1|Page
PHTLS POST TEST EXAM 2026
ACTUAL EXAM ALL QUESTIONS
AND VERIFIED ANSWERS WITH
RATIONALE | ALREADY A GRADED |
NEW AND REVISED
1. A 28-year-old male was ejected from a motorcycle. He is
conscious but restless, has pale, clammy skin, a heart rate
of 130 bpm, and BP of 88/60 mmHg. What is your priority
intervention?
A) Administer high-flow oxygen via non-rebreather mask
B) Start an IV line and prepare for rapid fluid resuscitation
C) Apply direct pressure to any visible bleeding and
maintain airway
D) Perform a full spinal immobilization before moving the
patient
Rationale: Immediate life threats (airway, breathing,
circulation) take priority. Direct bleeding control and airway
assessment come first before fluid resuscitation in a trauma
patient.
,2|Page
2. During the primary survey, a trauma patient has absent
breath sounds on the left and tracheal deviation to the right.
You suspect:
A) Tension pneumothorax
B) Hemothorax
C) Cardiac tamponade
D) Pulmonary contusion
Rationale: Tracheal deviation and absent breath sounds suggest
tension pneumothorax. Rapid decompression is required.
3. A 45-year-old male presents with blunt abdominal trauma
after a fall. He is hypotensive and tachycardic, with
distended abdomen and bruising around the flanks. This is
most consistent with:
A) Liver laceration
B) Splenic rupture
C) Retroperitoneal bleeding (e.g., renal injury or
pancreatic injury)
D) Perforated bowel
Rationale: Grey-Turner sign (flank bruising) suggests
retroperitoneal bleeding, which may not be obvious externally
but can cause shock.
4. In a trauma patient with suspected cervical spine injury,
which method is safest for airway management?
A) Head-tilt, chin-lift maneuver
B) Jaw-thrust without head extension
C) Use of advanced airway with manual in-line
stabilization
D) Hyperextension of the neck with intubation
,3|Page
Rationale: Jaw-thrust or advanced airway with manual in-line
stabilization prevents cervical spine movement.
5. During rapid trauma assessment, you notice a pelvic
fracture with hypotension. You should:
A) Immediately transport without intervention
B) Apply a pelvic binder and assess for other injuries
C) Begin aggressive IV fluid resuscitation before
transport
D) Perform internal fixation at the scene
Rationale: Stabilization of pelvic fractures with a binder
controls bleeding and prevents further injury; IV fluids may be
required but not delay transport.
6. A trauma patient presents with GCS 6 after a high-speed
collision. Which is the first step in management?
A) Rapid transport to hospital
B) Secure airway and provide ventilatory support
C) Complete secondary survey
D) Obtain full vital signs
Rationale: Airway and ventilation are priorities in severely
decreased GCS to prevent hypoxia.
7. You are called to a 65-year-old male with penetrating chest
trauma. He is hypotensive and tachycardic. You hear
muffled heart sounds, distended neck veins, and
hypotension. The most likely diagnosis is:
A) Tension pneumothorax
B) Cardiac tamponade
, 4|Page
C) Hemothorax
D) Pulmonary contusion
Rationale: Beck’s triad (hypotension, muffled heart sounds,
JVD) indicates cardiac tamponade.
8. Which of the following is not part of the primary survey?
A) Airway assessment
B) Breathing assessment
C) Circulation assessment
D) Detailed neurological examination
Rationale: The primary survey focuses on immediate life
threats; detailed neuro exam is part of secondary survey.
9. A patient with severe burns over 40% of total body surface
area (TBSA) is hypotensive. The priority is:
A) Pain control with opioids
B) Fluid resuscitation according to Parkland formula
C) Debridement of burns
D) Administration of antibiotics
Rationale: Hypovolemia from burn shock is life-threatening and
requires rapid fluid replacement.
10. Which of the following is the most accurate method to
determine shock in a trauma patient?
