PHTLS POST TEST - 9TH EDITION
Prehospital Trauma Life Support | Post-Test Examination Preparation | Aligned with the 2026/2027 PHTLS 9th
Edition Curriculum
ANSWER KEY +
50 QUESTIONS 7 SECTIONS GRADE A VERIFIED
RATIONALES
CANDIDATE INSTRUCTIONS
This post-test examination contains exactly 50 multiple-choice questions aligned with the NAEMT PHTLS 9th Edition
post-test assessment domains, organized into seven content sections. Each question offers four options (A-D) with ONE best
answer; select the single most appropriate action or interpretation based on current evidence-based prehospital trauma
guidelines. Questions reflect the 9th Edition emphasis on primary survey sequencing, hemorrhage control, airway
decision-making, and clinical reasoning, with a mix of approximately 25% recall, 50% application, and 25% analysis items. A
verified answer and a comprehensive rationale follow every item, explaining why the correct choice is right and why each
distractor represents a common field or post-test pitfall. Suggested time: 60 minutes, closed reference.
SECTION 1 - TRAUMA ASSESSMENT AND SCENE MANAGEMENT
Scene Safety • Scene Size-Up • Primary and Secondary Survey • Rapid Transport | Questions 1-10
Q1: Your crew responds to a two-vehicle collision on a rural highway. On arrival you note a tanker
truck in the ditch with a visible vapor cloud leaking from its rear valve assembly and liquid pooling
downhill toward the wrecked cars, where several patients are visible. Which action should the crew
take FIRST?
A. Approach the wrecked vehicles immediately and begin primary surveys before the cloud
disperses
B. Reposition the ambulance downhill of the leak to shield the crew from oncoming traffic
C. Stage uphill and upwind at a safe distance, deny entry, and await clearance by hazmat-trained
personnel [CORRECT]
D. Don gowns, gloves, and eye protection and proceed with patient care using standard
precautions
Correct Answer: C
Rationale: Scene safety is the first and overriding priority of scene size-up: a visible vapor cloud with pooling liquid indicates
an active hazardous materials release, and rescuers who approach become additional patients. Crews must stage uphill, upwind,
and at a safe distance, deny entry to others, and request hazmat resources through dispatch. Standard PPE and gowns provide
no protection against toxic inhalation hazards, and positioning downhill or downstream only increases exposure. Patient care
begins only after the scene is declared safe, which makes early specialized-resource notification critical.
NAEMT PHTLS 9th Edition - Post Test Examination Preparation Page 1 of 26
,PHTLS POST TEST 9TH EDITION - EXAMINATION PREPARATION 2026/2027
Q2: A critically injured patient presents with bright red blood spurting from an open thigh wound
following a motorcycle crash. According to the PHTLS 9th Edition primary survey (XABCDE), which
action has the HIGHEST priority?
A. Immediate tourniquet application 5-7 cm proximal to the wound [CORRECT]
B. Jaw-thrust maneuver with cervical spine restriction and an oropharyngeal airway
C. Insertion of two large-bore IVs followed by a 1-liter crystalloid bolus
D. Application of a cervical collar and full spinal immobilization
Correct Answer: A
Rationale: The PHTLS 9th Edition primary survey (XABCDE) places eXsanguinating hemorrhage before airway because
complete exsanguination can kill within minutes — faster than an unprotected airway. Immediate tourniquet application 5-7 cm
proximal to the wound, tightened until bleeding and the distal pulse stop, is the definitive field control for arterial extremity
bleeding. Airway management with cervical spine restriction comes next, followed by breathing and circulation. Large-volume
crystalloid given before hemorrhage control dilutes clotting factors, cools the patient, and can dislodge forming clot.
Q3: You have controlled exsanguinating bleeding and established a patent airway with a jaw-thrust and
an oropharyngeal airway in an unconscious multisystem trauma patient. What is your NEXT step in the
primary survey?
A. Perform a detailed head-to-toe examination at the scene
B. Obtain a complete SAMPLE history and full set of baseline vital signs
C. Assess breathing for rate, depth, symmetry, and chest wall expansion, then evaluate circulation
[CORRECT]
D. Elevate the legs and apply a pelvic binder as a routine precaution
Correct Answer: C
Rationale: The primary survey follows a fixed sequence — eXsanguinating hemorrhage, airway, breathing, circulation,
disability, expose and environment — so breathing assessment (rate, depth, symmetry, chest wall motion) precedes circulation
evaluation. Life-threatening chest injuries such as tension pneumothorax and flail chest are sought and corrected during this
phase. The detailed secondary survey and SAMPLE history are completed after critical interventions, typically during
transport, and never delay movement of an unstable patient. Performing either before finishing the primary survey violates the
XABCDE logic and postpones treatable lethal conditions.
