Trauma, Medical, Airway, Cardiology, OBGYN, Operations Complete Certification Exam
| Actual Questions & Verified Answers | All Domains Covered | Pass Guarantee
________________
TRAUMA (Questions 1–30)
1. Dispatch: 03:14 – MVC, single vehicle vs tree, driver trapped. Scene: Safe, odor
of fuel dissipating. Pt: 19-year-old male, belted, GCS 14 (confused speech), HR
118, RR 28, BP 94/60, SpO₂ 96 % RA. Findings: Steering-wheel deformity, seat-belt
sign across abdomen, pelvis stable, bilateral femurs tender, no external bleeding.
Which finding best predicts need for immediate trauma-center transport per CDC
Field Triage Step 2?
A. Heart rate 118 beats/min
B. Systolic BP < 100 mmHg
C. SpO₂ 96 % on room air
D. RR 28 breaths/min
Correct Answer: B
Rationale: Systolic BP < 100 mmHg with suspected bleeding meets Step-2 criteria.
Tachycardia and tachypnea are supportive but not threshold values.
________________
2. Same patient. After 2 L NS, BP 88/58, HR 120, still confused. Next fluid
strategy per PHTLS?
A. 2 L more NS wide open
B. 1 L LR + initiate TXA 1 g over 10 min
C. 250 mL bolus, allow permissive hypotension
D. 2 units PRBC if available, limit crystalloid
Correct Answer: D
Rationale: Balanced resuscitation with blood products when bleeding suspected;
avoids hemodilution and acidosis.
________________
3. Mechanism: 35-foot fall onto feet. Pt alert, HR 112, BP 100/70, pelvis
stable, no femur fractures. Which occult injury is most likely?
A. Calcaneal fracture
B. Lumbar burst fracture
C. Scaphoid fracture
D. Pneumothorax
Correct Answer: B
Rationale: Axial load transmits force to spine; burst fracture common with foot-
first fall.
________________
4. Penetrating: Stab to right 5th ICS mid-clavicular line, HR 120, BP
80/50, neck veins flat, breath sounds equal. Most likely cause of shock?
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Flail chest
Correct Answer: A
Rationale: Penetrating chest + hypotension + flat neck veins suggests pericardial
tamponade; equal breath sounds rule out tension.
________________
5. Burn: 70-kg adult, partial-thickness burns entire anterior trunk,
,entire right arm, half left thigh. TBSA?
A. 27 %
B. 31 %
C. 36 %
D. 40 %
Correct Answer: A
Rationale: Rule of 9s: anterior trunk 18 %, right arm 9 %, half left thigh 4.5 % ≈
27 %.
________________
6. Same burn. Using Parkland (4 mL × kg × %TBSA), half in first 8 h,
calculate total crystalloid for first 8 h.
A. 3 780 mL
B. 4 725 mL
C. 5 400 mL
D. 6 050 mL
Correct Answer: A
Rationale: 4 × 70 × 27 = 7 560 mL total; half = 3 780 mL over first 8 h from time
of burn.
________________
7. Pediatric fall: 4-year-old, 10-foot fall, altered, GCS 10, no
external bleed. Which vital sign change is earliest indicator of shock?
A. SBP 70 mmHg
B. HR 150
C. RR 30
D. Cap refill 3 s
Correct Answer: B
Rationale: Pediatric compensation ↑ HR first; hypotension is late.
________________
8. Tension pneumothorax: HR 130, RR 36, BP 70/40, trachea
deviated left, absent right breath sounds. Needle decompression site?
A. 2nd ICS mid-clavicular
B. 4th ICS anterior-axillary
C. 5th ICS mid-axillary
D. Suprasternal notch
Correct Answer: A
Rationale: 2nd ICS mid-clavicular line is standard; avoids vessels.
________________
9. Flail chest: Segments 4–6 right, paradoxical motion, HR
120, RR 28, SpO₂ 90 % NRB, BP 130/80. Primary concern?
A. Pain control
B. Underlying pulmonary contusion
C. Rib plating
D. Pneumothorax
Correct Answer: B
Rationale: Contusion, not instability, causes hypoxia; treat pain & monitor
ventilation.
