How Many Questions Are on the ATLS Exam? (2025 Guide)

If you’re getting ready to take the Advanced Trauma Life Support (ATLS) exam, one of the first things you’ll want to know is how many questions you’ll face and what kind of content to expect. The ATLS course is fast-paced and intense, and understanding the exam structure will help you prepare effectively and reduce test-day stress.

Let’s break down exactly how many questions are on the ATLS exam, what topics they cover, and how to study for each section.

👉 Check out our ATLS Practice Questions + Study Guide — updated for 2025, with trauma-focused scenarios and evidence-based algorithms reflecting the latest Advanced Trauma Life Support guidelines.

ATLS Exam Format Overview

The ATLS exam is divided into two parts — a written test and a practical skills assessment — both of which you must pass to become certified.

Exam Section

Details

Written Exam

40 multiple-choice questions

Passing Score

Minimum 80% (32 correct answers)

Practical Exam

Scenario-based trauma assessment simulation

Course Duration

Approximately 2 days

Certification Validity

4 years

What the 40 Questions Cover

Each question tests your understanding of core trauma principles, drawn from the official ATLS manual. You can expect questions on:

  • The ABCDE assessment and initial management steps
  • Airway and ventilation control
  • Shock and fluid resuscitation
  • Head, spinal, chest, abdominal, and extremity trauma
  • Pediatric and obstetric considerations
  • Burns, hypothermia, and triage

The questions are practical, scenario-based, and require critical reasoning. They are not designed to trick you — but they do expect you to know what to do first in each trauma situation.

Example Question Styles

You might encounter questions like:

“A 25-year-old male arrives following a motor vehicle collision. His airway is patent, but he has labored breathing and diminished breath sounds on the left. What should be your next step?”

The correct answer tests whether you understand immediate chest decompression as a life-saving action, not a delayed diagnostic step.

What Makes These Questions Tricky

  • Multiple correct-sounding answers — only one is immediate and appropriate.
  • You must recall the sequence of interventions, not just isolated facts.
  • Some questions blend multiple trauma issues to test your prioritization skills.

Study Tips for the Written Exam

  1. Review the ATLS manual thoroughly — it’s your primary study source.
  2. Understand the flow of trauma management, not just the individual topics.
  3. Use flashcards to memorize algorithms and emergency sequences.
  4. Take practice tests to get used to time pressure and question style.
  5. Discuss trauma cases with peers — explaining concepts aloud reinforces understanding.

How the Questions Are Scored

Each question is worth 1 point, with no penalties for wrong answers. A score of 32 out of 40 or higher is required to pass the written portion.
 If you don’t reach 80%, you can usually retake just the written section after review.

Study Tip

Don’t overcomplicate the questions. When in doubt, choose the answer that saves a life first. The ATLS exam always prioritizes immediate action over diagnostic exploration.

👉 Check out our ATLS Practice Questions + Study Guide — updated for 2025, with trauma-focused scenarios and evidence-based algorithms reflecting the latest Advanced Trauma Life Support guidelines.

Final Thought:

There are only 40 questions on the ATLS written exam, but each one tests your ability to think quickly and act decisively. Learn the sequence, practice real-world reasoning, and you’ll walk into your test confident and prepared.

Back to blog