PHTLS 10th Practice Exam 3 Question and
Answers with Rationales Latest Version Top
Rated A+
1.
A patient is found unresponsive after a motor-vehicle crash. Which action is most appropriate
first?
• A. Perform endotracheal intubation attempt
• B. Assess scene safety and ensure PPE, then primary survey (ABC)
• C. Start defibrillator pad placement only
• D. Obtain detailed history from bystanders
Correct Answer: B
Rationale: Trauma care begins with scene safety and initiating the primary survey to
identify and correct immediate life threats.
2.
While performing the primary assessment, you find a patient with absent breath sounds on the
left and signs of respiratory distress. What is the best next step?
• A. Immobilize spine only and recheck in 30 minutes
• B. Consider immediate intervention for a life-threatening ventilation problem while
maintaining airway/breathing management
• C. Focus only on circulation and ignore breathing
• D. Obtain a CT scan before any treatment
Correct Answer: B
Rationale: Unilateral absent breath sounds with distress may indicate tension
pneumothorax or other critical breathing problem—treat promptly while managing
airway/breathing.
3.
Which patient finding best suggests shock?
• A. Capillary refill <2 seconds and normal mentation
• B. Warm, dry skin with bounding pulses
• C. Tachycardia, hypotension (or signs of poor perfusion), altered mental status
• D. Bradycardia with hypertension
Correct Answer: C
Rationale: Shock is characterized by inadequate perfusion—often manifested by
tachycardia, hypotension, altered mentation, delayed cap refill, and cool/clammy skin.
,4.
You suspect internal bleeding after trauma. What is the priority treatment concept?
• A. Delay hemorrhage control until the hospital
• B. Rapid transport with ongoing assessment and aggressive hemorrhage control
• C. Provide oral fluids
• D. Wait for pain to decrease before reassessment
Correct Answer: B
Rationale: Internal hemorrhage requires rapid transport, but ongoing reassessment and
hemorrhage control measures (as applicable) remain priorities.
5.
In spinal motion restriction, the goal is primarily to:
• A. Increase patient comfort only
• B. Prevent unnecessary movement while maintaining airway/breathing and minimizing
additional injury
• C. Immobilize every joint completely
• D. Eliminate all patient motion at all costs
Correct Answer: B
Rationale: The aim is to minimize motion that could worsen spinal injury while still
addressing life threats.
6.
A patient has oral blood and noisy breathing. What is the best immediate intervention?
• A. Leave airway contamination untreated
• B. Suction and position the airway to maintain patency, then reassess
• C. Give oxygen only without clearing airway
• D. Sedate the patient
Correct Answer: B
Rationale: A contaminated airway can obstruct ventilation; clear/maintain patency and
reassess response.
7.
Which of the following best describes reassessment frequency during the primary survey?
• A. Only once, then stop unless the patient arrests
• B. Periodic reassessment of airway, breathing, circulation, and mental status as
interventions occur
• C. Every 2 days
, • D. Only after transport is complete
Correct Answer: B
Rationale: Reassessment prevents missed deterioration and confirms effectiveness of
interventions.
8.
Which pulse finding is more consistent with poor perfusion?
• A. Weak but normal-rate pulse with warm skin
• B. Thready pulse, tachycardia, cool clammy skin
• C. Strong pulse and normal skin temperature
• D. Normal mental status with hypertension
Correct Answer: B
Rationale: Thready pulses and cool clammy skin are typical perfusion-compromise
signs.
9.
A patient with massive external bleeding has dressings that quickly soak through. What is the
most appropriate step?
• A. Remove dressings and wait
• B. Apply additional pressure and consider direct pressure/packing per protocol
• C. Elevate the limb above the heart
• D. Only apply a cold pack
Correct Answer: B
Rationale: Ongoing hemorrhage requires immediate pressure and hemorrhage-control
measures; time-critical.
10.
Which condition is a common cause of altered mental status in trauma patients?
• A. Hypothermia, hypoxia, shock, head injury
• B. Only hunger
• C. Only dehydration without injury
• D. Sleep deprivation
Correct Answer: A
Rationale: Multiple trauma-related factors can impair mentation—particularly hypoxia,
shock, hypothermia, and head injury.
11.
, A 10-year-old with blunt abdominal trauma is pale, diaphoretic, and increasingly lethargic. What
should you prioritize?
• A. Delayed evaluation to control pain first
• B. Rapid transport with continuous reassessment and treat life threats
• C. Encourage oral intake
• D. Wait for confirmation of internal bleeding with imaging
Correct Answer: B
Rationale: Worsening mental status and perfusion compromise suggest shock—treat life
threats and transport quickly.
12.
You arrive at a scene with high-risk factors (unstable structures). What is your first action?
• A. Remove the patient from the scene immediately
• B. Assess scene safety and coordinate appropriately
• C. Begin full immobilization before moving
• D. Ignore hazards if the patient is young
Correct Answer: B
Rationale: Scene safety prevents rescuer injury and enables appropriate operation
planning.
13.
During airway management, the “best” suction strategy is:
• A. Only suction if visible blood is present
• B. Suction as needed to maintain patency while minimizing interruptions
• C. Suction continuously without reassessment
• D. Never suction to avoid hypoxia
Correct Answer: B
Rationale: Use suction when it improves patency and ventilation; avoid prolonged
interruptions.
14.
Which statement is true about oxygen therapy in trauma?
• A. Oxygen is irrelevant in trauma
• B. Oxygen should be used to support ventilation/oxygenation while correcting underlying
causes
• C. Oxygen can replace airway interventions
• D. Oxygen is only for cardiac arrests
Correct Answer: B
Answers with Rationales Latest Version Top
Rated A+
1.
