lOMoARcPSD| 68366729
PHTLS 10th Edition Pre and
Post Test Exam Questions and
Correct Answers 2026/2027
Question 1
A parent asks an advanced practice registered nurse (APRN) about applying an over-
the-counter topical antihistamine to alleviate their toddler's atopic dermatitis
symptoms. What crucial safety guidance should the clinician provide?
✔✔ The clinician must advise against it, explaining that the widespread
topical application of antihistamines in young children carries a significant
risk of systemic drug toxicity due to increased cutaneous absorption.
Question 2
A 5-year-old child presents with atopic dermatitis that has failed to improve despite
consistent treatment with a low-potency hydrocortisone acetate 2.5% cream. What is the
most appropriate next step in topical steroid management for this pediatric patient?
✔✔ The primary care provider should transition the patient to a mid-
potency corticosteroid, such as triamcinolone acetonide cream.
Question 3
A patient returns for a follow-up visit after treating a severe case of contact dermatitis
on both forearms with the ultra-high-potency corticosteroid clobetasol propionate
cream. The APRN observes that the lesions have completely resolved. What is the
correct protocol for discontinuing this medication?
✔✔ The clinician should instruct the patient to stop the clobetasol
propionate to prevent skin atrophy, and step down therapy by prescribing a
, lOMoARcPSD| 68366729
mid-potency steroid like triamcinolone cream for an additional 2 weeks to
prevent a rebound flare.
Question 4
A patient being treated with fluocinolone cream for contact dermatitis returns for a
evaluation after 2 weeks. They report that their itching (pruritus) has diminished, but
the physical exam still reveals active, reddened (erythematous) and scratched
(excoriated) areas of skin. What is the appropriate clinical plan?
✔✔ The provider should instruct the patient to continue applying the
fluocinolone for another 3 to 4 weeks to allow the inflammatory process to
fully resolve.
Which of the following procedures is considered an essential airway skill?
A. Needle cricothyroidotomy
B. Endotracheal intubation
C. Insertion of an oropharyngeal airway
D. Retrograde endotracheal intubation CORRECT ANSWER: C. Insertion of an
oropharyngeal airway
Pericardial tamponade is most likely to occur in which of the following situations?
A. Stab wound to the chest
B. Fall from a height
C. Frontal impact vehicle crash
D. Gunshot wound to the chest CORRECT ANSWER: A. Stab wound to the chest
Which of the following is the preferred site for needle decompression of a tension
pneumothorax?
A. 4th intercostal space, midclavicular line, just over the top of the 5th rib
B. 4th intercostal space, midclavicular line, just below the 4th rib
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
D. 2nd intercostal space, midclavicular line, just below the 2nd rib CORRECT
ANSWER:
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
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 CORRECT ANSWER:
D. Blood and fluid in the alveoli and interstitial spaces of the lung
, lOMoARcPSD| 68366729
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 CORRECT 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 CORRECT 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 CORRECT 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 CORRECT 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 CORRECT 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
PHTLS 10th Edition Pre and
Post Test Exam Questions and
Correct Answers 2026/2027
Question 1
A parent asks an advanced practice registered nurse (APRN) about applying an over-
the-counter topical antihistamine to alleviate their toddler's atopic dermatitis
symptoms. What crucial safety guidance should the clinician provide?
✔✔ The clinician must advise against it, explaining that the widespread
topical application of antihistamines in young children carries a significant
risk of systemic drug toxicity due to increased cutaneous absorption.
Question 2
A 5-year-old child presents with atopic dermatitis that has failed to improve despite
consistent treatment with a low-potency hydrocortisone acetate 2.5% cream. What is the
most appropriate next step in topical steroid management for this pediatric patient?
✔✔ The primary care provider should transition the patient to a mid-
potency corticosteroid, such as triamcinolone acetonide cream.
Question 3
A patient returns for a follow-up visit after treating a severe case of contact dermatitis
on both forearms with the ultra-high-potency corticosteroid clobetasol propionate
cream. The APRN observes that the lesions have completely resolved. What is the
correct protocol for discontinuing this medication?
✔✔ The clinician should instruct the patient to stop the clobetasol
propionate to prevent skin atrophy, and step down therapy by prescribing a
, lOMoARcPSD| 68366729
mid-potency steroid like triamcinolone cream for an additional 2 weeks to
prevent a rebound flare.
Question 4
A patient being treated with fluocinolone cream for contact dermatitis returns for a
evaluation after 2 weeks. They report that their itching (pruritus) has diminished, but
the physical exam still reveals active, reddened (erythematous) and scratched
(excoriated) areas of skin. What is the appropriate clinical plan?
✔✔ The provider should instruct the patient to continue applying the
fluocinolone for another 3 to 4 weeks to allow the inflammatory process to
fully resolve.
Which of the following procedures is considered an essential airway skill?
A. Needle cricothyroidotomy
B. Endotracheal intubation
C. Insertion of an oropharyngeal airway
D. Retrograde endotracheal intubation CORRECT ANSWER: C. Insertion of an
oropharyngeal airway
Pericardial tamponade is most likely to occur in which of the following situations?
A. Stab wound to the chest
B. Fall from a height
C. Frontal impact vehicle crash
D. Gunshot wound to the chest CORRECT ANSWER: A. Stab wound to the chest
Which of the following is the preferred site for needle decompression of a tension
pneumothorax?
A. 4th intercostal space, midclavicular line, just over the top of the 5th rib
B. 4th intercostal space, midclavicular line, just below the 4th rib
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
D. 2nd intercostal space, midclavicular line, just below the 2nd rib CORRECT
ANSWER:
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
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 CORRECT ANSWER:
D. Blood and fluid in the alveoli and interstitial spaces of the lung
, lOMoARcPSD| 68366729
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 CORRECT 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 CORRECT 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 CORRECT 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 CORRECT 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 CORRECT 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
