PHTLS ACTUAL EXAM PRACTICE QUESTIONS AND 100% VERIFIED
CORRECT ANSWERS | COMPLETE EXAM PREP TESTBANK |
GUARANTEED PASS | INSTANT DOWNLOAD PDF
Core Domains
Kinematics of Trauma: Physics of energy transfer and mechanism of injury (MOI).
Airway and Ventilation Management: Advanced oxygenation and ventilation strategies.
Shock and Resuscitation: Pathophysiology of perfusion and fluid resuscitation
dynamics.
Abdominal and Thoracic Trauma: Life-threatening injury identification and intervention.
Neurological Trauma: Management of Traumatic Brain Injury (TBI) and spinal cord
protection.
Special Populations: Pediatric, geriatric, and environmental trauma considerations.
Introduction
This comprehensive evaluation is designed to simulate the high-stakes decision-making
environment required for Pre-Hospital Trauma Life Support (PHTLS) certification. Moving
beyond simple rote memorization, this assessment focuses on the synthesis of clinical data
,and the evaluation of complex trauma scenarios. Participants must demonstrate a mastery of
the XABCDE mnemonic, prioritizing life-threatening hemorrhage control and physiological
stability over anatomical injuries. Each scenario requires the practitioner to navigate the
"Golden Period" by applying advanced critical thinking to prioritize interventions, manage multi-
system trauma, and determine the most appropriate transport destinations based on injury
severity and resource availability.
Questions 1–35
1. A 34-year-old male is found unconscious after a high-speed motor vehicle collision. He
has snoring respirations at a rate of 6 per minute and cyanosis around the lips. What is
the immediate priority for this patient?
A. Perform endotracheal intubation
B. Apply a cervical collar
C. Manual stabilization of the cervical spine and jaw-thrust maneuver
D. Administer high-flow oxygen via non-rebreather mask
Correct Answer: Manual stabilization of the cervical spine and jaw-thrust maneuver
Rationale: In a trauma patient with suspected spinal injury and airway compromise, the
first step is to open the airway using a technique that minimizes spinal movement. While
oxygen and intubation may be needed, the immediate mechanical opening of the airway
is the first priority. A cervical collar does not manage the airway.
,2. You are treating a patient with a traumatic amputation of the right leg at the mid-thigh
level. Brisk, bright red bleeding is noted. A pressure dressing is failing to control the
hemorrhage. What is the next step?
A. Apply a second pressure dressing
B. Apply a combat application tourniquet (CAT) proximal to the wound
C. Perform wound packing with hemostatic gauze
D. Elevate the limb and apply pressure to the femoral artery
Correct Answer: Apply a combat application tourniquet (CAT) proximal to the wound
Rationale: Current trauma guidelines (XABCDE) prioritize the control of exsanguinating
hemorrhage. If a pressure dressing fails on an extremity, a tourniquet should be applied
immediately to prevent hypovolemic shock. Wound packing is less effective for a
complete arterial transection in a large muscle mass like the thigh.
3. A patient presents with a sucking chest wound following a stab injury. The patient is in
respiratory distress. What is the most appropriate initial intervention?
A. Perform needle decompression
B. Apply an occlusive dressing taped on three sides
C. Assist ventilations with a bag-mask device
D. Apply a sterile gauze dressing and wrap tightly
Correct Answer: Apply an occlusive dressing taped on three sides
Rationale: An open pneumothorax requires an occlusive dressing to prevent atmospheric
air from entering the pleural space. Taping on three sides creates a flutter-valve effect,
, allowing air to escape the chest but not enter, reducing the risk of a tension
pneumothorax.
4. During the primary survey of a trauma patient, you note shifted interior breath sounds,
jugular venous distension (JVD), and hypotension. What condition do you suspect?
A. Massive hemothorax
B. Cardiac tamponade
C. Tension pneumothorax
D. Simple pneumothorax
Correct Answer: Tension pneumothorax
Rationale: The triad of absent breath sounds, JVD, and hypotension (obstructive shock)
is classic for tension pneumothorax. While cardiac tamponade also presents with JVD
and hypotension, breath sounds would typically be equal.
5. A 62-year-old female fell from a height of 10 feet. She is pale, cool, and diaphoretic. Her
blood pressure is 82/40 mmHg and heart rate is 128 bpm. What is the target systolic
blood pressure during fluid resuscitation for this patient, assuming no TBI?
