2025 VERIFIED

ATLS Post-Test Exam PRACTICE QUESTIONS AND

CORRECT DETAILED ANSWERS 2025 (VERIFIED

ANSWERS) LATEST UPDATE

• What is the first priority in the primary survey of trauma care?
• Assessing disability
• Securing the airway with cervical spine protection
• Controlling hemorrhage
• Evaluating exposure/environmental control

Answer: B) Securing the airway with cervical spine protection

Rationale: The primary survey follows the ABCDE approach: Airway, Breathing, Circulation, Disability, Exposure. Securing a patent airway with cervical spine protection is the first and most critical step to prevent hypoxia and secondary injury.

• Which of the following is the most reliable sign of tension pneumothorax?
• Hypotension and distended neck veins
• Decreased breath sounds on the affected side
• Subcutaneous emphysema
• Tachycardia and diaphoresis

Answer: A) Hypotension and distended neck veins

Rationale: Tension pneumothorax causes increased intrathoracic pressure,

compressing the great vessels, leading to decreased venous return, hypotension, 1 / 4

and distended neck veins. While decreased breath sounds are common, hypotension and jugular venous distension are more specific for tension.

• During the secondary survey, which imaging modality is preferred to evaluate

intra-abdominal injury in a hemodynamically stable patient?

• FAST (Focused Assessment with Sonography for Trauma)
• Diagnostic peritoneal lavage
• CT scan of the abdomen and pelvis
• Abdominal X-ray

Answer: C) CT scan of the abdomen and pelvis

Rationale: CT scan is the gold standard for detailed evaluation of abdominal

injuries in stable patients. FAST is quick and useful but less sensitive. Diagnostic peritoneal lavage is largely replaced by FAST and CT.

• Which of the following indicates a need for immediate chest decompression

in trauma?

• Simple pneumothorax without respiratory distress
• Open pneumothorax with bubbling at the wound
• Hemothorax with less than 500 mL blood on chest tube placement
• Tension pneumothorax with respiratory distress and hypotension

Answer: D) Tension pneumothorax with respiratory distress and hypotension

Rationale: Tension pneumothorax is a life-threatening emergency requiring

immediate decompression (needle thoracostomy followed by chest tube) to relieve pressure. Other options can be managed less emergently.

• What is the normal physiological response to hemorrhagic shock?
• Bradycardia and hypotension
• Tachycardia and peripheral vasoconstriction 2 / 4

• Hypertension and tachypnea
• Bradycardia and vasodilation

Answer: B) Tachycardia and peripheral vasoconstriction

Rationale: Hemorrhagic shock leads to decreased circulating volume; the body

responds with tachycardia to maintain cardiac output and peripheral vasoconstriction to preserve vital organ perfusion.

• Which of the following is NOT part of the ‘C’ (Circulation) assessment in the

primary survey?

• Control of hemorrhage
• Assessment of pulses
• Capillary refill
• Glasgow Coma Scale

Answer: D) Glasgow Coma Scale

Rationale: Glasgow Coma Scale is part of ‘D’ (Disability) assessment to evaluate neurological status. ‘C’ focuses on circulation including hemorrhage control, pulses, and perfusion indicators like capillary refill.

• Which is the correct order of steps in the primary survey?
• Airway, Breathing, Circulation, Disability, Exposure
• Breathing, Airway, Circulation, Disability, Exposure
• Circulation, Airway, Breathing, Disability, Exposure
• Airway, Circulation, Breathing, Disability, Exposure

Answer: A) Airway, Breathing, Circulation, Disability, Exposure

Rationale: The ATLS primary survey follows the ABCDE mnemonic to prioritize life- threatening issues systematically.

• A trauma patient with a flail chest is likely to present with: 3 / 4

• Paradoxical chest wall movement
• Subcutaneous emphysema only
• Unilateral leg swelling
• Hypotension without respiratory distress

Answer: A) Paradoxical chest wall movement

Rationale: Flail chest involves multiple rib fractures causing a free-floating

segment of the chest wall that moves paradoxically (inward on inspiration, outward on expiration), impairing ventilation.

• Which fluid is preferred for initial resuscitation in trauma patients?
• Lactated Ringer’s solution
• 5% Dextrose in water
• Normal saline
• Whole blood transfusion

Answer: A) Lactated Ringer’s solution

Rationale: Lactated Ringer’s is isotonic and closely mimics plasma electrolyte composition, preferred for initial volume resuscitation. Whole blood is used when indicated, but crystalloids are first line.

• When is cervical spine immobilization NOT required in trauma patients?
• Loss of consciousness after trauma
• Presence of neurological deficits
• Isolated superficial scalp laceration without altered mental status
• Distracting injury like long bone fracture

Answer: C) Isolated superficial scalp laceration without altered mental status

Rationale: Cervical spine immobilization is required when there is a risk of spinal injury (altered consciousness, neurological signs, distracting injuries). Isolated minor scalp wounds without altered mental status usually do not require immobilization.

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