ITLS Advanced Provider
INTERNATIONAL TRAUMA LIFE SUPPORT (ITLS) – ADVANCED
PROVIDER WRITTEN EXAM | EXAM QUESTIONS AND CORRECT
ANSWERS | 2026/2027
INTERNATIONAL TRAUMA LIFE SUPPORT
ADVANCED PROVIDER - WRITTEN
1. Which component comes first in the ITLS Primary Survey?
A. Scene size-up
B. Initial assessment
C. Rapid trauma survey
D. Ongoing exam
A. Scene size-up
Scene size-up always comes first; responder safety, BSI and resource
needs are settled before the patient is approached.
2. During scene size-up, which of the following is NOT one of the core
elements?
A. Identifying hazards
B. Standard precautions
C. Determining the number of patients
D. Obtaining a SAMPLE history
D. Obtaining a SAMPLE history
SAMPLE history belongs to the secondary survey. Size-up covers
precautions, hazards, patient count, extra resources and mechanism of
injury.
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, ITLS Advanced Provider
3. The main purpose of evaluating mechanism of injury at the scene is
to:
A. Decide the receiving hospital without further assessment
B. Replace the physical examination
C. Determine legal liability
D. Raise the index of suspicion for occult injuries
D. Raise the index of suspicion for occult injuries
Mechanism guides suspicion for hidden injury; it never replaces a hands-
on assessment.
4. A team leader arrives to find a car on its roof with fuel leaking. What
is the first priority?
A. Count the patients
B. Begin rapid extrication
C. Make the scene safe or request resources to do so
D. Apply a cervical collar to the driver
C. Make the scene safe or request resources to do so
An unsafe scene must be controlled before patient contact. Injured
rescuers add to the casualty count.
5. In the initial assessment, the general impression of the patient is
formed by noting:
A. Pupil size and reactivity only
B. The SAMPLE history
C. Age, sex, weight, general appearance, position, purposeful movement
and obvious injuries
D. Blood pressure and pulse oximetry
C. Age, sex, weight, general appearance, position, purposeful
movement and obvious injuries
The general impression is a quick visual overview made as the team
leader approaches, before any vital signs are taken.
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, ITLS Advanced Provider
6. Which mnemonic does ITLS use to assess initial level of
consciousness?
A. DCAP-BTLS
B. SAMPLE
C. AVPU
D. OPQRST
C. AVPU
AVPU (Alert, Verbal, Painful, Unresponsive) is the rapid LOC check used in
the initial assessment.
7. A patient opens his eyes only when you squeeze his trapezius. On the
AVPU scale he is:
A. A
B. U
C. P
D. V
C. P
A response only to a painful stimulus scores P.
8. In the initial assessment, a radial pulse that is present but rapid and
weak most likely indicates:
A. Normal perfusion
B. Compensated or early decompensated shock
C. Hypertensive emergency
D. Neurogenic shock only
B. Compensated or early decompensated shock
A weak, fast radial pulse is a sign of hypoperfusion and calls for a careful
search for bleeding.
9. The rapid trauma survey is performed on which patients?
A. Every trauma patient regardless of findings
B. Only unconscious patients
C. Those with a dangerous mechanism or an altered initial assessment
D. Only patients with isolated limb injuries
C. Those with a dangerous mechanism or an altered initial
assessment
A generalised or dangerous mechanism, or abnormal findings in the initial
assessment, call for the rapid trauma survey.
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, ITLS Advanced Provider
10. A patient who twisted an ankle stepping off a curb, with a normal
initial assessment, should receive:
A. Immediate load-and-go transport
B. Spinal motion restriction and needle decompression
C. A focused exam of the injured area
D. A full rapid trauma survey
C. A focused exam of the injured area
An isolated, localised mechanism with normal initial findings needs only a
focused exam.
11. During the rapid trauma survey, the neck is examined before the
collar is applied in order to look for:
A. Pupil reactivity
B. Abdominal rigidity
C. Pelvic instability
D. Tracheal deviation, distended neck veins and wounds
D. Tracheal deviation, distended neck veins and wounds
Once a collar is on, the neck is hidden; JVD, tracheal position and wounds
must be checked first.
12. The baseline vital signs in ITLS are ideally obtained:
A. Before checking the airway
B. By a team member at the end of the rapid trauma survey
C. Before scene size-up
D. Only after arrival at hospital
B. By a team member at the end of the rapid trauma survey
Airway, breathing and circulation take priority; a partner records baseline
vitals at the end of the rapid survey.
13. Which finding during the Primary Survey makes the patient a load-
and-go?
A. A closed wrist fracture
B. A minor scalp laceration
C. An abrasion to the knee
D. Signs of shock
D. Signs of shock
Shock is a critical condition that warrants rapid transport with
interventions en route.
Page 4
INTERNATIONAL TRAUMA LIFE SUPPORT (ITLS) – ADVANCED
PROVIDER WRITTEN EXAM | EXAM QUESTIONS AND CORRECT
ANSWERS | 2026/2027
INTERNATIONAL TRAUMA LIFE SUPPORT
ADVANCED PROVIDER - WRITTEN
1. Which component comes first in the ITLS Primary Survey?
A. Scene size-up
B. Initial assessment
C. Rapid trauma survey
D. Ongoing exam
A. Scene size-up
Scene size-up always comes first; responder safety, BSI and resource
needs are settled before the patient is approached.
2. During scene size-up, which of the following is NOT one of the core
elements?
A. Identifying hazards
B. Standard precautions
C. Determining the number of patients
D. Obtaining a SAMPLE history
D. Obtaining a SAMPLE history
SAMPLE history belongs to the secondary survey. Size-up covers
precautions, hazards, patient count, extra resources and mechanism of
injury.
Page 1
, ITLS Advanced Provider
3. The main purpose of evaluating mechanism of injury at the scene is
to:
A. Decide the receiving hospital without further assessment
B. Replace the physical examination
C. Determine legal liability
D. Raise the index of suspicion for occult injuries
D. Raise the index of suspicion for occult injuries
Mechanism guides suspicion for hidden injury; it never replaces a hands-
on assessment.
4. A team leader arrives to find a car on its roof with fuel leaking. What
is the first priority?
A. Count the patients
B. Begin rapid extrication
C. Make the scene safe or request resources to do so
D. Apply a cervical collar to the driver
C. Make the scene safe or request resources to do so
An unsafe scene must be controlled before patient contact. Injured
rescuers add to the casualty count.
5. In the initial assessment, the general impression of the patient is
formed by noting:
A. Pupil size and reactivity only
B. The SAMPLE history
C. Age, sex, weight, general appearance, position, purposeful movement
and obvious injuries
D. Blood pressure and pulse oximetry
C. Age, sex, weight, general appearance, position, purposeful
movement and obvious injuries
The general impression is a quick visual overview made as the team
leader approaches, before any vital signs are taken.
Page 2
, ITLS Advanced Provider
6. Which mnemonic does ITLS use to assess initial level of
consciousness?
A. DCAP-BTLS
B. SAMPLE
C. AVPU
D. OPQRST
C. AVPU
AVPU (Alert, Verbal, Painful, Unresponsive) is the rapid LOC check used in
the initial assessment.
7. A patient opens his eyes only when you squeeze his trapezius. On the
AVPU scale he is:
A. A
B. U
C. P
D. V
C. P
A response only to a painful stimulus scores P.
8. In the initial assessment, a radial pulse that is present but rapid and
weak most likely indicates:
A. Normal perfusion
B. Compensated or early decompensated shock
C. Hypertensive emergency
D. Neurogenic shock only
B. Compensated or early decompensated shock
A weak, fast radial pulse is a sign of hypoperfusion and calls for a careful
search for bleeding.
9. The rapid trauma survey is performed on which patients?
A. Every trauma patient regardless of findings
B. Only unconscious patients
C. Those with a dangerous mechanism or an altered initial assessment
D. Only patients with isolated limb injuries
C. Those with a dangerous mechanism or an altered initial
assessment
A generalised or dangerous mechanism, or abnormal findings in the initial
assessment, call for the rapid trauma survey.
Page 3
, ITLS Advanced Provider
10. A patient who twisted an ankle stepping off a curb, with a normal
initial assessment, should receive:
A. Immediate load-and-go transport
B. Spinal motion restriction and needle decompression
C. A focused exam of the injured area
D. A full rapid trauma survey
C. A focused exam of the injured area
An isolated, localised mechanism with normal initial findings needs only a
focused exam.
11. During the rapid trauma survey, the neck is examined before the
collar is applied in order to look for:
A. Pupil reactivity
B. Abdominal rigidity
C. Pelvic instability
D. Tracheal deviation, distended neck veins and wounds
D. Tracheal deviation, distended neck veins and wounds
Once a collar is on, the neck is hidden; JVD, tracheal position and wounds
must be checked first.
12. The baseline vital signs in ITLS are ideally obtained:
A. Before checking the airway
B. By a team member at the end of the rapid trauma survey
C. Before scene size-up
D. Only after arrival at hospital
B. By a team member at the end of the rapid trauma survey
Airway, breathing and circulation take priority; a partner records baseline
vitals at the end of the rapid survey.
13. Which finding during the Primary Survey makes the patient a load-
and-go?
A. A closed wrist fracture
B. A minor scalp laceration
C. An abrasion to the knee
D. Signs of shock
D. Signs of shock
Shock is a critical condition that warrants rapid transport with
interventions en route.
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