PHTLS 10th Edition Pre & Post-Test and Self-
Test Questions & Answers () – 100%
Guarantee Pass (Complete Package)
Question 1
A 28-year-old male involved in a high-speed MVC is conscious but has absent breath sounds and
tracheal deviation to the right. His BP is 90/60 mmHg and HR is 120 bpm. The most immediate
prehospital intervention is:
A. Application of a cervical collar
B. Needle decompression on the left side
C. IV fluid bolus of 1000 mL normal saline
D. Endotracheal intubation
Correct Answer: B. Needle decompression on the left side
Rationale: Clinical picture is tension pneumothorax—tracheal deviation, absent breath sounds, and
shock. Immediate needle decompression restores venous return and ventilation before other measures.
Question 2
On scene, a 6-year-old child presents with a Glasgow Coma Scale (GCS) of 10, HR 160, and capillary refill
4 seconds. Estimated blood loss is most likely:
A. <15 %
B. 15–30 %
C. 30–40 %
D. >40 %
Correct Answer: C. 30–40 %
Rationale: In pediatric patients, tachycardia >150, delayed capillary refill >2 s, and GCS depression
suggest Class III hemorrhage (30–40 %) before hypotension occurs.
Question 3
During a night-time MCI, you apply a pelvic binder to a hemodynamically unstable 34-year-old female
after a fall from height. The primary purpose is to:
A. Reduce pain
B. Facilitate log-roll
C. Decrease pelvic volume and hemorrhage
D. Allow easier scoop-stretcher placement
,Correct Answer: C. Decrease pelvic volume and hemorrhage
Rationale: Unstable pelvic fractures can lose 2–4 L of blood into the retroperitoneum; circumferential
binders close the pelvic ring, reducing venous bleeding.
Question 4
A motorcyclist wearing a full-face helmet complains of dyspnea and has facial cyanosis after a collision.
Helmet removal is indicated when:
A. Patient is agitated
B. Airway or ventilation is compromised and cannot be managed with helmet in place
C. Spinal immobilization is complete
D. Patient requests it
Correct Answer: B. Airway or ventilation is compromised and cannot be managed with helmet in place
Rationale: PHTLS teaches “life over limb”; if airway cannot be secured or ventilations are inadequate,
helmet removal with inline stabilization is mandatory.
Question 5
A 55-year-old restrained driver has a steering-wheel imprint on the chest, BP 80/50, HR 130, and JVD.
The most likely diagnosis is:
A. Tension pneumothorax
B. Cardiac tamponade
C. Flail chest
D. Pulmonary contusion
Correct Answer: B. Cardiac tamponade
Rationale: Beck’s triad (hypotension, JVD, muffled heart sounds) plus mechanism suggests tamponade;
JVD is absent in tension pneumothorax without mediastinal shift.
Question 6
You arrive to find a patient supine, helmet on, with spontaneous respirations 30/min and SpO₂ 88 %.
The first airway maneuver is:
A. Jaw-thrust with spinal stabilization
B. Insert oropharyngeal airway
C. Apply bag-mask without jaw lift
D. Remove helmet immediately
Correct Answer: A. Jaw-thrust with spinal stabilization
Rationale: Jaw-thrust opens the airway without cervical motion; oxygenation precedes helmet removal
unless airway is obstructed.
, Question 7
A 3-year-old child is found apneic and pulseless after a drowning incident. The compression-to-
ventilation ratio for two-rescuer CPR is:
A. 15:2
B. 30:2
C. Continuous compressions 100/min
D. 5:1
Correct Answer: A. 15:2
Rationale: Pediatric CPR (non-arrest) uses 15:2 for two rescuers to prioritize oxygenation in hypoxic
arrests such as drowning.
Question 8
A trauma patient has a visible femur fracture with 500 mL visible blood loss and a weak radial pulse. This
represents at least which ATLS hemorrhage class?
A. Class I
B. Class II
C. Class III
D. Class IV
Correct Answer: C. Class III
Rationale: Weak radial pulse = systolic BP ≈ 80 mmHg; visible 500 mL plus physiological signs places the
patient in Class III (30–40 % blood volume).
Question 9
You apply a tourniquet to a mangled lower extremity. The time of application is recorded because:
A. Tourniquets must be removed within 6 hours to prevent muscle necrosis
B. It provides legal documentation of care
C. It helps the receiving hospital decide on fasciotomy timing
D. All of the above
Correct Answer: D. All of the above
Rationale: Time documentation guides surgical decision-making, legal audit, and safe tourniquet
duration (≤ 2 h preferred, ≤ 6 h acceptable).
Question 10
A patient with a suspected spinal injury is found sitting in a wrecked vehicle, breathing 24/min. The most
appropriate initial extrication maneuver is:
Test Questions & Answers () – 100%
Guarantee Pass (Complete Package)
Question 1
A 28-year-old male involved in a high-speed MVC is conscious but has absent breath sounds and
tracheal deviation to the right. His BP is 90/60 mmHg and HR is 120 bpm. The most immediate
prehospital intervention is:
A. Application of a cervical collar
B. Needle decompression on the left side
C. IV fluid bolus of 1000 mL normal saline
D. Endotracheal intubation
Correct Answer: B. Needle decompression on the left side
Rationale: Clinical picture is tension pneumothorax—tracheal deviation, absent breath sounds, and
shock. Immediate needle decompression restores venous return and ventilation before other measures.
Question 2
On scene, a 6-year-old child presents with a Glasgow Coma Scale (GCS) of 10, HR 160, and capillary refill
4 seconds. Estimated blood loss is most likely:
A. <15 %
B. 15–30 %
C. 30–40 %
D. >40 %
Correct Answer: C. 30–40 %
Rationale: In pediatric patients, tachycardia >150, delayed capillary refill >2 s, and GCS depression
suggest Class III hemorrhage (30–40 %) before hypotension occurs.
Question 3
During a night-time MCI, you apply a pelvic binder to a hemodynamically unstable 34-year-old female
after a fall from height. The primary purpose is to:
A. Reduce pain
B. Facilitate log-roll
C. Decrease pelvic volume and hemorrhage
D. Allow easier scoop-stretcher placement
,Correct Answer: C. Decrease pelvic volume and hemorrhage
Rationale: Unstable pelvic fractures can lose 2–4 L of blood into the retroperitoneum; circumferential
binders close the pelvic ring, reducing venous bleeding.
Question 4
A motorcyclist wearing a full-face helmet complains of dyspnea and has facial cyanosis after a collision.
Helmet removal is indicated when:
A. Patient is agitated
B. Airway or ventilation is compromised and cannot be managed with helmet in place
C. Spinal immobilization is complete
D. Patient requests it
Correct Answer: B. Airway or ventilation is compromised and cannot be managed with helmet in place
Rationale: PHTLS teaches “life over limb”; if airway cannot be secured or ventilations are inadequate,
helmet removal with inline stabilization is mandatory.
Question 5
A 55-year-old restrained driver has a steering-wheel imprint on the chest, BP 80/50, HR 130, and JVD.
The most likely diagnosis is:
A. Tension pneumothorax
B. Cardiac tamponade
C. Flail chest
D. Pulmonary contusion
Correct Answer: B. Cardiac tamponade
Rationale: Beck’s triad (hypotension, JVD, muffled heart sounds) plus mechanism suggests tamponade;
JVD is absent in tension pneumothorax without mediastinal shift.
Question 6
You arrive to find a patient supine, helmet on, with spontaneous respirations 30/min and SpO₂ 88 %.
The first airway maneuver is:
A. Jaw-thrust with spinal stabilization
B. Insert oropharyngeal airway
C. Apply bag-mask without jaw lift
D. Remove helmet immediately
Correct Answer: A. Jaw-thrust with spinal stabilization
Rationale: Jaw-thrust opens the airway without cervical motion; oxygenation precedes helmet removal
unless airway is obstructed.
, Question 7
A 3-year-old child is found apneic and pulseless after a drowning incident. The compression-to-
ventilation ratio for two-rescuer CPR is:
A. 15:2
B. 30:2
C. Continuous compressions 100/min
D. 5:1
Correct Answer: A. 15:2
Rationale: Pediatric CPR (non-arrest) uses 15:2 for two rescuers to prioritize oxygenation in hypoxic
arrests such as drowning.
Question 8
A trauma patient has a visible femur fracture with 500 mL visible blood loss and a weak radial pulse. This
represents at least which ATLS hemorrhage class?
A. Class I
B. Class II
C. Class III
D. Class IV
Correct Answer: C. Class III
Rationale: Weak radial pulse = systolic BP ≈ 80 mmHg; visible 500 mL plus physiological signs places the
patient in Class III (30–40 % blood volume).
Question 9
You apply a tourniquet to a mangled lower extremity. The time of application is recorded because:
A. Tourniquets must be removed within 6 hours to prevent muscle necrosis
B. It provides legal documentation of care
C. It helps the receiving hospital decide on fasciotomy timing
D. All of the above
Correct Answer: D. All of the above
Rationale: Time documentation guides surgical decision-making, legal audit, and safe tourniquet
duration (≤ 2 h preferred, ≤ 6 h acceptable).
Question 10
A patient with a suspected spinal injury is found sitting in a wrecked vehicle, breathing 24/min. The most
appropriate initial extrication maneuver is:
