International Trauma Life Support (ITLS)
Provider Certification Exam
Board certification examination for prehospital
trauma management
1. Which of the following best describes the "Scene Size-Up"?
A. A detailed head-to-toe physical examination of the trauma patient.
B. The process of packaging a patient for rapid transport.
C. Observations made and actions taken at a trauma scene before approaching the patient.
D. The administration of oxygen and application of a cervical collar.
Correct Answer – “C”
Rationale – The Scene Size-Up is defined as the initial step in the ITLS Primary Survey,
involving observations and actions taken before patient approach to ensure safety and identify
mechanism of injury.
2. Which of the following best describes the term "Index of Suspicion"?
A. The medical provider's estimate of the likelihood of a specific disease or injury being present.
B. A checklist for managing a multiple casualty incident.
C. The measurement of end-tidal carbon dioxide.
D. The force involved in a blunt trauma mechanism.
Correct Answer – “A”
Rationale – The index of suspicion is defined as the provider's estimate of the probability of an
injury, with a high index indicating a high probability.
3. Which of the following best describes the three collisions in a typical motor-vehicle collision
(MVC)?
,A. Vehicle, Passenger, Environmental
B. Machine, Body, Organ
C. Primary, Secondary, Tertiary
D. Frontal, Lateral, Rotational
Correct Answer – “B”
Rationale – The three associated collisions are identified as the machine collision (vehicle
impact), the body collision (patient impacting the interior), and the organ collision (internal
organs impacting body structures).
4. Which of the following is a potential injury pattern associated with a lateral impact (T-bone)
mechanism?
A. Posterior hip dislocation
B. Myocardial contusion
C. Contralateral neck sprain
D. Knee dislocation
Correct Answer – “C”
Rationale – A contralateral neck sprain is listed as a specific potential injury pattern for a lateral
impact mechanism.
5. A person ejected from a vehicle during an accident is how many times more likely to die?
A. 5
B. 15
C. 25
D. 50
,Correct Answer – “C”
Rationale – The content states that an ejected person is 25 times more likely to die.
6. Which of the following best describes the "Deadly Dozen" in thoracic trauma?
A. The twelve steps of the ITLS Ongoing Exam.
B. Twelve immediate life-threatening thoracic injuries.
C. The twelve components of the Glasgow Coma Scale.
D. Twelve predictors of difficult intubation.
Correct Answer – “B”
Rationale – The "Deadly Dozen" refers to the immediate life-threatening thoracic injuries found
during the ITLS Primary and Secondary Surveys.
7. Which of the following best describes the clinical presentation of a tension pneumothorax?
A. Hypotension with muffled heart sounds and distended neck veins.
B. Dyspnea, distended neck veins, tracheal deviation, and unilateral hyperresonance.
C. Hemoptysis, subcutaneous emphysema, and asymmetrical chest movement.
D. Cyanosis, dullness to percussion, and flat neck veins.
Correct Answer – “B”
Rationale – The listed signs for a tension pneumothorax include dyspnea, anxiety, tachypnea,
distended neck veins, tracheal deviation, diminished breath sounds, and hyperresonance on the
affected side.
8. Which of the following best describes Beck's triad, a sign of cardiac tamponade?
A. Hypertension, bradycardia, irregular respiration
B. Distended neck veins, muffled heart sounds, hypotension
, C. Pallor, tachycardia, diaphoresis
D. Tracheal deviation, cyanosis, shock
Correct Answer – “B”
Rationale – Beck's triad is explicitly defined as distended neck veins, muffled heart sounds, and
hypotension.
9. Which of the following best describes the pathophysiology of neurogenic shock?
A. Pump failure due to direct damage to the heart muscle.
B. Absolute loss of blood volume from hemorrhage.
C. Relative hypovolemia from vasodilation due to spinal cord injury.
D. Obstructed blood flow to the heart from a tension pneumothorax.
Correct Answer – “C”
Rationale – Neurogenic shock is described as a distributive shock caused by the loss of
sympathetic tone, leading to vasodilation and a relative hypovolemia, often with bradycardia and
warm, dry skin.
10. In a patient with a severe head injury (GCS ≤ 8) and shock, to what systolic blood pressure
should they be fluid resuscitated to maintain cerebral perfusion?
