PHTLS 10th Practice Exam 2 Question and
Answers with Rationales Latest Version Top
Rated A+
Question 1
A trauma patient arrives after a high-speed motor vehicle collision. The patient is unconscious,
has snoring respirations, and a suspected cervical spine injury. What is the priority intervention?
A. Apply a cervical collar
B. Insert an oropharyngeal airway
C. Open the airway using a jaw-thrust maneuver
D. Perform a secondary assessment
Correct Answer: C. Open the airway using a jaw-thrust maneuver
Rationale:
In trauma patients, airway management is the first priority while protecting the cervical spine.
The jaw-thrust maneuver opens the airway without extending the neck and reduces the risk of
worsening a spinal injury. A cervical collar does not open the airway, and secondary assessment
occurs after life threats are addressed.
Question 2
According to the PHTLS approach, which assessment is performed first when arriving at a
trauma scene?
A. Obtain a complete patient history
B. Perform a rapid trauma assessment
C. Ensure scene safety and assess for hazards
D. Check blood pressure
Correct Answer: C. Ensure scene safety and assess for hazards
Rationale:
Provider safety comes first. Before approaching the patient, responders must evaluate scene
safety, mechanisms of injury, hazards, and need for additional resources. A rescuer who becomes
injured cannot help the patient.
,Question 3
A patient with severe external bleeding from a leg injury remains hypotensive despite direct
pressure. What is the next appropriate intervention?
A. Apply a tourniquet proximal to the wound
B. Elevate the extremity
C. Apply ice to the injury
D. Delay treatment until hospital arrival
Correct Answer: A. Apply a tourniquet proximal to the wound
Rationale:
Life-threatening extremity hemorrhage requires rapid control. Modern trauma care emphasizes
early tourniquet use when direct pressure is ineffective. Elevation and ice are not appropriate for
uncontrolled hemorrhage.
Question 4
A trauma patient has a respiratory rate of 8 breaths/min, shallow breathing, and altered mental
status. What is the most likely concern?
A. Hyperventilation
B. Impending respiratory failure
C. Normal compensation
D. Mild anxiety reaction
Correct Answer: B. Impending respiratory failure
Rationale:
Slow, shallow respirations with altered mental status indicate inadequate ventilation. Trauma
patients may deteriorate quickly and require airway support and assisted ventilation.
Question 5
A patient with blunt chest trauma has severe respiratory distress, absent breath sounds on one
side, and worsening hypotension. Which condition should be suspected?
A. Simple pneumothorax
B. Hemothorax
,C. Tension pneumothorax
D. Pulmonary contusion
Correct Answer: C. Tension pneumothorax
Rationale:
A tension pneumothorax occurs when trapped air increases pressure within the chest,
compressing the lung and reducing cardiac output. Signs include respiratory distress, absent
unilateral breath sounds, and shock.
Question 6
Which finding indicates that a trauma patient may be developing compensated shock?
A. Normal mental status with warm skin
B. Increased heart rate and anxiety
C. Severe hypertension
D. Slow pulse and improved circulation
Correct Answer: B. Increased heart rate and anxiety
Rationale:
Early shock may present with tachycardia, anxiety, restlessness, and cool skin as the body
attempts to maintain perfusion. Blood pressure may remain normal initially.
Question 7
A patient has a penetrating abdominal injury with organs protruding from the wound. What is the
appropriate treatment?
A. Push organs back into the abdomen
B. Cover with moist sterile dressings
C. Apply firm pressure directly over organs
D. Allow organs to dry to reduce infection risk
Correct Answer: B. Cover with moist sterile dressings
Rationale:
Eviscerated organs should not be pushed back inside. They should be covered with sterile moist
dressings and protected from further contamination or drying.
, Question 8
During the primary survey, the "C" in the XABCDE approach refers to:
A. Cervical spine stabilization
B. Circulation and hemorrhage control
C. Cardiac monitoring
D. Capillary refill
Correct Answer: B. Circulation and hemorrhage control
Rationale:
PHTLS emphasizes controlling catastrophic bleeding early. The XABCDE approach identifies
exsanguinating hemorrhage before airway, breathing, circulation, disability, and exposure.
Question 9
A trauma patient has a Glasgow Coma Scale (GCS) score of 7. What does this indicate?
A. Mild neurological impairment
B. Moderate trauma
C. Severe brain injury requiring airway consideration
D. Normal neurological function
Correct Answer: C. Severe brain injury requiring airway consideration
Rationale:
A GCS score of 8 or less suggests the patient may not be able to protect their airway. Airway
management should be considered while continuing trauma evaluation.
Question 10
Why is minimizing scene time important for critically injured trauma patients?
