ITLS Advanced Post-Test 9th Edition (2026)
– Actual Remembered Questions with
100% Verified Correct Answers
1. The primary objective of the ITLS Primary Survey is to:
A. Determine the patient's past medical history.
B. Identify and manage immediate life threats.
C. Perform a detailed head-to-toe examination.
D. Obtain a complete set of vital signs.
Answer: B ✓
2. During the rapid trauma assessment of an unresponsive multi-system trauma patient, the
first step after assessing the head is to assess the:
A. Pelvis
B. Neck
C. Abdomen
D. Chest
Answer: D ✓
3. A patient with a flail chest segment is likely to have an underlying injury of:
A. Pulmonary contusion
B. Tension pneumothorax
C. Pericardial tamponade
D. Aortic dissection
Answer: A ✓
4. The "golden hour" in trauma care begins at the time of:
A. Hospital admission
B. The injury
C. EMS dispatch
D. Patient extrication
Answer: B ✓
5. Which of the following findings is the MOST reliable indicator of shock in an adult trauma
patient?
A. Tachycardia
B. Cool, clammy skin
,C. Altered mental status
D. Decreased blood pressure
Answer: C ✓
6. When performing a needle decompression for a suspected tension pneumothorax, the
preferred initial site is the:
A. Midclavicular line, 2nd intercostal space
B. Midaxillary line, 4th intercostal space
C. Anterior axillary line, 5th intercostal space
D. Midclavicular line, 1st intercostal space
Answer: A ✓
7. A patient with a severe head injury presents with a Glasgow Coma Scale (GCS) score of 6.
This is classified as a:
A. Mild head injury
B. Moderate head injury
C. Severe head injury
D. Catastrophic head injury
Answer: C ✓
8. The appropriate fluid of choice for initial resuscitation of a patient in hemorrhagic shock is:
A. Lactated Ringer's
B. 5% Dextrose in Water
C. Normal Saline
D. Hypertonic Saline
Answer: A ✓
9. In a patient with a suspected spinal injury, the preferred method of securing the airway is:
A. Nasotracheal intubation
B. Orotracheal intubation with manual in-line stabilization
C. Blind insertion airway device (BIAD)
D. Cricothyrotomy
Answer: B ✓
10. Beck's triad, often associated with cardiac tamponade, includes all of the following
EXCEPT:
A. Muffled heart sounds
B. Jugular venous distention (JVD)
C. Hypertension
,D. Narrowing pulse pressure
Answer: C ✓
11. A patient with a traumatic above-the-knee amputation has a tourniquet applied. The next
priority in management should be to:
A. Administer high-dose morphine for pain
B. Locate and package the amputated part
C. Assess for other life-threatening injuries
D. Initiate a 16-gauge IV with a fluid bolus
Answer: C ✓
12. The mnemonic "DCAP-BTLS" is used during the trauma assessment to identify:
A. Mechanism of injury
B. Types of deformities
C. Specific injuries and abnormalities
D. Past medical history
Answer: C ✓
13. A patient with a depressed skull fracture should be treated by:
A. Manually stabilizing the head without applying pressure to the depressed area
B. Applying a pressure dressing to control bleeding
C. Gently manipulating the bone fragments back into place
D. Placing the patient in a prone position
Answer: A ✓
14. Which of the following signs is most specific for a basilar skull fracture?
A. Periorbital ecchymosis (Raccoon eyes)
B. Battle's sign
C. Hemotympanum
D. Cerebrospinal fluid (CSF) otorrhea or rhinorrhea
Answer: D ✓
15. The recommended initial dose of crystalloid fluid for an adult trauma patient in shock is:
A. 200 mL bolus
B. 500 mL bolus
C. 1 L bolus
D. 2 L bolus
Answer: C ✓
, 16. When logrolling a patient with a suspected spinal injury, the team leader should be
positioned at the:
A. Head to maintain manual in-line stabilization
B. Torso to direct the roll
C. Pelvis to stabilize the hips
D. Feet to guide the movement
Answer: A ✓
17. A patient with a penetrating injury to the right upper quadrant of the abdomen is most at
risk for injury to the:
A. Spleen
B. Liver
C. Stomach
D. Kidney
Answer: B ✓
18. The use of tranexamic acid (TXA) in trauma is primarily indicated for:
A. Control of external hemorrhage
B. Patients with suspected traumatic brain injury and hemorrhage
C. All trauma patients regardless of blood pressure
D. Reversal of anticoagulant medications
Answer: B ✓
19. A patient presents with paradoxical movement of the chest wall, severe dyspnea, and
cyanosis. The immediate treatment should include:
A. Needle decompression
B. Positive pressure ventilation
C. Application of a bulky dressing to the flail segment
D. Rapid fluid administration
Answer: B ✓
20. The MOST common cause of shock in the trauma patient is:
A. Cardiogenic
B. Neurogenic
C. Hemorrhagic
D. Obstructive
Answer: C ✓
21. When preparing a patient with a suspected pelvic fracture for transport, the most
appropriate stabilization device is a:
