PHTLS Pre-Test
9th Edition
Latest
50 Questions and Verified Answers
Grade A — Comprehensive Pre-Test Assessment
with PHTLS 9th Edition–Specific Rationales
SECTION
1 • Trauma Fundamentals & Scene Management (Q1–Q12)
2 • Airway, Breathing & Ventilation (Q13–Q20)
3 • Circulation, Shock & Hemorrhage Control (Q21–Q28)
4 • Thoracic, Abdominal & Pelvic Trauma (Q29–Q36)
5 • Head, Spine & Musculoskeletal Trauma (Q37–Q44)
6 • Special Populations & Trauma Systems (Q45–Q50)
Aligned with NAEMT PHTLS 9th Edition Pre-Test Assessment Domains
Cognitive Distribution: 30% Recall • 50% Application • 20% Analysis
70% Scenario-Based • 30% Foundational Recall
,PHTLS Pre-Test — 9th Edition (2026/2027) Grade A • Verified Answers & Rationales
PHTLS Pre-Test — 9th Edition (Latest
2026/2027)
Questions and Verified Answers — Grade A
Aligned with NAEMT PHTLS 9th Edition Curriculum & Pre-Test Assessment Standards
Examination Overview: This 50-question pre-test assessment is structured to evaluate foundational and applied
knowledge across the six core PHTLS 9th Edition pre-test domains: trauma fundamentals and scene management;
airway, breathing, and ventilation; circulation, shock, and hemorrhage control; thoracic, abdominal, and pelvic
trauma; head, spine, and musculoskeletal trauma; and special populations including pediatric, geriatric, pregnant, and
environmental trauma. Each question is designed to align with current NAEMT PHTLS 9th Edition evidence-based
practice principles, including the 2026/2027 updates reflecting contemporary prehospital trauma care.
Cognitive Distribution: The exam follows the recommended distribution of 30% recall (foundational knowledge),
50% application (clinical scenario-based reasoning), and 20% analysis (integration of multiple concepts). The 70%
scenario-based / 30% direct-recall design reinforces real-world decision-making reflective of field practice.
Distractors represent common PHTLS pre-test pitfalls, including primary survey sequencing errors, airway adjunct
selection mistakes, hemorrhage control prioritization errors, shock classification confusion, thoracic injury
identification errors, spinal motion restriction application mistakes, and special population considerations.
Format: Each item includes a stem, four lettered options (A–D) with one correct answer marked [CORRECT], the
verified correct answer letter, and a 2–4 sentence PHTLS 9th Edition–specific rationale explaining both why the
correct answer is right and why each distractor is wrong. Rationales incorporate trauma assessment principles,
evidence-based interventions, and patient safety considerations consistent with current prehospital trauma standards.
SECTION 1: Trauma Fundamentals and Scene Management (Scene Safety,
Assessment Principles, & Core Concepts) — Q1–Q12
Q1: You arrive on scene at a two-vehicle motor vehicle collision with downed power lines
across one vehicle. Which action is the MOST appropriate FIRST step in patient care?
A. Rapidly approach the vehicle closest to the downed lines to assess the most visibly injured patient.
B. Ensure the scene is safe by waiting for the power company to confirm lines are de-energized before
patient contact. [CORRECT]
C. Use a wooden broom handle to push the power lines off the vehicle so you can access the patients.
D. Direct a bystander to move the downed lines with a dry tree branch while you begin primary surveys.
Correct Answer: B
Rationale: Scene safety is the cornerstone of the PHTLS 9th Edition assessment sequence and must precede any patient
contact. Downed power lines remain energized until confirmed otherwise by the utility company; treating them as live is
mandatory because electrocution risk to rescuers and patients is lethal. Options A, C, and D all involve approaching or
manipulating energized lines, which is a critical violation of prehospital scene safety principles.
NAEMT PHTLS 9th Edition • Pre-Test Assessment Page 2
, PHTLS Pre-Test — 9th Edition (2026/2027) Grade A • Verified Answers & Rationales
Q2: A 24-year-old male was ejected from a vehicle traveling 55 mph. He was unrestrained and
the steering column is severely deformed. Which kinematic principle BEST explains the
mechanism of injury and predicts internal injury patterns?
A. The patient decelerated gradually, distributing energy over time and minimizing internal organ injury.
B. The patient experienced rapid deceleration, causing internal organs to continue moving forward and
strike fixed structures, producing shearing and compression injuries. [CORRECT]
C. The patient's ejection absorbed most of the kinetic energy, eliminating the risk of significant internal injury.
D. Energy transfer in ejections is limited to the skin surface, making internal injuries unlikely without external
wounds.
