PHTLS -Prehospital Trauma Life Support Exam
2026/2027 | Practice Questions And Answers
2026/2027 | Complete Questions And Answers (Verified
Answers) | Exam Prep | Comprehensive Exam Guide
2026&2027
1. A trauma patient is found after a high-speed motor vehicle collision. He is conscious but
has severe respiratory distress and obvious chest trauma. Which action should the
prehospital provider prioritize during the initial assessment?
A. Obtain a complete medical history
B. Address an immediate life threat affecting oxygenation and ventilation
C. Splint all suspected extremity fractures
D. Determine the patient's last oral intake
Answer: B
The initial trauma assessment prioritizes immediately life-threatening problems. Severe
respiratory distress requires rapid identification and management of compromised
oxygenation or ventilation before less urgent information is obtained.
2. A patient involved in a motorcycle crash has massive external bleeding from the thigh.
Direct pressure is applied, but bleeding continues. What is the most appropriate next
intervention?
A. Apply a tourniquet proximal to the wound
B. Elevate the extremity above the heart
C. Apply a cold compress
D. Delay treatment until a complete secondary assessment
Answer: A
Persistent life-threatening extremity hemorrhage that is not controlled with direct pressure
requires rapid hemorrhage-control measures such as an appropriately applied tourniquet.
3. During the primary survey, a trauma patient becomes increasingly confused and
develops shallow respirations. Which finding should most strongly increase concern for
impending respiratory failure?
A. Mild tachycardia
B. Superficial abrasions
C. Decreasing respiratory effort and altered mental status
D. Isolated ankle pain
Answer: C
,Decreasing respiratory effort accompanied by altered mental status indicates inadequate
ventilation and possible impending respiratory failure.
4. A patient with blunt chest trauma has severe dyspnea, hypotension, distended neck
veins, and markedly decreased breath sounds on one side. What condition should be
suspected?
A. Simple rib fracture
B. Pulmonary contusion
C. Isolated hemothorax
D. Tension pneumothorax
Answer: D
The combination of respiratory distress, hypotension, unilateral absent or markedly
diminished breath sounds, and obstructive shock findings is strongly concerning for tension
pneumothorax.
5. Which principle best describes the primary objective of prehospital trauma care?
A. Complete every diagnostic test before transport
B. Identify and treat immediately reversible life threats while arranging appropriate transport
C. Stabilize every injury before considering transportation
D. Obtain a detailed medical history before beginning treatment
Answer: B
Prehospital trauma care emphasizes rapid identification and management of immediately
life-threatening conditions while avoiding unnecessary delays in definitive care.
6. A trauma patient has a weak radial pulse, cool skin, and increasing anxiety after
significant blood loss. These findings are most consistent with:
A. Compensated shock
B. Neurogenic shock
C. Isolated respiratory failure
D. Increased intracranial pressure
Answer: A
Early hemorrhagic shock may initially present with tachycardia, peripheral vasoconstriction,
cool skin, anxiety, and preserved blood pressure before decompensation occurs.
7. A patient has an open wound to the abdomen with bowel visible through the opening.
What is the most appropriate prehospital management?
A. Push the bowel back into the abdomen
B. Apply dry gauze and firm pressure directly over the bowel
C. Cover the exposed organs with a sterile moist dressing and appropriate occlusive covering
D. Irrigate the wound extensively
,Answer: C
Eviscerated abdominal organs should not be pushed back into the abdominal cavity. They
should be protected with an appropriate sterile dressing to minimize contamination and
tissue drying.
8. Which mechanism generally creates the greatest concern for multisystem trauma?
A. Low-speed fall from standing
B. High-energy motor vehicle collision
C. Minor sports collision
D. Superficial laceration
Answer: B
High-energy mechanisms can transfer substantial force to multiple body regions, producing
injuries that may initially be occult.
9. A trauma patient is alert, speaking clearly, and maintaining his airway. During
reassessment, his mental status suddenly deteriorates. What should the provider do first?
A. Continue the secondary survey
B. Reassess airway and breathing immediately
C. Obtain a detailed medication history
D. Splint the patient's suspected femur fracture
Answer: B
A sudden deterioration requires immediate reassessment of the primary survey, particularly
airway, breathing, circulation, and neurologic status.
