PHTLS 10th Practice Exam 4 Question and
Answers with Rationales Latest Version Top
Rated A+
Question 1
A trauma patient arrives after a high-speed motor vehicle crash. The patient is unconscious, has
noisy respirations, and is not following commands. What is the first priority in trauma
assessment?
A. Obtain a complete SAMPLE history
B. Assess airway and protect the cervical spine
C. Check blood glucose level
D. Apply a traction splint
Correct Answer: B. Assess airway and protect the cervical spine
Rationale:
The primary survey follows the ABCDE approach. Airway management with cervical spine
protection is the first priority because airway obstruction can rapidly lead to death. Spinal
precautions are maintained because trauma mechanisms may involve cervical injury.
Question 2
During the primary survey, a patient has severe external bleeding from a femoral wound. The
patient is pale, anxious, and tachycardic. What intervention should be performed first?
A. Apply a tourniquet
B. Insert an IV catheter
C. Obtain a blood pressure reading
D. Administer oxygen
Correct Answer: A. Apply a tourniquet
Rationale:
Life-threatening hemorrhage must be controlled immediately. Extremity bleeding causing shock
should be managed with direct pressure and, when indicated, a tourniquet. Delaying hemorrhage
control increases mortality risk.
,Question 3
A trauma patient has a decreased level of consciousness after a head injury. Which finding is
most concerning?
A. Mild headache
B. Equal pupil size
C. Vomiting with worsening mental status
D. Small superficial scalp wound
Correct Answer: C. Vomiting with worsening mental status
Rationale:
A declining level of consciousness and vomiting may indicate increasing intracranial pressure or
traumatic brain injury progression. Neurologic deterioration requires rapid reassessment and
transport.
Question 4
A patient with chest trauma presents with severe respiratory distress, absent breath sounds on
one side, and hypotension. Which condition should be suspected?
A. Simple rib fracture
B. Tension pneumothorax
C. Pulmonary contusion
D. Cardiac tamponade
Correct Answer: B. Tension pneumothorax
Rationale:
The combination of respiratory distress, unilateral absent breath sounds, and shock suggests
tension pneumothorax. This is a life-threatening condition requiring immediate recognition and
treatment according to local protocols.
Question 5
Which statement best describes the purpose of the PHTLS primary survey?
A. Identify every injury before treatment begins
B. Determine the patient's insurance status
,C. Rapidly identify and treat life threats
D. Complete a detailed physical examination
Correct Answer: C. Rapidly identify and treat life threats
Rationale:
The primary survey focuses on finding and correcting immediate threats to life. Detailed
assessment occurs after critical problems have been addressed.
Question 6
A patient has a penetrating abdominal injury with a protruding organ. What is the appropriate
management?
A. Push the organ back inside
B. Cover with moist sterile dressings
C. Apply firm pressure directly over the organ
D. Remove the object causing the injury
Correct Answer: B. Cover with moist sterile dressings
Rationale:
Eviscerated organs should not be replaced into the abdomen. They should be covered with moist
sterile dressings and protected from further injury.
Question 7
A trauma patient is confused, cool, and clammy with a rapid pulse. Which condition is most
likely?
A. Compensated shock
B. Hypertension crisis
C. Spinal cord recovery
D. Isolated anxiety
Correct Answer: A. Compensated shock
Rationale:
Early shock signs include anxiety, altered mental status, tachycardia, cool skin, and delayed
perfusion changes. Trauma providers must recognize shock before hypotension develops.
, Question 8
Which patient should receive the highest transport priority?
A. Patient with a closed ankle fracture
B. Patient with controlled bleeding and normal vital signs
C. Patient with airway obstruction and altered consciousness
D. Patient with minor abrasions
Correct Answer: C. Patient with airway obstruction and altered consciousness
Rationale:
Airway compromise and altered mental status represent immediate threats to survival. PHTLS
emphasizes identifying the most critical patients first.
Question 9
A patient involved in a motorcycle crash complains of severe pelvic pain and instability. What
complication should be suspected?
A. Pelvic hemorrhage
B. Isolated muscle strain
C. Mild soft tissue injury
D. Simple dehydration
Correct Answer: A. Pelvic hemorrhage
Rationale:
Pelvic fractures can cause significant internal bleeding. Early recognition, stabilization, and rapid
transport are essential.
Question 10
Why is reassessment important during trauma care?
