PHTLS END-OF-COURSE WRITTEN EXAM: ACTUAL EXAM PRACTICE
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Core Domains
Trauma Scene Management & Kinematics of Injury
Airway Management & Ventilatory Support
Hemorrhage Control & Shock Management
Traumatic Brain Injury (TBI) & Spinal Trauma
Thoracic & Abdominal Trauma
Musculoskeletal Trauma & Soft Tissue Injuries
Special Populations (Pediatrics, Geriatrics, Pregnant Patients)
Prehospital Decision-Making & Critical Thinking
Rapid Trauma Assessment & Prioritization
Resuscitation Strategies & Fluid Management
Tactical and Mass Casualty Incident Management
Ethical & Legal Considerations in Trauma Care
,Introduction
This comprehensive assessment is designed to evaluate advanced clinical reasoning,
decision-making, and application of trauma care principles in dynamic, high-stakes
environments. Candidates are expected to synthesize theoretical knowledge with practical
judgment, prioritize interventions under pressure, and demonstrate the ability to manage
complex, real-world prehospital trauma scenarios with precision and adaptability.
Questions 1–35
1. A 28-year-old male is found unconscious after a high-speed motor vehicle collision. He
has snoring respirations and visible facial trauma. What is the most appropriate immediate
intervention?
A. Insert a nasopharyngeal airway
B. Perform a jaw-thrust maneuver and suction
C. Begin positive pressure ventilation immediately
D. Place the patient in recovery position
Correct Answer: B. Perform a jaw-thrust maneuver and suction
Rationale: Airway obstruction from soft tissue and blood is likely. Jaw-thrust maintains spinal
precautions while suction clears obstruction. NPA may be contraindicated in facial trauma.
,Ventilation without clearing airway is ineffective. Recovery position is inappropriate in
trauma with suspected spinal injury.
2. A trauma patient presents with tachycardia, hypotension, and cool clammy skin after a
fall. No external bleeding is noted. What is the most likely cause?
A. Neurogenic shock
B. Cardiogenic shock
C. Hypovolemic shock from internal bleeding
D. Septic shock
Correct Answer: C. Hypovolemic shock from internal bleeding
Rationale: Classic signs of hypovolemic shock with no external bleeding suggest internal
hemorrhage. Neurogenic shock presents with bradycardia. Cardiogenic shock would show
signs of cardiac dysfunction. Septic shock is unlikely in acute trauma.
3. A patient with suspected tension pneumothorax deteriorates rapidly. What is the
priority intervention?
A. Administer high-flow oxygen
B. Perform needle decompression
C. Obtain chest X-ray
D. Start IV fluids
, Correct Answer: B. Perform needle decompression
Rationale: Tension pneumothorax is life-threatening and requires immediate decompression.
Oxygen and fluids are supportive but not definitive. Imaging delays life-saving treatment.
4. A patient with a GCS of 6 following head trauma shows unequal pupils. What does this
indicate?
A. Hypoglycemia
B. Increased intracranial pressure with herniation
C. Spinal cord injury
D. Mild concussion
Correct Answer: B. Increased intracranial pressure with herniation
Rationale: Unequal pupils suggest brain herniation from increased ICP. Hypoglycemia does
not cause anisocoria. Spinal injuries do not affect pupils. Concussion is mild and does not
cause this finding.
5. During transport, a trauma patient becomes hypotensive with distended neck veins and
muffled heart sounds. What is the likely diagnosis?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
QUESTIONS AND 100% VERIFIED CORRECT ANSWERS | COMPLETE
EXAM PREP TESTBANK | GUARANTEED PASS | INSTANT DOWNLOAD
Core Domains
Trauma Scene Management & Kinematics of Injury
Airway Management & Ventilatory Support
Hemorrhage Control & Shock Management
Traumatic Brain Injury (TBI) & Spinal Trauma
Thoracic & Abdominal Trauma
Musculoskeletal Trauma & Soft Tissue Injuries
Special Populations (Pediatrics, Geriatrics, Pregnant Patients)
Prehospital Decision-Making & Critical Thinking
Rapid Trauma Assessment & Prioritization
Resuscitation Strategies & Fluid Management
Tactical and Mass Casualty Incident Management
Ethical & Legal Considerations in Trauma Care
,Introduction
This comprehensive assessment is designed to evaluate advanced clinical reasoning,
decision-making, and application of trauma care principles in dynamic, high-stakes
environments. Candidates are expected to synthesize theoretical knowledge with practical
judgment, prioritize interventions under pressure, and demonstrate the ability to manage
complex, real-world prehospital trauma scenarios with precision and adaptability.
Questions 1–35
1. A 28-year-old male is found unconscious after a high-speed motor vehicle collision. He
has snoring respirations and visible facial trauma. What is the most appropriate immediate
intervention?
A. Insert a nasopharyngeal airway
B. Perform a jaw-thrust maneuver and suction
C. Begin positive pressure ventilation immediately
D. Place the patient in recovery position
Correct Answer: B. Perform a jaw-thrust maneuver and suction
Rationale: Airway obstruction from soft tissue and blood is likely. Jaw-thrust maintains spinal
precautions while suction clears obstruction. NPA may be contraindicated in facial trauma.
,Ventilation without clearing airway is ineffective. Recovery position is inappropriate in
trauma with suspected spinal injury.
2. A trauma patient presents with tachycardia, hypotension, and cool clammy skin after a
fall. No external bleeding is noted. What is the most likely cause?
A. Neurogenic shock
B. Cardiogenic shock
C. Hypovolemic shock from internal bleeding
D. Septic shock
Correct Answer: C. Hypovolemic shock from internal bleeding
Rationale: Classic signs of hypovolemic shock with no external bleeding suggest internal
hemorrhage. Neurogenic shock presents with bradycardia. Cardiogenic shock would show
signs of cardiac dysfunction. Septic shock is unlikely in acute trauma.
3. A patient with suspected tension pneumothorax deteriorates rapidly. What is the
priority intervention?
A. Administer high-flow oxygen
B. Perform needle decompression
C. Obtain chest X-ray
D. Start IV fluids
, Correct Answer: B. Perform needle decompression
Rationale: Tension pneumothorax is life-threatening and requires immediate decompression.
Oxygen and fluids are supportive but not definitive. Imaging delays life-saving treatment.
4. A patient with a GCS of 6 following head trauma shows unequal pupils. What does this
indicate?
A. Hypoglycemia
B. Increased intracranial pressure with herniation
C. Spinal cord injury
D. Mild concussion
Correct Answer: B. Increased intracranial pressure with herniation
Rationale: Unequal pupils suggest brain herniation from increased ICP. Hypoglycemia does
not cause anisocoria. Spinal injuries do not affect pupils. Concussion is mild and does not
cause this finding.
5. During transport, a trauma patient becomes hypotensive with distended neck veins and
muffled heart sounds. What is the likely diagnosis?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
