PHTLS POST TEST QUESTIONS WITH
VERIFIED ANSWERS
1. What is the most reliable indicator of inadequate ventilation in a trauma patient?
A. Cyanosis
B. Decreasing level of consciousness
C. Progressive hypercarbia demonstrated by ETCO2
D. Tachypnea
Answer: B
Conceptual Explanation: Decreasing level of consciousness is often the most reliable
indicator of hypoxia and inadequate ventilation leading to cerebral hypoxia in trauma
patients.
2. Which of the following is the preferred fluid for initial resuscitation of hemorrhagic shock
in the field?
A. Normal saline
B. Blood products
C. Lactated Ringer’s
D. Hypertonic saline
,Answer: B
Conceptual Explanation: Current PHTLS guidelines emphasize the early use of blood
products for hemorrhagic shock over crystalloids.
3. What is the primary physiological consequence of a tension pneumothorax?
A. Increased cardiac preload
B. Systemic vasodilation
C. Decreased venous return to the heart
D. Increased minute ventilation
Answer: C
Conceptual Explanation: A tension pneumothorax increases intrathoracic pressure, which
compresses the vena cava and decreases venous return, leading to obstructive shock.
4. In managing a patient with a suspected traumatic brain injury (TBI), which of the following
should be strictly avoided?
A. Elevation of the head of the bed
B. Normocarbia
C. Oxygen administration
D. Hypotension
Answer: D
, Conceptual Explanation: Hypotension is devastating to an injured brain because it
severely compromises cerebral perfusion pressure and worsens secondary brain injury.
5. When is spinal motion restriction (SMR) indicated based on current PHTLS guidelines?
A. Every patient with a mechanism for spinal trauma
B. Only when the patient has focal neurological deficits or spinal pain
C. Patients with a Glasgow Coma Scale of 15 only
D. All patients involved in motor vehicle collisions
Answer: B
Conceptual Explanation: SMR is applied selectively based on clinical criteria such as
midline pain, intoxication, distracting injuries, or neurological deficits, rather than
mechanism alone.
6. Which of the following findings is most characteristic of early neurogenic shock?
A. Tachycardia and pale skin
B. Bradycardia and warm, dry skin
C. Tachycardia and diaphoresis
D. Bradycardia and cool, clammy skin
Answer: B
Conceptual Explanation: Neurogenic shock results in loss of sympathetic tone, causing
vasodilation (warm, dry skin) and unopposed vagal tone leading to bradycardia.
VERIFIED ANSWERS
1. What is the most reliable indicator of inadequate ventilation in a trauma patient?
A. Cyanosis
B. Decreasing level of consciousness
C. Progressive hypercarbia demonstrated by ETCO2
D. Tachypnea
Answer: B
Conceptual Explanation: Decreasing level of consciousness is often the most reliable
indicator of hypoxia and inadequate ventilation leading to cerebral hypoxia in trauma
patients.
2. Which of the following is the preferred fluid for initial resuscitation of hemorrhagic shock
in the field?
A. Normal saline
B. Blood products
C. Lactated Ringer’s
D. Hypertonic saline
,Answer: B
Conceptual Explanation: Current PHTLS guidelines emphasize the early use of blood
products for hemorrhagic shock over crystalloids.
3. What is the primary physiological consequence of a tension pneumothorax?
A. Increased cardiac preload
B. Systemic vasodilation
C. Decreased venous return to the heart
D. Increased minute ventilation
Answer: C
Conceptual Explanation: A tension pneumothorax increases intrathoracic pressure, which
compresses the vena cava and decreases venous return, leading to obstructive shock.
4. In managing a patient with a suspected traumatic brain injury (TBI), which of the following
should be strictly avoided?
A. Elevation of the head of the bed
B. Normocarbia
C. Oxygen administration
D. Hypotension
Answer: D
, Conceptual Explanation: Hypotension is devastating to an injured brain because it
severely compromises cerebral perfusion pressure and worsens secondary brain injury.
5. When is spinal motion restriction (SMR) indicated based on current PHTLS guidelines?
A. Every patient with a mechanism for spinal trauma
B. Only when the patient has focal neurological deficits or spinal pain
C. Patients with a Glasgow Coma Scale of 15 only
D. All patients involved in motor vehicle collisions
Answer: B
Conceptual Explanation: SMR is applied selectively based on clinical criteria such as
midline pain, intoxication, distracting injuries, or neurological deficits, rather than
mechanism alone.
6. Which of the following findings is most characteristic of early neurogenic shock?
A. Tachycardia and pale skin
B. Bradycardia and warm, dry skin
C. Tachycardia and diaphoresis
D. Bradycardia and cool, clammy skin
Answer: B
Conceptual Explanation: Neurogenic shock results in loss of sympathetic tone, causing
vasodilation (warm, dry skin) and unopposed vagal tone leading to bradycardia.