A. 120 mmHg
B. 100 mmHg
C. 80-90 mmHg
D. 60 mmHg
Correct Answer: 80-90 mmHg
CORRECT ANSWERS | COMPLETE EXAM PREP TESTBANK |
GUARANTEED PASS | INSTANT DOWNLOAD PDF
Core Domains
Kinematics of Trauma: Physics of energy transfer and mechanism of injury (MOI).
Airway and Ventilation Management: Advanced oxygenation and ventilation strategies.
Shock and Resuscitation: Pathophysiology of perfusion and fluid resuscitation
dynamics.
Abdominal and Thoracic Trauma: Life-threatening injury identification and intervention.
Neurological Trauma: Management of Traumatic Brain Injury (TBI) and spinal cord
protection.
Special Populations: Pediatric, geriatric, and environmental trauma considerations.
Introduction
This comprehensive evaluation is designed to simulate the high-stakes decision-making
environment required for Pre-Hospital Trauma Life Support (PHTLS) certification. Moving
beyond simple rote memorization, this assessment focuses on the synthesis of clinical data
,and the evaluation of complex trauma scenarios. Participants must demonstrate a mastery of
the XABCDE mnemonic, prioritizing life-threatening hemorrhage control and physiological
stability over anatomical injuries. Each scenario requires the practitioner to navigate the
"Golden Period" by applying advanced critical thinking to prioritize interventions, manage multi-
system trauma, and determine the most appropriate transport destinations based on injury
severity and resource availability.
Questions 1–35
1. A 34-year-old male is found unconscious after a high-speed motor vehicle collision. He
has snoring respirations at a rate of 6 per minute and cyanosis around the lips. What is
the immediate priority for this patient?
A. Perform endotracheal intubation
B. Apply a cervical collar
C. Manual stabilization of the cervical spine and jaw-thrust maneuver
D. Administer high-flow oxygen via non-rebreather mask
Correct Answer: Manual stabilization of the cervical spine and jaw-thrust maneuver
Rationale: In a trauma patient with suspected spinal injury and airway compromise, the
first step is to open the airway using a technique that minimizes spinal movement. While
oxygen and intubation may be needed, the immediate mechanical opening of the airway
is the first priority. A cervical collar does not manage the airway.
,2. You are treating a patient with a traumatic amputation of the right leg at the mid-thigh
level. Brisk, bright red bleeding is noted. A pressure dressing is failing to control the
hemorrhage. What is the next step?
A. Apply a second pressure dressing
B. Apply a combat application tourniquet (CAT) proximal to the wound
C. Perform wound packing with hemostatic gauze
D. Elevate the limb and apply pressure to the femoral artery
Correct Answer: Apply a combat application tourniquet (CAT) proximal to the wound
Rationale: Current trauma guidelines (XABCDE) prioritize the control of exsanguinating
hemorrhage. If a pressure dressing fails on an extremity, a tourniquet should be applied
immediately to prevent hypovolemic shock. Wound packing is less effective for a
complete arterial transection in a large muscle mass like the thigh.
3. A patient presents with a sucking chest wound following a stab injury. The patient is in
respiratory distress. What is the most appropriate initial intervention?
A. Perform needle decompression
B. Apply an occlusive dressing taped on three sides
C. Assist ventilations with a bag-mask device
D. Apply a sterile gauze dressing and wrap tightly
Correct Answer: Apply an occlusive dressing taped on three sides
Rationale: An open pneumothorax requires an occlusive dressing to prevent atmospheric
air from entering the pleural space. Taping on three sides creates a flutter-valve effect,
, allowing air to escape the chest but not enter, reducing the risk of a tension
pneumothorax.
4. During the primary survey of a trauma patient, you note shifted interior breath sounds,
jugular venous distension (JVD), and hypotension. What condition do you suspect?
A. Massive hemothorax
B. Cardiac tamponade
C. Tension pneumothorax
D. Simple pneumothorax
Correct Answer: Tension pneumothorax
Rationale: The triad of absent breath sounds, JVD, and hypotension (obstructive shock)
is classic for tension pneumothorax. While cardiac tamponade also presents with JVD
and hypotension, breath sounds would typically be equal.
5. A 62-year-old female fell from a height of 10 feet. She is pale, cool, and diaphoretic. Her
blood pressure is 82/40 mmHg and heart rate is 128 bpm. What is the target systolic
blood pressure during fluid resuscitation for this patient, assuming no TBI?
A. 120 mmHg
B. 100 mmHg
C. 80-90 mmHg
D. 60 mmHg
Correct Answer: 80-90 mmHg
