PHTLS 9th Ed. Self-test 2026 with
complete solution
Course
PHTLS
1. A trauma patient has severe bleeding from an amputated lower extremity. Bystanders have
applied an improvised tourniquet. What should the provider do first?
A. Remove the tourniquet immediately
B. Confirm that the tourniquet is appropriately applied and controlling hemorrhage
C. Perform a complete secondary survey
D. Apply ice to the amputation
Answer: B. Confirm that the tourniquet is appropriately applied and controlling hemorrhage
Complete solution: The immediate priority is control of life-threatening hemorrhage. If a
tourniquet is already present, assess whether it is properly positioned and effective. Do not
unnecessarily remove an effective tourniquet in the field.
2. Which assessment belongs primarily to the secondary survey?
A. Immediate control of massive hemorrhage
B. Airway assessment
C. Detailed head-to-toe examination and vital signs
D. Immediate recognition of respiratory arrest
Answer: C. Detailed head-to-toe examination and vital signs
Complete solution: The secondary survey is a more detailed assessment performed after
immediate life threats have been identified and managed. It includes repeated vital signs and a
systematic examination for additional injuries.
3. In PHTLS, a treatment principle is best described as:
A. A preference based only on available equipment
B. An action necessary for patient improvement or survival
C. A treatment selected because it is easiest
D. A hospital-only intervention
Answer: B. An action necessary for patient improvement or survival
, Complete solution: A principle describes what is necessary to improve or preserve the patient's
condition. The specific method used to accomplish that principle can vary according to
circumstances, patient condition, resources, and other factors.
4. Which factor should influence the specific method chosen to manage a trauma patient?
A. Patient condition
B. Available equipment
C. Circumstances of the situation
D. All of the above
Answer: D. All of the above
Complete solution: Trauma care requires adapting treatment to the patient's condition, the
situation, and resources available. PHTLS emphasizes critical thinking rather than blindly
applying one technique to every patient.
5. A patient has blunt chest trauma, absent breath sounds on one side, severe respiratory
distress, and signs of obstructive shock. Which condition is most likely?
A. Simple rib fracture
B. Tension pneumothorax
C. Isolated pulmonary contusion
D. Cardiac contusion
Answer: B. Tension pneumothorax
Complete solution: A tension pneumothorax can progressively impair ventilation and venous
return, producing severe respiratory distress and obstructive shock. It is an immediately life-
threatening condition.
6. Which finding is most suggestive of tension pneumothorax in a deteriorating trauma patient?
A. Mild localized chest pain
B. Severe respiratory distress with unilateral absent breath sounds
C. Isolated bruising of the abdomen
D. Normal respiratory effort
Answer: B. Severe respiratory distress with unilateral absent breath sounds
Complete solution: The combination of significant respiratory distress and markedly diminished
or absent breath sounds on one side after trauma should raise strong concern for
pneumothorax, particularly tension physiology when the patient is deteriorating.
7. A patient has an open chest wound. What is the primary concern?
complete solution
Course
PHTLS
1. A trauma patient has severe bleeding from an amputated lower extremity. Bystanders have
applied an improvised tourniquet. What should the provider do first?
A. Remove the tourniquet immediately
B. Confirm that the tourniquet is appropriately applied and controlling hemorrhage
C. Perform a complete secondary survey
D. Apply ice to the amputation
Answer: B. Confirm that the tourniquet is appropriately applied and controlling hemorrhage
Complete solution: The immediate priority is control of life-threatening hemorrhage. If a
tourniquet is already present, assess whether it is properly positioned and effective. Do not
unnecessarily remove an effective tourniquet in the field.
2. Which assessment belongs primarily to the secondary survey?
A. Immediate control of massive hemorrhage
B. Airway assessment
C. Detailed head-to-toe examination and vital signs
D. Immediate recognition of respiratory arrest
Answer: C. Detailed head-to-toe examination and vital signs
Complete solution: The secondary survey is a more detailed assessment performed after
immediate life threats have been identified and managed. It includes repeated vital signs and a
systematic examination for additional injuries.
3. In PHTLS, a treatment principle is best described as:
A. A preference based only on available equipment
B. An action necessary for patient improvement or survival
C. A treatment selected because it is easiest
D. A hospital-only intervention
Answer: B. An action necessary for patient improvement or survival
, Complete solution: A principle describes what is necessary to improve or preserve the patient's
condition. The specific method used to accomplish that principle can vary according to
circumstances, patient condition, resources, and other factors.
4. Which factor should influence the specific method chosen to manage a trauma patient?
A. Patient condition
B. Available equipment
C. Circumstances of the situation
D. All of the above
Answer: D. All of the above
Complete solution: Trauma care requires adapting treatment to the patient's condition, the
situation, and resources available. PHTLS emphasizes critical thinking rather than blindly
applying one technique to every patient.
5. A patient has blunt chest trauma, absent breath sounds on one side, severe respiratory
distress, and signs of obstructive shock. Which condition is most likely?
A. Simple rib fracture
B. Tension pneumothorax
C. Isolated pulmonary contusion
D. Cardiac contusion
Answer: B. Tension pneumothorax
Complete solution: A tension pneumothorax can progressively impair ventilation and venous
return, producing severe respiratory distress and obstructive shock. It is an immediately life-
threatening condition.
6. Which finding is most suggestive of tension pneumothorax in a deteriorating trauma patient?
A. Mild localized chest pain
B. Severe respiratory distress with unilateral absent breath sounds
C. Isolated bruising of the abdomen
D. Normal respiratory effort
Answer: B. Severe respiratory distress with unilateral absent breath sounds
Complete solution: The combination of significant respiratory distress and markedly diminished
or absent breath sounds on one side after trauma should raise strong concern for
pneumothorax, particularly tension physiology when the patient is deteriorating.
7. A patient has an open chest wound. What is the primary concern?