________________
10. Spine: 45-year-old unrestrained driver, rear-impact,
ambulatory at scene, denies pain, GCS 15. NEXUS criterion for spinal motion
, restriction?
A. Midline tenderness C5
B. No neuro deficit
C. Able to walk
D. No distracting injury
Correct Answer: A
Rationale: Midline tenderness = criterion for spinal motion restriction per NEXUS.
________________
11. TBI: GCS 10, blown R pupil, HR 50, BP 180/100.
Which herniation syndrome?
A. Central
B. Uncal
C. Cingulate
D. Tonsillar
Correct Answer: B
Rationale: Uncal (temporal) herniation compresses CN III → ipsilateral blown pupil.
________________
12. Helicopter transport: 25-mile flight, 15 min
vs 45-min ground. Indication?
A. GCS 14, isolated radius fx
B. Penetrating torso, unstable, trauma center 45 min away
C. 8 cm laceration, stable
D. Nursing home transfer
Correct Answer: B
Rationale: Time-critical unstable trauma with > 30 min ground benefit.
________________
13. Burn eschar circumferential chest, HR 120,
RR 30, falling SpO₂ 88 %, difficult ventilation. Intervention?
A. Silver sulfadiazine
B. Escharotomy
C. Intubation only
D. Needle decompression
Correct Answer: B
Rationale: Chest wall restriction impairs mechanics; escharotomy restores
compliance.
________________
14. Pediatric burn: 5-year-old, scald both
feet and ankles, partial-thickness. Fluid rate first 8 h (Parkland adjusted)?
A. 1 200 mL
B. 1 800 mL
C. 2 200 mL
D. 2 800 mL
Correct Answer: B
Rationale: Feet + ankles ≈ 7 % TBSA; 4 × 18 kg × 7 = 504 mL total; half = 252 mL
per 8 h ≈ 31 mL/h; rounded practical 1 800 mL over 8 h.
________________
15. Hemothorax: 1 200 mL blood evacuated,
re-accumulates 600 mL in 1 h. Management?
A. Continue observation
| Actual Questions & Verified Answers | All Domains Covered | Pass Guarantee
________________
TRAUMA (Questions 1–30)
1. Dispatch: 03:14 – MVC, single vehicle vs tree, driver trapped. Scene: Safe, odor
of fuel dissipating. Pt: 19-year-old male, belted, GCS 14 (confused speech), HR
118, RR 28, BP 94/60, SpO₂ 96 % RA. Findings: Steering-wheel deformity, seat-belt
sign across abdomen, pelvis stable, bilateral femurs tender, no external bleeding.
Which finding best predicts need for immediate trauma-center transport per CDC
Field Triage Step 2?
A. Heart rate 118 beats/min
B. Systolic BP < 100 mmHg
C. SpO₂ 96 % on room air
D. RR 28 breaths/min
Correct Answer: B
Rationale: Systolic BP < 100 mmHg with suspected bleeding meets Step-2 criteria.
Tachycardia and tachypnea are supportive but not threshold values.
________________
2. Same patient. After 2 L NS, BP 88/58, HR 120, still confused. Next fluid
strategy per PHTLS?
A. 2 L more NS wide open
B. 1 L LR + initiate TXA 1 g over 10 min
C. 250 mL bolus, allow permissive hypotension
D. 2 units PRBC if available, limit crystalloid
Correct Answer: D
Rationale: Balanced resuscitation with blood products when bleeding suspected;
avoids hemodilution and acidosis.
________________
3. Mechanism: 35-foot fall onto feet. Pt alert, HR 112, BP 100/70, pelvis
stable, no femur fractures. Which occult injury is most likely?
A. Calcaneal fracture
B. Lumbar burst fracture
C. Scaphoid fracture
D. Pneumothorax
Correct Answer: B
Rationale: Axial load transmits force to spine; burst fracture common with foot-
first fall.
________________
4. Penetrating: Stab to right 5th ICS mid-clavicular line, HR 120, BP
80/50, neck veins flat, breath sounds equal. Most likely cause of shock?
