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Section 1: AMLS Assessment Pathway & Scene Management
(Questions 1-10)
Question 1
Upon arriving at a multi-vehicle collision on a busy highway, the first priority after
ensuring personal BSI is:
A. Immediately beginning patient triage
B. Scene size-up to identify hazards, mechanism of injury, and number of patients
C. Applying a cervical collar to the closest patient
D. Calling for air medical transport for all patients
Correct Answer: B B. Scene size-up to identify hazards, mechanism of injury, and
number of patients [CORRECT] Rationale: The AMLS assessment pathway mandates
scene size-up as the initial step to ensure provider safety, identify mechanism of
injury, determine the number of patients, and request additional resources before
patient contact. Immediate triage (A) or intervention (C) without scene size-up risks
provider safety and missed hazards. Air medical (D) is requested only when indicated
after assessment.
Question 2
During the primary survey, a responsive patient with facial trauma is found to have
gurgling respirations and inadequate air exchange. The immediate intervention is:
A. Insert an oropharyngeal airway and prepare for suctioning
B. Apply a non-rebreather mask at 15 L/min
,C. Perform a jaw-thrust maneuver and suction the oropharynx
D. Obtain a 12-lead ECG
Correct Answer: C C. Perform a jaw-thrust maneuver and suction the oropharynx
[CORRECT] Rationale: Gurgling respirations indicate airway obstruction by blood,
vomitus, or secretions; the AMLS airway priority is to open the airway with jaw-thrust
(assuming spinal injury precaution) and suction before any other intervention. An
OPA (A) may be needed but only after clearing the airway. Oxygen (B) is ineffective if
the airway is obstructed. ECG (D) is not a primary survey priority.
Question 3
In the primary survey, which assessment finding during the breathing phase most
reliably indicates inadequate ventilation requiring immediate intervention?
A. SpO2 of 94% on room air
B. EtCO2 of 38 mmHg
C. Bilateral absent breath sounds with tracheal deviation
D. Respiratory rate of 18 breaths per minute
Correct Answer: C C. Bilateral absent breath sounds with tracheal deviation
[CORRECT] Rationale: Bilateral absent breath sounds with tracheal deviation
indicates a tension pneumothorax causing severe respiratory compromise and
hemodynamic collapse—a life threat requiring immediate needle decompression.
SpO2 94% (A) and EtCO2 38 (B) are within normal limits. RR 18 (D) is normal. AMLS
prioritizes life-threatening breathing pathologies during the primary survey.
Question 4
A trauma patient presents with cool, pale, diaphoretic skin; delayed capillary refill >3
seconds; and weak radial pulses. These findings indicate:
A. Normal perfusion
B. Compensated shock
,C. Decompensated shock
D. Neurogenic shock
Correct Answer: B B. Compensated shock [CORRECT] Rationale: Cool, pale,
diaphoretic skin with delayed capillary refill and weak pulses—but preserved mental
status and measurable BP—indicates compensated shock where sympathetic
mechanisms maintain perfusion to vital organs. Normal perfusion (A) would show
warm, pink skin with brisk refill. Decompensated shock (C) presents with hypotension
and altered mental status. Neurogenic shock (D) produces warm, dry skin due to loss
of sympathetic tone.
Question 5
During the disability component of the primary survey, a patient opens eyes to
painful stimuli, makes incomprehensible sounds, and withdraws from pain. The GCS
score is:
A. 9
B. 8
C. 7
D. 6
Correct Answer: B B. 8 [CORRECT] Rationale: Eye opening to pain = 2,
incomprehensible sounds = 2, withdrawal from pain = 4; total GCS = 8. This indicates
severe head injury requiring airway protection consideration and immediate
transport. A GCS of 9 (A) would require localizing to pain (5) or verbal confusion (4).
AMLS uses GCS and AVPU to identify patients requiring rapid intervention.
Question 6
During the secondary survey, which mnemonic is used to obtain a focused history
including signs and symptoms, allergies, medications, past medical history, last oral
intake, and events leading to the emergency?
, A. OPQRST
B. SAMPLE
C. AVPU
D. DCAP-BTLS
Correct Answer: B B. SAMPLE [CORRECT] Rationale: SAMPLE history collects
Signs/Symptoms, Allergies, Medications, Pertinent history, Last oral intake, and
Events—essential for differential diagnosis and treatment planning. OPQRST (A)
characterizes pain. AVPU (C) is a consciousness assessment. DCAP-BTLS (D) is a
trauma physical exam mnemonic. AMLS integrates SAMPLE during the secondary
survey after life threats are addressed.
Question 7
When developing a differential diagnosis for a patient with acute abdominal pain,
which condition must be categorized as a "can't miss" diagnosis due to high
mortality if missed?
A. Gastroenteritis
B. Constipation
C. Ruptured abdominal aortic aneurysm
D. Irritable bowel syndrome
Correct Answer: C C. Ruptured abdominal aortic aneurysm [CORRECT] Rationale:
A ruptured AAA is a time-sensitive, life-threatening condition with extremely high
mortality if not identified and addressed immediately—making it a "can't miss"
diagnosis. Gastroenteritis (A), constipation (B), and IBS (D) are benign or self-limited
conditions. AMLS clinical reasoning requires ranking differentials by acuity,
probability, and time sensitivity, with "can't miss" conditions ruled out first.
Question 8