Correct Answer: B
Rationale: PHTLS 9th Edition emphasizes kinematics of trauma: energy cannot be created or destroyed, only transferred.
In rapid deceleration, the body stops but internal organs continue at the original speed, striking fixed structures (e.g.,
steering column, dashboard), producing shearing of vascular pedicles and compression of solid organs. Ejection actually
INCREASES energy transfer and injury severity, contradicting options A, C, and D.
Q3: Which sequence represents the correct PHTLS 9th Edition primary survey order for a
critically injured trauma patient?
A. Airway, Breathing, Circulation, Disability, Exposure [CORRECT]
B. Circulation, Airway, Breathing, Disability, Exposure
C. Airway, Circulation, Breathing, Exposure, Disability
D. Disability, Airway, Breathing, Circulation, Exposure
Correct Answer: A
Rationale: The PHTLS 9th Edition primary survey follows the standardized ABCDE sequence: Airway (with cervical
spine protection), Breathing, Circulation (with hemorrhage control), Disability (neurologic status), and
Exposure/Environment. This order reflects the principle that the most immediately life-threatening problems—airway
compromise, breathing failure, and exsanguination—must be addressed before neurologic assessment and full exposure,
which is the foundation of the 9th Edition's time-critical approach.
Q4: What is the PRIMARY purpose of the secondary survey in a stable trauma patient per
PHTLS 9th Edition guidelines?
A. To identify and immediately intervene on life-threatening conditions before transport.
B. To perform a systematic head-to-toe assessment, obtain vital signs and SAMPLE history, and identify
injuries not found in the primary survey. [CORRECT]
C. To determine the appropriate trauma center destination and activate the trauma team.
D. To provide pain management and document injuries for the patient care report only.
Correct Answer: B
Rationale: The secondary survey is a comprehensive head-to-toe physical examination performed AFTER the primary
survey has identified and addressed immediately life-threatening conditions. It includes vital signs, SAMPLE history
(Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading), and identification of
non-life-threatening injuries. Option A describes the primary survey purpose; options C and D are transport and
documentation tasks that occur separately.
NAEMT PHTLS 9th Edition • Pre-Test Assessment Page 3
9th Edition
Latest
50 Questions and Verified Answers
Grade A — Comprehensive Pre-Test Assessment
with PHTLS 9th Edition–Specific Rationales
SECTION
1 • Trauma Fundamentals & Scene Management (Q1–Q12)
2 • Airway, Breathing & Ventilation (Q13–Q20)
3 • Circulation, Shock & Hemorrhage Control (Q21–Q28)
4 • Thoracic, Abdominal & Pelvic Trauma (Q29–Q36)
5 • Head, Spine & Musculoskeletal Trauma (Q37–Q44)
6 • Special Populations & Trauma Systems (Q45–Q50)
Aligned with NAEMT PHTLS 9th Edition Pre-Test Assessment Domains
Cognitive Distribution: 30% Recall • 50% Application • 20% Analysis
70% Scenario-Based • 30% Foundational Recall
,PHTLS Pre-Test — 9th Edition (2026/2027) Grade A • Verified Answers & Rationales
PHTLS Pre-Test — 9th Edition (Latest
2026/2027)
Questions and Verified Answers — Grade A
Aligned with NAEMT PHTLS 9th Edition Curriculum & Pre-Test Assessment Standards
Examination Overview: This 50-question pre-test assessment is structured to evaluate foundational and applied
knowledge across the six core PHTLS 9th Edition pre-test domains: trauma fundamentals and scene management;
airway, breathing, and ventilation; circulation, shock, and hemorrhage control; thoracic, abdominal, and pelvic
trauma; head, spine, and musculoskeletal trauma; and special populations including pediatric, geriatric, pregnant, and
environmental trauma. Each question is designed to align with current NAEMT PHTLS 9th Edition evidence-based
practice principles, including the 2026/2027 updates reflecting contemporary prehospital trauma care.
Cognitive Distribution: The exam follows the recommended distribution of 30% recall (foundational knowledge),
50% application (clinical scenario-based reasoning), and 20% analysis (integration of multiple concepts). The 70%
scenario-based / 30% direct-recall design reinforces real-world decision-making reflective of field practice.
Distractors represent common PHTLS pre-test pitfalls, including primary survey sequencing errors, airway adjunct
selection mistakes, hemorrhage control prioritization errors, shock classification confusion, thoracic injury
identification errors, spinal motion restriction application mistakes, and special population considerations.