10. Which finding most strongly suggests inadequate perfusion in a trauma patient?
A. Warm hands with normal mentation
B. Strong peripheral pulses
C. Delayed capillary refill alone
D. Altered mental status with weak peripheral pulses
Answer: D
Altered mental status combined with weak peripheral pulses can indicate inadequate cerebral
and systemic perfusion and should prompt urgent reassessment and treatment.
11. A patient has a penetrating chest wound with air visibly moving through the wound
during inspiration. What intervention is most appropriate?
A. Leave the wound completely uncovered
B. Apply an appropriate occlusive chest dressing while monitoring ventilation
C. Pack the chest wound deeply with gauze
D. Apply a circumferential abdominal binder
, Answer: B
An open chest wound can impair ventilation and permit air entry through the chest wall. An
appropriate occlusive dressing helps limit this while the patient is closely monitored for
worsening respiratory compromise.
12. A trauma patient has suspected cervical spine injury but is maintaining his own airway.
Which principle should guide spinal motion restriction?
A. Every trauma patient must automatically receive prolonged immobilization
B. Spinal precautions should be based on mechanism, examination, and clinical risk factors
C. Spinal precautions are unnecessary in conscious patients
D. The patient's comfort should always override airway management
Answer: B
Modern trauma care emphasizes selective spinal motion restriction based on clinical
assessment rather than automatically immobilizing every trauma patient.
13. Which assessment finding is most concerning for severe traumatic brain injury?
A. Mild headache after a minor impact
B. Small superficial scalp abrasion
C. Declining level of consciousness with abnormal pupils
D. Localized bruising without neurologic symptoms
Answer: C
A declining level of consciousness and abnormal pupillary findings suggest significant
neurologic dysfunction and require urgent evaluation and transport.
14. A patient with suspected traumatic brain injury has repeated vomiting and decreasing
responsiveness. What is the priority?
A. Obtain a complete dietary history
B. Protect the airway while maintaining appropriate spinal precautions
C. Delay transport until vomiting stops
D. Place the patient upright without further assessment
Answer: B
Decreasing responsiveness and repeated vomiting increase the risk of aspiration and airway
compromise. Airway protection and appropriate trauma management take priority.
15. A patient has a penetrating injury to the neck with active bleeding. What is the most
appropriate immediate approach?
A. Apply appropriate direct pressure while protecting the airway
B. Explore the wound with a finger
2026/2027 | Practice Questions And Answers
2026/2027 | Complete Questions And Answers (Verified
Answers) | Exam Prep | Comprehensive Exam Guide
2026&2027
1. A trauma patient is found after a high-speed motor vehicle collision. He is conscious but
has severe respiratory distress and obvious chest trauma. Which action should the
prehospital provider prioritize during the initial assessment?
A. Obtain a complete medical history
B. Address an immediate life threat affecting oxygenation and ventilation
C. Splint all suspected extremity fractures
D. Determine the patient's last oral intake
Answer: B
The initial trauma assessment prioritizes immediately life-threatening problems. Severe
respiratory distress requires rapid identification and management of compromised
oxygenation or ventilation before less urgent information is obtained.
2. A patient involved in a motorcycle crash has massive external bleeding from the thigh.
Direct pressure is applied, but bleeding continues. What is the most appropriate next
intervention?
A. Apply a tourniquet proximal to the wound
B. Elevate the extremity above the heart
C. Apply a cold compress
D. Delay treatment until a complete secondary assessment
Answer: A
Persistent life-threatening extremity hemorrhage that is not controlled with direct pressure
requires rapid hemorrhage-control measures such as an appropriately applied tourniquet.
3. During the primary survey, a trauma patient becomes increasingly confused and
develops shallow respirations. Which finding should most strongly increase concern for
impending respiratory failure?
A. Mild tachycardia
B. Superficial abrasions
C. Decreasing respiratory effort and altered mental status
D. Isolated ankle pain
Answer: C
,Decreasing respiratory effort accompanied by altered mental status indicates inadequate
ventilation and possible impending respiratory failure.
4. A patient with blunt chest trauma has severe dyspnea, hypotension, distended neck
veins, and markedly decreased breath sounds on one side. What condition should be
suspected?
A. Simple rib fracture
B. Pulmonary contusion
C. Isolated hemothorax
D. Tension pneumothorax
Answer: D
The combination of respiratory distress, hypotension, unilateral absent or markedly
diminished breath sounds, and obstructive shock findings is strongly concerning for tension
pneumothorax.
