Paramedic Trauma 2026 Study Guide
Practice Questions Answer Explanations
Trauma Assessment Hemorrhage Shock
Burns Spinal Injuries Clinical Scenarios
Exam Preparation.
Section 1: Trauma Assessment and Primary Survey (1–15)
1. What is the correct sequence of the primary trauma survey?
A) Airway, Breathing, Circulation, Disability, Exposure
B) Breathing, Airway, Circulation, Disability, Exposure
C) Circulation, Airway, Breathing, Disability, Exposure
D) Disability, Airway, Breathing, Circulation, Exposure
Answer: A) Airway, Breathing, Circulation, Disability, Exposure
Rationale: The ABCDE approach ensures life threats are identified and treated in
order of immediacy. Airway obstruction kills fastest, followed by breathing and
circulation problems.
2. What is the first priority when treating a trauma patient with massive
external hemorrhage?
A) Airway management
B) Control of catastrophic bleeding
C) Cervical spine immobilization
D) IV access
Answer: B) Control of catastrophic bleeding
Rationale: In modern trauma care, massive hemorrhage control takes precedence
over airway in the <C>ABC or MARCH sequence. Exsanguination is the most
common preventable cause of death in trauma.
,3. A patient has a Glasgow Coma Scale score of 8. What does this indicate?
A) Mild head injury
B) Moderate head injury
C) Severe head injury
D) Normal neurological function
Answer: C) Severe head injury
Rationale: GCS 8 or less indicates severe head injury and coma. These patients
generally require definitive airway management.
4. What does the "E" in the ABCDE primary survey stand for?
A) Evaluation
B) Exposure and environmental control
C) Extremities
D) ECG monitoring
Answer: B) Exposure and environmental control
Rationale: Exposure involves undressing the patient to identify all injuries while
preventing hypothermia, which worsens coagulopathy and acidosis.
5. Which finding during the primary survey requires immediate intervention?
A) Bruise on the forearm
B) Tension pneumothorax with tracheal deviation
C) Mild ankle pain
D) Abrasion on the knee
Answer: B) Tension pneumothorax with tracheal deviation
Rationale: Tension pneumothorax is an immediate life threat requiring needle
decompression before other interventions.
6. What is the purpose of the secondary survey?
A) To identify all injuries after life threats are addressed
B) To replace the primary survey
,C) To determine transport priority
D) To assess airway only
Answer: A) To identify all injuries after life threats are addressed
Rationale: The secondary survey is a head-to-toe examination performed after the
primary survey and resuscitation to identify all injuries.
7. What is the "golden hour" in trauma care?
A) The first 60 minutes after injury when definitive care improves survival
B) The time to complete documentation
C) The time to transport
D) The time to triage
Answer: A) The first 60 minutes after injury when definitive care improves
survival
Rationale: The golden hour emphasizes rapid assessment, treatment, and transport
to definitive care to improve outcomes.
8. Which patient requires transport to a trauma center?
A) Patient with a minor laceration
B) Patient with hypotension and abdominal rigidity after blunt trauma
C) Patient with a sprained ankle
D) Patient requesting a routine check
Answer: B) Patient with hypotension and abdominal rigidity after blunt
trauma
Rationale: Hemodynamic instability with abdominal rigidity suggests intra-
abdominal hemorrhage requiring surgical intervention at a trauma center.
9. What is the correct sequence for a trauma patient with both airway
obstruction and external hemorrhage?
A) Control hemorrhage first, then airway
B) Airway first, then hemorrhage
, C) Both simultaneously
D) Transport first
Answer: A) Control hemorrhage first, then airway
Rationale: In modern trauma care (MARCH), massive hemorrhage control
precedes airway management because exsanguination is the leading cause of
preventable death.
10. What does the "C" in the ABCDE primary survey include?
A) Pulse, blood pressure, skin signs, and hemorrhage control
B) Chest auscultation only
C) Consciousness only
D) Capnography only
Answer: A) Pulse, blood pressure, skin signs, and hemorrhage control
Rationale: Circulation assessment includes pulse quality, blood pressure, skin
color/temperature, capillary refill, and control of external bleeding.
11. What is a sign of impending herniation in a head-injured patient?
A) Unilateral pupil dilation with decreased consciousness
B) Mild headache
C) Bilateral equal pupils
D) Normal mental status
Answer: A) Unilateral pupil dilation with decreased consciousness
Rationale: Unilateral pupil dilation, posturing, and decreased consciousness
suggest increased intracranial pressure and herniation.
12. What is the correct GCS score for a patient who opens eyes to pain, makes
incomprehensible sounds, and withdraws from pain?