Format: Each item includes a stem, four lettered options (A–D) with one correct answer marked [CORRECT], the
verified correct answer letter, and a 2–4 sentence PHTLS 9th Edition–specific rationale explaining both why the
correct answer is right and why each distractor is wrong. Rationales incorporate trauma assessment principles,
evidence-based interventions, and patient safety considerations consistent with current prehospital trauma standards.
SECTION 1: Trauma Fundamentals and Scene Management (Scene Safety,
Assessment Principles, & Core Concepts) — Q1–Q12
Q1: You arrive on scene at a two-vehicle motor vehicle collision with downed power lines
across one vehicle. Which action is the MOST appropriate FIRST step in patient care?
A. Rapidly approach the vehicle closest to the downed lines to assess the most visibly injured patient.
B. Ensure the scene is safe by waiting for the power company to confirm lines are de-energized before
patient contact. [CORRECT]
C. Use a wooden broom handle to push the power lines off the vehicle so you can access the patients.
D. Direct a bystander to move the downed lines with a dry tree branch while you begin primary surveys.
Correct Answer: B
Rationale: Scene safety is the cornerstone of the PHTLS 9th Edition assessment sequence and must precede any patient
contact. Downed power lines remain energized until confirmed otherwise by the utility company; treating them as live is
mandatory because electrocution risk to rescuers and patients is lethal. Options A, C, and D all involve approaching or
manipulating energized lines, which is a critical violation of prehospital scene safety principles.
NAEMT PHTLS 9th Edition • Pre-Test Assessment Page 2
, PHTLS Pre-Test — 9th Edition (2026/2027) Grade A • Verified Answers & Rationales
Q2: A 24-year-old male was ejected from a vehicle traveling 55 mph. He was unrestrained and
the steering column is severely deformed. Which kinematic principle BEST explains the
mechanism of injury and predicts internal injury patterns?
A. The patient decelerated gradually, distributing energy over time and minimizing internal organ injury.
B. The patient experienced rapid deceleration, causing internal organs to continue moving forward and
strike fixed structures, producing shearing and compression injuries. [CORRECT]
C. The patient's ejection absorbed most of the kinetic energy, eliminating the risk of significant internal injury.
D. Energy transfer in ejections is limited to the skin surface, making internal injuries unlikely without external
wounds.
Correct Answer: B
Rationale: PHTLS 9th Edition emphasizes kinematics of trauma: energy cannot be created or destroyed, only transferred.
In rapid deceleration, the body stops but internal organs continue at the original speed, striking fixed structures (e.g.,
steering column, dashboard), producing shearing of vascular pedicles and compression of solid organs. Ejection actually
INCREASES energy transfer and injury severity, contradicting options A, C, and D.
Q3: Which sequence represents the correct PHTLS 9th Edition primary survey order for a
critically injured trauma patient?
A. Airway, Breathing, Circulation, Disability, Exposure [CORRECT]
B. Circulation, Airway, Breathing, Disability, Exposure
C. Airway, Circulation, Breathing, Exposure, Disability
D. Disability, Airway, Breathing, Circulation, Exposure
Correct Answer: A
Rationale: The PHTLS 9th Edition primary survey follows the standardized ABCDE sequence: Airway (with cervical
spine protection), Breathing, Circulation (with hemorrhage control), Disability (neurologic status), and
Exposure/Environment. This order reflects the principle that the most immediately life-threatening problems—airway
compromise, breathing failure, and exsanguination—must be addressed before neurologic assessment and full exposure,
which is the foundation of the 9th Edition's time-critical approach.
Q4: What is the PRIMARY purpose of the secondary survey in a stable trauma patient per
PHTLS 9th Edition guidelines?
A. To identify and immediately intervene on life-threatening conditions before transport.
B. To perform a systematic head-to-toe assessment, obtain vital signs and SAMPLE history, and identify
injuries not found in the primary survey. [CORRECT]
C. To determine the appropriate trauma center destination and activate the trauma team.
D. To provide pain management and document injuries for the patient care report only.
Correct Answer: B
Rationale: The secondary survey is a comprehensive head-to-toe physical examination performed AFTER the primary
survey has identified and addressed immediately life-threatening conditions. It includes vital signs, SAMPLE history
(Symptoms, Allergies, Medications, Past history, Last oral intake, Events leading), and identification of
non-life-threatening injuries. Option A describes the primary survey purpose; options C and D are transport and
documentation tasks that occur separately.
NAEMT PHTLS 9th Edition • Pre-Test Assessment Page 3
