PHTLS 10TH UPDATED 20026 EXAMINERS
QUESTIONS AND ANSWERS SURE A+
✔✔1. Your patient is experiencing severe pain after sustaining a femur fracture in a
motorcycle crash. You have a 20 minute transport to the nearest trauma center. There
are no other injuries noted on your primary and secondary assessments. Which of the
following medications would be the best pain management choice?
A. NSAIDs
B. Acetaminophen
C. Fentanyl
D. Morphine - ✔✔Question 1: C
Fentanyl is often a first-line agent due to speed of onset, short duration of action, and
minimal effect on hemodynamics. Fentanyl can beadministered IN, IM, IO, or IV. The IV
route provides effects instantly whereasthe IN and IM route have an onset of <10
minutes. The duration of fentanyl is short at 30 minutes to an hour. This will provide
enough time to ease pain during transport and let the traumacenter decide pain
management upon arrival.
✔✔2. You are responding to a call to an MVC involving one patient. When you perform
your primary survey, you find a patent airway, but abnormalities with breathing and
circulation. You suspect hypovolemic shock, but cannot determine the source. What
does this finding most likely indicate?
A. Hemothorax
, B. Intra-abdominal bleed
C. Blunt cardiac injury
D. Diaphragmatic rupture - ✔✔Question 2: B
The most reliable indicator of an intraabdominal bleed is the presence of hypovolemic
shock from an unexplained source.
✔✔3. You are transporting a 37-year-old male patient with a suspected intraabdominal
bleed. His blood pressure is 70/50 mm Hg (MAP 57), and his skin is pale and
diaphoretic. How will you manage fluid resuscitation for this patient?
A. Aggressively administer IV fluids to compensate for internal blood loss.
B. Do not administer IV fluids to patients with intra-abdominal bleeding.
C. Obtain the patient's medical records and resuscitate to his normal blood pressure
reading.
D. Carefully administer IV fluids to raise the patient's systolic blood pressure to between
80 and 90 mm Hg. - ✔✔Question 3: D
Abdominal trauma represents one of the key situations in which a balanced
resuscitation is indicated. Aggressive administration of IV fluid may elevate the patient's
blood pressure to levels that will disrupt any clot that has formed and result in
recurrence of bleeding that had ceased because of blood clotting and hypotension.
Prehospital care practitioners must achieve a delicate balance: maintain a blood
pressure that provides perfusion to vital organs without restoring blood pressure to
elevated or even normal ranges, which may reinitiate bleeding sites in the abdomen or
pelvis. In the absence of TBI, the target systolic blood pressure is 80 to 90 mm Hg
(mean arterial pressure of 60 to 65 mmHg).
✔✔. Which of the following requires you to develop a plan of action, initiate the plan,
reassess the plan as care for the patient moves forward, and adjust the plan as the
patient's condition or circumstances change?
A. Principles of PHTLS
B. The Golden Period
C. The XABCDE assessment
D. Critical thinking process - ✔✔Question 1: D
To help achieve the PHTLS goals, you will apply your critical thinking skills in the field.
Critical thinking in medicine is a process in which the healthcare practitioner assesses
the situation, the patient, and the resources available and uses the information to decide
on and provide the best care for the patient.
✔✔2. When using the XABCDE assessment, which of the following takes precedence
over all other actions?
A. Controlling severe bleeding from a limb or other compressible site
B. Airway stabilization and assessing circulatory status
C. Exposing the body to allow a thorough evaluation
D. Ensuring adequate breathing - ✔✔Question 2: A
QUESTIONS AND ANSWERS SURE A+
✔✔1. Your patient is experiencing severe pain after sustaining a femur fracture in a
motorcycle crash. You have a 20 minute transport to the nearest trauma center. There
are no other injuries noted on your primary and secondary assessments. Which of the
following medications would be the best pain management choice?
A. NSAIDs
B. Acetaminophen
C. Fentanyl
D. Morphine - ✔✔Question 1: C
Fentanyl is often a first-line agent due to speed of onset, short duration of action, and
minimal effect on hemodynamics. Fentanyl can beadministered IN, IM, IO, or IV. The IV
route provides effects instantly whereasthe IN and IM route have an onset of <10
minutes. The duration of fentanyl is short at 30 minutes to an hour. This will provide
enough time to ease pain during transport and let the traumacenter decide pain
management upon arrival.
✔✔2. You are responding to a call to an MVC involving one patient. When you perform
your primary survey, you find a patent airway, but abnormalities with breathing and
circulation. You suspect hypovolemic shock, but cannot determine the source. What
does this finding most likely indicate?
A. Hemothorax
, B. Intra-abdominal bleed
C. Blunt cardiac injury
D. Diaphragmatic rupture - ✔✔Question 2: B
The most reliable indicator of an intraabdominal bleed is the presence of hypovolemic
shock from an unexplained source.
✔✔3. You are transporting a 37-year-old male patient with a suspected intraabdominal
bleed. His blood pressure is 70/50 mm Hg (MAP 57), and his skin is pale and
diaphoretic. How will you manage fluid resuscitation for this patient?
A. Aggressively administer IV fluids to compensate for internal blood loss.
B. Do not administer IV fluids to patients with intra-abdominal bleeding.
C. Obtain the patient's medical records and resuscitate to his normal blood pressure
reading.
D. Carefully administer IV fluids to raise the patient's systolic blood pressure to between
80 and 90 mm Hg. - ✔✔Question 3: D
Abdominal trauma represents one of the key situations in which a balanced
resuscitation is indicated. Aggressive administration of IV fluid may elevate the patient's
blood pressure to levels that will disrupt any clot that has formed and result in
recurrence of bleeding that had ceased because of blood clotting and hypotension.
Prehospital care practitioners must achieve a delicate balance: maintain a blood
pressure that provides perfusion to vital organs without restoring blood pressure to
elevated or even normal ranges, which may reinitiate bleeding sites in the abdomen or
pelvis. In the absence of TBI, the target systolic blood pressure is 80 to 90 mm Hg
(mean arterial pressure of 60 to 65 mmHg).
✔✔. Which of the following requires you to develop a plan of action, initiate the plan,
reassess the plan as care for the patient moves forward, and adjust the plan as the
patient's condition or circumstances change?
A. Principles of PHTLS
B. The Golden Period
C. The XABCDE assessment
D. Critical thinking process - ✔✔Question 1: D
To help achieve the PHTLS goals, you will apply your critical thinking skills in the field.
Critical thinking in medicine is a process in which the healthcare practitioner assesses
the situation, the patient, and the resources available and uses the information to decide
on and provide the best care for the patient.
✔✔2. When using the XABCDE assessment, which of the following takes precedence
over all other actions?
A. Controlling severe bleeding from a limb or other compressible site
B. Airway stabilization and assessing circulatory status
C. Exposing the body to allow a thorough evaluation
D. Ensuring adequate breathing - ✔✔Question 2: A