A. Cardiac tamponade
B. Tension pneumothorax
C. Massive hemothorax
D. Flail chest
Correct Answer: A
Rationale: Penetrating chest + hypotension + flat neck veins suggests pericardial
tamponade; equal breath sounds rule out tension.
________________
5. Burn: 70-kg adult, partial-thickness burns entire anterior trunk,
,entire right arm, half left thigh. TBSA?
A. 27 %
B. 31 %
C. 36 %
D. 40 %
Correct Answer: A
Rationale: Rule of 9s: anterior trunk 18 %, right arm 9 %, half left thigh 4.5 % ≈
27 %.
________________
6. Same burn. Using Parkland (4 mL × kg × %TBSA), half in first 8 h,
calculate total crystalloid for first 8 h.
A. 3 780 mL
B. 4 725 mL
C. 5 400 mL
D. 6 050 mL
Correct Answer: A
Rationale: 4 × 70 × 27 = 7 560 mL total; half = 3 780 mL over first 8 h from time
of burn.
________________
7. Pediatric fall: 4-year-old, 10-foot fall, altered, GCS 10, no
external bleed. Which vital sign change is earliest indicator of shock?
A. SBP 70 mmHg
B. HR 150
C. RR 30
D. Cap refill 3 s
Correct Answer: B
Rationale: Pediatric compensation ↑ HR first; hypotension is late.
________________
8. Tension pneumothorax: HR 130, RR 36, BP 70/40, trachea
deviated left, absent right breath sounds. Needle decompression site?
A. 2nd ICS mid-clavicular
B. 4th ICS anterior-axillary
C. 5th ICS mid-axillary
D. Suprasternal notch
Correct Answer: A
Rationale: 2nd ICS mid-clavicular line is standard; avoids vessels.
________________
9. Flail chest: Segments 4–6 right, paradoxical motion, HR
120, RR 28, SpO₂ 90 % NRB, BP 130/80. Primary concern?
A. Pain control
B. Underlying pulmonary contusion
C. Rib plating
D. Pneumothorax
Correct Answer: B
Rationale: Contusion, not instability, causes hypoxia; treat pain & monitor
ventilation.
________________
10. Spine: 45-year-old unrestrained driver, rear-impact,
ambulatory at scene, denies pain, GCS 15. NEXUS criterion for spinal motion
, restriction?
A. Midline tenderness C5
B. No neuro deficit
C. Able to walk
D. No distracting injury
Correct Answer: A
Rationale: Midline tenderness = criterion for spinal motion restriction per NEXUS.
________________
11. TBI: GCS 10, blown R pupil, HR 50, BP 180/100.
Which herniation syndrome?
A. Central
B. Uncal
C. Cingulate
D. Tonsillar
Correct Answer: B
Rationale: Uncal (temporal) herniation compresses CN III → ipsilateral blown pupil.
________________
12. Helicopter transport: 25-mile flight, 15 min
vs 45-min ground. Indication?
A. GCS 14, isolated radius fx
B. Penetrating torso, unstable, trauma center 45 min away
C. 8 cm laceration, stable
D. Nursing home transfer
Correct Answer: B
Rationale: Time-critical unstable trauma with > 30 min ground benefit.
________________
13. Burn eschar circumferential chest, HR 120,
RR 30, falling SpO₂ 88 %, difficult ventilation. Intervention?
A. Silver sulfadiazine
B. Escharotomy
C. Intubation only
D. Needle decompression
Correct Answer: B
Rationale: Chest wall restriction impairs mechanics; escharotomy restores
compliance.
________________
14. Pediatric burn: 5-year-old, scald both
feet and ankles, partial-thickness. Fluid rate first 8 h (Parkland adjusted)?
A. 1 200 mL
B. 1 800 mL
C. 2 200 mL
D. 2 800 mL
Correct Answer: B
Rationale: Feet + ankles ≈ 7 % TBSA; 4 × 18 kg × 7 = 504 mL total; half = 252 mL
per 8 h ≈ 31 mL/h; rounded practical 1 800 mL over 8 h.
________________
15. Hemothorax: 1 200 mL blood evacuated,
re-accumulates 600 mL in 1 h. Management?
A. Continue observation
