PHTLS EXAM 2025/2026 QUESTIONS WITH ANSWERS
GRADED A+
✔✔Hyperventlation of a patient with suspected traumatic brain injury should occur
when? - ✔✔when signs of impending brain herniation are present
✔✔Patients with a suspected traumatic brain injury (TBI) are susceptible to secondary
injuries which are typically preventable. In addition to hypoxia and hypotension which of
the following can also decrease cerebral perfusion? - ✔✔inadvertent of excess
hyperventilation
✔✔Hypotension due to a spinal cord injury is a result of what physiological
mechanisms? - ✔✔Loss of sympathetic tone causing vasodilation
✔✔Which of the following patients will compensate for blood loss the longest? - ✔✔6
year old male
✔✔You respond to a reported assault at a local bar. On arrival, you find a 46 year old
male in the bathroom floor with snoring respirations at 4 times per minute and obvious
facial injuries. Pupils reveal the R pupil is 4mm and the L pupil is 7mm and non-reactive.
What is the most appropriate first step? - ✔✔Jaw thrust maneuver
✔✔In a multi-system trauma patient what s considered the best method for confirming
proper placement of an endotracheal tube? - ✔✔wave form capnography
✔✔What is the most likely source of bleeding in a patient with signs of shock and no
obvious injury? - ✔✔Intra-abdominal injury
✔✔Hypoperfusion will affect which of the following organs first? - ✔✔Brain
✔✔a 23 year old male construction worker fell approximately 30 feet from the roof. The
patient is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his L pupil
is 3mm. He has irregular respirations at 8 breaths per min. You do not have waveform
capnography, so what is the most appropriate rate of ventilations? - ✔✔20 BPM
✔✔A 30 year old males thrown from his horse, landing on the top rail of a pipe fence
and now has loss of sensation from the nipples down. What level of the spine do you
suspect he injured? - ✔✔T4
✔✔In a patient with a suspected traumatic brain injury, what is the most concerning
physical finding? - ✔✔Altered level of consciousness
, ✔✔You have a patient who is 35 weeks pregnant who was assaulted by her boyfriend.
Patient is having severe abdominal pain described as "tearing" and on exam toy not her
abdomen is asymmetrical and believe you can feel the fetus through the abdominal
wall. What condition do you suspect? - ✔✔Ruptured Uterus
✔✔EMS responds to an adult barista with partial thickness burns to the abdomen and
right leg, sustained from a cooking accident. Initial treatment of this injury would include:
- ✔✔Cover burned area with dry sterile dressings
✔✔Prehospital providers have treated a sucking chest wound with an occlusive
dressing. During transport to the hospital, the patient developed increasing respiratory
distress with increased respirations and absent lung sounds are noted on repeat
auscultation. What is the most appropriate next intervention? - ✔✔Release and reapply
the occlusive dressing
✔✔EMS arrivals on a scene and finds that emergency medical responders have
attempted,pted to immobilize a pediatric patient onto a long backboard. They note that
the patients head is in a flexed position. Which of the following actions is the most
appropriate? - ✔✔Place padding under the patients torso
✔✔Falls are most common cause of death in trauma patients over ____ years of age. -
✔✔75
✔✔________ is the earliest sign of deterioration in a patient with a flail chest. -
✔✔respiratory rate increases
✔✔EMS is treating a 24 year old soccer player who was kicked in the chest. Prehospital
providers note paradoxical moment of portion of the patients chest wall. The patients
respiratory rate is 16 and oxygen saturation is 94%. What is the appropriate action? -
✔✔Provide supplemental oxygen and transport to a trauma center
✔✔Prehospital providers respond to a 17 year old male who fell through a sliding glass
door and sustained a large laceration to his arm that is bleeding heavily. He is restless
and diaphoretic, with a weak, thready pulse. What is the most approbate first action? -
✔✔Apply direct pressure
✔✔When managing a pediatric patient, prehospital providers should do all of the
following except: - ✔✔Use half the adult dose of medication administration
✔✔Which of the following is a golden principle of trauma care? - ✔✔Ensure adequate
airway and ventilation
GRADED A+
✔✔Hyperventlation of a patient with suspected traumatic brain injury should occur
when? - ✔✔when signs of impending brain herniation are present
✔✔Patients with a suspected traumatic brain injury (TBI) are susceptible to secondary
injuries which are typically preventable. In addition to hypoxia and hypotension which of
the following can also decrease cerebral perfusion? - ✔✔inadvertent of excess
hyperventilation
✔✔Hypotension due to a spinal cord injury is a result of what physiological
mechanisms? - ✔✔Loss of sympathetic tone causing vasodilation
✔✔Which of the following patients will compensate for blood loss the longest? - ✔✔6
year old male
✔✔You respond to a reported assault at a local bar. On arrival, you find a 46 year old
male in the bathroom floor with snoring respirations at 4 times per minute and obvious
facial injuries. Pupils reveal the R pupil is 4mm and the L pupil is 7mm and non-reactive.
