Combat Lifesaver (CLS) and Tactical Field Care: Military Trauma Management
Exam Newest Actual Exam with Complete Questions And Correct Detailed
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Question 1
Given a casualty with an abdominal evisceration who is unable to swallow or is in a state of
shock, what is the recommended antibiotic medication and delivery route?
A) Moxifloxacin; Oral
B) Ertapenem; IV/IO/IM
C) Penicillin G; IV
D) Cefazolin; IM
E) Amoxicillin; Oral
Correct Answer: B) Ertapenem; IV/IO/IM
Rationale: Casualties with penetrating abdominal trauma and evisceration are at extremely
high risk for peritonitis and sepsis due to the exposure of the peritoneal cavity and potential
bowel rupture. TCCC guidelines dictate that if a casualty is unable to take oral medications
(due to the severity of the injury, shock, or altered mental status), the antibiotic of choice is
Ertapenem (1g). It can be administered via Intravenous (IV), Intraosseous (IO), or
Intramuscular (IM) routes. Moxifloxacin is only used if the casualty is conscious and able
to swallow.
Question 2
A casualty is exhibiting nasal flaring, tachypnea, cyanosis, and diaphoresis during the "R" phase
of the MARCH algorithm. These symptoms are collectively indicative of:
A) Hemorrhagic shock
B) Traumatic Brain Injury (TBI)
C) Respiratory distress
D) Hypothermia
E) Neurogenic shock
Correct Answer: C) Respiratory distress
Rationale: Nasal flaring and tachypnea (rapid breathing) are compensatory mechanisms as
the body attempts to increase oxygen intake. Cyanosis (bluish skin tint) indicates a lack of
oxygen saturation in the blood, and diaphoresis (sweating) often accompanies the extreme
, 2
physical effort of struggling to breathe. In a tactical environment, these signs are critical
indicators that the casualty's airway or lung function is compromised, potentially due to a
tension pneumothorax or airway obstruction.
Question 3
A casualty still has no palpable pulses in the left upper extremity after a successful tourniquet
(TQ) conversion in the field. The bleeding from the original gunshot wound remains controlled
by a pressure dressing. Under which evacuation category does this casualty fall?
A) Routine
B) Priority
C) Urgent
D) Urgent Surgical
E) Convenience
Correct Answer: D) Urgent Surgical
Rationale: While the life-threatening hemorrhage has been controlled, the absence of a
distal pulse after loosening a tourniquet indicates a major vascular injury or limb-
threatening ischemia. This casualty requires immediate surgical intervention to restore
blood flow to the limb to prevent necrosis and amputation. In the military triage system,
"Urgent Surgical" is reserved for those requiring forward surgical intervention to save life,
limb, or eyesight within a very narrow window of time.
Question 4
You are in a Tactical Field Care (TFC) situation. The casualty is lying on his back, breathing,
alert, and has no serious wounds to his extremities or head. You identify an entrance wound on
the casualty's chest. What is the priority action?
A) Perform an immediate needle decompression
B) Administer the Combat Wound Medication Pack
C) Use a vented chest seal to cover the wound and check the back for an exit wound
D) Apply a pressure dressing and wrap it with an elastic bandage
E) Provide high-flow oxygen via a non-rebreather mask
, 3
Correct Answer: C) Use a vented chest seal to cover the wound and check the back for an
exit wound
Rationale: Any penetrating wound to the "box" (the torso between the neck and navel)
must be treated as a potential sucking chest wound (open pneumothorax). The immediate
priority is to apply an occlusive dressing—specifically a vented chest seal—to prevent air
from being sucked into the pleural space during inhalation. Simultaneously, the responder
must "log roll" the casualty to check for an exit wound, as a second hole in the chest wall
will continue to allow air entry if not also sealed.
Question 5
As a casualty enters the evacuation phase, who is primarily responsible for the transition of care
and the verbal handoff to the receiving medical team?
