PHTLS 10TH EDITION – PREHOSPITAL TRAUMA LIFE SUPPORT
COMPREHENSIVE PRACTICE EXAM (ORIGINAL PRACTICE QUESTIONS
WITH ANSWERS AND RATIONALES, 2026–2027 EDITION) INSTANT PDF
ANYWHERE ANYTIME
1. During the primary survey, which of the following is assessed first?
A. Circulation
B. Disability
C. Airway with cervical spine protection
D. Exposure
Answer: C. Airway with cervical spine protection
The primary survey follows the ABCDE approach; airway with cervical spine protection is
always the first step to ensure the patient can ventilate safely.
2. A patient presents with hypotension, tachycardia, and cool, clammy skin after a car crash. The
MOST likely cause is:
A. Cardiogenic shock
B. Hypovolemic shock
C. Neurogenic shock
D. Anaphylactic shock
Answer: B. Hypovolemic shock
Trauma patients with these signs are most commonly experiencing blood loss, leading to
hypovolemic shock.
3. When applying a cervical collar, which action is most important?
A. Rapid placement without concern for patient comfort
B. Avoid moving the head and neck; maintain inline stabilization
C. Allow the patient to assist in neck movement
D. Position the head in full extension
Answer: B. Avoid moving the head and neck; maintain inline stabilization
Inline stabilization prevents secondary spinal cord injury during cervical collar application.
4. Which of the following best describes “airway compromise” in trauma patients?
A. Shortness of breath only
B. Any obstruction that prevents adequate ventilation or oxygenation
,C. Absence of pulse
D. Hypertension and tachypnea
Answer: B. Any obstruction that prevents adequate ventilation or oxygenation
Airway compromise can result from obstruction, swelling, or trauma and must be addressed
immediately.
5. A 25-year-old patient with penetrating chest trauma is having difficulty breathing. What is the
FIRST prehospital intervention?
A. Apply a high-flow oxygen mask
B. Perform needle decompression if tension pneumothorax suspected
C. Initiate IV fluids
D. Prepare for rapid transport
Answer: B. Perform needle decompression if tension pneumothorax suspected
Life-threatening thoracic injuries like tension pneumothorax require immediate intervention
before fluid resuscitation.
6. Which type of burn is considered life-threatening and requires immediate intervention?
A. Superficial (first-degree) burn on the arm
B. Partial-thickness (second-degree) burn covering 5% TBSA
C. Full-thickness (third-degree) burn covering 20% TBSA
D. Superficial burn to the leg
Answer: C. Full-thickness (third-degree) burn covering 20% TBSA
Large full-thickness burns can cause hypovolemia, infection, and systemic complications.
7. In a trauma patient, the “golden hour” refers to:
A. The first 60 minutes after injury when prompt care is most critical
B. The first hour after hospital arrival
C. The time needed to complete a full physical assessment
D. The duration of prehospital transport
Answer: A. The first 60 minutes after injury when prompt care is most critical
Early intervention during the golden hour improves survival in trauma patients.
8. Which finding is MOST indicative of internal bleeding in trauma?
A. Bruising of the forearm
, B. Abdominal distension and hypotension
C. Swelling of the ankle
D. Mild headache
Answer: B. Abdominal distension and hypotension
Signs like hypotension, tachycardia, and distension may indicate significant internal
hemorrhage.
9. When performing a rapid trauma assessment, which sequence is correct?
A. Head → Neck → Chest → Abdomen → Pelvis → Extremities → Posterior
B. Neck → Head → Abdomen → Chest → Extremities → Posterior
C. Chest → Head → Neck → Abdomen → Extremities → Posterior
D. Extremities → Head → Chest → Abdomen → Neck → Posterior
Answer: A. Head → Neck → Chest → Abdomen → Pelvis → Extremities → Posterior
This is the standard sequence for a rapid trauma assessment.
10. Which statement about spinal immobilization is TRUE?
A. All trauma patients must be fully immobilized
B. Spinal immobilization is only required if there is neurological deficit or mechanism
suggesting spinal injury
C. Cervical collars are optional in head trauma
D. Immobilization delays transport and is rarely used
Answer: B. Spinal immobilization is only required if there is neurological deficit or
mechanism suggesting spinal injury
Evidence-based practice emphasizes selective spinal immobilization to prevent unnecessary
delay.
11. A patient with suspected pelvic fracture is hypotensive. Which intervention is MOST
appropriate prehospital?
A. Trendelenburg positioning
B. Apply a pelvic binder and initiate IV fluids
C. Immediate surgical fixation
D. Elevate legs without pelvic stabilization
Answer: B. Apply a pelvic binder and initiate IV fluids
Pelvic binders reduce hemorrhage; IV fluids support perfusion until definitive care.
COMPREHENSIVE PRACTICE EXAM (ORIGINAL PRACTICE QUESTIONS
WITH ANSWERS AND RATIONALES, 2026–2027 EDITION) INSTANT PDF
ANYWHERE ANYTIME
1. During the primary survey, which of the following is assessed first?
A. Circulation
B. Disability
C. Airway with cervical spine protection
D. Exposure
Answer: C. Airway with cervical spine protection
The primary survey follows the ABCDE approach; airway with cervical spine protection is
always the first step to ensure the patient can ventilate safely.
2. A patient presents with hypotension, tachycardia, and cool, clammy skin after a car crash. The
MOST likely cause is:
A. Cardiogenic shock
B. Hypovolemic shock
C. Neurogenic shock
D. Anaphylactic shock
Answer: B. Hypovolemic shock
Trauma patients with these signs are most commonly experiencing blood loss, leading to
hypovolemic shock.
3. When applying a cervical collar, which action is most important?
A. Rapid placement without concern for patient comfort
B. Avoid moving the head and neck; maintain inline stabilization
C. Allow the patient to assist in neck movement
D. Position the head in full extension
Answer: B. Avoid moving the head and neck; maintain inline stabilization
Inline stabilization prevents secondary spinal cord injury during cervical collar application.
4. Which of the following best describes “airway compromise” in trauma patients?
A. Shortness of breath only
B. Any obstruction that prevents adequate ventilation or oxygenation
,C. Absence of pulse
D. Hypertension and tachypnea
Answer: B. Any obstruction that prevents adequate ventilation or oxygenation
Airway compromise can result from obstruction, swelling, or trauma and must be addressed
immediately.
5. A 25-year-old patient with penetrating chest trauma is having difficulty breathing. What is the
FIRST prehospital intervention?
A. Apply a high-flow oxygen mask
B. Perform needle decompression if tension pneumothorax suspected
C. Initiate IV fluids
D. Prepare for rapid transport
Answer: B. Perform needle decompression if tension pneumothorax suspected
Life-threatening thoracic injuries like tension pneumothorax require immediate intervention
before fluid resuscitation.
6. Which type of burn is considered life-threatening and requires immediate intervention?
A. Superficial (first-degree) burn on the arm
B. Partial-thickness (second-degree) burn covering 5% TBSA
C. Full-thickness (third-degree) burn covering 20% TBSA
D. Superficial burn to the leg
Answer: C. Full-thickness (third-degree) burn covering 20% TBSA
Large full-thickness burns can cause hypovolemia, infection, and systemic complications.
7. In a trauma patient, the “golden hour” refers to:
A. The first 60 minutes after injury when prompt care is most critical
B. The first hour after hospital arrival
C. The time needed to complete a full physical assessment
D. The duration of prehospital transport
Answer: A. The first 60 minutes after injury when prompt care is most critical
Early intervention during the golden hour improves survival in trauma patients.
8. Which finding is MOST indicative of internal bleeding in trauma?
A. Bruising of the forearm
, B. Abdominal distension and hypotension
C. Swelling of the ankle
D. Mild headache
Answer: B. Abdominal distension and hypotension
Signs like hypotension, tachycardia, and distension may indicate significant internal
hemorrhage.
9. When performing a rapid trauma assessment, which sequence is correct?
A. Head → Neck → Chest → Abdomen → Pelvis → Extremities → Posterior
B. Neck → Head → Abdomen → Chest → Extremities → Posterior
C. Chest → Head → Neck → Abdomen → Extremities → Posterior
D. Extremities → Head → Chest → Abdomen → Neck → Posterior
Answer: A. Head → Neck → Chest → Abdomen → Pelvis → Extremities → Posterior
This is the standard sequence for a rapid trauma assessment.
10. Which statement about spinal immobilization is TRUE?
A. All trauma patients must be fully immobilized
B. Spinal immobilization is only required if there is neurological deficit or mechanism
suggesting spinal injury
C. Cervical collars are optional in head trauma
D. Immobilization delays transport and is rarely used
Answer: B. Spinal immobilization is only required if there is neurological deficit or
mechanism suggesting spinal injury
Evidence-based practice emphasizes selective spinal immobilization to prevent unnecessary
delay.
11. A patient with suspected pelvic fracture is hypotensive. Which intervention is MOST
appropriate prehospital?
A. Trendelenburg positioning
B. Apply a pelvic binder and initiate IV fluids
C. Immediate surgical fixation
D. Elevate legs without pelvic stabilization
Answer: B. Apply a pelvic binder and initiate IV fluids
Pelvic binders reduce hemorrhage; IV fluids support perfusion until definitive care.
