PHTLS ADVANCED TRAUMA LIFE
SUPPORT EXAM QUESTIONS AND
ANSWERS 2027
1. Which of the following is the most reliable indicator of inadequate perfusion in a trauma
patient?
A. Alteration in mental status
B. Tachycardia
C. Narrowing pulse pressure
D. Delayed capillary refill
Answer: A
Conceptual Explanation: Alteration in mental status is one of the earliest and most
reliable indicators of poor cerebral perfusion and shock in trauma patients.
2. What is the primary goal of fluid resuscitation in the hypotensive trauma patient with
uncontrolled hemorrhage?
A. Restore normal blood pressure immediately
B. Maintain a palpable radial pulse and adequate mental status
C. Achieve a mean arterial pressure of at least 90 mmHg
,D. Administer 2 liters of normal saline rapidly
Answer: B
Conceptual Explanation: Permissive hypotension aims for perfusion of vital organs
without dislodging developing blood clots, usually targeting a radial pulse or MAP of 65
mmHg.
3. Which mechanism of injury is most commonly associated with a deceleration spinal cord
injury?
A. Rotational sheer
B. Lateral bending
C. Axial loading
D. Hyperflexion and hyperextension
Answer: D
Conceptual Explanation: Rapid deceleration injuries typically cause severe hyperflexion
and hyperextension of the cervical and thoracic spine.
4. During the secondary survey, you note bilateral equal breath sounds but worsening
subcutaneous emphysema in the neck. What should you suspect?
A. Simple pneumothorax
B. Massive hemothorax
C. Tracheobronchial tree injury
, D. Cardiac tamponade
Answer: C
Conceptual Explanation: Subcutaneous emphysema combined with respiratory distress
strongly suggests a disruption of the tracheobronchial tree.
5. What is the definitive initial treatment for a tension pneumothorax in the field?
A. Rapid fluid bolus
B. Endotracheal intubation
C. Application of a 3-sided occlusive dressing
D. Needle decompression or finger thoracostomy
Answer: D
Conceptual Explanation: Tension pneumothorax requires immediate decompression via
needle thoracostomy or finger thoracostomy to relieve intrathoracic pressure.
6. Which sign is characteristic of Beck’s triad for cardiac tamponade?
A. Hypertension, muffled heart sounds, tracheal deviation
B. Hyperresonance, absent breath sounds, hypotension
C. Hypotension, distended neck veins, muffled heart sounds
D. Bradycardia, bradypnea, hypertension
Answer: C
SUPPORT EXAM QUESTIONS AND
ANSWERS 2027
1. Which of the following is the most reliable indicator of inadequate perfusion in a trauma
patient?
A. Alteration in mental status
B. Tachycardia
C. Narrowing pulse pressure
D. Delayed capillary refill
Answer: A
Conceptual Explanation: Alteration in mental status is one of the earliest and most
reliable indicators of poor cerebral perfusion and shock in trauma patients.
2. What is the primary goal of fluid resuscitation in the hypotensive trauma patient with
uncontrolled hemorrhage?
A. Restore normal blood pressure immediately
B. Maintain a palpable radial pulse and adequate mental status
C. Achieve a mean arterial pressure of at least 90 mmHg
,D. Administer 2 liters of normal saline rapidly
Answer: B
Conceptual Explanation: Permissive hypotension aims for perfusion of vital organs
without dislodging developing blood clots, usually targeting a radial pulse or MAP of 65
mmHg.
3. Which mechanism of injury is most commonly associated with a deceleration spinal cord
injury?
A. Rotational sheer
B. Lateral bending
C. Axial loading
D. Hyperflexion and hyperextension
Answer: D
Conceptual Explanation: Rapid deceleration injuries typically cause severe hyperflexion
and hyperextension of the cervical and thoracic spine.
4. During the secondary survey, you note bilateral equal breath sounds but worsening
subcutaneous emphysema in the neck. What should you suspect?
A. Simple pneumothorax
B. Massive hemothorax
C. Tracheobronchial tree injury
, D. Cardiac tamponade
Answer: C
Conceptual Explanation: Subcutaneous emphysema combined with respiratory distress
strongly suggests a disruption of the tracheobronchial tree.
5. What is the definitive initial treatment for a tension pneumothorax in the field?
A. Rapid fluid bolus
B. Endotracheal intubation
C. Application of a 3-sided occlusive dressing
D. Needle decompression or finger thoracostomy
Answer: D
Conceptual Explanation: Tension pneumothorax requires immediate decompression via
needle thoracostomy or finger thoracostomy to relieve intrathoracic pressure.
6. Which sign is characteristic of Beck’s triad for cardiac tamponade?
A. Hypertension, muffled heart sounds, tracheal deviation
B. Hyperresonance, absent breath sounds, hypotension
C. Hypotension, distended neck veins, muffled heart sounds
D. Bradycardia, bradypnea, hypertension
Answer: C
