PHTLS ACTUAL 2026 TEST PAPER QUESTIONS AND
SOLUTIONS GRADED A+
✔✔How much blood loss can occur from a fractured pelvis? - ✔✔Massive
✔✔What is the most common thoracic injury? - ✔✔Rib fractures.
✔✔What four questions guide management of shock? - ✔✔- What is the cause of this
shock?
- What is the care for this type of shock?
- What can and should be done between now and the time the patient reaches definitive
care?
- Were is the best place for the patient to get definitive care?
✔✔What does proper management of shock achieve? - ✔✔Improves the oxygenation
of RBCs and improves the delivery of RBCs to the tissue.
✔✔How should the shock patient be positioned? - ✔✔Supine, as the trendelenburg
position is no longer recommended.
✔✔What temperature should the patient compartment be maintained at? - ✔✔85F
✔✔What are the three responses to fluid therapy? - ✔✔- Rapid response
- Transient Response
- Minimal or No Response.
✔✔What is the frontal lobe responsible for? - ✔✔Foresight, personality, judgement
✔✔What is the Parietal lobe responsible for? - ✔✔Sensation from the body
✔✔What is the Temporal lobe responsible for? - ✔✔Hearing and speech
✔✔What is the Occipital lobe responsible for? - ✔✔Vision
✔✔What is primary damage? - ✔✔Damage that occurs at the moment of impact.
✔✔What is secondary damage? - ✔✔Damage that occurs subsequent to the initial
impact.
✔✔What are some systemic causes of secondary brain injury? - ✔✔Hypoxia, CO2
abnormalities, Anemia, Hypotension, CBG abnormalities.
✔✔What are some intrinsic causes of secondary brain injury? - ✔✔Seizures, Edema,
Hematomas, increased ICP
, ✔✔What is a typical ICP? - ✔✔10-15 mmHg
✔✔What does hypercarbia cause? - ✔✔Cerebral vasodilation
✔✔Onto which brain structure does pressure produce vomiting? - ✔✔The
hypothalamus
✔✔What are the six components of a complete prehospital neurological exam? -
✔✔Mental Status, Cranial Nerves, Motor Responses, Sensory Response, Coordination,
Reflexes
✔✔When do you score the GCS? - ✔✔AFTER the correctable causes of ALOC have
been addressed.
✔✔What is normal pupil size? - ✔✔3-5 mm. Difference greater than 1mm is abnormal.
✔✔What does paralysis of lateral gaze indicate? - ✔✔Possible rising ICP
✔✔What does paralysis of upward gaze indicate? - ✔✔Possible fracture of orbital floor.
✔✔Most of the bad TBI stuff presents in which ways? - ✔✔Headache, Vomiting, Altered
Mentation, Neurological Deficits
✔✔What is the earliest and best indicator of a patients ICP? - ✔✔A change in LOC
✔✔What are warning signs of possible increasing ICP and impending herniation? -
✔✔GCS drop of 2 or more, development of sluggish or no reactive pupils, development
of hemiplegia or hemiparesis, Cushing's phenomenon
✔✔What is the ventilatory rate for Adults with suspected intercranial herniation? - ✔✔20
bpm
✔✔What is the ventilatory rate for Children with suspected intercranial herniation? -
✔✔25 bpm
✔✔What is the ventilatory rate for Infants with suspected intercranial herniation? -
✔✔30 bpm
✔✔How much blood must be lost before children show signs of hypotension? -
✔✔30.00%
✔✔What is a fourth degree burn? - ✔✔A burn to the bone.
SOLUTIONS GRADED A+
✔✔How much blood loss can occur from a fractured pelvis? - ✔✔Massive
✔✔What is the most common thoracic injury? - ✔✔Rib fractures.
✔✔What four questions guide management of shock? - ✔✔- What is the cause of this
shock?
- What is the care for this type of shock?
- What can and should be done between now and the time the patient reaches definitive
care?
- Were is the best place for the patient to get definitive care?
✔✔What does proper management of shock achieve? - ✔✔Improves the oxygenation
of RBCs and improves the delivery of RBCs to the tissue.
✔✔How should the shock patient be positioned? - ✔✔Supine, as the trendelenburg
position is no longer recommended.
✔✔What temperature should the patient compartment be maintained at? - ✔✔85F
✔✔What are the three responses to fluid therapy? - ✔✔- Rapid response
- Transient Response
- Minimal or No Response.
✔✔What is the frontal lobe responsible for? - ✔✔Foresight, personality, judgement
✔✔What is the Parietal lobe responsible for? - ✔✔Sensation from the body
✔✔What is the Temporal lobe responsible for? - ✔✔Hearing and speech
✔✔What is the Occipital lobe responsible for? - ✔✔Vision
✔✔What is primary damage? - ✔✔Damage that occurs at the moment of impact.
✔✔What is secondary damage? - ✔✔Damage that occurs subsequent to the initial
impact.
✔✔What are some systemic causes of secondary brain injury? - ✔✔Hypoxia, CO2
abnormalities, Anemia, Hypotension, CBG abnormalities.
✔✔What are some intrinsic causes of secondary brain injury? - ✔✔Seizures, Edema,
Hematomas, increased ICP
, ✔✔What is a typical ICP? - ✔✔10-15 mmHg
✔✔What does hypercarbia cause? - ✔✔Cerebral vasodilation
✔✔Onto which brain structure does pressure produce vomiting? - ✔✔The
hypothalamus
✔✔What are the six components of a complete prehospital neurological exam? -
✔✔Mental Status, Cranial Nerves, Motor Responses, Sensory Response, Coordination,
Reflexes
✔✔When do you score the GCS? - ✔✔AFTER the correctable causes of ALOC have
been addressed.
✔✔What is normal pupil size? - ✔✔3-5 mm. Difference greater than 1mm is abnormal.
✔✔What does paralysis of lateral gaze indicate? - ✔✔Possible rising ICP
✔✔What does paralysis of upward gaze indicate? - ✔✔Possible fracture of orbital floor.
✔✔Most of the bad TBI stuff presents in which ways? - ✔✔Headache, Vomiting, Altered
Mentation, Neurological Deficits
✔✔What is the earliest and best indicator of a patients ICP? - ✔✔A change in LOC
✔✔What are warning signs of possible increasing ICP and impending herniation? -
✔✔GCS drop of 2 or more, development of sluggish or no reactive pupils, development
of hemiplegia or hemiparesis, Cushing's phenomenon
✔✔What is the ventilatory rate for Adults with suspected intercranial herniation? - ✔✔20
bpm
✔✔What is the ventilatory rate for Children with suspected intercranial herniation? -
✔✔25 bpm
✔✔What is the ventilatory rate for Infants with suspected intercranial herniation? -
✔✔30 bpm
✔✔How much blood must be lost before children show signs of hypotension? -
✔✔30.00%
✔✔What is a fourth degree burn? - ✔✔A burn to the bone.
