ATLS MCQ Test 1 Latest 2026 With Complete Solution

ATLS MCQ Test 1 Latest 2026 With Complete Solution

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 2 liters of crystalloid solution 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. His breath sounds are decreased in the left hemithorax, and after initial IV fluid resuscitation, a closed tube thoracostomy is performed for decreased left 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 - Reexamine the chest -Perform aortogram - CT scan of chest - ABG analysis 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 - Compartment pressure -Retrograde urethrogram - Doppler US studies - Complete spine xray The principle of balanced resuscitation is: Permissive hypotension and early plasma infusion Equal amount of crystalloid and colloids simultaneous management of breathing and circulation Maintenance of a normal acid base balance Explanation: Balanced resuscitation minimizes coagulopathy through permissive hypotension, restrictive crystalloid use, and high ratios of plasma and platelet to red blood cell transfusion. A primary goal of fluid resuscitation is to increase cardiac output and improve organ perfusion. Only half of hemodynamically unstable patients, however, experience an improvement in stroke volume with fluid administration What is the principle of permissive hypotension? Permissive hypotension is the act of maintaining a blood pressure lower than physiologic levels in a patient that has suffered from hemorrhagic blood loss. The practice is employed in order to maintain adequate vasoconstriction, organ perfusion, and prevent an undesired coagulopathy during initial fluid resuscitation. In managing the head-injured patient, the most important initial step is to Obtain c spine film Secure the airway Support the circulation Control scalp hemorrhage A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following statements applies to this patient? His pulse pressure will be widened His urinary output will be at lower limits of normal He will have tachycardia, but no change in his systolic blood pressure His systolic blood pressure will be decreased with a narrowed pulse pressure The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by Reducing the need for blood transfusion Increasing the risk of pulmonary edema Increasing the volume of blood loss to produce maternal hypotension Complicating the management of closed head injury The best assessment of fluid resuscitation of the burn patient is Adequate urinary output Reversal of systemic acidosis Normalization of heart rate A normal central venous pressure The diagnosis of shock must include Increased vascular resistance Evidence of inadequate organ perfusion Acidosis Hypoxemia 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 Application of a tourniquet Direct pressure on the wound Packing the wound with gauze direct pressure on the femoral artery at the groin For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent Respiratory acidosis Metabolic acidosis Cerebral vasoconstriction with diminished perfusion Neurogenic pulmonary edema A 25-year-old man is brought to a hospital with a general surgeon after being involved in a motor vehicle crash. Computed tomography shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next step is Contrast angiography Transfer to higher level trauma center Exploratory laporatomy Infuse additional crystalloids Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? Leakage of amniotic fluid is an indication for hospital admission The first maneuver to improve oxygenation after chest injury is Administration of 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 painful stimuli. He does not follow commands, but he does moan periodically. His right arm is deformed and does not respond to painful stimulus; however, his left hand reaches purposefully toward the painful stimulus. Both legs are stiffly extended. His GCS Score is 9 A 20-year-old woman, 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 Perform needle decompression of the right chest The most important, immediate step in the management of an open pneumothorax is Placement of occlussive dressing over the wound 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? Breath sound Bronchial intubation of the right or left mainstem bronchus can easily occur during infant endotracheal intubation because The Trachea is relatively short 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, and 2 liters of crystalloid solution are infused through 2 large-caliber IVs. His blood pressure now is 60/0 mm Hg, heart rate is 160 beats per minute, and respiratory rate is 14 breaths per minute