A. It reduces documentation requirements
B. It prevents unnecessary communication
C. Definitive trauma care occurs at the hospital
D. It eliminates the need for assessment
Correct Answer: C. Definitive trauma care occurs at the hospital
Answers with Rationales Latest Version Top
Rated A+
Question 1
A trauma patient arrives after a high-speed motor vehicle collision. The patient is unconscious,
has snoring respirations, and a suspected cervical spine injury. What is the priority intervention?
A. Apply a cervical collar
B. Insert an oropharyngeal airway
C. Open the airway using a jaw-thrust maneuver
D. Perform a secondary assessment
Correct Answer: C. Open the airway using a jaw-thrust maneuver
Rationale:
In trauma patients, airway management is the first priority while protecting the cervical spine.
The jaw-thrust maneuver opens the airway without extending the neck and reduces the risk of
worsening a spinal injury. A cervical collar does not open the airway, and secondary assessment
occurs after life threats are addressed.
Question 2
According to the PHTLS approach, which assessment is performed first when arriving at a
trauma scene?
A. Obtain a complete patient history
B. Perform a rapid trauma assessment
C. Ensure scene safety and assess for hazards
D. Check blood pressure
Correct Answer: C. Ensure scene safety and assess for hazards
Rationale:
Provider safety comes first. Before approaching the patient, responders must evaluate scene
safety, mechanisms of injury, hazards, and need for additional resources. A rescuer who becomes
injured cannot help the patient.
,Question 3
A patient with severe external bleeding from a leg injury remains hypotensive despite direct
pressure. What is the next appropriate intervention?
A. Apply a tourniquet proximal to the wound
B. Elevate the extremity
C. Apply ice to the injury
D. Delay treatment until hospital arrival
Correct Answer: A. Apply a tourniquet proximal to the wound
Rationale:
Life-threatening extremity hemorrhage requires rapid control. Modern trauma care emphasizes
early tourniquet use when direct pressure is ineffective. Elevation and ice are not appropriate for
uncontrolled hemorrhage.
Question 4
A trauma patient has a respiratory rate of 8 breaths/min, shallow breathing, and altered mental
status. What is the most likely concern?
A. Hyperventilation
B. Impending respiratory failure
C. Normal compensation
D. Mild anxiety reaction
Correct Answer: B. Impending respiratory failure
Rationale:
Slow, shallow respirations with altered mental status indicate inadequate ventilation. Trauma
patients may deteriorate quickly and require airway support and assisted ventilation.
Question 5
A patient with blunt chest trauma has severe respiratory distress, absent breath sounds on one
side, and worsening hypotension. Which condition should be suspected?
A. Simple pneumothorax
B. Hemothorax
,C. Tension pneumothorax
D. Pulmonary contusion
Correct Answer: C. Tension pneumothorax
Rationale:
A tension pneumothorax occurs when trapped air increases pressure within the chest,
compressing the lung and reducing cardiac output. Signs include respiratory distress, absent
unilateral breath sounds, and shock.
Question 6
Which finding indicates that a trauma patient may be developing compensated shock?
A. Normal mental status with warm skin
B. Increased heart rate and anxiety
C. Severe hypertension
D. Slow pulse and improved circulation
Correct Answer: B. Increased heart rate and anxiety
Rationale:
Early shock may present with tachycardia, anxiety, restlessness, and cool skin as the body
attempts to maintain perfusion. Blood pressure may remain normal initially.
Question 7
A patient has a penetrating abdominal injury with organs protruding from the wound. What is the
appropriate treatment?
A. Push organs back into the abdomen
B. Cover with moist sterile dressings
C. Apply firm pressure directly over organs
D. Allow organs to dry to reduce infection risk
Correct Answer: B. Cover with moist sterile dressings
Rationale:
Eviscerated organs should not be pushed back inside. They should be covered with sterile moist
dressings and protected from further contamination or drying.
, Question 8
During the primary survey, the "C" in the XABCDE approach refers to:
A. Cervical spine stabilization
B. Circulation and hemorrhage control
C. Cardiac monitoring
D. Capillary refill
Correct Answer: B. Circulation and hemorrhage control
Rationale:
PHTLS emphasizes controlling catastrophic bleeding early. The XABCDE approach identifies
exsanguinating hemorrhage before airway, breathing, circulation, disability, and exposure.
Question 9
A trauma patient has a Glasgow Coma Scale (GCS) score of 7. What does this indicate?
A. Mild neurological impairment
B. Moderate trauma
C. Severe brain injury requiring airway consideration
D. Normal neurological function
Correct Answer: C. Severe brain injury requiring airway consideration
Rationale:
A GCS score of 8 or less suggests the patient may not be able to protect their airway. Airway
management should be considered while continuing trauma evaluation.
Question 10
Why is minimizing scene time important for critically injured trauma patients?
A. It reduces documentation requirements
B. It prevents unnecessary communication
C. Definitive trauma care occurs at the hospital
D. It eliminates the need for assessment
Correct Answer: C. Definitive trauma care occurs at the hospital
