This updated ITLS Exam 2026/2027 study guide contains 40+ exam questions with correct answers and selected rationales across 16 pages, providing focused preparation in International Trauma Life Support and prehospital emergency trauma care. The material begins with scene size-up, ITLS Primary Survey, scene-time management, hyperventilation and capnography, then progresses into scenario-based questions requiring candidates to recognize immediate life threats and select appropriate interventions. The document specifically defines the purpose of the ITLS Primary Survey as identifying immediate life threats rapidly and highlights ineffective team collaboration as a potential contributor to prolonged scene times.
A major component covers airway, ventilation and thoracic trauma. Candidates review airway suctioning, laryngeal mask airway complications, indications for intubation, endotracheal tube depth, oxygenation, ventilatory assistance and SpO₂ monitoring. Chest-trauma scenarios address flail chest, tension pneumothorax, chest decompression, cardiac contusion and traumatic cardiopulmonary arrest, with clinical findings such as diminished breath sounds, distended neck veins, cyanosis and abnormal respiratory patterns used to guide decisions. The material also connects suspected myocardial contusion with cardiac monitoring and ECG assessment.
The guide provides substantial practice in shock, perfusion and vascular access. Questions distinguish relative hypovolemic/neurogenic shock from cardiogenic and hemorrhagic presentations and reinforce the relationship among cardiac pumping, circulating volume, vascular integrity and oxygenation in maintaining adequate perfusion. Candidates also review external jugular cannulation, indications for vascular access, and intraosseous access at the proximal tibia, including appropriate needle orientation. Clinical scenarios require interpretation of blood pressure, pulse characteristics, skin findings and mechanisms of injury rather than simple recall of terminology.
Another high-yield section addresses traumatic brain injury, neurologic assessment and spinal motion restriction. Topics include Glasgow Coma Scale assessment, pupil examination, glucose evaluation in altered mental status, increasing intracranial pressure, the combination of hypertension and bradycardia associated with rising ICP, monitoring level of consciousness in pediatric head trauma, and considerations surrounding sedative medications in head-injured patients. The document also examines cervical-collar application and circumstances in which spinal motion restriction may not be indicated, including isolated penetrating trauma without clinical evidence of spinal injury.
Additional exam content covers abdominal trauma, evisceration, crush injury, fractures, burns, blast injuries and hemorrhage-related trauma management. Students review blunt-force abdominal injury, retroperitoneal anatomy, management priorities for abdominal evisceration, prolonged extremity entrapment, immobilization of forearm fractures, partial-thickness thermal burns and secondary blast injuries caused by propelled debris. Emergency-rescue decisions and exposure to airborne or fluid-borne contaminants are also represented, broadening preparation beyond routine trauma assessment.
The final sections emphasize special-population trauma, including pediatric, geriatric and pregnant patients. Questions cover pediatric respiratory distress and head-injury monitoring, increased risk of fatal outcomes in older trauma patients, cardiac assessment in geriatric patients, pregnancy-related physiologic changes, early shock recognition and supine hypotension syndrome caused by uterine compression of venous return. The guide also reviews leftward positioning of third-trimester pregnant trauma patients during spinal motion restriction.
For authoritative academic preparation, students should use this material alongside the applicable edition of International Trauma Life Support for Emergency Care Providers, which provides the primary textbook framework for ITLS trauma assessment and prehospital management. Current evidence-based trauma and EMS guidance should also be consulted for airway management, traumatic brain injury, chest decompression, crush injury, oxygen targets, spinal motion restriction and resuscitation. The document itself references textbook page numbers throughout but does not clearly identify the edition represented by those page citations, so candidates should verify clinical recommendations against their current ITLS course manual, local EMS protocols and medical direction.
Relevant Students: ITLS exam candidates, ITLS certification candidates, ITLS recertification candidates, EMT students, AEMT students, paramedic students, EMS students, emergency medical technicians, prehospital care students, first responders, trauma-care students, emergency nursing students, flight paramedics, critical care transport students, emergency medical services professionals
Keywords: ITLS Exam , ITLS exam questions and correct answers, International Trauma Life Support exam, ITLS practice test, ITLS study guide, ITLS certification exam, ITLS Primary Survey, scene size up trauma, trauma assessment questions, airway management trauma, endotracheal intubation, trauma ventilation, capnography trauma, SpO2 trauma, flail chest, tension pneumothorax, chest decompression, cardiac contusion, traumatic brain injury, increasing intracranial pressure, GCS trauma assessment, spinal motion restriction, shock assessment, neurogenic shock, relative hypovolemia, cardiogenic shock, trauma perfusion, intraosseous access, proximal tibia IO, abdominal trauma, abdominal evisceration, crush injury, burn management, blast injury, pediatric trauma, geriatric trauma, pregnancy trauma, supine hypotension syndrome, EMS trauma exam, EMT trauma questions, paramedic trauma exam, prehospital trauma care
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ITLS Exam 2026/2027 Exam
Questions and Correct
Answers | New Update
Upon arrival at a trauma scene, you should complete a(n) - ANSWER
✔✔Scene Size-up
pg 2
Prolonged scene times may reflect: - ANSWER ✔✔Ineffective team
collaboration
pg 34
Which of the following indicates a state of hyperventilation? -
ANSWER ✔✔An end tidal CO2 level less than 30 mmHG
,pg 79
A 23 year old female fell from a 2nd floor balcony. Upon arrival, you find
her lying in the grass. She responds to verbal commands and your
assessment reveals flat neck veins, & normal chest/abdomen/pelvic
examinations. Vital signs are: BP 74/40, P 54 & Weak, and R 16. You
should suspect: - ANSWER ✔✔Relative hypovolemic (high-space)
shock
pg 161
Rationale: The condition causing the vascular space to be too large for a
normal amount of blood has been called "shock", or relative
hypovolemia. Neurogenic shock, commonly called spinal shock, is a
form of relative hypovolemia. The clinical presentation of neurogenic
shock differs from hemorrhagic shock in that there is no catecholamine
release and this no pallor (vasoconstriction), tachycardia, or sweating.
The patient will have a decreased BP but the HR will be normal or slow,
and the skin is usually warm, dry and pink
An unresponsive 34 y/o female was struck by a vehicle. You observe
Asymmetrical chest wall movement with a flail segment on the right.
, Following delegation of c-spine control and opening the airway, you
should? - ANSWER ✔✔Stabilize the chest wall
pg 131
Which of the following regarding PT positioning for external jugular
cannulation is Incorrect? - ANSWER ✔✔Elevate the head to distend
the vein and prevent air embolism.
pg 178
Rationale: The PT must be in the supine position, preferably head down,
to distend the vein and prevent air embolism.
Which of the following set of vital signs is most compatible with a
diagnosis of isolated traumatic brain injury with increasing ICP? -
ANSWER ✔✔BP 170/100, P 50
pg 193
Rationale: When the ICP increases, the systemic BP increases to try to
preserve blood flow to the brain. The body senses the rise in systemic
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