PHTLS POST TEST QUESTIONS AND
ANSWERS 2027
1. What is the most critical intervention in the management of a trauma patient with a
tension pneumothorax?
A. Administration of high-flow oxygen via non-rebreather mask
B. Immediate endotracheal intubation
C. Needle decompression or finger thoracostomy
D. Aggressive fluid resuscitation with crystalloids
Answer: C
Conceptual Explanation: A tension pneumothorax is a life-threatening condition that
requires immediate decompression (needle decompression or finger thoracostomy) to
relieve pressure on the mediastinum before attempting other interventions.
2. Which of the following findings is most characteristic of early hemorrhagic shock?
A. Hypotension and bradycardia
B. Flushed skin and bounding pulses
C. Unresponsiveness and irregular breathing
D. Anxiety, tachycardia, and narrow pulse pressure
,Answer: D
Conceptual Explanation: In early hemorrhagic shock, compensatory mechanisms
(catecholamine release) cause anxiety, tachycardia, and vasoconstriction, leading to a
narrowed pulse pressure. Hypotension is a late sign.
3. When evaluating a helmeted motorcyclist involved in a collision, when should the helmet
be removed?
A. Always remove the helmet immediately upon patient contact.
B. Never remove the helmet under any circumstances in the field.
C. Remove it only if it interferes with airway management or assessment of the airway.
D. Remove it strictly to check for scalp lacerations.
Answer: C
Conceptual Explanation: A helmet should be removed if it interferes with the ability to
assess and manage the airway or ventilation, or if it prevents proper spinal motion
restriction.
4. What is the primary goal of fluid resuscitation in penetrating trauma with uncontrolled
hemorrhage prior to surgical intervention?
A. Restore normal blood pressure immediately
B. Prevent peripheral edema entirely
C. Administer 20 mL/kg of normal saline rapidly
, D. Maintain permissive hypotension to preserve clot formation
Answer: D
Conceptual Explanation: Permissive hypotension (maintaining a radial pulse or target
systolic BP around 80-90 mmHg) prevents disruption of newly formed clots and reduces
dilutional coagulopathy.
5. Which of the following is the preferred method for controlling severe extremity bleeding
when direct pressure fails or is impractical?
A. Elevation of the extremity above the heart
B. Application of an arterial tourniquet
C. Applying a pressure point on the brachial or femoral artery
D. Applying ice packs directly to the wound
Answer: B
Conceptual Explanation: Arterial tourniquets are the standard of care for controlling life-
threatening extremity hemorrhage when direct pressure is ineffective or not feasible.
6. During the primary survey, what does the ‘C’ in the ABCDE mnemonic stand for?
A. Circulation
B. Cervical spine
C. Chest compressions
D. Consciousness
ANSWERS 2027
1. What is the most critical intervention in the management of a trauma patient with a
tension pneumothorax?
A. Administration of high-flow oxygen via non-rebreather mask
B. Immediate endotracheal intubation
C. Needle decompression or finger thoracostomy
D. Aggressive fluid resuscitation with crystalloids
Answer: C
Conceptual Explanation: A tension pneumothorax is a life-threatening condition that
requires immediate decompression (needle decompression or finger thoracostomy) to
relieve pressure on the mediastinum before attempting other interventions.
2. Which of the following findings is most characteristic of early hemorrhagic shock?
A. Hypotension and bradycardia
B. Flushed skin and bounding pulses
C. Unresponsiveness and irregular breathing
D. Anxiety, tachycardia, and narrow pulse pressure
,Answer: D
Conceptual Explanation: In early hemorrhagic shock, compensatory mechanisms
(catecholamine release) cause anxiety, tachycardia, and vasoconstriction, leading to a
narrowed pulse pressure. Hypotension is a late sign.
3. When evaluating a helmeted motorcyclist involved in a collision, when should the helmet
be removed?
A. Always remove the helmet immediately upon patient contact.
B. Never remove the helmet under any circumstances in the field.
C. Remove it only if it interferes with airway management or assessment of the airway.
D. Remove it strictly to check for scalp lacerations.
Answer: C
Conceptual Explanation: A helmet should be removed if it interferes with the ability to
assess and manage the airway or ventilation, or if it prevents proper spinal motion
restriction.
4. What is the primary goal of fluid resuscitation in penetrating trauma with uncontrolled
hemorrhage prior to surgical intervention?
A. Restore normal blood pressure immediately
B. Prevent peripheral edema entirely
C. Administer 20 mL/kg of normal saline rapidly
, D. Maintain permissive hypotension to preserve clot formation
Answer: D
Conceptual Explanation: Permissive hypotension (maintaining a radial pulse or target
systolic BP around 80-90 mmHg) prevents disruption of newly formed clots and reduces
dilutional coagulopathy.
5. Which of the following is the preferred method for controlling severe extremity bleeding
when direct pressure fails or is impractical?
A. Elevation of the extremity above the heart
B. Application of an arterial tourniquet
C. Applying a pressure point on the brachial or femoral artery
D. Applying ice packs directly to the wound
Answer: B
Conceptual Explanation: Arterial tourniquets are the standard of care for controlling life-
threatening extremity hemorrhage when direct pressure is ineffective or not feasible.
6. During the primary survey, what does the ‘C’ in the ABCDE mnemonic stand for?
A. Circulation
B. Cervical spine
C. Chest compressions
D. Consciousness
