ITLS International Trauma Life Support 9th Ed. Exam Bank
Actual Exam 2026/2027 – Complete Test Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Scene Size-Up, Primary Survey & Initial Assessment
(Questions 1–15)
Q1: You arrive at a motor vehicle collision on an interstate highway. The first action you
must take before approaching any patient is:
A. Don high-visibility vests and establish traffic control
B. Perform a rapid triage of all visible patients
C. Conduct scene size-up to ensure safety of rescuers and patients [CORRECT]
D. Begin spinal motion restriction on the closest patient
Correct Answer: C
Rationale: ITLS 9th Edition mandates that scene size-up is the absolute first step on any
trauma scene to assess hazards, mechanism of injury, number of patients, and need for
additional resources before patient contact. Options A and B occur during or after
size-up; D is a patient care intervention that follows initial assessment.
Q2: During scene size-up at a multi-vehicle crash, you identify downed power lines, three
patients, and a fuel leak. Which factor should prompt you to immediately stop the
assessment and evacuate?
A. Presence of three patients requiring triage
B. Active scene hazard such as downed power lines [CORRECT]
C. A patient with obvious bilateral femur fractures
D. The need to request additional ambulance resources
Correct Answer: B
Rationale: ITLS identifies three things that stop assessment: scene hazard, airway
obstruction, and cardiac arrest. Downed power lines represent an active life-threatening
,hazard to rescuers and patients, requiring immediate evacuation. The other options are
manageable within the trauma care sequence.
Q3: A trauma patient has been extricated from a vehicle. According to ITLS 9th Edition,
the maximum recommended length for the initial assessment is:
A. 30 seconds
B. 90 seconds
C. 2 minutes [CORRECT]
D. 5 minutes
Correct Answer: C
Rationale: The ITLS 9th Edition specifies that the initial assessment should be
completed within 2 minutes to rapidly identify life-threatening conditions. Prolonged
scene times reflect ineffective team collaboration and poor coordination, which the
2-minute limit helps prevent.
Q4: For a critically injured trauma patient with significant mechanism of injury, the
maximum critical scene time recommended by ITLS is:
A. 10 minutes
B. 8 minutes
C. 5 minutes or less [CORRECT]
D. 15 minutes
Correct Answer: C
Rationale: ITLS 9th Edition emphasizes the "load and go" concept for critical trauma
patients, with scene time not exceeding 5 minutes. This minimizes the "Golden Period"
time loss, as the clock starts at injury occurrence, not at EMS arrival.
Q5: The "Golden Period" in trauma care refers to the critical time frame that:
A. Begins when EMS arrives on scene
B. Starts at the moment of injury occurrence [CORRECT]
C. Ends when the patient reaches the trauma center
D. Applies only to patients with penetrating trauma
Correct Answer: B
Rationale: The Golden Period clock starts at injury occurrence, not at EMS arrival or
hospital admission. This concept underscores why rapid extrication and transport are
critical, as every minute from injury impacts patient outcome.
,Q6: During the initial assessment of a trauma patient, your team is working inefficiently
and the scene time is extending beyond acceptable limits. According to ITLS, prolonged
scene times most commonly reflect:
A. Severe patient injuries requiring extended care
B. Ineffective team collaboration, poor coordination, unclear roles, or inefficient
communication [CORRECT]
C. Lack of advanced airway equipment on scene
D. Delayed hospital notification by dispatch
Correct Answer: B
Rationale: ITLS 9th Edition explicitly states that prolonged scene times reflect
ineffective team collaboration, poor coordination, unclear roles, or inefficient
communication among the prehospital team, not solely patient severity or equipment
limitations.
Q7: Which of the following correctly lists the components of the ITLS Primary Survey in
proper sequence?
A. Scene Size-Up → Critical Interventions → Initial Assessment → Transport Decisions
B. Scene Size-Up → Initial Assessment → Rapid Trauma Survey/Focused Exam →
Critical Interventions → Transport Decisions [CORRECT]
C. Initial Assessment → Scene Size-Up → Rapid Trauma Survey → Transport Decisions
→ Critical Interventions
D. Rapid Trauma Survey → Scene Size-Up → Initial Assessment → Critical Interventions
→ Transport Decisions
Correct Answer: B
Rationale: The ITLS Primary Survey follows a strict algorithm: Scene Size-Up first, then
Initial Assessment, followed by Rapid Trauma Survey or Focused Exam, then Critical
Interventions, and finally Transport Decisions. This sequence ensures life threats are
identified before definitive care begins.