A patient is found unresponsive after a motor-vehicle crash. Which action is most appropriate
first?
• A. Perform endotracheal intubation attempt
• B. Assess scene safety and ensure PPE, then primary survey (ABC)
• C. Start defibrillator pad placement only
• D. Obtain detailed history from bystanders
Correct Answer: B
Rationale: Trauma care begins with scene safety and initiating the primary survey to
identify and correct immediate life threats.
2.
While performing the primary assessment, you find a patient with absent breath sounds on the
left and signs of respiratory distress. What is the best next step?
• A. Immobilize spine only and recheck in 30 minutes
• B. Consider immediate intervention for a life-threatening ventilation problem while
maintaining airway/breathing management
• C. Focus only on circulation and ignore breathing
• D. Obtain a CT scan before any treatment
Correct Answer: B
Rationale: Unilateral absent breath sounds with distress may indicate tension
pneumothorax or other critical breathing problem—treat promptly while managing
airway/breathing.
3.
Which patient finding best suggests shock?
• A. Capillary refill <2 seconds and normal mentation
• B. Warm, dry skin with bounding pulses
• C. Tachycardia, hypotension (or signs of poor perfusion), altered mental status
• D. Bradycardia with hypertension
Correct Answer: C
Rationale: Shock is characterized by inadequate perfusion—often manifested by
tachycardia, hypotension, altered mentation, delayed cap refill, and cool/clammy skin.
,4.
You suspect internal bleeding after trauma. What is the priority treatment concept?
• A. Delay hemorrhage control until the hospital
• B. Rapid transport with ongoing assessment and aggressive hemorrhage control
• C. Provide oral fluids
• D. Wait for pain to decrease before reassessment
Correct Answer: B
Rationale: Internal hemorrhage requires rapid transport, but ongoing reassessment and
hemorrhage control measures (as applicable) remain priorities.
5.
In spinal motion restriction, the goal is primarily to:
• A. Increase patient comfort only
• B. Prevent unnecessary movement while maintaining airway/breathing and minimizing
additional injury
• C. Immobilize every joint completely
• D. Eliminate all patient motion at all costs
Correct Answer: B
Rationale: The aim is to minimize motion that could worsen spinal injury while still
addressing life threats.
6.
A patient has oral blood and noisy breathing. What is the best immediate intervention?
• A. Leave airway contamination untreated
• B. Suction and position the airway to maintain patency, then reassess
• C. Give oxygen only without clearing airway
• D. Sedate the patient
Correct Answer: B
Rationale: A contaminated airway can obstruct ventilation; clear/maintain patency and
reassess response.
7.
Which of the following best describes reassessment frequency during the primary survey?
• A. Only once, then stop unless the patient arrests
• B. Periodic reassessment of airway, breathing, circulation, and mental status as
interventions occur
• C. Every 2 days
, • D. Only after transport is complete
Correct Answer: B
Rationale: Reassessment prevents missed deterioration and confirms effectiveness of
interventions.
8.
Which pulse finding is more consistent with poor perfusion?
• A. Weak but normal-rate pulse with warm skin
• B. Thready pulse, tachycardia, cool clammy skin
• C. Strong pulse and normal skin temperature
• D. Normal mental status with hypertension
Correct Answer: B
Rationale: Thready pulses and cool clammy skin are typical perfusion-compromise
signs.
9.
A patient with massive external bleeding has dressings that quickly soak through. What is the
most appropriate step?
• A. Remove dressings and wait
• B. Apply additional pressure and consider direct pressure/packing per protocol
• C. Elevate the limb above the heart
• D. Only apply a cold pack
Correct Answer: B
Rationale: Ongoing hemorrhage requires immediate pressure and hemorrhage-control
measures; time-critical.
10.
Which condition is a common cause of altered mental status in trauma patients?
• A. Hypothermia, hypoxia, shock, head injury
• B. Only hunger
• C. Only dehydration without injury
• D. Sleep deprivation
Correct Answer: A
Rationale: Multiple trauma-related factors can impair mentation—particularly hypoxia,
shock, hypothermia, and head injury.
11.
, A 10-year-old with blunt abdominal trauma is pale, diaphoretic, and increasingly lethargic. What
should you prioritize?
• A. Delayed evaluation to control pain first
• B. Rapid transport with continuous reassessment and treat life threats
• C. Encourage oral intake
• D. Wait for confirmation of internal bleeding with imaging
Correct Answer: B
Rationale: Worsening mental status and perfusion compromise suggest shock—treat life
threats and transport quickly.
12.
You arrive at a scene with high-risk factors (unstable structures). What is your first action?
• A. Remove the patient from the scene immediately
• B. Assess scene safety and coordinate appropriately
• C. Begin full immobilization before moving
• D. Ignore hazards if the patient is young
Correct Answer: B
Rationale: Scene safety prevents rescuer injury and enables appropriate operation
planning.
13.
During airway management, the “best” suction strategy is:
• A. Only suction if visible blood is present
• B. Suction as needed to maintain patency while minimizing interruptions
• C. Suction continuously without reassessment
• D. Never suction to avoid hypoxia
Correct Answer: B
Rationale: Use suction when it improves patency and ventilation; avoid prolonged
interruptions.
14.
Which statement is true about oxygen therapy in trauma?
• A. Oxygen is irrelevant in trauma
• B. Oxygen should be used to support ventilation/oxygenation while correcting underlying
causes
• C. Oxygen can replace airway interventions
• D. Oxygen is only for cardiac arrests
Correct Answer: B
