PHTLS PRE AND POST TEST EXAM SCRIPT
2026 COMPLETE QUESTIONS AND
SOLUTIONS
◉ Which of the following is the mechanism by which pulmonary
contusion interferes with oxygenation?
A. Inability to generate negative intrapleural pressure
B. Decrease in vital capacity due to collapse of the flail segment
C. Increased intrathoracic pressure
D. Blood and fluid in the alveoli and interstitial spaces of the lung.
Answer: D. Blood and fluid in the alveoli and interstitial spaces of the
lung
◉ Your patient is a 55 year old male who was struck in the right side
of the chest with a piece of steel pipe. He presents with
uncooperative behavior, his skin is pale and moist, the ventilatory
rate is 32, there is a weak radial pulse of 112, and breath sounds are
decreased on the right side. The trachea is midline and jugular veins
are flat while the patient is supine. There is isolated crepitus over
the 4th and 5th ribs in the midaxillary line on the patient's right
side. Based on the mechanism of injury and the assessment findings,
which of the following is the most likely cause of the patient's signs
and symptoms?
,A. Tension pneumothorax
B. Simple pneumothorax
C. Pulmonary contusion
D. Hemothorax. Answer: D. Hemothorax
◉ Deterioration of ventilation and oxygenation after inflation of a
PASG in a patient who has sustained a high-pressure compression
injury of the abdomen, such as a sudden deceleration with the lap
belt placed across the abdomen, most likely represents which of the
following injuries?
A. Abdominal aortic aneurysm
B. Ruptured diaphragm
C. Ruptured esophagus
D. "Paper bag" syndrome of the lungs. Answer: B. Ruptured
diaphragm
◉ Which of the following is NOT a component of the Fick Principle?
A. Adequate number of platelets in the blood
B. Oxygenation of red blood cells
C. Transportation of red blood cells to the tissues of the body
, D. Off-loading oxygen from the red blood cells to the tissues. Answer:
A. Adequate number of platelets in the blood
◉ One of the earliest signs of hypovolemic shock is:
A. Hypotension
B. Bradycardia
C. Anxiety
D. Reduced urine output. Answer: C. Anxiety
◉ Which of the following characterizes the washout phase of shock?
A. Systemic acidosis
B. Localized tissue acidosis
C. Edema
D. Reduced capillary blood flow. Answer: A. Systemic acidosis
◉ A trauma patient who has fallen 20 feet from an apartment
balcony is alert with warm, dry, pink skin, with normal capillary
refilling time to the lower extremities, and is hypotensive. The upper
extremities are cool, pale and diaphoretic. Which of the following
injuries should be suspected?
2026 COMPLETE QUESTIONS AND
SOLUTIONS
◉ Which of the following is the mechanism by which pulmonary
contusion interferes with oxygenation?
A. Inability to generate negative intrapleural pressure
B. Decrease in vital capacity due to collapse of the flail segment
C. Increased intrathoracic pressure
D. Blood and fluid in the alveoli and interstitial spaces of the lung.
Answer: D. Blood and fluid in the alveoli and interstitial spaces of the
lung
◉ Your patient is a 55 year old male who was struck in the right side
of the chest with a piece of steel pipe. He presents with
uncooperative behavior, his skin is pale and moist, the ventilatory
rate is 32, there is a weak radial pulse of 112, and breath sounds are
decreased on the right side. The trachea is midline and jugular veins
are flat while the patient is supine. There is isolated crepitus over
the 4th and 5th ribs in the midaxillary line on the patient's right
side. Based on the mechanism of injury and the assessment findings,
which of the following is the most likely cause of the patient's signs
and symptoms?
,A. Tension pneumothorax
B. Simple pneumothorax
C. Pulmonary contusion
D. Hemothorax. Answer: D. Hemothorax
◉ Deterioration of ventilation and oxygenation after inflation of a
PASG in a patient who has sustained a high-pressure compression
injury of the abdomen, such as a sudden deceleration with the lap
belt placed across the abdomen, most likely represents which of the
following injuries?
A. Abdominal aortic aneurysm
B. Ruptured diaphragm
C. Ruptured esophagus
D. "Paper bag" syndrome of the lungs. Answer: B. Ruptured
diaphragm
◉ Which of the following is NOT a component of the Fick Principle?
A. Adequate number of platelets in the blood
B. Oxygenation of red blood cells
C. Transportation of red blood cells to the tissues of the body
, D. Off-loading oxygen from the red blood cells to the tissues. Answer:
A. Adequate number of platelets in the blood
◉ One of the earliest signs of hypovolemic shock is:
A. Hypotension
B. Bradycardia
C. Anxiety
D. Reduced urine output. Answer: C. Anxiety
◉ Which of the following characterizes the washout phase of shock?
A. Systemic acidosis
B. Localized tissue acidosis
C. Edema
D. Reduced capillary blood flow. Answer: A. Systemic acidosis
◉ A trauma patient who has fallen 20 feet from an apartment
balcony is alert with warm, dry, pink skin, with normal capillary
refilling time to the lower extremities, and is hypotensive. The upper
extremities are cool, pale and diaphoretic. Which of the following
injuries should be suspected?