A) The Senior Tactical Commander
B) The First Responder/CLS
C) The Combat Medic/Corpsman
D) The Pilot or Crew Chief
E) The Casualty themselves if conscious
Correct Answer: C) Combat Medic/Corpsman
Rationale: The Combat Medic or Corpsman is the highest-level medical provider on the
scene during Tactical Field Care. They are responsible for summarizing the MARCH
PAWS interventions, documenting treatments on the DD Form 1380 (TCCC Card), and
providing a concise verbal report (MIST) to the flight medic or evacuation team. This
ensures continuity of care and alerts the next providers to any life-saving measures already
performed, such as tourniquet times or administered medications.
Question 6
In a standard medical evacuation (MEDEVAC) process, which casualties are typically loaded last
onto the evacuation platform to ensure they are the first to be offloaded at the treatment facility?
A) Expectant
B) Routine
C) Priority
, 4
D) Urgent
E) Walking Wounded
Correct Answer: D) Urgent
Rationale: While loading procedures can vary based on the specific airframe or vehicle, the
general principle of "Last In, First Out" (LIFO) is applied to the most critical patients. By
loading Urgent casualties last, they are positioned near the doors of the aircraft or vehicle,
allowing them to be offloaded immediately upon arrival at the Medical Treatment Facility
(MTF). This reduces the time between the final transport and the initiation of definitive
surgical care.
Question 7
What is the primary objective of providing pain management (analgesia) to a casualty on the
battlefield?
A) To make the casualty unconscious for easier transport
B) To stop all physiological stress responses
C) To preserve the fighting force
D) To ensure the casualty does not remember the event
E) To prevent the development of PTSD
Correct Answer: C) To preserve the fighting force
Rationale: Pain management in TCCC is not just about comfort; it is a tactical
consideration. By managing pain with options that do not cause respiratory depression or
altered mental status (such as Meloxicam and Acetaminophen for mild pain, or Ketamine
for moderate/severe pain), the responder may be able to keep a casualty functional enough
to maintain their own security or even stay in the fight. This reduces the burden on the unit
and maintains tactical momentum.
Question 8
Which of the following scenarios should prompt a high index of suspicion for a potential
traumatic brain injury (TBI) or head injury?
A) A casualty with a gunshot wound to the foot
B) A casualty involved in a motor vehicle collision (MVC) near a blast event
Exam Newest Actual Exam with Complete Questions And Correct Detailed
Answers (Verified Answers) |Already Graded A+
Question 1
Given a casualty with an abdominal evisceration who is unable to swallow or is in a state of
shock, what is the recommended antibiotic medication and delivery route?
A) Moxifloxacin; Oral
B) Ertapenem; IV/IO/IM
C) Penicillin G; IV
D) Cefazolin; IM
E) Amoxicillin; Oral
Correct Answer: B) Ertapenem; IV/IO/IM
Rationale: Casualties with penetrating abdominal trauma and evisceration are at extremely
high risk for peritonitis and sepsis due to the exposure of the peritoneal cavity and potential
bowel rupture. TCCC guidelines dictate that if a casualty is unable to take oral medications
(due to the severity of the injury, shock, or altered mental status), the antibiotic of choice is
Ertapenem (1g). It can be administered via Intravenous (IV), Intraosseous (IO), or
Intramuscular (IM) routes. Moxifloxacin is only used if the casualty is conscious and able
to swallow.
Question 2
A casualty is exhibiting nasal flaring, tachypnea, cyanosis, and diaphoresis during the "R" phase
of the MARCH algorithm. These symptoms are collectively indicative of:
A) Hemorrhagic shock
B) Traumatic Brain Injury (TBI)
C) Respiratory distress
D) Hypothermia
E) Neurogenic shock
Correct Answer: C) Respiratory distress
Rationale: Nasal flaring and tachypnea (rapid breathing) are compensatory mechanisms as
the body attempts to increase oxygen intake. Cyanosis (bluish skin tint) indicates a lack of
oxygen saturation in the blood, and diaphoresis (sweating) often accompanies the extreme
, 2
physical effort of struggling to breathe. In a tactical environment, these signs are critical
indicators that the casualty's airway or lung function is compromised, potentially due to a
tension pneumothorax or airway obstruction.
Question 3
A casualty still has no palpable pulses in the left upper extremity after a successful tourniquet
(TQ) conversion in the field. The bleeding from the original gunshot wound remains controlled
by a pressure dressing. Under which evacuation category does this casualty fall?
A) Routine
B) Priority
C) Urgent
D) Urgent Surgical
E) Convenience
Correct Answer: D) Urgent Surgical
Rationale: While the life-threatening hemorrhage has been controlled, the absence of a
distal pulse after loosening a tourniquet indicates a major vascular injury or limb-
threatening ischemia. This casualty requires immediate surgical intervention to restore
blood flow to the limb to prevent necrosis and amputation. In the military triage system,
"Urgent Surgical" is reserved for those requiring forward surgical intervention to save life,
limb, or eyesight within a very narrow window of time.
Question 4
You are in a Tactical Field Care (TFC) situation. The casualty is lying on his back, breathing,
alert, and has no serious wounds to his extremities or head. You identify an entrance wound on
the casualty's chest. What is the priority action?
A) Perform an immediate needle decompression
B) Administer the Combat Wound Medication Pack
C) Use a vented chest seal to cover the wound and check the back for an exit wound
D) Apply a pressure dressing and wrap it with an elastic bandage
E) Provide high-flow oxygen via a non-rebreather mask
, 3
Correct Answer: C) Use a vented chest seal to cover the wound and check the back for an
exit wound
Rationale: Any penetrating wound to the "box" (the torso between the neck and navel)
must be treated as a potential sucking chest wound (open pneumothorax). The immediate
priority is to apply an occlusive dressing—specifically a vented chest seal—to prevent air
from being sucked into the pleural space during inhalation. Simultaneously, the responder
must "log roll" the casualty to check for an exit wound, as a second hole in the chest wall
will continue to allow air entry if not also sealed.
Question 5
As a casualty enters the evacuation phase, who is primarily responsible for the transition of care
and the verbal handoff to the receiving medical team?
A) The Senior Tactical Commander
B) The First Responder/CLS
C) The Combat Medic/Corpsman
D) The Pilot or Crew Chief
E) The Casualty themselves if conscious
Correct Answer: C) Combat Medic/Corpsman
Rationale: The Combat Medic or Corpsman is the highest-level medical provider on the
scene during Tactical Field Care. They are responsible for summarizing the MARCH
PAWS interventions, documenting treatments on the DD Form 1380 (TCCC Card), and
providing a concise verbal report (MIST) to the flight medic or evacuation team. This
ensures continuity of care and alerts the next providers to any life-saving measures already
performed, such as tourniquet times or administered medications.
Question 6
In a standard medical evacuation (MEDEVAC) process, which casualties are typically loaded last
onto the evacuation platform to ensure they are the first to be offloaded at the treatment facility?
A) Expectant
B) Routine
C) Priority
, 4
D) Urgent
E) Walking Wounded
Correct Answer: D) Urgent
Rationale: While loading procedures can vary based on the specific airframe or vehicle, the
general principle of "Last In, First Out" (LIFO) is applied to the most critical patients. By
loading Urgent casualties last, they are positioned near the doors of the aircraft or vehicle,
allowing them to be offloaded immediately upon arrival at the Medical Treatment Facility
(MTF). This reduces the time between the final transport and the initiation of definitive
surgical care.
Question 7
What is the primary objective of providing pain management (analgesia) to a casualty on the
battlefield?
A) To make the casualty unconscious for easier transport
B) To stop all physiological stress responses
C) To preserve the fighting force
D) To ensure the casualty does not remember the event
E) To prevent the development of PTSD
Correct Answer: C) To preserve the fighting force
Rationale: Pain management in TCCC is not just about comfort; it is a tactical
consideration. By managing pain with options that do not cause respiratory depression or
altered mental status (such as Meloxicam and Acetaminophen for mild pain, or Ketamine
for moderate/severe pain), the responder may be able to keep a casualty functional enough
to maintain their own security or even stay in the fight. This reduces the burden on the unit
and maintains tactical momentum.
Question 8
Which of the following scenarios should prompt a high index of suspicion for a potential
traumatic brain injury (TBI) or head injury?
A) A casualty with a gunshot wound to the foot
B) A casualty involved in a motor vehicle collision (MVC) near a blast event