A. 60-70 mmHg
B. 80-90 mmHg
C. 90-100 mmHg
D. 110-120 mmHg
Correct Answer – “C”
Rationale – The content specifies that a patient with a severe head injury and shock should be
Provider Certification Exam
Board certification examination for prehospital
trauma management
1. Which of the following best describes the "Scene Size-Up"?
A. A detailed head-to-toe physical examination of the trauma patient.
B. The process of packaging a patient for rapid transport.
C. Observations made and actions taken at a trauma scene before approaching the patient.
D. The administration of oxygen and application of a cervical collar.
Correct Answer – “C”
Rationale – The Scene Size-Up is defined as the initial step in the ITLS Primary Survey,
involving observations and actions taken before patient approach to ensure safety and identify
mechanism of injury.
2. Which of the following best describes the term "Index of Suspicion"?
A. The medical provider's estimate of the likelihood of a specific disease or injury being present.
B. A checklist for managing a multiple casualty incident.
C. The measurement of end-tidal carbon dioxide.
D. The force involved in a blunt trauma mechanism.
Correct Answer – “A”
Rationale – The index of suspicion is defined as the provider's estimate of the probability of an
injury, with a high index indicating a high probability.
3. Which of the following best describes the three collisions in a typical motor-vehicle collision
(MVC)?
,A. Vehicle, Passenger, Environmental
B. Machine, Body, Organ
C. Primary, Secondary, Tertiary
D. Frontal, Lateral, Rotational
Correct Answer – “B”
Rationale – The three associated collisions are identified as the machine collision (vehicle
impact), the body collision (patient impacting the interior), and the organ collision (internal
organs impacting body structures).
4. Which of the following is a potential injury pattern associated with a lateral impact (T-bone)
mechanism?
A. Posterior hip dislocation
B. Myocardial contusion
C. Contralateral neck sprain
D. Knee dislocation
Correct Answer – “C”
Rationale – A contralateral neck sprain is listed as a specific potential injury pattern for a lateral
impact mechanism.
5. A person ejected from a vehicle during an accident is how many times more likely to die?
A. 5
B. 15
C. 25
D. 50
,Correct Answer – “C”
Rationale – The content states that an ejected person is 25 times more likely to die.
6. Which of the following best describes the "Deadly Dozen" in thoracic trauma?
A. The twelve steps of the ITLS Ongoing Exam.
B. Twelve immediate life-threatening thoracic injuries.
C. The twelve components of the Glasgow Coma Scale.
D. Twelve predictors of difficult intubation.
Correct Answer – “B”
Rationale – The "Deadly Dozen" refers to the immediate life-threatening thoracic injuries found
during the ITLS Primary and Secondary Surveys.
7. Which of the following best describes the clinical presentation of a tension pneumothorax?
A. Hypotension with muffled heart sounds and distended neck veins.
B. Dyspnea, distended neck veins, tracheal deviation, and unilateral hyperresonance.
C. Hemoptysis, subcutaneous emphysema, and asymmetrical chest movement.
D. Cyanosis, dullness to percussion, and flat neck veins.
Correct Answer – “B”
Rationale – The listed signs for a tension pneumothorax include dyspnea, anxiety, tachypnea,
distended neck veins, tracheal deviation, diminished breath sounds, and hyperresonance on the
affected side.
8. Which of the following best describes Beck's triad, a sign of cardiac tamponade?
A. Hypertension, bradycardia, irregular respiration
B. Distended neck veins, muffled heart sounds, hypotension
, C. Pallor, tachycardia, diaphoresis
D. Tracheal deviation, cyanosis, shock
Correct Answer – “B”
Rationale – Beck's triad is explicitly defined as distended neck veins, muffled heart sounds, and
hypotension.
9. Which of the following best describes the pathophysiology of neurogenic shock?
A. Pump failure due to direct damage to the heart muscle.
B. Absolute loss of blood volume from hemorrhage.
C. Relative hypovolemia from vasodilation due to spinal cord injury.
D. Obstructed blood flow to the heart from a tension pneumothorax.
Correct Answer – “C”
Rationale – Neurogenic shock is described as a distributive shock caused by the loss of
sympathetic tone, leading to vasodilation and a relative hypovolemia, often with bradycardia and
warm, dry skin.
10. In a patient with a severe head injury (GCS ≤ 8) and shock, to what systolic blood pressure
should they be fluid resuscitated to maintain cerebral perfusion?
A. 60-70 mmHg
B. 80-90 mmHg
C. 90-100 mmHg
D. 110-120 mmHg
Correct Answer – “C”
Rationale – The content specifies that a patient with a severe head injury and shock should be
