1. A combat medic is providing care during active enemy fire. What is the most appropriate
immediate action?
A) Begin a detailed head-to-toe assessment
B) Return fire and take cover while directing the casualty to remain engaged
C) Start an IV with normal saline
D) Perform a complete neurological exam
Correct Answer: B) Return fire and take cover while directing the casualty to remain engaged
Rationale: During Care Under Fire, gaining fire superiority and establishing scene safety are the top
priorities before any medical intervention can be safely initiated.
2. What is the leading cause of preventable death on the modern battlefield?
A) Tension pneumothorax
B) Airway obstruction
C) Massive hemorrhage
D) Traumatic brain injury
Correct Answer: C) Massive hemorrhage
Rationale: Hemorrhage has been identified as the number one cause of preventable death in combat,
accounting for the majority of potentially survivable fatalities.
3. A casualty has an altered mental status after a blast injury. What should be done with their
weapon?
A) Leave it within reach for self-defense
B) Secure it and remove it from the casualty's possession
C) Return it to the casualty after checking for consciousness
D) Use it to signal for evacuation
Correct Answer: B) Secure it and remove it from the casualty's possession
Rationale: Casualties with altered mental status must be immediately disarmed to prevent accidental
discharge or harm to themselves or others.
,4. During Tactical Field Care, which sequence should be followed for assessment and treatment?
A) ABCDE
B) MARCH PAWS
C) CAB
D) SAMPLE
Correct Answer: B) MARCH PAWS
Rationale: The MARCH PAWS sequence is the standardized TCCC assessment framework that
prioritizes massive hemorrhage, airway, respiration, circulation, hypothermia/head injury, pain,
antibiotics, wounds, and splinting.
5. What is the appropriate tourniquet placement for a severely bleeding arm wound?
A) Directly on the wound
B) 2-3 inches above the wound
C) Below the wound to prevent distal bleeding
D) At the axilla level
Correct Answer: B) 2-3 inches above the wound
Rationale: When the wound is visible, the tourniquet should be placed 2-3 inches proximal to the
injury site to effectively occlude arterial blood flow.
6. Which finding would indicate a tension pneumothorax in a casualty with a chest wound?
A) Slow, shallow breathing
B) Diminished breath sounds and distended neck veins
C) Clear breath sounds bilaterally
D) Decreased heart rate
Correct Answer: B) Diminished breath sounds and distended neck veins
Rationale: Tension pneumothorax presents with absent or diminished breath sounds on the affected
side and jugular venous distension due to increased intrathoracic pressure.
7. How should a Combat Lifesaver manage a casualty with gurgling sounds during respiration?
A) Insert a nasopharyngeal airway
B) Perform needle decompression
, C) Administer supplemental oxygen
D) Begin chest compressions
Correct Answer: A) Insert a nasopharyngeal airway
Rationale: Gurgling sounds indicate airway obstruction, and a nasopharyngeal airway is the
preferred method to maintain a patent airway in a conscious casualty with an intact gag reflex.
8. What is the primary difference between MEDEVAC and CASEVAC?
A) MEDEVAC is faster than CASEVAC
B) MEDEVAC vehicles are unarmed and protected under Geneva Convention
C) CASEVAC requires more medical personnel
D) MEDEVAC can only be used during daylight
Correct Answer: B) MEDEVAC vehicles are unarmed and protected under Geneva Convention
Rationale: Medical evacuation (MEDEVAC) assets are unarmed and legally protected, while casualty
evacuation (CASEVAC) assets may carry weapons for self-defense.
9. What dose of TXA should be administered for a casualty with non-compressible hemorrhage?
A) 500 mg in 50 mL NS over 5 minutes
B) 1 g in 100 mL NS or LR infused over 10 minutes
C) 2 g in 250 mL NS rapid push
D) 500 mg IM
Correct Answer: B) 1 g in 100 mL NS or LR infused over 10 minutes
Rationale: The recommended TXA dose is 1 gram in 100 mL of normal saline or lactated Ringer's
solution infused slowly over 10 minutes, ideally within 3 hours of injury.
