PHTLS 10th Edition Final Exam
2026/2027 | Verified Questions &
Answers with Detailed Rationales |
Prehospital Trauma Life Support
Certification Prep | Pass Guaranteed –
A+ Graded | Instant PDF Download
Question 1: Scene Safety Priority
You arrive at a nighttime motor vehicle collision on an interstate
highway. One vehicle has struck a guardrail at high speed and is
smoking with fluids leaking onto the roadway. Traffic continues to
pass at highway speeds in the adjacent lane. The driver is
conscious and attempting to exit the vehicle. What is your FIRST
priority?
A. Immediately approach the patient and assist them in exiting the
vehicle
B. Request law enforcement for traffic control and stage apparatus
to block oncoming traffic
C. Establish a safe zone using the vehicle as a barrier and don
high-visibility PPE before patient contact
D. Begin rapid extrication using hydraulic tools while the patient is
still belted
Answer: C
,Rationale: Scene safety is the absolute foundation of all PHTLS care.
Per the 10th Edition, providers must don appropriate PPE and
establish scene safety before any patient contact. While traffic
control (B) is important, your immediate safety actions take
precedence. Never allow a patient to self-extricate (A) without
spinal motion restriction assessment, and extrication (D) cannot
begin until the scene is secured.
Question 2: XABCDE Primary Survey
In the XABCDE primary survey, what is the FIRST priority when
assessing a trauma patient?
A. Airway management
B. Breathing assessment
C. eXsanguination control (severe hemorrhage control)
D. Disability (neurologic) assessment
Answer: C
Rationale: The XABCDE approach places eXsanguination control
first, reflecting evidence that exsanguinating hemorrhage can kill a
patient faster than an airway compromise. Massive external
hemorrhage must be addressed immediately with direct pressure,
tourniquet application, or hemostatic dressings before proceeding
to airway management. Catastrophic bleeding can cause death
within 2–3 minutes, whereas a patient with a patent airway can
typically maintain oxygenation for several minutes through existing
reserves.
,Question 3: Tension Pneumothorax Management
During the primary survey of a trauma patient, you note absent
breath sounds on the left side, jugular venous distension, and
tracheal deviation to the right. What is the MOST appropriate
immediate intervention?
A. Needle decompression of the left chest
B. Endotracheal intubation
C. Rapid fluid bolus administration
D. Chest tube insertion
Answer: A
Rationale: The clinical presentation described is the classic triad of
tension pneumothorax: absent breath sounds on the affected side,
jugular venous distension, and tracheal deviation away from the
affected side. Tension pneumothorax is a life-threatening condition
requiring immediate needle decompression before any other
intervention. Delaying decompression for intubation or chest tube
placement can result in cardiovascular collapse and death.
Question 4: Compensated Shock Recognition
In circulatory assessment, what is the earliest sign of
compensated shock?
, A. Hypotension
B. Tachycardia
C. Cool, clammy skin
D. Altered mental status
Answer: B
Rationale: Tachycardia is an early compensatory mechanism to
maintain cardiac output. Compensation maintains near-normal
blood pressure via vasoconstriction and increased heart rate.
Hypotension is a late, decompensated sign. Cool, clammy skin and
altered mental status occur as shock progresses and compensation
begins to fail.
Question 5: START Triage in Mass Casualty
At a mass-casualty incident involving an explosion, you are
performing triage using the START method. An adult patient is
found walking, has a respiratory rate of 28, capillary refill of 3
seconds, and is able to follow simple commands. How should this
patient be tagged?
A. Delayed (yellow)
B. Expectant (black)
C. Immediate (red)
D. Minimal (green)
Answer: D
2026/2027 | Verified Questions &
Answers with Detailed Rationales |
Prehospital Trauma Life Support
Certification Prep | Pass Guaranteed –
A+ Graded | Instant PDF Download
Question 1: Scene Safety Priority
You arrive at a nighttime motor vehicle collision on an interstate
highway. One vehicle has struck a guardrail at high speed and is
smoking with fluids leaking onto the roadway. Traffic continues to
pass at highway speeds in the adjacent lane. The driver is
conscious and attempting to exit the vehicle. What is your FIRST
priority?
A. Immediately approach the patient and assist them in exiting the
vehicle
B. Request law enforcement for traffic control and stage apparatus
to block oncoming traffic
C. Establish a safe zone using the vehicle as a barrier and don
high-visibility PPE before patient contact
D. Begin rapid extrication using hydraulic tools while the patient is
still belted
Answer: C
,Rationale: Scene safety is the absolute foundation of all PHTLS care.
Per the 10th Edition, providers must don appropriate PPE and
establish scene safety before any patient contact. While traffic
control (B) is important, your immediate safety actions take
precedence. Never allow a patient to self-extricate (A) without
spinal motion restriction assessment, and extrication (D) cannot
begin until the scene is secured.
Question 2: XABCDE Primary Survey
In the XABCDE primary survey, what is the FIRST priority when
assessing a trauma patient?
A. Airway management
B. Breathing assessment
C. eXsanguination control (severe hemorrhage control)
D. Disability (neurologic) assessment
Answer: C
Rationale: The XABCDE approach places eXsanguination control
first, reflecting evidence that exsanguinating hemorrhage can kill a
patient faster than an airway compromise. Massive external
hemorrhage must be addressed immediately with direct pressure,
tourniquet application, or hemostatic dressings before proceeding
to airway management. Catastrophic bleeding can cause death
within 2–3 minutes, whereas a patient with a patent airway can
typically maintain oxygenation for several minutes through existing
reserves.
,Question 3: Tension Pneumothorax Management
During the primary survey of a trauma patient, you note absent
breath sounds on the left side, jugular venous distension, and
tracheal deviation to the right. What is the MOST appropriate
immediate intervention?
A. Needle decompression of the left chest
B. Endotracheal intubation
C. Rapid fluid bolus administration
D. Chest tube insertion
Answer: A
Rationale: The clinical presentation described is the classic triad of
tension pneumothorax: absent breath sounds on the affected side,
jugular venous distension, and tracheal deviation away from the
affected side. Tension pneumothorax is a life-threatening condition
requiring immediate needle decompression before any other
intervention. Delaying decompression for intubation or chest tube
placement can result in cardiovascular collapse and death.
Question 4: Compensated Shock Recognition
In circulatory assessment, what is the earliest sign of
compensated shock?
, A. Hypotension
B. Tachycardia
C. Cool, clammy skin
D. Altered mental status
Answer: B
Rationale: Tachycardia is an early compensatory mechanism to
maintain cardiac output. Compensation maintains near-normal
blood pressure via vasoconstriction and increased heart rate.
Hypotension is a late, decompensated sign. Cool, clammy skin and
altered mental status occur as shock progresses and compensation
begins to fail.
Question 5: START Triage in Mass Casualty
At a mass-casualty incident involving an explosion, you are
performing triage using the START method. An adult patient is
found walking, has a respiratory rate of 28, capillary refill of 3
seconds, and is able to follow simple commands. How should this
patient be tagged?
A. Delayed (yellow)
B. Expectant (black)
C. Immediate (red)
D. Minimal (green)
Answer: D
