PHTLS 10th Edition–aligned comprehensive
practice assessment Questions and Answers
Latest Version Top Rated A+
Question 1
You arrive at a high-speed motor-vehicle collision. One vehicle has
significant intrusion into the passenger compartment and fuel is leaking.
What should the EMT/paramedic do first?
A. Begin a primary survey
B. Apply a cervical collar
C. Assess scene safety and identify hazards
D. Obtain the patient's SAMPLE history
Answer: C. Assess scene safety and identify hazards
Rationale: Provider and scene safety come before patient assessment.
Fuel leakage, unstable vehicles, traffic, fire, electrical hazards, or
hazardous materials may place rescuers at risk. PHTLS emphasizes
ensuring the safety of providers and patients before beginning patient
care.
Question 2
A trauma patient has massive bleeding from an extremity. What
intervention should occur immediately?
A. Obtain a blood pressure
B. Apply direct pressure and appropriate hemorrhage-control measures
C. Complete the secondary assessment
D. Establish two large-bore IVs before treating the wound
,Answer: B. Apply direct pressure and appropriate hemorrhage-
control measures
Rationale: Significant external hemorrhage is immediately life-
threatening and should be controlled as soon as it is identified.
Definitive hemorrhage control should not be delayed for routine
assessment procedures.
Question 3
A patient involved in a motorcycle collision is unconscious and making
gurgling sounds. What is the priority?
A. Assess pupils
B. Obtain a blood glucose level
C. Establish and maintain a patent airway
D. Splint suspected femur fractures
Answer: C. Establish and maintain a patent airway
Rationale: Airway compromise can rapidly cause hypoxia and death. In
an unconscious trauma patient, the airway must be assessed and
managed immediately while maintaining appropriate cervical-spine
precautions when indicated.
Question 4
During the primary survey, a trauma patient suddenly develops severe
respiratory distress, hypotension, distended neck veins, and absent
breath sounds on the left. What condition should be strongly suspected?
A. Simple pneumothorax
B. Tension pneumothorax
,C. Hemothorax
D. Pulmonary contusion
Answer: B. Tension pneumothorax
Rationale: The combination of respiratory distress, unilateral absent
breath sounds, and obstructive shock findings is highly concerning for
tension pneumothorax. This is a time-critical condition requiring
immediate management according to the provider's scope and local
protocol.
Question 5
Which finding is most concerning for inadequate tissue perfusion in a
trauma patient?
A. Warm skin and normal mental status
B. Anxiety with a normal pulse
C. Altered mental status and cool, pale skin
D. Respiratory rate of 14/min with normal work of breathing
Answer: C. Altered mental status and cool, pale skin
Rationale: Altered mental status and peripheral vasoconstriction can
indicate inadequate perfusion. Trauma patients may compensate for
significant blood loss before developing obvious hypotension, so
providers should not rely on blood pressure alone.
Question 6
A patient has a penetrating wound to the chest. Air is visibly moving
through the wound. What is the most appropriate immediate
intervention?
, A. Leave the wound completely uncovered
B. Apply an appropriate occlusive chest dressing according to protocol
C. Pack the wound deeply with gauze
D. Apply a pressure dressing circumferentially around the chest
Answer: B. Apply an appropriate occlusive chest dressing according
to protocol
Rationale: An open chest wound can allow air to enter the pleural space
and interfere with ventilation. Appropriate occlusive management helps
limit air entry while the patient is rapidly transported and monitored for
developing tension physiology.
Question 7
A patient with blunt chest trauma has paradoxical movement of a section
of the chest wall. What injury is most likely?
A. Cardiac tamponade
B. Flail chest
C. Simple pneumothorax
D. Hemothorax
Answer: B. Flail chest
Rationale: Flail chest occurs when multiple adjacent ribs are fractured
in multiple locations, producing an unstable segment of the chest wall.
Respiratory compromise may result from associated pulmonary injury
and impaired mechanics.