10. Which sign is considered a reliable indicator of shock in the Tactical Field Care setting?
A) Weak radial pulse
B) Blood pressure reading below 90/60
C) Respiratory rate less than 12
D) Temperature above 101°F
Correct Answer: A) Weak radial pulse
Rationale: In the tactical environment, the quality of the radial pulse and state of consciousness are
the most reliable battlefield indicators of shock.
, 11. What equipment is found in the Joint First Aid Kit (JFAK)?
A) Only bandages and gauze
B) Chest seal, NPA, and tourniquet
C) IV supplies and medications
D) Surgical instruments
Correct Answer: B) Chest seal, NPA, and tourniquet
Rationale: The JFAK contains essential life-saving equipment including a tourniquet, hemostatic
dressing, nasopharyngeal airway, and chest seal for immediate care.
12. A casualty is in hypovolemic shock. When should fluid resuscitation be stopped?
A) When blood pressure reaches 120/80
B) When a palpable radial pulse is achieved
C) After 2 liters of fluid
D) Only when reaching definitive care
Correct Answer: B) When a palpable radial pulse is achieved
Rationale: Fluid resuscitation should be titrated to maintain a palpable radial pulse, which
corresponds to a systolic blood pressure of approximately 80-90 mmHg, avoiding over-resuscitation
that could worsen hemorrhage.
13. Which medication is the preferred analgesic for a casualty in moderate to severe pain with no
signs of shock?
A) Ketamine 50 mg IM
B) Fentanyl citrate 800 mcg lozenge
C) Meloxicam 15 mg PO
D) Morphine 5 mg IV
Correct Answer: B) Fentanyl citrate 800 mcg lozenge
Rationale: Fentanyl lozenge is the preferred transmucosal analgesic for conscious casualties with
moderate to severe pain who are not in shock or respiratory distress.
14. What is a contraindication for administering fentanyl to a trauma casualty?
A) Mild headache
B) Hypovolemic shock
immediate action?
A) Begin a detailed head-to-toe assessment
B) Return fire and take cover while directing the casualty to remain engaged
C) Start an IV with normal saline
D) Perform a complete neurological exam
Correct Answer: B) Return fire and take cover while directing the casualty to remain engaged
Rationale: During Care Under Fire, gaining fire superiority and establishing scene safety are the top
priorities before any medical intervention can be safely initiated.
2. What is the leading cause of preventable death on the modern battlefield?
A) Tension pneumothorax
B) Airway obstruction
C) Massive hemorrhage
D) Traumatic brain injury
Correct Answer: C) Massive hemorrhage
Rationale: Hemorrhage has been identified as the number one cause of preventable death in combat,
accounting for the majority of potentially survivable fatalities.
3. A casualty has an altered mental status after a blast injury. What should be done with their
weapon?
A) Leave it within reach for self-defense
B) Secure it and remove it from the casualty's possession
C) Return it to the casualty after checking for consciousness
D) Use it to signal for evacuation
Correct Answer: B) Secure it and remove it from the casualty's possession
Rationale: Casualties with altered mental status must be immediately disarmed to prevent accidental
discharge or harm to themselves or others.
,4. During Tactical Field Care, which sequence should be followed for assessment and treatment?
A) ABCDE
B) MARCH PAWS
C) CAB
D) SAMPLE
Correct Answer: B) MARCH PAWS
Rationale: The MARCH PAWS sequence is the standardized TCCC assessment framework that
prioritizes massive hemorrhage, airway, respiration, circulation, hypothermia/head injury, pain,
antibiotics, wounds, and splinting.
5. What is the appropriate tourniquet placement for a severely bleeding arm wound?
A) Directly on the wound
B) 2-3 inches above the wound
C) Below the wound to prevent distal bleeding
D) At the axilla level
Correct Answer: B) 2-3 inches above the wound
Rationale: When the wound is visible, the tourniquet should be placed 2-3 inches proximal to the
injury site to effectively occlude arterial blood flow.