NAEMT PHTLS 9th Edition - Post Test Examination Preparation Page 2 of 26
, PHTLS POST TEST 9TH EDITION - EXAMINATION PREPARATION 2026/2027
Q4: During scene size-up of a frontal collision involving a hybrid vehicle, your crew notes visible
orange high-voltage cabling under the floor pan and three undeployed airbag modules. The single
patient is conscious but entrapped by her lower legs. Which action best reflects appropriate situational
awareness?
A. Begin immediate manual extrication; hybrid cabling poses no residual hazard after a crash
B. Instruct the patient to pull herself free to minimize crew exposure to electrical components
C. Cut the orange high-voltage cables to de-energize the system before touching the vehicle
D. Request specialized rescue resources and maintain a safety zone around undeployed airbags
and high-voltage components while providing care within reach of the patient [CORRECT]
Correct Answer: D
Rationale: Situational awareness means identifying hazards before they harm the crew: hybrid high-voltage cabling and
undeployed airbag inflators remain energetic after a collision. PHTLS emphasizes requesting specialized rescue resources early
and maintaining a safety perimeter rather than improvising extrication around unknown energy systems. Cutting high-voltage
cables is dangerous and does not guarantee de-energization, while asking an entrapped patient to self-extricate risks worsening
spinal and lower-extremity injuries. Patient contact and assessment can continue at a safe working distance while rescue
support is en route.
Q5: In the SAMPLE history format obtained during the secondary survey, the letter 'E' prompts the
rescuer to determine:
A. Exposure and environmental conditions at the scene
B. Events leading to the injury or illness [CORRECT]
C. Estimate of blood loss at the scene
D. Existing advance directives
Correct Answer: B
Rationale: SAMPLE stands for Signs and symptoms, Allergies, Medications, Past pertinent medical history, Last oral intake,
and Events leading to the injury or illness. Only 'E' correctly maps to events preceding the incident, which shapes suspicion for
an underlying medical cause of the trauma, such as syncope before a crash. Mechanism of injury is evaluated separately during
scene size-up and the primary survey. Misassigning the letters is a common post-test pitfall that produces incomplete histories
and missed medical-trauma interactions.
NAEMT PHTLS 9th Edition - Post Test Examination Preparation Page 3 of 26
Prehospital Trauma Life Support | Post-Test Examination Preparation | Aligned with the 2026/2027 PHTLS 9th
Edition Curriculum
ANSWER KEY +
50 QUESTIONS 7 SECTIONS GRADE A VERIFIED
RATIONALES
CANDIDATE INSTRUCTIONS
This post-test examination contains exactly 50 multiple-choice questions aligned with the NAEMT PHTLS 9th Edition
post-test assessment domains, organized into seven content sections. Each question offers four options (A-D) with ONE best
answer; select the single most appropriate action or interpretation based on current evidence-based prehospital trauma
guidelines. Questions reflect the 9th Edition emphasis on primary survey sequencing, hemorrhage control, airway
decision-making, and clinical reasoning, with a mix of approximately 25% recall, 50% application, and 25% analysis items. A
verified answer and a comprehensive rationale follow every item, explaining why the correct choice is right and why each
distractor represents a common field or post-test pitfall. Suggested time: 60 minutes, closed reference.
SECTION 1 - TRAUMA ASSESSMENT AND SCENE MANAGEMENT
Scene Safety • Scene Size-Up • Primary and Secondary Survey • Rapid Transport | Questions 1-10
Q1: Your crew responds to a two-vehicle collision on a rural highway. On arrival you note a tanker
truck in the ditch with a visible vapor cloud leaking from its rear valve assembly and liquid pooling
downhill toward the wrecked cars, where several patients are visible. Which action should the crew
take FIRST?
A. Approach the wrecked vehicles immediately and begin primary surveys before the cloud
disperses
B. Reposition the ambulance downhill of the leak to shield the crew from oncoming traffic
C. Stage uphill and upwind at a safe distance, deny entry, and await clearance by hazmat-trained
personnel [CORRECT]
D. Don gowns, gloves, and eye protection and proceed with patient care using standard
precautions
Correct Answer: C
Rationale: Scene safety is the first and overriding priority of scene size-up: a visible vapor cloud with pooling liquid indicates
an active hazardous materials release, and rescuers who approach become additional patients. Crews must stage uphill, upwind,
and at a safe distance, deny entry to others, and request hazmat resources through dispatch. Standard PPE and gowns provide
no protection against toxic inhalation hazards, and positioning downhill or downstream only increases exposure. Patient care
begins only after the scene is declared safe, which makes early specialized-resource notification critical.