A) Heart rate alone
B) Blood pressure alone
C) Clinical signs including mental status, skin
perfusion, and vital signs
D) Urine output alone
PHTLS POST TEST EXAM 2026
ACTUAL EXAM ALL QUESTIONS
AND VERIFIED ANSWERS WITH
RATIONALE | ALREADY A GRADED |
NEW AND REVISED
1. A 28-year-old male was ejected from a motorcycle. He is
conscious but restless, has pale, clammy skin, a heart rate
of 130 bpm, and BP of 88/60 mmHg. What is your priority
intervention?
A) Administer high-flow oxygen via non-rebreather mask
B) Start an IV line and prepare for rapid fluid resuscitation
C) Apply direct pressure to any visible bleeding and
maintain airway
D) Perform a full spinal immobilization before moving the
patient
Rationale: Immediate life threats (airway, breathing,
circulation) take priority. Direct bleeding control and airway
assessment come first before fluid resuscitation in a trauma
patient.
,2|Page
2. During the primary survey, a trauma patient has absent
breath sounds on the left and tracheal deviation to the right.
You suspect:
A) Tension pneumothorax
B) Hemothorax
C) Cardiac tamponade
D) Pulmonary contusion
Rationale: Tracheal deviation and absent breath sounds suggest
tension pneumothorax. Rapid decompression is required.
3. A 45-year-old male presents with blunt abdominal trauma
after a fall. He is hypotensive and tachycardic, with
distended abdomen and bruising around the flanks. This is
most consistent with:
A) Liver laceration
B) Splenic rupture
C) Retroperitoneal bleeding (e.g., renal injury or
pancreatic injury)
D) Perforated bowel
Rationale: Grey-Turner sign (flank bruising) suggests
retroperitoneal bleeding, which may not be obvious externally
but can cause shock.
4. In a trauma patient with suspected cervical spine injury,
which method is safest for airway management?
A) Head-tilt, chin-lift maneuver
B) Jaw-thrust without head extension
C) Use of advanced airway with manual in-line
stabilization
D) Hyperextension of the neck with intubation
,3|Page
Rationale: Jaw-thrust or advanced airway with manual in-line
stabilization prevents cervical spine movement.
5. During rapid trauma assessment, you notice a pelvic
fracture with hypotension. You should:
A) Immediately transport without intervention
B) Apply a pelvic binder and assess for other injuries
C) Begin aggressive IV fluid resuscitation before
transport
D) Perform internal fixation at the scene
Rationale: Stabilization of pelvic fractures with a binder
controls bleeding and prevents further injury; IV fluids may be
required but not delay transport.
6. A trauma patient presents with GCS 6 after a high-speed
collision. Which is the first step in management?
A) Rapid transport to hospital
B) Secure airway and provide ventilatory support
C) Complete secondary survey
D) Obtain full vital signs
Rationale: Airway and ventilation are priorities in severely
decreased GCS to prevent hypoxia.
7. You are called to a 65-year-old male with penetrating chest
trauma. He is hypotensive and tachycardic. You hear
muffled heart sounds, distended neck veins, and
hypotension. The most likely diagnosis is:
A) Tension pneumothorax
B) Cardiac tamponade
, 4|Page
C) Hemothorax
D) Pulmonary contusion
Rationale: Beck’s triad (hypotension, muffled heart sounds,
JVD) indicates cardiac tamponade.
8. Which of the following is not part of the primary survey?
A) Airway assessment
B) Breathing assessment
C) Circulation assessment
D) Detailed neurological examination
Rationale: The primary survey focuses on immediate life
threats; detailed neuro exam is part of secondary survey.
9. A patient with severe burns over 40% of total body surface
area (TBSA) is hypotensive. The priority is:
A) Pain control with opioids
B) Fluid resuscitation according to Parkland formula
C) Debridement of burns
D) Administration of antibiotics
Rationale: Hypovolemia from burn shock is life-threatening and
requires rapid fluid replacement.
10. Which of the following is the most accurate method to
determine shock in a trauma patient?
A) Heart rate alone
B) Blood pressure alone
C) Clinical signs including mental status, skin
perfusion, and vital signs
D) Urine output alone
