CSTR EXAM 2026 2027 VERIFIED QUESTIONS & ANSWERS
DETAILED RATIONALES & STUDY GUIDE 140 Qu
Updated Questions and Verified Answers | 140 Questions | 100% VERIFIED
Introduction
The CSTR examination evaluates the knowledge and clinical judgment required for safe,
competent trauma care across the continuum of injury. This comprehensive assessment
spans eight core domains: Trauma Assessment and Triage; Hemorrhage Control and Shock
Management; Airway Management and Respiratory Trauma; Neurological Trauma and TBI;
Musculoskeletal and Spinal Injuries; Burn, Thermal, and Soft Tissue Trauma; Trauma
Resuscitation and Fluid Therapy; and Post-Trauma Care and Complication Prevention. Each
question that follows targets a distinct sub-topic within this blueprint. Mastery of these
domains supports professional certification and strengthens trauma nursing clinical
execution and professional judgment in high-acuity settings.
1. The primary survey in trauma follows which sequence?
A. Breathing, Airway, Circulation, Disability, Exposure
B. Airway, Breathing, Circulation, Disability, Exposure
C. Circulation, Airway, Breathing, Exposure, Disability
D. Exposure, Disability, Circulation, Breathing, Airway
Correct Answer: B. Airway, Breathing, Circulation, Disability, Exposure
Rationale: The primary survey proceeds ABCDE—Airway (with cervical spine
protection), Breathing, Circulation, Disability, and Exposure—to address the most
immediate threats to life first. Any other order delays critical interventions.
2. Which color triage tag identifies a patient requiring immediate life-saving
intervention?
A. Red
B. Green
C. Yellow
D. Black
Correct Answer: A. Red
Rationale: Red indicates immediate need due to life-threatening injuries. Yellow is
delayed, green is minor (walking wounded), and black is deceased or expectant.
3. The first action in the primary survey is to:
A. Assess and secure a patent airway with cervical spine precautions
B. Check distal pulses
C. Insert two large-bore IVs
D. Obtain a chest radiograph
, Correct Answer: A. Assess and secure a patent airway with cervical spine
precautions
Rationale: Airway management with cervical spine protection is the first priority
because airway obstruction or apnea is fatal within minutes. Circulation, IV access, and
imaging follow.
4. The Glasgow Coma Scale evaluates:
A. Heart rate, blood pressure, and temperature
B. Pupil size, reflexes, and speech only
C. Eye opening, verbal response, and motor response
D. Memory, orientation, and balance only
Correct Answer: C. Eye opening, verbal response, and motor response
Rationale: The GCS scores best eye opening (1–4), verbal response (1–5), and motor
response (1–6). Vital signs and pupil checks are separate assessments.
5. A Glasgow Coma Scale score of 8 or less generally indicates the need for:
A. Routine observation only
B. An oral fluid challenge
C. Immediate discharge
D. Definitive airway management (intubation)
Correct Answer: D. Definitive airway management (intubation)
Rationale: A GCS of 8 or less signals an inability to protect the airway, so intubation is
generally indicated. Observation or discharge would be unsafe.
6. The purpose of the secondary survey is to:
A. Replace the primary survey entirely
B. Determine the patient's insurance status
C. Administer all medications
D. Perform a systematic head-to-toe evaluation after life threats are addressed
Correct Answer: D. Perform a systematic head-to-toe evaluation after life threats
are addressed
Rationale: The secondary survey is a complete head-to-toe examination and history to
identify all injuries after the primary survey stabilizes life threats.
7. The Revised Trauma Score is calculated from:
A. Heart rate, temperature, and oxygen saturation
B. Glasgow Coma Scale, systolic blood pressure, and respiratory rate
C. Age, weight, and blood type
D. Urine output, hemoglobin, and glucose
Correct Answer: B. Glasgow Coma Scale, systolic blood pressure, and respiratory
rate
, Rationale: The Revised Trauma Score uses GCS, systolic blood pressure, and
respiratory rate to estimate physiologic derangement. The other sets are not
components of the score.
8. The FAST (Focused Assessment with Sonography for Trauma) examination
primarily detects:
A. Intracranial hemorrhage
B. Free fluid in the abdomen or pericardium
C. Long bone fractures
D. Airway obstruction
Correct Answer: B. Free fluid in the abdomen or pericardium
Rationale: FAST is a rapid bedside ultrasound looking for free fluid (hemoperitoneum)
and pericardial fluid. It does not image the brain or long bones.
9. A patient with penetrating torso trauma, hypotension, and tachycardia should be
transported to:
A. The nearest designated trauma center
B. Any walk-in clinic
C. Home with instructions
D. A pharmacy
Correct Answer: A. The nearest designated trauma center
Rationale: Physiologic derangement plus a concerning mechanism meets trauma triage
criteria for the nearest appropriate trauma center.