– Actual Remembered Questions with
100% Verified Correct Answers
1. The primary objective of the ITLS Primary Survey is to:
A. Determine the patient's past medical history.
B. Identify and manage immediate life threats.
C. Perform a detailed head-to-toe examination.
D. Obtain a complete set of vital signs.
Answer: B ✓
2. During the rapid trauma assessment of an unresponsive multi-system trauma patient, the
first step after assessing the head is to assess the:
A. Pelvis
B. Neck
C. Abdomen
D. Chest
Answer: D ✓
3. A patient with a flail chest segment is likely to have an underlying injury of:
A. Pulmonary contusion
B. Tension pneumothorax
C. Pericardial tamponade
D. Aortic dissection
Answer: A ✓
4. The "golden hour" in trauma care begins at the time of:
A. Hospital admission
B. The injury
C. EMS dispatch
D. Patient extrication
Answer: B ✓
5. Which of the following findings is the MOST reliable indicator of shock in an adult trauma
patient?
A. Tachycardia
B. Cool, clammy skin
,C. Altered mental status
D. Decreased blood pressure
Answer: C ✓
6. When performing a needle decompression for a suspected tension pneumothorax, the
preferred initial site is the:
A. Midclavicular line, 2nd intercostal space
B. Midaxillary line, 4th intercostal space
C. Anterior axillary line, 5th intercostal space
D. Midclavicular line, 1st intercostal space
Answer: A ✓
7. A patient with a severe head injury presents with a Glasgow Coma Scale (GCS) score of 6.
This is classified as a:
A. Mild head injury
B. Moderate head injury
C. Severe head injury
D. Catastrophic head injury
Answer: C ✓
8. The appropriate fluid of choice for initial resuscitation of a patient in hemorrhagic shock is:
A. Lactated Ringer's
B. 5% Dextrose in Water
C. Normal Saline
D. Hypertonic Saline
Answer: A ✓
9. In a patient with a suspected spinal injury, the preferred method of securing the airway is:
A. Nasotracheal intubation
B. Orotracheal intubation with manual in-line stabilization
C. Blind insertion airway device (BIAD)
D. Cricothyrotomy
Answer: B ✓
10. Beck's triad, often associated with cardiac tamponade, includes all of the following
EXCEPT:
A. Muffled heart sounds
B. Jugular venous distention (JVD)
C. Hypertension
,D. Narrowing pulse pressure
Answer: C ✓
11. A patient with a traumatic above-the-knee amputation has a tourniquet applied. The next
priority in management should be to:
A. Administer high-dose morphine for pain
B. Locate and package the amputated part
C. Assess for other life-threatening injuries
D. Initiate a 16-gauge IV with a fluid bolus
Answer: C ✓
12. The mnemonic "DCAP-BTLS" is used during the trauma assessment to identify:
A. Mechanism of injury
B. Types of deformities
C. Specific injuries and abnormalities
D. Past medical history
Answer: C ✓
13. A patient with a depressed skull fracture should be treated by:
A. Manually stabilizing the head without applying pressure to the depressed area
B. Applying a pressure dressing to control bleeding
C. Gently manipulating the bone fragments back into place
D. Placing the patient in a prone position
Answer: A ✓
14. Which of the following signs is most specific for a basilar skull fracture?
A. Periorbital ecchymosis (Raccoon eyes)
B. Battle's sign
C. Hemotympanum
D. Cerebrospinal fluid (CSF) otorrhea or rhinorrhea
Answer: D ✓
15. The recommended initial dose of crystalloid fluid for an adult trauma patient in shock is:
A. 200 mL bolus
B. 500 mL bolus
C. 1 L bolus
D. 2 L bolus
Answer: C ✓
, 16. When logrolling a patient with a suspected spinal injury, the team leader should be
positioned at the:
A. Head to maintain manual in-line stabilization
B. Torso to direct the roll
C. Pelvis to stabilize the hips
D. Feet to guide the movement
Answer: A ✓
17. A patient with a penetrating injury to the right upper quadrant of the abdomen is most at
risk for injury to the:
A. Spleen
B. Liver
C. Stomach
D. Kidney
Answer: B ✓
18. The use of tranexamic acid (TXA) in trauma is primarily indicated for:
A. Control of external hemorrhage
B. Patients with suspected traumatic brain injury and hemorrhage
C. All trauma patients regardless of blood pressure
D. Reversal of anticoagulant medications
Answer: B ✓
19. A patient presents with paradoxical movement of the chest wall, severe dyspnea, and
cyanosis. The immediate treatment should include:
A. Needle decompression
B. Positive pressure ventilation
C. Application of a bulky dressing to the flail segment
D. Rapid fluid administration
Answer: B ✓
20. The MOST common cause of shock in the trauma patient is:
A. Cardiogenic
B. Neurogenic
C. Hemorrhagic
D. Obstructive
Answer: C ✓
21. When preparing a patient with a suspected pelvic fracture for transport, the most
appropriate stabilization device is a:
