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250 Questions with Answers and Detailed Rationales
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TBS PHASE 1 EXAM ACTUAL UPDATED QUESTIONS AND CORRECT ANSWERS WITH RATIONALES.. It
contains 250 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
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identify areas requiring further question format and content
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Review Summary 250 Questions
Foundations - Application - TBS Phase 1 Actual Updated AND Correct WITH Rationales Tactical Combat
Casualty CARE Operational Medicine AND Leadership Graduate / Professional School Phase 1 OF A US
Military OR Federal Training Program
All answers with rationales
,Table of Contents
Section A - TBS Operations AND Section B - Tactical Combat Casualty
Command Structure CARE TCCC
Questions 1 to 63 Questions 64 to 126
Section C - Small UNIT Tactics AND Section D - Weapons Systems AND
Patrolling Marksmanship
Questions 127 to 189 Questions 190 to 250
,Section A - TBS Operations AND Command Structure
Q1.
During a tactical field care phase, a casualty is unconscious with a palpable carotid pulse
but no spontaneous respirations. A nasopharyngeal airway (NPA) is in place, and the
oxygen saturation is 88%. Which of the following is the next most appropriate step?
A. Begin chest compressions at a rate of B. Insert a supraglottic airway and begin
100-120/min positive pressure ventilation
C. Remove the NPA and insert an D. Administer 100% oxygen via a
oropharyngeal airway (OPA) nonrebreather mask at 15 L/min
Correct: B - Insert a supraglottic airway and begin positive pressure ventilation
Rationale:In the absence of spontaneous respirations and with a patent NPA, the casualty
requires positive pressure ventilation. A supraglottic airway (e.g., i-gel or King LT) is preferred
in the tactical field care setting for apneic patients when endotracheal intubation is not
immediately feasible. Chest compressions are indicated only if the pulse is absent. An OPA is
contraindicated with an NPA in place unless the NPA is removed, but the priority is ventilation,
not airway adjunct change. A nonrebreather mask will not provide adequate ventilation for an
apneic patient.
Q2.
A medic is evaluating three casualties in a secure area after an ambush. Casualty A has
bilateral traumatic amputations of the lower extremities with tourniquets applied and is
unconscious with no radial pulse. Casualty B has a penetrating chest wound with a
sucking chest wound sealed with an occlusive dressing and is breathing at 28
breaths/min. Casualty C has a gunshot wound to the forearm with a distal radial pulse and
no active bleeding. Using the TCCC triage categories, which casualty is classified as
EXPECTANT?
A. Casualty A B. Casualty B
C. Casualty C D. None of the above
Correct: A - Casualty A
Rationale:In TCCC, the EXPECTANT category is reserved for casualties who have severe
injuries (e.g., bilateral traumatic amputations, unconscious, no radial pulse) and are unlikely to
survive given the resources available. Casualty B is IMMEDIATE (chest wound, tachypnea),
and Casualty C is MINIMAL (distal pulse present, controlled bleeding). Casualty A meets the
criteria for EXPECTANT due to the combination of bilateral amputations, unconsciousness,
and absent radial pulse.
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, Section A - TBS Operations AND Command Structure
Q3.
Which of the following is the primary reason that intramuscular (IM) administration of
ketamine is preferred over intravenous (IV) administration for battlefield analgesia during
tactical field care?
A. IV access is often impossible in a tactical B. IM ketamine has a faster onset of action
environment due to vasoconstriction and than IV ketamine
hypovolemia
C. IM administration allows for lower total D. Ketamine is not stable in IV solution for
dosing and reduced side effects more than 30 minutes
Correct: A - IV access is often impossible in a tactical environment due to
vasoconstriction and hypovolemia
Rationale:In the tactical environment, casualties with significant hemorrhage often have
collapsed peripheral veins, making IV access difficult or impossible. IM administration
provides reliable absorption and is the recommended route for ketamine in TCCC guidelines.
IM ketamine has a slower onset than IV (3-5 min vs. 1-2 min), not faster. Dosing is similar
regardless of route, and ketamine is stable in IV solutions for extended periods.
Q4.
A squad leader is planning a helicopter landing zone (HLZ) for casualty evacuation
(CASEVAC) during daylight in a desert environment with low threat. The HLZ should be
oriented relative to the wind to minimize dust and debris. Which of the following is the
correct orientation?
A. The landing point should be B. The landing point should be into the wind,
perpendicular to the wind, with the approach with the approach path into the wind
path crosswind
C. The landing point should be downwind, D. The landing point should be upwind, with
with the approach path downwind the approach path crosswind
Correct: B - The landing point should be into the wind, with the approach path into the
wind
Rationale:Helicopters typically land into the wind to maximize lift and stability. An approach
path into the wind reduces the risk of dynamic rollover and minimizes dust and debris being
blown into the landing zone. Perpendicular or downwind approaches increase the risk of
settling with power and can create hazardous dust clouds.
Q5.
A medic is treating a casualty with a suspected tension pneumothorax after a blast injury.
The casualty has decreased breath sounds on the left, tracheal deviation to the right, and
hypotension. Needle decompression is performed at the second intercostal space,
midclavicular line, with no rush of air and no clinical improvement. What is the most likely
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