10. The “golden hour” concept refers to:
A. A specific 60-minute surgical limit
B. The time allowed for paperwork
C. The duration of a blood transfusion
D. The critical early period after injury when rapid assessment and intervention
improve outcomes
Correct Answer: D. The critical early period after injury when rapid assessment
and intervention improve outcomes
Rationale: The golden hour emphasizes that early, organized assessment and treatment
after injury reduce morbidity and mortality. It is a guiding concept, not a rigid clock.
11. A patient with suspected spinal injury should be moved using:
A. Log-roll technique with inline stabilization
B. Unassisted sitting up
C. Lifting by the arms and legs alone
D. Dragging by the shoulders
Correct Answer: A. Log-roll technique with inline stabilization
Rationale: Log-roll with manual inline stabilization maintains spinal alignment during
movement. Other methods risk further spinal cord injury.
, 12. Which finding indicates poor perfusion during the circulation assessment?
A. Warm, dry, pink skin
B. Strong regular pulses
C. Cool, pale, clammy skin with weak pulses
D. Normal capillary refill
Correct Answer: C. Cool, pale, clammy skin with weak pulses
Rationale: Cool, pale, clammy skin and weak pulses reflect vasoconstriction and
reduced perfusion. The other options describe adequate perfusion.
13. A “green” triage tag designates a patient who is:
A. In cardiac arrest
B. In immediate need of airway support
C. Ambulating with minor injuries (walking wounded)
D. Deceased
Correct Answer: C. Ambulating with minor injuries (walking wounded)
Rationale: Green denotes minor injuries in patients who can walk. Red is immediate,
yellow is delayed, and black is deceased or expectant.
14. During the “Exposure” step, the team should also:
A. Prevent hypothermia after removing clothing
B. Leave the patient fully dressed
C. Avoid inspecting the back
D. Delay all assessment
Correct Answer: A. Prevent hypothermia after removing clothing
Rationale: Exposure requires removing clothing to find hidden injuries, and the patient
must be covered and warmed to prevent hypothermia.
15. Blunt versus penetrating trauma is classified as part of:
A. Glasgow Coma Scale
B. Revised Trauma Score
C. Triage tag color only
D. Mechanism of injury
Correct Answer: D. Mechanism of injury
Rationale: The mechanism of injury (blunt, penetrating, thermal, or blast) is a key
component of trauma assessment and guides suspected injury patterns.
16. A normal adult respiratory rate is approximately:
A. 40–60 breaths per minute
B. 4–6 breaths per minute
C. 12–20 breaths per minute
D. 30–40 breaths per minute
Correct Answer: C. 12–20 breaths per minute
DETAILED RATIONALES & STUDY GUIDE 140 Qu
Updated Questions and Verified Answers | 140 Questions | 100% VERIFIED
Introduction
The CSTR examination evaluates the knowledge and clinical judgment required for safe,
competent trauma care across the continuum of injury. This comprehensive assessment
spans eight core domains: Trauma Assessment and Triage; Hemorrhage Control and Shock
Management; Airway Management and Respiratory Trauma; Neurological Trauma and TBI;
Musculoskeletal and Spinal Injuries; Burn, Thermal, and Soft Tissue Trauma; Trauma
Resuscitation and Fluid Therapy; and Post-Trauma Care and Complication Prevention. Each
question that follows targets a distinct sub-topic within this blueprint. Mastery of these
domains supports professional certification and strengthens trauma nursing clinical
execution and professional judgment in high-acuity settings.
1. The primary survey in trauma follows which sequence?
A. Breathing, Airway, Circulation, Disability, Exposure
B. Airway, Breathing, Circulation, Disability, Exposure
C. Circulation, Airway, Breathing, Exposure, Disability
D. Exposure, Disability, Circulation, Breathing, Airway
Correct Answer: B. Airway, Breathing, Circulation, Disability, Exposure
Rationale: The primary survey proceeds ABCDE—Airway (with cervical spine
protection), Breathing, Circulation, Disability, and Exposure—to address the most
immediate threats to life first. Any other order delays critical interventions.
2. Which color triage tag identifies a patient requiring immediate life-saving
intervention?
A. Red
B. Green
C. Yellow
D. Black
Correct Answer: A. Red
Rationale: Red indicates immediate need due to life-threatening injuries. Yellow is
delayed, green is minor (walking wounded), and black is deceased or expectant.
3. The first action in the primary survey is to:
A. Assess and secure a patent airway with cervical spine precautions
B. Check distal pulses
C. Insert two large-bore IVs
D. Obtain a chest radiograph
, Correct Answer: A. Assess and secure a patent airway with cervical spine
precautions
Rationale: Airway management with cervical spine protection is the first priority
because airway obstruction or apnea is fatal within minutes. Circulation, IV access, and
imaging follow.
4. The Glasgow Coma Scale evaluates:
A. Heart rate, blood pressure, and temperature
B. Pupil size, reflexes, and speech only
C. Eye opening, verbal response, and motor response
D. Memory, orientation, and balance only
Correct Answer: C. Eye opening, verbal response, and motor response
Rationale: The GCS scores best eye opening (1–4), verbal response (1–5), and motor
response (1–6). Vital signs and pupil checks are separate assessments.