A. Injuries may evolve and patient condition may change
B. It replaces the initial assessment
C. It eliminates the need for documentation
D. It delays transport
Correct Answer: A. Injuries may evolve and patient condition may change
Answers with Rationales Latest Version Top
Rated A+
Question 1
A trauma patient arrives after a high-speed motor vehicle crash. The patient is unconscious, has
noisy respirations, and is not following commands. What is the first priority in trauma
assessment?
A. Obtain a complete SAMPLE history
B. Assess airway and protect the cervical spine
C. Check blood glucose level
D. Apply a traction splint
Correct Answer: B. Assess airway and protect the cervical spine
Rationale:
The primary survey follows the ABCDE approach. Airway management with cervical spine
protection is the first priority because airway obstruction can rapidly lead to death. Spinal
precautions are maintained because trauma mechanisms may involve cervical injury.
Question 2
During the primary survey, a patient has severe external bleeding from a femoral wound. The
patient is pale, anxious, and tachycardic. What intervention should be performed first?
A. Apply a tourniquet
B. Insert an IV catheter
C. Obtain a blood pressure reading
D. Administer oxygen
Correct Answer: A. Apply a tourniquet
Rationale:
Life-threatening hemorrhage must be controlled immediately. Extremity bleeding causing shock
should be managed with direct pressure and, when indicated, a tourniquet. Delaying hemorrhage
control increases mortality risk.
,Question 3
A trauma patient has a decreased level of consciousness after a head injury. Which finding is
most concerning?
A. Mild headache
B. Equal pupil size
C. Vomiting with worsening mental status
D. Small superficial scalp wound
Correct Answer: C. Vomiting with worsening mental status
Rationale:
A declining level of consciousness and vomiting may indicate increasing intracranial pressure or
traumatic brain injury progression. Neurologic deterioration requires rapid reassessment and
transport.
Question 4
A patient with chest trauma presents with severe respiratory distress, absent breath sounds on
one side, and hypotension. Which condition should be suspected?
A. Simple rib fracture
B. Tension pneumothorax
C. Pulmonary contusion
D. Cardiac tamponade
Correct Answer: B. Tension pneumothorax
Rationale:
The combination of respiratory distress, unilateral absent breath sounds, and shock suggests
tension pneumothorax. This is a life-threatening condition requiring immediate recognition and
treatment according to local protocols.
Question 5
Which statement best describes the purpose of the PHTLS primary survey?
A. Identify every injury before treatment begins
B. Determine the patient's insurance status
,C. Rapidly identify and treat life threats
D. Complete a detailed physical examination
Correct Answer: C. Rapidly identify and treat life threats
Rationale:
The primary survey focuses on finding and correcting immediate threats to life. Detailed
assessment occurs after critical problems have been addressed.
Question 6
A patient has a penetrating abdominal injury with a protruding organ. What is the appropriate
management?
A. Push the organ back inside
B. Cover with moist sterile dressings
C. Apply firm pressure directly over the organ
D. Remove the object causing the injury
Correct Answer: B. Cover with moist sterile dressings
Rationale:
Eviscerated organs should not be replaced into the abdomen. They should be covered with moist
sterile dressings and protected from further injury.
Question 7
A trauma patient is confused, cool, and clammy with a rapid pulse. Which condition is most
likely?
A. Compensated shock
B. Hypertension crisis
C. Spinal cord recovery
D. Isolated anxiety
Correct Answer: A. Compensated shock
Rationale:
Early shock signs include anxiety, altered mental status, tachycardia, cool skin, and delayed
perfusion changes. Trauma providers must recognize shock before hypotension develops.
, Question 8
Which patient should receive the highest transport priority?
A. Patient with a closed ankle fracture
B. Patient with controlled bleeding and normal vital signs
C. Patient with airway obstruction and altered consciousness
D. Patient with minor abrasions
Correct Answer: C. Patient with airway obstruction and altered consciousness
Rationale:
Airway compromise and altered mental status represent immediate threats to survival. PHTLS
emphasizes identifying the most critical patients first.
Question 9
A patient involved in a motorcycle crash complains of severe pelvic pain and instability. What
complication should be suspected?
A. Pelvic hemorrhage
B. Isolated muscle strain
C. Mild soft tissue injury
D. Simple dehydration
Correct Answer: A. Pelvic hemorrhage
Rationale:
Pelvic fractures can cause significant internal bleeding. Early recognition, stabilization, and rapid
transport are essential.
Question 10
Why is reassessment important during trauma care?
A. Injuries may evolve and patient condition may change
B. It replaces the initial assessment
C. It eliminates the need for documentation
D. It delays transport
Correct Answer: A. Injuries may evolve and patient condition may change
