ITLS FINAL TEST PAPER 2026 QUESTIONS
AND ANSWERS GRADED A PLUS
◉ What does the 'X' in the ITLS 'ABCDE-X' approach stand for?
Answer: eXposure and environmental control
◉ Which of the following is a late sign of increased intracranial
pressure?
Answer: Cushing's triad
◉ What is the next priority for a patient with blunt abdominal
trauma and a distended, rigid abdomen?
Answer: Immediate transport
◉ In a pediatric trauma patient, what is the most common cause of
cardiac arrest?
Answer: Hypovolemia leading to respiratory failure
◉ What is the correct landmark for needle thoracostomy in an
adult?
Answer: 2nd intercostal space, midclavicular line
,◉ Which of the following is a contraindication for the application of
a tourniquet?
Answer: None - tourniquets can be used for life-threatening
extremity hemorrhage
◉ What does the 'Golden Period' refer to?
Answer: Time from injury to definitive care for optimal survival
◉ During the secondary survey, what should be done first for a
patient with pelvic pain after a fall?
Answer: A pelvic binder if unstable
◉ What is the most consistent finding for a patient with blunt chest
trauma and paradoxical chest wall movement?
Answer: Flail chest
◉ What is the ITLS approach to shock in trauma?
Answer: Permissive hypotension for penetrating trauma
◉ What is the initial fluid bolus for an adult trauma patient in
hemorrhagic shock?
Answer: 1 liter crystalloid
, ◉ Which sign is most concerning for spinal cord injury?
Answer: Priapism
◉ What presentation is classic for a patient with a stab wound to the
left lower chest, hypotension, muffled heart sounds, and distended
neck veins?
Answer: Pericardial tamponade
◉ In a geriatric trauma patient, which factor increases mortality
risk?
Answer: All of the above
◉ What is the first priority in a trauma patient with an impaled
object?
Answer: Stabilize the object in place
◉ Where should a trauma patient with suspected shock and a
positive FAST exam be taken?
Answer: Operating room (bypass trauma bay)
◉ What is the most reliable method to confirm endotracheal tube
placement in a trauma patient?
Answer: End-tidal CO2 (capnography)
AND ANSWERS GRADED A PLUS
◉ What does the 'X' in the ITLS 'ABCDE-X' approach stand for?
Answer: eXposure and environmental control
◉ Which of the following is a late sign of increased intracranial
pressure?
Answer: Cushing's triad
◉ What is the next priority for a patient with blunt abdominal
trauma and a distended, rigid abdomen?
Answer: Immediate transport
◉ In a pediatric trauma patient, what is the most common cause of
cardiac arrest?
Answer: Hypovolemia leading to respiratory failure
◉ What is the correct landmark for needle thoracostomy in an
adult?
Answer: 2nd intercostal space, midclavicular line
,◉ Which of the following is a contraindication for the application of
a tourniquet?
Answer: None - tourniquets can be used for life-threatening
extremity hemorrhage
◉ What does the 'Golden Period' refer to?
Answer: Time from injury to definitive care for optimal survival
◉ During the secondary survey, what should be done first for a
patient with pelvic pain after a fall?
Answer: A pelvic binder if unstable
◉ What is the most consistent finding for a patient with blunt chest
trauma and paradoxical chest wall movement?
Answer: Flail chest
◉ What is the ITLS approach to shock in trauma?
Answer: Permissive hypotension for penetrating trauma
◉ What is the initial fluid bolus for an adult trauma patient in
hemorrhagic shock?
Answer: 1 liter crystalloid
, ◉ Which sign is most concerning for spinal cord injury?
Answer: Priapism
◉ What presentation is classic for a patient with a stab wound to the
left lower chest, hypotension, muffled heart sounds, and distended
neck veins?
Answer: Pericardial tamponade
◉ In a geriatric trauma patient, which factor increases mortality
risk?
Answer: All of the above
◉ What is the first priority in a trauma patient with an impaled
object?
Answer: Stabilize the object in place
◉ Where should a trauma patient with suspected shock and a
positive FAST exam be taken?
Answer: Operating room (bypass trauma bay)
◉ What is the most reliable method to confirm endotracheal tube
placement in a trauma patient?
Answer: End-tidal CO2 (capnography)