5. A Glasgow Coma Scale score of 8 or less generally indicates the need for:
A. Routine observation only
B. An oral fluid challenge
C. Immediate discharge
D. Definitive airway management (intubation)
Correct Answer: D. Definitive airway management (intubation)
Rationale: A GCS of 8 or less signals an inability to protect the airway, so intubation is
generally indicated. Observation or discharge would be unsafe.
6. The purpose of the secondary survey is to:
A. Replace the primary survey entirely
B. Determine the patient's insurance status
C. Administer all medications
D. Perform a systematic head-to-toe evaluation after life threats are addressed
Correct Answer: D. Perform a systematic head-to-toe evaluation after life threats
are addressed
Rationale: The secondary survey is a complete head-to-toe examination and history to
identify all injuries after the primary survey stabilizes life threats.
7. The Revised Trauma Score is calculated from:
A. Heart rate, temperature, and oxygen saturation
B. Glasgow Coma Scale, systolic blood pressure, and respiratory rate
C. Age, weight, and blood type
D. Urine output, hemoglobin, and glucose
Correct Answer: B. Glasgow Coma Scale, systolic blood pressure, and respiratory
rate
, Rationale: The Revised Trauma Score uses GCS, systolic blood pressure, and
respiratory rate to estimate physiologic derangement. The other sets are not
components of the score.
8. The FAST (Focused Assessment with Sonography for Trauma) examination
primarily detects:
A. Intracranial hemorrhage
B. Free fluid in the abdomen or pericardium
C. Long bone fractures
D. Airway obstruction
Correct Answer: B. Free fluid in the abdomen or pericardium
Rationale: FAST is a rapid bedside ultrasound looking for free fluid (hemoperitoneum)
and pericardial fluid. It does not image the brain or long bones.
9. A patient with penetrating torso trauma, hypotension, and tachycardia should be
transported to:
A. The nearest designated trauma center
B. Any walk-in clinic
C. Home with instructions
D. A pharmacy
Correct Answer: A. The nearest designated trauma center
Rationale: Physiologic derangement plus a concerning mechanism meets trauma triage
criteria for the nearest appropriate trauma center.
10. The “golden hour” concept refers to:
A. A specific 60-minute surgical limit
B. The time allowed for paperwork
C. The duration of a blood transfusion
D. The critical early period after injury when rapid assessment and intervention
improve outcomes
Correct Answer: D. The critical early period after injury when rapid assessment
and intervention improve outcomes
Rationale: The golden hour emphasizes that early, organized assessment and treatment
after injury reduce morbidity and mortality. It is a guiding concept, not a rigid clock.
11. A patient with suspected spinal injury should be moved using:
A. Log-roll technique with inline stabilization
B. Unassisted sitting up
C. Lifting by the arms and legs alone
D. Dragging by the shoulders
Correct Answer: A. Log-roll technique with inline stabilization
Rationale: Log-roll with manual inline stabilization maintains spinal alignment during
movement. Other methods risk further spinal cord injury.
, 12. Which finding indicates poor perfusion during the circulation assessment?
A. Warm, dry, pink skin
B. Strong regular pulses
C. Cool, pale, clammy skin with weak pulses
D. Normal capillary refill
Correct Answer: C. Cool, pale, clammy skin with weak pulses
Rationale: Cool, pale, clammy skin and weak pulses reflect vasoconstriction and
reduced perfusion. The other options describe adequate perfusion.
13. A “green” triage tag designates a patient who is:
A. In cardiac arrest
B. In immediate need of airway support
C. Ambulating with minor injuries (walking wounded)
D. Deceased
Correct Answer: C. Ambulating with minor injuries (walking wounded)
Rationale: Green denotes minor injuries in patients who can walk. Red is immediate,
yellow is delayed, and black is deceased or expectant.
14. During the “Exposure” step, the team should also:
A. Prevent hypothermia after removing clothing
B. Leave the patient fully dressed
C. Avoid inspecting the back
D. Delay all assessment
Correct Answer: A. Prevent hypothermia after removing clothing
Rationale: Exposure requires removing clothing to find hidden injuries, and the patient
must be covered and warmed to prevent hypothermia.
15. Blunt versus penetrating trauma is classified as part of:
A. Glasgow Coma Scale
B. Revised Trauma Score
C. Triage tag color only
D. Mechanism of injury
Correct Answer: D. Mechanism of injury
Rationale: The mechanism of injury (blunt, penetrating, thermal, or blast) is a key
component of trauma assessment and guides suspected injury patterns.
16. A normal adult respiratory rate is approximately:
A. 40–60 breaths per minute
B. 4–6 breaths per minute
C. 12–20 breaths per minute
D. 30–40 breaths per minute
Correct Answer: C. 12–20 breaths per minute