What is the most appropriate first step? - ✔✔Jaw thrust maneuver
✔✔In a multi-system trauma patient what s considered the best method for confirming
proper placement of an endotracheal tube? - ✔✔wave form capnography
✔✔What is the most likely source of bleeding in a patient with signs of shock and no
obvious injury? - ✔✔Intra-abdominal injury
✔✔Hypoperfusion will affect which of the following organs first? - ✔✔Brain
✔✔a 23 year old male construction worker fell approximately 30 feet from the roof. The
patient is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his L pupil
is 3mm. He has irregular respirations at 8 breaths per min. You do not have waveform
capnography, so what is the most appropriate rate of ventilations? - ✔✔20 BPM
✔✔A 30 year old males thrown from his horse, landing on the top rail of a pipe fence
and now has loss of sensation from the nipples down. What level of the spine do you
suspect he injured? - ✔✔T4
✔✔In a patient with a suspected traumatic brain injury, what is the most concerning
physical finding? - ✔✔Altered level of consciousness
, ✔✔You have a patient who is 35 weeks pregnant who was assaulted by her boyfriend.
Patient is having severe abdominal pain described as "tearing" and on exam toy not her
abdomen is asymmetrical and believe you can feel the fetus through the abdominal
wall. What condition do you suspect? - ✔✔Ruptured Uterus
✔✔EMS responds to an adult barista with partial thickness burns to the abdomen and
right leg, sustained from a cooking accident. Initial treatment of this injury would include:
- ✔✔Cover burned area with dry sterile dressings
✔✔Prehospital providers have treated a sucking chest wound with an occlusive
dressing. During transport to the hospital, the patient developed increasing respiratory
distress with increased respirations and absent lung sounds are noted on repeat
auscultation. What is the most appropriate next intervention? - ✔✔Release and reapply
the occlusive dressing
✔✔EMS arrivals on a scene and finds that emergency medical responders have
attempted,pted to immobilize a pediatric patient onto a long backboard. They note that
the patients head is in a flexed position. Which of the following actions is the most
appropriate? - ✔✔Place padding under the patients torso
✔✔Falls are most common cause of death in trauma patients over ____ years of age. -
✔✔75
✔✔________ is the earliest sign of deterioration in a patient with a flail chest. -
✔✔respiratory rate increases
✔✔EMS is treating a 24 year old soccer player who was kicked in the chest. Prehospital
providers note paradoxical moment of portion of the patients chest wall. The patients
respiratory rate is 16 and oxygen saturation is 94%. What is the appropriate action? -
✔✔Provide supplemental oxygen and transport to a trauma center
✔✔Prehospital providers respond to a 17 year old male who fell through a sliding glass
door and sustained a large laceration to his arm that is bleeding heavily. He is restless
and diaphoretic, with a weak, thready pulse. What is the most approbate first action? -
✔✔Apply direct pressure
✔✔When managing a pediatric patient, prehospital providers should do all of the
following except: - ✔✔Use half the adult dose of medication administration
✔✔Which of the following is a golden principle of trauma care? - ✔✔Ensure adequate
airway and ventilation