Q8: At an industrial accident scene, you encounter a patient trapped under heavy
machinery with an unstable structure overhead. Your immediate priority is to:
A. Begin the primary survey while requesting extrication equipment
B. Stabilize the overhead structure and ensure scene safety before patient contact
[CORRECT]
C. Initiate rapid extrication regardless of scene hazards
D. Perform a focused exam on the patient's exposed extremities
, Correct Answer: B
Rationale: Scene hazards stop assessment. ITLS mandates that rescuer safety and
scene stabilization take absolute precedence. Attempting patient care in an unstable
environment risks rescuer lives and prevents effective care delivery.
Q9: The mechanism of injury (MOI) assessment during scene size-up is important
primarily because it:
A. Determines the exact diagnosis before patient contact
B. Predicts the need for spinal motion restriction only
C. Helps anticipate potential injuries and guides the depth of assessment needed
[CORRECT]
D. Replaces the need for a physical examination
Correct Answer: C
Rationale: MOI assessment guides the prehospital provider in anticipating injuries (e.g.,
high-speed MVC predicts multisystem trauma) and determines whether a Rapid Trauma
Survey or Focused Exam is indicated. It does not replace physical examination or
provide definitive diagnosis.
Q10: During the initial assessment, you identify an unresponsive patient with gurgling
respirations and no palpable carotid pulse. According to ITLS, which condition has
occurred that stops the assessment sequence?
A. Severe hemorrhage from an extremity
B. Airway obstruction and cardiac arrest [CORRECT]
C. Tension pneumothorax
D. Pelvic instability
Correct Answer: B
Rationale: The three things that stop assessment per ITLS are scene hazard, airway
obstruction, and cardiac arrest. This patient presents two of the three stoppers
simultaneously, requiring immediate airway management and CPR before continuing
the survey.
Q11: A trauma patient presents with a Glasgow Coma Scale (GCS) score of 14, patent
airway, and respiratory rate of 22. During the initial assessment, which finding would
most indicate the need for immediate critical intervention?
A. GCS of 14
Actual Exam 2026/2027 – Complete Test Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Scene Size-Up, Primary Survey & Initial Assessment
(Questions 1–15)
Q1: You arrive at a motor vehicle collision on an interstate highway. The first action you
must take before approaching any patient is:
A. Don high-visibility vests and establish traffic control
B. Perform a rapid triage of all visible patients
C. Conduct scene size-up to ensure safety of rescuers and patients [CORRECT]
D. Begin spinal motion restriction on the closest patient
Correct Answer: C
Rationale: ITLS 9th Edition mandates that scene size-up is the absolute first step on any
trauma scene to assess hazards, mechanism of injury, number of patients, and need for
additional resources before patient contact. Options A and B occur during or after
size-up; D is a patient care intervention that follows initial assessment.
Q2: During scene size-up at a multi-vehicle crash, you identify downed power lines, three
patients, and a fuel leak. Which factor should prompt you to immediately stop the
assessment and evacuate?
A. Presence of three patients requiring triage
B. Active scene hazard such as downed power lines [CORRECT]
C. A patient with obvious bilateral femur fractures
D. The need to request additional ambulance resources
Correct Answer: B
Rationale: ITLS identifies three things that stop assessment: scene hazard, airway
obstruction, and cardiac arrest. Downed power lines represent an active life-threatening
,hazard to rescuers and patients, requiring immediate evacuation. The other options are
manageable within the trauma care sequence.
Q3: A trauma patient has been extricated from a vehicle. According to ITLS 9th Edition,
the maximum recommended length for the initial assessment is:
A. 30 seconds
B. 90 seconds
C. 2 minutes [CORRECT]
D. 5 minutes
Correct Answer: C
Rationale: The ITLS 9th Edition specifies that the initial assessment should be
completed within 2 minutes to rapidly identify life-threatening conditions. Prolonged
scene times reflect ineffective team collaboration and poor coordination, which the
2-minute limit helps prevent.
