1. The golden period in trauma care refers to the:
A) Time it takes for EMS to arrive on scene
B) First hour after injury when definitive surgical care is most beneficial
C) Time from injury to discharge from the hospital
D) Period when the patient is in the emergency department
Correct Answer: B
Rationale: The "golden hour" (or golden period) is the concept that trauma patients have better
survival rates if they reach definitive surgical care within the first hour after injury.
2. The first step in managing any trauma patient is to:
A) Perform a rapid trauma assessment
B) Control major hemorrhage
C) Ensure scene safety
D) Open the airway
Correct Answer: C
Rationale: Scene safety is always the priority before any patient contact. The EMT cannot
provide care if injured.
,3. The XABC approach to trauma prioritizes which intervention first?
A) Airway management
B) Exsanguinating hemorrhage control
C) Breathing assessment
D) Cervical spine stabilization
Correct Answer: B
Rationale: The X (or M in MARCH) stands for massive hemorrhage control. Life-threatening
external bleeding must be addressed immediately, even before airway.
4. Which of the following is a sign of arterial bleeding?
A) Dark red, steady flow
B) Bright red, spurting blood
C) Slow, even oozing
D) Dark, clotted blood
Correct Answer: B
Rationale: Arterial bleeding is typically bright red and spurts with each heartbeat due to high
pressure.
5. The first-line treatment for external hemorrhage is:
A) Tourniquet application
B) Direct pressure with a sterile dressing
C) Elevation of the wound
D) Pressure point compression
Correct Answer: B
Rationale: Direct pressure is the initial intervention for external bleeding. If life-threatening
bleeding is not controlled, a tourniquet is indicated.
6. A tourniquet should be placed:
A) Directly over the wound
B) 2–3 inches above the wound, not over a joint
C) On the nearest joint
D) As loosely as possible to allow some circulation
Correct Answer: B
Rationale: The tourniquet is applied proximal to the wound (2–3 inches), avoiding joints. It is
tightened until bleeding stops and the time is documented.
7. Which of the following patients should receive a tourniquet?
A) A patient with a nosebleed
,B) A patient with a scalp laceration
C) A patient with a forearm laceration with slow venous oozing
D) A patient with an amputated arm with spurting blood not controlled by direct pressure
Correct Answer: D
Rationale: Tourniquets are used for life-threatening extremity hemorrhage that cannot be
controlled by direct pressure.
8. Hemostatic agents are most effective when applied:
A) On top of a bulky dressing
B) Directly to the source of bleeding, with direct pressure
C) As a loose powder around the wound
D) Only to venous bleeding
Correct Answer: B
Rationale: Hemostatic gauze should be packed directly into the wound at the bleeding source,
followed by direct pressure and a pressure bandage.
9. A patient with internal bleeding may present with all of the following EXCEPT:
A) Tachycardia
B) Hypotension
C) Flushed, warm skin
D) Altered mental status
Correct Answer: C
Rationale: Internal bleeding leads to shock, causing pale, cool, clammy skin, not flushed warm
skin.
10. A patient with a femur fracture can lose up to how much blood into the thigh?
A) 500 mL
B) 1,000–2,000 mL
C) 3,000 mL
D) 100 mL
Correct Answer: B
Rationale: Femur fractures can cause significant internal blood loss, typically 1,000–2,000 mL,
enough to cause hypovolemic shock.
11. A pelvic fracture can cause massive hemorrhage. The EMT should:
A) Log roll the patient to assess the back
B) Apply a pelvic binder or sheet to stabilize the pelvis and reduce hemorrhage
, C) Apply traction to both legs
D) Palpate the pelvis deeply to assess stability
Correct Answer: B
Rationale: A pelvic binder stabilizes the pelvis and reduces the volume of the pelvis,
tamponading bleeding. Do not palpate or log roll unnecessarily.
12. The most sensitive early sign of shock in an adult trauma patient is:
A) Hypotension
B) Tachycardia
C) Bradycardia
D) Cyanosis
Correct Answer: B
Rationale: Tachycardia is an early compensatory mechanism in shock. Hypotension is a late and
ominous sign.
13. Decompensated shock is characterized by:
A) Normal blood pressure
B) Hypotension and altered mental status
C) Flushed skin
D) Bradycardia
Correct Answer: B
Rationale: In decompensated shock, compensatory mechanisms fail, leading to hypotension,
altered mental status, and cardiac arrest.
14. A trauma patient with cool, clammy skin, tachycardia, tachypnea, and a blood pressure of
80/50 mm Hg is likely in:
A) Compensated shock
B) Decompensated shock
C) Irreversible shock
D) Normal post-injury state
Correct Answer: B
Rationale: Hypotension with signs of poor perfusion indicates decompensated (progressive)
shock.
15. The most appropriate position for a trauma patient in shock without suspected spinal
injury is:
A) Sitting upright
B) Supine with legs elevated 12 inches (if no contraindications)