NAEMT PHTLS 9th Edition - Post Test Examination Preparation Page 1 of 26
,PHTLS POST TEST 9TH EDITION - EXAMINATION PREPARATION 2026/2027
Q2: A critically injured patient presents with bright red blood spurting from an open thigh wound
following a motorcycle crash. According to the PHTLS 9th Edition primary survey (XABCDE), which
action has the HIGHEST priority?
A. Immediate tourniquet application 5-7 cm proximal to the wound [CORRECT]
B. Jaw-thrust maneuver with cervical spine restriction and an oropharyngeal airway
C. Insertion of two large-bore IVs followed by a 1-liter crystalloid bolus
D. Application of a cervical collar and full spinal immobilization
Correct Answer: A
Rationale: The PHTLS 9th Edition primary survey (XABCDE) places eXsanguinating hemorrhage before airway because
complete exsanguination can kill within minutes — faster than an unprotected airway. Immediate tourniquet application 5-7 cm
proximal to the wound, tightened until bleeding and the distal pulse stop, is the definitive field control for arterial extremity
bleeding. Airway management with cervical spine restriction comes next, followed by breathing and circulation. Large-volume
crystalloid given before hemorrhage control dilutes clotting factors, cools the patient, and can dislodge forming clot.
Q3: You have controlled exsanguinating bleeding and established a patent airway with a jaw-thrust and
an oropharyngeal airway in an unconscious multisystem trauma patient. What is your NEXT step in the
primary survey?
A. Perform a detailed head-to-toe examination at the scene
B. Obtain a complete SAMPLE history and full set of baseline vital signs
C. Assess breathing for rate, depth, symmetry, and chest wall expansion, then evaluate circulation
[CORRECT]
D. Elevate the legs and apply a pelvic binder as a routine precaution
Correct Answer: C
Rationale: The primary survey follows a fixed sequence — eXsanguinating hemorrhage, airway, breathing, circulation,
disability, expose and environment — so breathing assessment (rate, depth, symmetry, chest wall motion) precedes circulation
evaluation. Life-threatening chest injuries such as tension pneumothorax and flail chest are sought and corrected during this
phase. The detailed secondary survey and SAMPLE history are completed after critical interventions, typically during
transport, and never delay movement of an unstable patient. Performing either before finishing the primary survey violates the
XABCDE logic and postpones treatable lethal conditions.
NAEMT PHTLS 9th Edition - Post Test Examination Preparation Page 2 of 26
, PHTLS POST TEST 9TH EDITION - EXAMINATION PREPARATION 2026/2027
Q4: During scene size-up of a frontal collision involving a hybrid vehicle, your crew notes visible
orange high-voltage cabling under the floor pan and three undeployed airbag modules. The single
patient is conscious but entrapped by her lower legs. Which action best reflects appropriate situational
awareness?
A. Begin immediate manual extrication; hybrid cabling poses no residual hazard after a crash
B. Instruct the patient to pull herself free to minimize crew exposure to electrical components
C. Cut the orange high-voltage cables to de-energize the system before touching the vehicle
D. Request specialized rescue resources and maintain a safety zone around undeployed airbags
and high-voltage components while providing care within reach of the patient [CORRECT]
Correct Answer: D
Rationale: Situational awareness means identifying hazards before they harm the crew: hybrid high-voltage cabling and
undeployed airbag inflators remain energetic after a collision. PHTLS emphasizes requesting specialized rescue resources early
and maintaining a safety perimeter rather than improvising extrication around unknown energy systems. Cutting high-voltage
cables is dangerous and does not guarantee de-energization, while asking an entrapped patient to self-extricate risks worsening
spinal and lower-extremity injuries. Patient contact and assessment can continue at a safe working distance while rescue
support is en route.
Q5: In the SAMPLE history format obtained during the secondary survey, the letter 'E' prompts the
rescuer to determine:
A. Exposure and environmental conditions at the scene
B. Events leading to the injury or illness [CORRECT]
C. Estimate of blood loss at the scene
D. Existing advance directives
Correct Answer: B
Rationale: SAMPLE stands for Signs and symptoms, Allergies, Medications, Past pertinent medical history, Last oral intake,
and Events leading to the injury or illness. Only 'E' correctly maps to events preceding the incident, which shapes suspicion for
an underlying medical cause of the trauma, such as syncope before a crash. Mechanism of injury is evaluated separately during
scene size-up and the primary survey. Misassigning the letters is a common post-test pitfall that produces incomplete histories
and missed medical-trauma interactions.
NAEMT PHTLS 9th Edition - Post Test Examination Preparation Page 3 of 26
