PHTLS 2023/ 2024 Exam Prep| Complete
Review with Questions and Verified Answers|
100% Correct
Q: less injury if energy can change form __
Answer:
before the collision
(example: bending of metal frame)
Q: What type of shock is it, aortic perforation (small hole)?
Answer:
hemorrhagic
Q: What type of shock is it, dysrhythmia?
Answer:
cardiogenic
Q: What type of shock is it, fluid has not been lost from the vascular system; the problem is
with the size of the container?
Answer:
distributive
Q: What type of shock is it, heart loses its efficiency as a pump?
Answer:
cardiogenic
Q: What type of shock is it, injury interrupts the spinal cord sympathetic nervous system
pathway?
Answer:
distributive / neurogenic
Q: What type of shock is it, interference with the pump action?
Answer:
cardiogenic
Q: What type of shock is it, typically mediated through the parasympathetic nervous system?
Answer:
distributive / psychogenic (vasovagal)
Q: What type of shock is it, life-threatening infections?
Answer:
distributive / septic
Q: What type of shock is it, loss of circulating blood?
Answer:
hypovolemic / hemorrhagic
Q: What type of shock is it, loss of vascular tone?
Answer:
distributive / vasogenic
Q: What type of shock is it, spinal cord trauma?
Answer:
distributive / neurogenic
Q: What type of shock is it, valvular disruption?
Answer:
cardiogenic
Q: What type of shock is it, vascular container enlarges without a proportional increase in fluid
volume?
Answer:
distributive
Q: What type of shock is it, vomiting, or diarrhea?
Answer:
hypovolemic
Q: What type of shock is it, simple fainting?
Answer:
distributive / psychogenic (vasovagal)
Q: What type of shock is it, severe infections?
Answer:
distributive / septic
Q: What type of shock is it, allergic reactions?
Answer:
distributive / anaphylactic
Q: Allergies are acquired following?
Answer:
initial exposure to an allergen
Q: How does the body respond to hypoperfusion?
Answer:
vasoconstriction, tachycardia, tachypnea
Q: The attraction of leukocytes to the site of inflammation (like chumming the waters for
sharks) during degranulation is called what?
Answer:
chemotaxis
PHTLS Pre & Post Test (Latest 2023/ 2024)
Questions and Verified Answers| 100%
Correct
Q: Which of the following is the preferred site for needle decompression of a tension
pneumothorax?
A. 4th intercostal space, midclavicular line, just over the top of the 5th rib
B. 4th intercostal space, midclavicular line, just below the 4th rib
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
D. 2nd intercostal space, midclavicular line, just below the 2nd rib
Answer:
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
Q: Which of the following is the mechanism by which pulmonary contusion interferes with
oxygenation?
A. Inability to generate negative intrapleural pressure
B. Decrease in vital capacity due to collapse of the flail segment
C. Increased intrathoracic pressure
D. Blood and fluid in the alveoli and interstitial spaces of the lung
Answer:
D. Blood and fluid in the alveoli and interstitial spaces of the lung
Q: Your patient is a 55 year old male who was struck in the right side of the chest with a piece
of steel pipe. He presents with uncooperative behavior, his skin is pale and moist, the ventilatory
rate is 32, there is a weak radial pulse of 112, and breath sounds are decreased on the right side.
The trachea is midline and jugular veins are flat while the patient is supine. There is isolated
crepitus over the 4th and 5th ribs in the midaxillary line on the patient’s right side. Based on the
mechanism of injury and the assessment findings, which of the following is the most likely cause
of the patient’s signs and symptoms?
A. Tension pneumothorax
B. Simple pneumothorax
C. Pulmonary contusion
D. Hemothorax
Answer:
D. Hemothorax
Q: Deterioration of ventilation and oxygenation after inflation of a PASG in a patient who has
sustained a high-pressure compression injury of the abdomen, such as a sudden deceleration with
the lap belt placed across the abdomen, most likely represents which of the following injuries?
A. Abdominal aortic aneurysm
B. Ruptured diaphragm
C. Ruptured esophagus
D. “Paper bag” syndrome of the lungs
Answer:
B. Ruptured diaphragm
Q: Which of the following is NOT a component of the Fick Principle?
A. Adequate number of platelets in the blood
B. Oxygenation of red blood cells
C. Transportation of red blood cells to the tissues of the body
D. Off-loading oxygen from the red blood cells to the tissues
Answer:
A. Adequate number of platelets in the blood
Q: One of the earliest signs of hypovolemic shock is:
A. Hypotension
B. Bradycardia
C. Anxiety
D. Reduced urine output
Answer:
C. Anxiety
Q: Which of the following characterizes the washout phase of shock?
A. Systemic acidosis
B. Localized tissue acidosis
C. Edema
D. Reduced capillary blood flow
Answer:
A. Systemic acidosis
Q: A trauma patient who has fallen 20 feet from an apartment balcony is alert with warm, dry,
pink skin, with normal capillary refilling time to the lower extremities, and is hypotensive. The
upper extremities are cool, pale and diaphoretic. Which of the following injuries should be
suspected?