Q4: For a critically injured trauma patient with significant mechanism of injury, the
maximum critical scene time recommended by ITLS is:
A. 10 minutes
B. 8 minutes
C. 5 minutes or less [CORRECT]
D. 15 minutes
Correct Answer: C
Rationale: ITLS 9th Edition emphasizes the "load and go" concept for critical trauma
patients, with scene time not exceeding 5 minutes. This minimizes the "Golden Period"
time loss, as the clock starts at injury occurrence, not at EMS arrival.
Q5: The "Golden Period" in trauma care refers to the critical time frame that:
A. Begins when EMS arrives on scene
B. Starts at the moment of injury occurrence [CORRECT]
C. Ends when the patient reaches the trauma center
D. Applies only to patients with penetrating trauma
Correct Answer: B
Rationale: The Golden Period clock starts at injury occurrence, not at EMS arrival or
hospital admission. This concept underscores why rapid extrication and transport are
critical, as every minute from injury impacts patient outcome.
,Q6: During the initial assessment of a trauma patient, your team is working inefficiently
and the scene time is extending beyond acceptable limits. According to ITLS, prolonged
scene times most commonly reflect:
A. Severe patient injuries requiring extended care
B. Ineffective team collaboration, poor coordination, unclear roles, or inefficient
communication [CORRECT]
C. Lack of advanced airway equipment on scene
D. Delayed hospital notification by dispatch
Correct Answer: B
Rationale: ITLS 9th Edition explicitly states that prolonged scene times reflect
ineffective team collaboration, poor coordination, unclear roles, or inefficient
communication among the prehospital team, not solely patient severity or equipment
limitations.
Q7: Which of the following correctly lists the components of the ITLS Primary Survey in
proper sequence?
A. Scene Size-Up → Critical Interventions → Initial Assessment → Transport Decisions
B. Scene Size-Up → Initial Assessment → Rapid Trauma Survey/Focused Exam →
Critical Interventions → Transport Decisions [CORRECT]
C. Initial Assessment → Scene Size-Up → Rapid Trauma Survey → Transport Decisions
→ Critical Interventions
D. Rapid Trauma Survey → Scene Size-Up → Initial Assessment → Critical Interventions
→ Transport Decisions
Correct Answer: B
Rationale: The ITLS Primary Survey follows a strict algorithm: Scene Size-Up first, then
Initial Assessment, followed by Rapid Trauma Survey or Focused Exam, then Critical
Interventions, and finally Transport Decisions. This sequence ensures life threats are
identified before definitive care begins.
Q8: At an industrial accident scene, you encounter a patient trapped under heavy
machinery with an unstable structure overhead. Your immediate priority is to:
A. Begin the primary survey while requesting extrication equipment
B. Stabilize the overhead structure and ensure scene safety before patient contact
[CORRECT]
C. Initiate rapid extrication regardless of scene hazards
D. Perform a focused exam on the patient's exposed extremities
, Correct Answer: B
Rationale: Scene hazards stop assessment. ITLS mandates that rescuer safety and
scene stabilization take absolute precedence. Attempting patient care in an unstable
environment risks rescuer lives and prevents effective care delivery.
Q9: The mechanism of injury (MOI) assessment during scene size-up is important
primarily because it:
A. Determines the exact diagnosis before patient contact
B. Predicts the need for spinal motion restriction only
C. Helps anticipate potential injuries and guides the depth of assessment needed
[CORRECT]
D. Replaces the need for a physical examination
Correct Answer: C
Rationale: MOI assessment guides the prehospital provider in anticipating injuries (e.g.,
high-speed MVC predicts multisystem trauma) and determines whether a Rapid Trauma
Survey or Focused Exam is indicated. It does not replace physical examination or
provide definitive diagnosis.
Q10: During the initial assessment, you identify an unresponsive patient with gurgling
respirations and no palpable carotid pulse. According to ITLS, which condition has
occurred that stops the assessment sequence?
A. Severe hemorrhage from an extremity
B. Airway obstruction and cardiac arrest [CORRECT]
C. Tension pneumothorax
D. Pelvic instability
Correct Answer: B
Rationale: The three things that stop assessment per ITLS are scene hazard, airway
obstruction, and cardiac arrest. This patient presents two of the three stoppers
simultaneously, requiring immediate airway management and CPR before continuing
the survey.
Q11: A trauma patient presents with a Glasgow Coma Scale (GCS) score of 14, patent
airway, and respiratory rate of 22. During the initial assessment, which finding would
most indicate the need for immediate critical intervention?
A. GCS of 14