5. Which principle best describes the primary objective of prehospital trauma care?
A. Complete every diagnostic test before transport
B. Identify and treat immediately reversible life threats while arranging appropriate transport
C. Stabilize every injury before considering transportation
D. Obtain a detailed medical history before beginning treatment
Answer: B
Prehospital trauma care emphasizes rapid identification and management of immediately
life-threatening conditions while avoiding unnecessary delays in definitive care.
6. A trauma patient has a weak radial pulse, cool skin, and increasing anxiety after
significant blood loss. These findings are most consistent with:
A. Compensated shock
B. Neurogenic shock
C. Isolated respiratory failure
D. Increased intracranial pressure
Answer: A
Early hemorrhagic shock may initially present with tachycardia, peripheral vasoconstriction,
cool skin, anxiety, and preserved blood pressure before decompensation occurs.
7. A patient has an open wound to the abdomen with bowel visible through the opening.
What is the most appropriate prehospital management?
A. Push the bowel back into the abdomen
B. Apply dry gauze and firm pressure directly over the bowel
C. Cover the exposed organs with a sterile moist dressing and appropriate occlusive covering
D. Irrigate the wound extensively
,Answer: C
Eviscerated abdominal organs should not be pushed back into the abdominal cavity. They
should be protected with an appropriate sterile dressing to minimize contamination and
tissue drying.
8. Which mechanism generally creates the greatest concern for multisystem trauma?
A. Low-speed fall from standing
B. High-energy motor vehicle collision
C. Minor sports collision
D. Superficial laceration
Answer: B
High-energy mechanisms can transfer substantial force to multiple body regions, producing
injuries that may initially be occult.
9. A trauma patient is alert, speaking clearly, and maintaining his airway. During
reassessment, his mental status suddenly deteriorates. What should the provider do first?
A. Continue the secondary survey
B. Reassess airway and breathing immediately
C. Obtain a detailed medication history
D. Splint the patient's suspected femur fracture
Answer: B
A sudden deterioration requires immediate reassessment of the primary survey, particularly
airway, breathing, circulation, and neurologic status.
10. Which finding most strongly suggests inadequate perfusion in a trauma patient?
A. Warm hands with normal mentation
B. Strong peripheral pulses
C. Delayed capillary refill alone
D. Altered mental status with weak peripheral pulses
Answer: D
Altered mental status combined with weak peripheral pulses can indicate inadequate cerebral
and systemic perfusion and should prompt urgent reassessment and treatment.
11. A patient has a penetrating chest wound with air visibly moving through the wound
during inspiration. What intervention is most appropriate?
A. Leave the wound completely uncovered
B. Apply an appropriate occlusive chest dressing while monitoring ventilation
C. Pack the chest wound deeply with gauze
D. Apply a circumferential abdominal binder
, Answer: B
An open chest wound can impair ventilation and permit air entry through the chest wall. An
appropriate occlusive dressing helps limit this while the patient is closely monitored for
worsening respiratory compromise.
12. A trauma patient has suspected cervical spine injury but is maintaining his own airway.
Which principle should guide spinal motion restriction?
A. Every trauma patient must automatically receive prolonged immobilization
B. Spinal precautions should be based on mechanism, examination, and clinical risk factors
C. Spinal precautions are unnecessary in conscious patients
D. The patient's comfort should always override airway management
Answer: B
Modern trauma care emphasizes selective spinal motion restriction based on clinical
assessment rather than automatically immobilizing every trauma patient.
13. Which assessment finding is most concerning for severe traumatic brain injury?
A. Mild headache after a minor impact
B. Small superficial scalp abrasion
C. Declining level of consciousness with abnormal pupils
D. Localized bruising without neurologic symptoms
Answer: C
A declining level of consciousness and abnormal pupillary findings suggest significant
neurologic dysfunction and require urgent evaluation and transport.
14. A patient with suspected traumatic brain injury has repeated vomiting and decreasing
responsiveness. What is the priority?
A. Obtain a complete dietary history
B. Protect the airway while maintaining appropriate spinal precautions
C. Delay transport until vomiting stops
D. Place the patient upright without further assessment
Answer: B
Decreasing responsiveness and repeated vomiting increase the risk of aspiration and airway
compromise. Airway protection and appropriate trauma management take priority.
15. A patient has a penetrating injury to the neck with active bleeding. What is the most
appropriate immediate approach?
A. Apply appropriate direct pressure while protecting the airway
B. Explore the wound with a finger