A. Aortic dissection
B. Liver laceration
C. Fractured pelvis
D. Spinal cord injury
Answer:
D. Spinal cord injury
Q: Which of the following is a limitation of prehospital fluid resuscitation of the patient in
hemorrhagic shock?
A. Inability of fluids to carry oxygen
B. Pulmonary edema
C. Increased hemorrhage
D. All of the above
Answer:
PHTLS Post Test 9th Edition (Latest 2023/
2024) Questions and Verified Answers| Grade
A
Q: Which of the following represents adequate spontaneous ventilation in an adult?
A. Tidal volume 100 mL, ventilatory rate 40/minute
B. Tidal volume 500 mL, ventilatory rate 8/minute
C. Tidal volume 300 mL, ventilatory rate 16/minute
D. Tidal volume 600 mL, ventilatory rate 12/minute
Answer:
D. Tidal volume 600 mL, ventilatory rate 12/minute
Q: Which of the following is 100% accurate in verifying endotracheal tube placement?
A. Pulse oximetry
B. End-tidal capnometry
C. Syringe aspiration
D. None of the above
Answer:
D. None of the above
Q: When utilizing percutaneous transtracheal ventilation, the correct ration of lung inflation to
lung inflation time, in seconds, is:
A. 1:4
B. 1:5
C. 1:2
D. 2:2
Answer:
A. 1:4
Q: Which of the following is a possible complication of using a manually triggered oxygen
powered device for ventilation?
A. Gastric distention
B. Pneumothorax
C. Inability to feel lung compliance
D. All of the above
Answer:
D. All of the above
Q: Which of the following procedures is considered an essential airway skill?
A. Needle cricothyroidotomy
B. Endotracheal intubation
C. Insertion of an oropharyngeal airway
D. Retrograde endotracheal intubation
Answer:
C. Insertion of an oropharyngeal airway
Q: Pericardial tamponade is most likely to occur in which of the following situations?
A. Stab wound to the chest
B. Fall from a height
C. Frontal impact vehicle crash
D. Gunshot wound to the chest
Answer:
A. Stab wound to the chest
Q: Which of the following is the preferred site for needle decompression of a tension
pneumothorax?
A. 4th intercostal space, midclavicular line, just over the top of the 5th rib
B. 4th intercostal space, midclavicular line, just below the 4th rib
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
D. 2nd intercostal space, midclavicular line, just below the 2nd rib
Answer:
C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib
Q: Which of the following is the mechanism by which pulmonary contusion interferes with
oxygenation?
A. Inability to generate negative intrapleural pressure
B. Decrease in vital capacity due to collapse of the flail segment
C. Increased intrathoracic pressure
D. Blood and fluid in the alveoli and interstitial spaces of the lung
Answer:
D. Blood and fluid in the alveoli and interstitial spaces of the lung
Q: Your patient is a 55 year old male who was struck in the right side of the chest with a piece
of steel pipe. He presents with uncooperative behavior, his skin is pale and moist, the ventilatory
rate is 32, there is a weak radial pulse of 112, and breath sounds are decreased on the right side.
The trachea is midline and jugular veins are flat while the patient is supine. There is isolated
crepitus over the 4th and 5th ribs in the midaxillary line on the patient’s right side. Based on the
mechanism of injury and the assessment findings, which of the following is the most likely cause
of the patient’s signs and symptoms?
A. Tension pneumothorax
B. Simple pneumothorax
C. Pulmonary contusion
D. Hemothorax
Answer:
D. Hemothorax
PHTLS Pre-Test 9th Edition (Latest 2023/
2024) Questions and Verified Answers| Grade
A
Q: When verifying ET tube placement on a perfusing patient, the “gold standard” of monitoring
is considered to be?
a) Colorimetric carbon dioxide detector
b) Pulse oximetry
c) Listening to lung sounds
d) Waveform capnography
Answer:
Waveform capnography
Q: A patient presents with a blunt trauma injury to the chest. On exam, he has absent breath
sounds on one side of his chest and respiratory distress. Which additional sign would indicate
that the patient has a tension pneumothorax?
a) Distended neck veins
b) Inspiratory wheezing
c) narrowed pulse pressure
d) Tracheal deviation towards the side of injury
Answer:
Distended neck veins
Q: Hemostatic agents should be used for excessive bleeding when direct pressure alone does
not work. The proper way to use most hemostatic agents is which of the following?
a) Placing the agent around the edges of the wound
b) Placing the agent properly into the wound and holding direct pressure
c) Only using it after a tourniquet has been applied for 10 minutes
d) Hemostatic agents should never be used unless you have a fall in blood pressure
Answer:
Placing the agent properly into the wound and holding direct pressure
Q: Of the following, which is a preventable cause of secondary brain injury addressable during
the transport phase?