6. Which finding would indicate a tension pneumothorax in a casualty with a chest wound?
A) Slow, shallow breathing
B) Diminished breath sounds and distended neck veins
C) Clear breath sounds bilaterally
D) Decreased heart rate
Correct Answer: B) Diminished breath sounds and distended neck veins
Rationale: Tension pneumothorax presents with absent or diminished breath sounds on the affected
side and jugular venous distension due to increased intrathoracic pressure.
7. How should a Combat Lifesaver manage a casualty with gurgling sounds during respiration?
A) Insert a nasopharyngeal airway
B) Perform needle decompression
, C) Administer supplemental oxygen
D) Begin chest compressions
Correct Answer: A) Insert a nasopharyngeal airway
Rationale: Gurgling sounds indicate airway obstruction, and a nasopharyngeal airway is the
preferred method to maintain a patent airway in a conscious casualty with an intact gag reflex.
8. What is the primary difference between MEDEVAC and CASEVAC?
A) MEDEVAC is faster than CASEVAC
B) MEDEVAC vehicles are unarmed and protected under Geneva Convention
C) CASEVAC requires more medical personnel
D) MEDEVAC can only be used during daylight
Correct Answer: B) MEDEVAC vehicles are unarmed and protected under Geneva Convention
Rationale: Medical evacuation (MEDEVAC) assets are unarmed and legally protected, while casualty
evacuation (CASEVAC) assets may carry weapons for self-defense.
9. What dose of TXA should be administered for a casualty with non-compressible hemorrhage?
A) 500 mg in 50 mL NS over 5 minutes
B) 1 g in 100 mL NS or LR infused over 10 minutes
C) 2 g in 250 mL NS rapid push
D) 500 mg IM
Correct Answer: B) 1 g in 100 mL NS or LR infused over 10 minutes
Rationale: The recommended TXA dose is 1 gram in 100 mL of normal saline or lactated Ringer's
solution infused slowly over 10 minutes, ideally within 3 hours of injury.
10. Which sign is considered a reliable indicator of shock in the Tactical Field Care setting?
A) Weak radial pulse
B) Blood pressure reading below 90/60
C) Respiratory rate less than 12
D) Temperature above 101°F
Correct Answer: A) Weak radial pulse
Rationale: In the tactical environment, the quality of the radial pulse and state of consciousness are
the most reliable battlefield indicators of shock.
, 11. What equipment is found in the Joint First Aid Kit (JFAK)?
A) Only bandages and gauze
B) Chest seal, NPA, and tourniquet
C) IV supplies and medications
D) Surgical instruments
Correct Answer: B) Chest seal, NPA, and tourniquet
Rationale: The JFAK contains essential life-saving equipment including a tourniquet, hemostatic
dressing, nasopharyngeal airway, and chest seal for immediate care.
12. A casualty is in hypovolemic shock. When should fluid resuscitation be stopped?
A) When blood pressure reaches 120/80
B) When a palpable radial pulse is achieved
C) After 2 liters of fluid
D) Only when reaching definitive care
Correct Answer: B) When a palpable radial pulse is achieved
Rationale: Fluid resuscitation should be titrated to maintain a palpable radial pulse, which
corresponds to a systolic blood pressure of approximately 80-90 mmHg, avoiding over-resuscitation
that could worsen hemorrhage.
13. Which medication is the preferred analgesic for a casualty in moderate to severe pain with no
signs of shock?
A) Ketamine 50 mg IM
B) Fentanyl citrate 800 mcg lozenge
C) Meloxicam 15 mg PO
D) Morphine 5 mg IV
Correct Answer: B) Fentanyl citrate 800 mcg lozenge
Rationale: Fentanyl lozenge is the preferred transmucosal analgesic for conscious casualties with
moderate to severe pain who are not in shock or respiratory distress.
14. What is a contraindication for administering fentanyl to a trauma casualty?
A) Mild headache
B) Hypovolemic shock
