PHTLS PRE TEST COMPREHENSIVE SCRIPT
2026 QUESTIONS AND SOLUTIONS
◉ A 42 year old female has been pulled from a smoke- filled
apartment. Her mouth and nose are covered in soot. She has a weak
hoarse cry with inspiratory strider. What should you do? Answer:
Prepare for a difficult intubation
◉ A 29 year old male falls 17ft (5m) to the ground from a tree. He
complains of pain with movement and pain on the right side of his
chest when he breathes. You note accessory muscle use, focal
tenderness, bony crepitus and absent breath sounds on his right
side. What should you suspect? Answer: Simple pneumothorax
◉ A 29 year old male was injured in a high speed motor vehicle
collision with lateral impact and intrusion into the side of a sedan.
He has pale and diaphoretic skin, appears anxious, and is coughing
up blood- tinged sputum. He complains of chest pain, has decreased
breath sounds on the left lateral side, has crepitus on palpation of
his ribs, and his jugular veins are flat. Vital signs are; BP 88/56 P
120 RR24 SPO 92%. What should you suspect? Answer: Hemothorax
◉ Which is an early finding in compartment syndrome Answer: Pain
,◉ A 20 year old male was hit in the chest with a baseball bat. He
complains of severe pain and tenderness on the left side. He is
unable to take a deep breath. Vital signs are BP 112/76 P 98 RR 20
SPO 98 ETCO2 38 mmHg. What should you do? Answer: Administer
100mcg Fentanyl
◉ A 26 y.o. M is supine on the ground. He was assaulted and has
obvious head and facial trauma. He has snoring respirations at a rate
of 8 per minute. What should you do? Answer: Perform a modified
jaw thrust
◉ A 28 year old female suffered a head injury after falling from a
horse. Her Glasgow coma scale is 6 (E1, V1, M4) and she has snoring
respirations at 8 per minute. Which should you do first? Answer:
Place an OPA
◉ A 41 year old male was stabbed in the chest immediately below
the sternum. He complains of shortness of breath and has engorged
jugular veins. Vital signs BP 108/84 P 130 RR 26. What should you
suspect? Answer: Cardiac tamponade
◉ A 24 year old construction worker amputated his thumb. How
should you manage the amputation? Answer: Wrap it in moistened
gauze
, ◉ An 80 y.o. F fell down a flight of stairs 3 days ago. Today the family
reports she has a headache and is " going in and out of
consciousness " Vital signs BP 170/72 RR 26 and irregular P 62 BGL
150 mg/dL. What should you suspect? Answer: Subdural hematoma
◉ A 23-year-old male was skateboarding down a ramp when he
flipped over and landed on his head. He is clenching his jaw, and you
are unable to insert an oral airway. He thrashes his head when you
attempt to provide BVM. His oxygen saturation is decreasing and his
ET CO2 is increasing. What is the best option to secure his airway
and provide effective ventilations? Answer: Pharmacologically
assisted intubation
◉ A 3 y.o. Female was involved in a car crash with 2 ft of intrusion
into the passenger compartment. She is crying and has an obvious
deformed right humerus. Her car seat has a crack on the side of
impact. What should you suspect? Answer: Significant energy has
been distributed to this patient
◉ A 27 y.o. F has multi system trauma. Which life threat is your first
priority? Answer: Significant external hemorrhage
◉ Upon examining a 43 y.o. M you note unequal breath sounds.
What is a sign or symptom of a simple pneumothorax? Answer:
Shortness of breath, decreased lung sounds on affected side
2026 QUESTIONS AND SOLUTIONS
◉ A 42 year old female has been pulled from a smoke- filled
apartment. Her mouth and nose are covered in soot. She has a weak
hoarse cry with inspiratory strider. What should you do? Answer:
Prepare for a difficult intubation
◉ A 29 year old male falls 17ft (5m) to the ground from a tree. He
complains of pain with movement and pain on the right side of his
chest when he breathes. You note accessory muscle use, focal
tenderness, bony crepitus and absent breath sounds on his right
side. What should you suspect? Answer: Simple pneumothorax
◉ A 29 year old male was injured in a high speed motor vehicle
collision with lateral impact and intrusion into the side of a sedan.
He has pale and diaphoretic skin, appears anxious, and is coughing
up blood- tinged sputum. He complains of chest pain, has decreased
breath sounds on the left lateral side, has crepitus on palpation of
his ribs, and his jugular veins are flat. Vital signs are; BP 88/56 P
120 RR24 SPO 92%. What should you suspect? Answer: Hemothorax
◉ Which is an early finding in compartment syndrome Answer: Pain
,◉ A 20 year old male was hit in the chest with a baseball bat. He
complains of severe pain and tenderness on the left side. He is
unable to take a deep breath. Vital signs are BP 112/76 P 98 RR 20
SPO 98 ETCO2 38 mmHg. What should you do? Answer: Administer
100mcg Fentanyl
◉ A 26 y.o. M is supine on the ground. He was assaulted and has
obvious head and facial trauma. He has snoring respirations at a rate
of 8 per minute. What should you do? Answer: Perform a modified
jaw thrust
◉ A 28 year old female suffered a head injury after falling from a
horse. Her Glasgow coma scale is 6 (E1, V1, M4) and she has snoring
respirations at 8 per minute. Which should you do first? Answer:
Place an OPA
◉ A 41 year old male was stabbed in the chest immediately below
the sternum. He complains of shortness of breath and has engorged
jugular veins. Vital signs BP 108/84 P 130 RR 26. What should you
suspect? Answer: Cardiac tamponade
◉ A 24 year old construction worker amputated his thumb. How
should you manage the amputation? Answer: Wrap it in moistened
gauze
, ◉ An 80 y.o. F fell down a flight of stairs 3 days ago. Today the family
reports she has a headache and is " going in and out of
consciousness " Vital signs BP 170/72 RR 26 and irregular P 62 BGL
150 mg/dL. What should you suspect? Answer: Subdural hematoma
◉ A 23-year-old male was skateboarding down a ramp when he
flipped over and landed on his head. He is clenching his jaw, and you
are unable to insert an oral airway. He thrashes his head when you
attempt to provide BVM. His oxygen saturation is decreasing and his
ET CO2 is increasing. What is the best option to secure his airway
and provide effective ventilations? Answer: Pharmacologically
assisted intubation
◉ A 3 y.o. Female was involved in a car crash with 2 ft of intrusion
into the passenger compartment. She is crying and has an obvious
deformed right humerus. Her car seat has a crack on the side of
impact. What should you suspect? Answer: Significant energy has
been distributed to this patient
◉ A 27 y.o. F has multi system trauma. Which life threat is your first
priority? Answer: Significant external hemorrhage
◉ Upon examining a 43 y.o. M you note unequal breath sounds.
What is a sign or symptom of a simple pneumothorax? Answer:
Shortness of breath, decreased lung sounds on affected side
