PHTLS POST TEST ADVANCED
ASSESSMENT QUESTIONS AND
ANSWERS 2027
1. Which of the following is the most reliable indicator of shock in the early stages of trauma?
A. Decreased blood pressure
B. Anxiety and altered mental status
C. Bradycardia
D. Cyanosis
Answer: B
Conceptual Explanation: In early shock, compensatory mechanisms maintain blood
pressure, but cerebral perfusion changes lead to anxiety, restlessness, and altered mental
status.
2. What is the primary physiological consequence of a tension pneumothorax?
A. Increased cardiac preload
B. Increased minute ventilation
C. Bilateral hyperresonance on percussion
D. Compression of the vena cava and decreased venous return
,Answer: D
Conceptual Explanation: A tension pneumothorax increases intrathoracic pressure, which
compresses the mediastinum, reduces venous return to the heart, and leads to obstructive
shock.
3. The Parkland formula for fluid resuscitation in burn patients calculates the volume of
Ringer’s Lactate needed within the first 24 hours based on:
A. Heart rate and blood pressure
B. Age and total body surface area burned
C. Height and weight
D. Weight in kilograms and percentage of BSA burned
Answer: D
Conceptual Explanation: The Parkland formula is 4 mL x body weight (kg) x % BSA
burned, administered over the first 24 hours.
4. Which of the following interventions is most critical for a patient with a suspected
traumatic brain injury (TBI) and signs of herniation?
A. Controlled ventilation to prevent hypoxia and hypercarbia
B. Aggressive fluid boluses to maintain a MAP above 110 mmHg
C. Prophylactic hyperventilation to a PaCO2 of 20 mmHg
D. Administration of high-dose steroids
, Answer: A
Conceptual Explanation: Hyperventilation is reserved only for acute signs of herniation;
otherwise, normoventilation and avoiding hypoxia/hypercarbia are critical.
5. What is the primary mechanism of injury in a blast injury categorized as ‘tertiary’?
A. The direct effect of pressure waves on gas-containing organs
B. The patient being thrown against a stationary object by the blast wind
C. Thermal burns from the explosion
D. Inhalation of toxic gases
Answer: B
Conceptual Explanation: Tertiary blast injuries occur when the patient is propelled by the
blast wind and strikes a stationary object.
6. During the management of a trauma patient, the ‘lethal triad’ consists of which of the
following?
A. Hypotension, tachycardia, hypoxia
B. Hypothermia, acidosis, coagulopathy
C. Hyperthermia, alkalosis, hyperglycemia
D. Hypertension, bradypnea, hypercapnia
Answer: B
ASSESSMENT QUESTIONS AND
ANSWERS 2027
1. Which of the following is the most reliable indicator of shock in the early stages of trauma?
A. Decreased blood pressure
B. Anxiety and altered mental status
C. Bradycardia
D. Cyanosis
Answer: B
Conceptual Explanation: In early shock, compensatory mechanisms maintain blood
pressure, but cerebral perfusion changes lead to anxiety, restlessness, and altered mental
status.
2. What is the primary physiological consequence of a tension pneumothorax?
A. Increased cardiac preload
B. Increased minute ventilation
C. Bilateral hyperresonance on percussion
D. Compression of the vena cava and decreased venous return
,Answer: D
Conceptual Explanation: A tension pneumothorax increases intrathoracic pressure, which
compresses the mediastinum, reduces venous return to the heart, and leads to obstructive
shock.
3. The Parkland formula for fluid resuscitation in burn patients calculates the volume of
Ringer’s Lactate needed within the first 24 hours based on:
A. Heart rate and blood pressure
B. Age and total body surface area burned
C. Height and weight
D. Weight in kilograms and percentage of BSA burned
Answer: D
Conceptual Explanation: The Parkland formula is 4 mL x body weight (kg) x % BSA
burned, administered over the first 24 hours.
4. Which of the following interventions is most critical for a patient with a suspected
traumatic brain injury (TBI) and signs of herniation?
A. Controlled ventilation to prevent hypoxia and hypercarbia
B. Aggressive fluid boluses to maintain a MAP above 110 mmHg
C. Prophylactic hyperventilation to a PaCO2 of 20 mmHg
D. Administration of high-dose steroids
, Answer: A
Conceptual Explanation: Hyperventilation is reserved only for acute signs of herniation;
otherwise, normoventilation and avoiding hypoxia/hypercarbia are critical.
5. What is the primary mechanism of injury in a blast injury categorized as ‘tertiary’?
A. The direct effect of pressure waves on gas-containing organs
B. The patient being thrown against a stationary object by the blast wind
C. Thermal burns from the explosion
D. Inhalation of toxic gases
Answer: B
Conceptual Explanation: Tertiary blast injuries occur when the patient is propelled by the
blast wind and strikes a stationary object.
6. During the management of a trauma patient, the ‘lethal triad’ consists of which of the
following?
A. Hypotension, tachycardia, hypoxia
B. Hypothermia, acidosis, coagulopathy
C. Hyperthermia, alkalosis, hyperglycemia
D. Hypertension, bradypnea, hypercapnia
Answer: B