A) GCS 6
B) GCS 7
Practice Questions Answer Explanations
Trauma Assessment Hemorrhage Shock
Burns Spinal Injuries Clinical Scenarios
Exam Preparation.
Section 1: Trauma Assessment and Primary Survey (1–15)
1. What is the correct sequence of the primary trauma survey?
A) Airway, Breathing, Circulation, Disability, Exposure
B) Breathing, Airway, Circulation, Disability, Exposure
C) Circulation, Airway, Breathing, Disability, Exposure
D) Disability, Airway, Breathing, Circulation, Exposure
Answer: A) Airway, Breathing, Circulation, Disability, Exposure
Rationale: The ABCDE approach ensures life threats are identified and treated in
order of immediacy. Airway obstruction kills fastest, followed by breathing and
circulation problems.
2. What is the first priority when treating a trauma patient with massive
external hemorrhage?
A) Airway management
B) Control of catastrophic bleeding
C) Cervical spine immobilization
D) IV access
Answer: B) Control of catastrophic bleeding
Rationale: In modern trauma care, massive hemorrhage control takes precedence
over airway in the <C>ABC or MARCH sequence. Exsanguination is the most
common preventable cause of death in trauma.
,3. A patient has a Glasgow Coma Scale score of 8. What does this indicate?
A) Mild head injury
B) Moderate head injury
C) Severe head injury
D) Normal neurological function
Answer: C) Severe head injury
Rationale: GCS 8 or less indicates severe head injury and coma. These patients
generally require definitive airway management.
4. What does the "E" in the ABCDE primary survey stand for?
A) Evaluation
B) Exposure and environmental control
C) Extremities
D) ECG monitoring
Answer: B) Exposure and environmental control
Rationale: Exposure involves undressing the patient to identify all injuries while
preventing hypothermia, which worsens coagulopathy and acidosis.
5. Which finding during the primary survey requires immediate intervention?
A) Bruise on the forearm
B) Tension pneumothorax with tracheal deviation
C) Mild ankle pain
D) Abrasion on the knee
Answer: B) Tension pneumothorax with tracheal deviation
Rationale: Tension pneumothorax is an immediate life threat requiring needle
decompression before other interventions.
6. What is the purpose of the secondary survey?
A) To identify all injuries after life threats are addressed
B) To replace the primary survey
,C) To determine transport priority
D) To assess airway only
Answer: A) To identify all injuries after life threats are addressed
Rationale: The secondary survey is a head-to-toe examination performed after the
primary survey and resuscitation to identify all injuries.
7. What is the "golden hour" in trauma care?
A) The first 60 minutes after injury when definitive care improves survival
B) The time to complete documentation
C) The time to transport
D) The time to triage
Answer: A) The first 60 minutes after injury when definitive care improves
survival
Rationale: The golden hour emphasizes rapid assessment, treatment, and transport
to definitive care to improve outcomes.
8. Which patient requires transport to a trauma center?
A) Patient with a minor laceration
B) Patient with hypotension and abdominal rigidity after blunt trauma
C) Patient with a sprained ankle
D) Patient requesting a routine check
Answer: B) Patient with hypotension and abdominal rigidity after blunt
trauma
Rationale: Hemodynamic instability with abdominal rigidity suggests intra-
abdominal hemorrhage requiring surgical intervention at a trauma center.
9. What is the correct sequence for a trauma patient with both airway
obstruction and external hemorrhage?
A) Control hemorrhage first, then airway
B) Airway first, then hemorrhage
, C) Both simultaneously
D) Transport first
Answer: A) Control hemorrhage first, then airway
Rationale: In modern trauma care (MARCH), massive hemorrhage control
precedes airway management because exsanguination is the leading cause of
preventable death.
10. What does the "C" in the ABCDE primary survey include?
A) Pulse, blood pressure, skin signs, and hemorrhage control
B) Chest auscultation only
C) Consciousness only
D) Capnography only
Answer: A) Pulse, blood pressure, skin signs, and hemorrhage control
Rationale: Circulation assessment includes pulse quality, blood pressure, skin
color/temperature, capillary refill, and control of external bleeding.
11. What is a sign of impending herniation in a head-injured patient?
A) Unilateral pupil dilation with decreased consciousness
B) Mild headache
C) Bilateral equal pupils
D) Normal mental status
Answer: A) Unilateral pupil dilation with decreased consciousness
Rationale: Unilateral pupil dilation, posturing, and decreased consciousness
suggest increased intracranial pressure and herniation.
12. What is the correct GCS score for a patient who opens eyes to pain, makes
incomprehensible sounds, and withdraws from pain?
A) GCS 6
B) GCS 7
