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Free PHTLS Practice Questions

10 free, exam-style Prehospital Trauma Life Support (PHTLS) practice questions with answers and explanations. No signup required. Work through them below, then take the full free PHTLS practice test to study every exam domain.

These 10 free PHTLS questions are organized by exam domain, so you can see how each part of the Prehospital Trauma Life Support blueprint is tested. Reveal the answer and explanation under each question.

Domain 2: Scene assessment

Question 1

According to the Golden Principles of Prehospital Trauma Care, initiating fluid replacement for a critically injured patient should occur:

  1. On scene before the patient is moved
  2. Only after a full secondary survey
  3. En route to the receiving facility
  4. After arrival at the trauma center
Show answer & explanation

Correct answer: C - En route to the receiving facility

Domain 3: Patient assessment

Question 2

A trauma patient presents with hypotension, a heart rate of 50, and warm, dry skin below the level of injury. This presentation is MOST consistent with:

  1. Hypovolemic shock
  2. Neurogenic shock
  3. Cardiogenic shock
  4. Septic shock
Show answer & explanation

Correct answer: B - Neurogenic shock

Question 3

An adult trauma patient is estimated to have lost approximately 35% of their blood volume. According to the classification of hemorrhage, this represents:

  1. Class I
  2. Class II
  3. Class III
  4. Class IV
Show answer & explanation

Correct answer: C - Class III

Question 4

A patient has severe, ongoing bleeding from a mangled forearm that continues despite firm, sustained direct pressure. The NEXT step in hemorrhage control is to:

  1. Apply a tourniquet proximal to the wound
  2. Elevate the extremity above the level of the heart
  3. Apply pressure over a proximal arterial point
  4. Establish IV access and begin fluid infusion
Show answer & explanation

Correct answer: A - Apply a tourniquet proximal to the wound

Question 5

For a trauma patient with uncontrolled internal hemorrhage, why does PHTLS favor a controlled (permissive hypotension) approach to fluid resuscitation?

  1. Rapid crystalloid infusion improves the blood's clotting ability
  2. A higher pressure can dislodge formed clots and worsen bleeding
  3. It reduces the amount of equipment that must be carried to the patient
  4. A normal blood pressure sharply increases the patient's risk of stroke
Show answer & explanation

Correct answer: B - A higher pressure can dislodge formed clots and worsen bleeding

Domain 4: Hemorrhage control

Question 6

In the kinetic energy relationship that governs injury from a collision, which factor has the GREATER influence on the amount of energy delivered?

  1. The mass of the moving object
  2. The surface area of contact
  3. The total duration of the impact
  4. The velocity of the moving object
Show answer & explanation

Correct answer: D - The velocity of the moving object

Domain 6: Breathing, ventilation, and oxygenation

Question 7

A young adult is found with heavy, pulsating bleeding from a thigh laceration after a motorcycle crash. The scene is safe and the airway is patent. Following the PHTLS primary survey, what should the practitioner address FIRST?

  1. Open and secure the airway
  2. Control the exsanguinating hemorrhage
  3. Assess the patient's mental status
  4. Apply high-flow supplemental oxygen
Show answer & explanation

Correct answer: B - Control the exsanguinating hemorrhage

Domain 8: Special populations

Question 8

In managing a patient with a traumatic brain injury, the PRIMARY goal of prehospital care is to:

  1. Prevent secondary injury from hypoxia and low blood pressure
  2. Reverse the damage caused at the moment of impact
  3. Lower pressure in the skull with aggressive hyperventilation
  4. Give medication on scene to shrink the swollen brain
Show answer & explanation

Correct answer: A - Prevent secondary injury from hypoxia and low blood pressure

More PHTLS practice questions

Question 9

A patient sustains an isolated gunshot wound to the abdomen. They are alert, moving all extremities, and deny neck or back pain. Regarding spinal motion restriction (SMR), the practitioner should:

  1. Not apply spinal motion restriction
  2. Apply a cervical collar as a precaution
  3. Immobilize fully on a long backboard
  4. Maintain manual in-line stabilization
Show answer & explanation

Correct answer: A - Not apply spinal motion restriction

Question 10

A patient struck in the chest has absent breath sounds on the right, distended neck veins, severe respiratory distress, and a falling blood pressure. The MOST appropriate immediate intervention is:

  1. Insert a supraglottic airway device
  2. Apply a three-sided occlusive dressing
  3. Begin positive-pressure ventilation only
  4. Perform needle chest decompression
Show answer & explanation

Correct answer: D - Perform needle chest decompression

The rest of the PHTLS blueprint

The PHTLS exam also covers these domains. Drill them in the full free practice test:

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