Question 8
practice assessment Questions and Answers
Latest Version Top Rated A+
Question 1
You arrive at a high-speed motor-vehicle collision. One vehicle has
significant intrusion into the passenger compartment and fuel is leaking.
What should the EMT/paramedic do first?
A. Begin a primary survey
B. Apply a cervical collar
C. Assess scene safety and identify hazards
D. Obtain the patient's SAMPLE history
Answer: C. Assess scene safety and identify hazards
Rationale: Provider and scene safety come before patient assessment.
Fuel leakage, unstable vehicles, traffic, fire, electrical hazards, or
hazardous materials may place rescuers at risk. PHTLS emphasizes
ensuring the safety of providers and patients before beginning patient
care.
Question 2
A trauma patient has massive bleeding from an extremity. What
intervention should occur immediately?
A. Obtain a blood pressure
B. Apply direct pressure and appropriate hemorrhage-control measures
C. Complete the secondary assessment
D. Establish two large-bore IVs before treating the wound
,Answer: B. Apply direct pressure and appropriate hemorrhage-
control measures
Rationale: Significant external hemorrhage is immediately life-
threatening and should be controlled as soon as it is identified.
Definitive hemorrhage control should not be delayed for routine
assessment procedures.
Question 3
A patient involved in a motorcycle collision is unconscious and making
gurgling sounds. What is the priority?
A. Assess pupils
B. Obtain a blood glucose level
C. Establish and maintain a patent airway
D. Splint suspected femur fractures
Answer: C. Establish and maintain a patent airway
Rationale: Airway compromise can rapidly cause hypoxia and death. In
an unconscious trauma patient, the airway must be assessed and
managed immediately while maintaining appropriate cervical-spine
precautions when indicated.
Question 4
During the primary survey, a trauma patient suddenly develops severe
respiratory distress, hypotension, distended neck veins, and absent
breath sounds on the left. What condition should be strongly suspected?
A. Simple pneumothorax
B. Tension pneumothorax
,C. Hemothorax
D. Pulmonary contusion
Answer: B. Tension pneumothorax
Rationale: The combination of respiratory distress, unilateral absent
breath sounds, and obstructive shock findings is highly concerning for
tension pneumothorax. This is a time-critical condition requiring
immediate management according to the provider's scope and local
protocol.
Question 5
Which finding is most concerning for inadequate tissue perfusion in a
trauma patient?
A. Warm skin and normal mental status
B. Anxiety with a normal pulse
C. Altered mental status and cool, pale skin
D. Respiratory rate of 14/min with normal work of breathing
Answer: C. Altered mental status and cool, pale skin
Rationale: Altered mental status and peripheral vasoconstriction can
indicate inadequate perfusion. Trauma patients may compensate for
significant blood loss before developing obvious hypotension, so
providers should not rely on blood pressure alone.
Question 6
A patient has a penetrating wound to the chest. Air is visibly moving
through the wound. What is the most appropriate immediate
intervention?
, A. Leave the wound completely uncovered
B. Apply an appropriate occlusive chest dressing according to protocol
C. Pack the wound deeply with gauze
D. Apply a pressure dressing circumferentially around the chest
Answer: B. Apply an appropriate occlusive chest dressing according
to protocol
Rationale: An open chest wound can allow air to enter the pleural space
and interfere with ventilation. Appropriate occlusive management helps
limit air entry while the patient is rapidly transported and monitored for
developing tension physiology.
Question 7
A patient with blunt chest trauma has paradoxical movement of a section
of the chest wall. What injury is most likely?
A. Cardiac tamponade
B. Flail chest
C. Simple pneumothorax
D. Hemothorax
Answer: B. Flail chest
Rationale: Flail chest occurs when multiple adjacent ribs are fractured
in multiple locations, producing an unstable segment of the chest wall.
Respiratory compromise may result from associated pulmonary injury
and impaired mechanics.
Question 8