a) Intraparenchymal hemorrhage
b) Systemic hypoxia
c) Intracranial hematomas
d) Herniation syndromes
Answer:
Systemic hypoxia
Q: You are called to treat a patient who was knocked unconscious when he slipped and fell on a
wet floor, striking his head. It is now several hours later. He is awake but confused, does not
recall the incident, and is vomiting with a headache. Which of the following injuries is most
likely?
a) Brain herniation
b) Intraabdominal hemorrhage
c) Diffuse axonal injury
d) Concussion
Answer:
Concussion
Q: When using a selective spinal immobilization protocol, which of the following findings
indicate the need for immobilization?
a) Past history of spinal injury
b) Being an unrestrained passenger in a motor vehicle crash
c) Being ambulatory at the scene
d) An associated femoral shaft fracture with severe pain
Answer:
An associated femoral shaft fracture with severe pain
PHTLS 9th Edition Exam (Latest 2023/ 2024)
Questions and Verified Answers| Grade A
Q: In a blast-related multiple patient situation, which of the following patients should be treated
first?
a. A 33-year-old female with altered level of consciousness and decreased capillary refill
b. A 28-year-old male with an arm amputation who has bleeding controlled with a tourniquet
c. A 14-year-old pulseless female with grey matter visible from a head wound
d. A 78-year-old male awake and unable to hear
Answer:
a. A 33-year-old female with altered level of consciousness and decreased capillary refill
Q: Excessive fluid resuscitation of the trauma patient can result in which of the following?
a. Increased blood loss
b. Decreased mortality
c. Earlier discharge from the hospital
d. A higher incidence of sepsis in the ICU
Answer:
a. Increased blood loss
Q: The secondary survey should be accomplished:
a. Never on a critical patient
b. Before transport
c. When time and Situation allow
d. Before moving the patient
Answer:
c. When time and Situation allow
Q: When approaching a trauma patient, what is the first assessment that must be made?
a. Circulation
b. Scene safety
c. Airway
d. Breathing
Answer:
b. Scene safety
Q: The most common type of shock resulting from trauma is?
a. Neurogenic
b. Septic
c. Spinal
d. Hemorrhagic
Answer:
d. Hemorrhagic
Q: 18. Which of the following best guides the decision to provide spinal immobilization?
a. History and complaint
b. Obvious signs of associated injury
c. Avoid due to possible pressure sores
d. Mechanism alone
Answer:
d. Mechanism alone
Q: A 38-year-old male sustains a large wound to his right thigh while at work. Which of the
following actions is the most important initial step?
a. Obtain IV access and infuse crystalloid
b. Administer supplemental oxygen
c. Hemorrhage control
d. Rapid transport
Answer:
c. Hemorrhage control
Q: You respond to a local bar for an unconscious person. On arrival, you are met by a police
officer who reports that one of their “regular alcoholics” was found in the alley behind the bar.
On exam, you note the smell of an alcoholic beverage as well as the following: Patient flexes his
arms to painful stimuli, has bilateral fixed and dilated pupils, irregular respirations at 12 breaths
per minute and a BP of 210/100. What condition do you suspect?
a. Subarachnoid hemorrhage
b. Alcohol poisoning
c. Epidural hematoma
d. Subdural hematoma
Answer:
d. Subdural hematoma
Q: The pre-hospital assessment of the trauma patient begins with which of the following?
a. Assessment of scene safety and situation
b. Information provided by the dispatcher
c. The initial assessment
d. The primary survey
Answer:
b. Information provided by the dispatcher
Q: EMS responds for a patient involved in a motorcycle vs. car collision. The patient is
unresponsive with no movement of lower extremities and loss of temperature control below the
T10. Which type of shock is the patient experiencing?
a. Cardiogenic
b. Hypovolemic
c. Neurogenic
d. Obstructive
Answer:
c. Neurogenic
Q: Which of the following is the best indicator of shock?
a. Depressed level of cognition
b. Heart rate of 80
c. Respirations of 18
d. GCS of 15
Answer:
a. Depressed level of cognition
Q: Which best describes the goal of airway management in a trauma patient?
a. Perform complex airway maneuvers
b. Perform a surgical Cricothyrotomy
c. Provide for adequate exchange of oxygen and C02
d. Perform RSI
Answer:
c. Provide for adequate exchange of oxygen and C02
Q: What is the most common cause of airway obstruction in the unresponsive trauma patient?
a. Blood
b. Teeth
c. Tongue
d. Vomitus
Answer:
c. Tongue
Q: While caring for a patient who was involved in an altercation, he vomits and his airway is
totally obstructed with vomitus and blood. What is the most important action?
a. Performing an RSI
b. Performing a head-tilt chin lift
c. Intubating
d. Suctioning the airway
Answer:
d. Suctioning the airway