ATLS Practice Test 10th Edition 2 — Questions and Answers
Question 1: According to ATLS 10th edition, what is the recommended initial crystalloid bolus for a hypotensive adult trauma patient?
- 500 mL normal saline
- 1 liter of warmed isotonic crystalloid (Correct answer)
- 2 liters of warmed lactated Ringer's
- 3 liters of normal saline
Correct answer: 1 liter of warmed isotonic crystalloid
The 10th edition changed from 2 liters to 1 liter, reflecting evidence that excessive crystalloid worsens outcomes.
Reflects PROPPR and PROMMTT trials. Emphasis on early blood products, minimal crystalloid, and damage control resuscitation.
Question 2: The ATLS 10th edition emphasizes that the MOST preventable cause of death in trauma is:
- Traumatic brain injury
- Hemorrhage (Correct answer)
- Sepsis
- Airway compromise
Correct answer: Hemorrhage
Hemorrhage is the most common preventable cause of death in trauma.
Drives several 10th edition updates: reduced crystalloid, earlier blood products, TXA within 3 hours, permissive hypotension, massive transfusion protocols.
Question 3: In the ATLS 10th edition, which mnemonic prioritizes hemorrhage control?
- ABCDE
- MARCH (Correct answer)
- FAST
- SAMPLE
Correct answer: MARCH
MARCH (Massive hemorrhage, Airway, Respirations, Circulation, Hypothermia) places hemorrhage first.
From TCCC military experience. The 10th edition incorporates <C>ABCDE where <C> is catastrophic hemorrhage control. Early tourniquet application for extremity hemorrhage.
Question 4: What did the 10th edition change regarding hemorrhagic shock classification?
- Added a fifth class
- Acknowledged vital signs overlap significantly between classes (Correct answer)
- Removed the classification
- Changed blood loss percentages
Correct answer: Acknowledged vital signs overlap significantly between classes
The 10th edition acknowledges the four-class system oversimplifies clinical reality.
Emphasizes base deficit and lactate as more objective indicators. Response to initial resuscitation is more useful than initial vital signs. Individual variation is significant.
Question 5: What is the 10th edition recommendation regarding whole blood in trauma?
- Contraindicated
- Recognized as potentially superior to component therapy for massive hemorrhage (Correct answer)
- Should replace all components
- Only for pediatrics
Correct answer: Recognized as potentially superior to component therapy for massive hemorrhage
Emerging evidence from military experience shows low-titer group O whole blood may be superior.
Provides RBCs, plasma, platelets, and clotting factors in physiologic ratios. Simplified logistics, reduced dilution. The SWIFT trial is evaluating civilian use.
Question 6: The 10th edition includes a new chapter on which topic?
- Musculoskeletal trauma
- Disaster management and mass casualty (Correct answer)
- Thermal injuries
- Head trauma
Correct answer: Disaster management and mass casualty
New content on mass casualty and disaster management was added.
Covers triage principles (START, SALT, JumpSTART), surge capacity, doing the greatest good for the greatest number. Other updates: reduced crystalloid, cervical spine clearance, geriatric considerations.
ATLS Practice Test 10th Edition 2
According to ATLS 10th edition, what is the recommended initial crystalloid bolus for a hypotensive adult trauma patient?