Trauma

Sample questions.

8 free trauma questions with answers and explanations. MedRelay's full question bank covers every NREMT domain, plus live scenarios that grade the decision, not just the answer.

1. Question 1

   A pelvic-injury patient is pale and hypotensive. What is your main concern?

   • A.Minor isolated pain
   • B.Internal bleeding and shockCorrect
   • C.Routine refusal
   • D.Need for aspirin

   Why:Correct. Pelvic trauma can cause severe internal bleeding. Treat for shock and transport rapidly.

2. Question 2

   You respond to a 26-year-old male who was struck by a car while crossing the street. He is unconscious at the scene. HR 152, BP 62/38, SpO2 88%, RR 6, GCS 5. He has obvious deformity of his left femur, a rigid abdomen, and an unstable pelvis on gentle compression. Your transport time to a Level I Trauma Center is 8 minutes. How should you allocate those 8 minutes?

   • A.Splint all fractures before loading
   • B.Load immediatelyCorrect
   • C.Complete a full secondary assessment on scene before leaving
   • D.Apply an advanced airway device before loading

   Why:Correct. Load-and-go for multisystem trauma with hemodynamic collapse. Airway management and pelvic binder are performed during the loading process. BVM for RR 6 is immediate. Scene time beyond immediate life threats approaches zero. 8 minutes to a trauma center with a hemodynamically unstable patient means movement within 60-90 seconds of arrival.

3. Question 3

   A 55-year-old male fell 20 feet. He is unconscious. On rapid trauma assessment, a section of the right chest wall moves inward on inspiration and outward on expiration. What injury causes paradoxical chest wall movement?

   • A.Flail chestCorrect
   • B.Tension pneumothorax
   • C.Diaphragmatic rupture
   • D.Subcutaneous emphysema

   Why:Correct. Flail chest: free-floating rib segment moves paradoxically (inward on inspiration, outward on expiration). The underlying pulmonary contusion is the more serious injury. BVM-assisted ventilation if tidal volume is insufficient. Priority 1 ALS transport.

4. Question 4

   You respond to a 38-year-old female who was the driver in a rear-end collision. She is conscious and ambulatory. She reports neck pain that started immediately after impact. Physical exam reveals midline cervical tenderness at C5-C6. She denies numbness or weakness. Vital signs are stable. She insists she is fine and wants to drive home. What is your assessment and how do you counsel her?

   • A.Midline cervical spine tenderness after trauma isCorrect
   • B.She is ambulatory so spinal injury is ruled out
   • C.No SMR needed
   • D.Apply a cervical collar only and allow her to drive

   Why:Correct. Midline cervical spine tenderness after a traumatic mechanism is a clinical criterion for spinal precautions. Ambulatory status does not rule out an unstable fracture. A neurologically intact patient can have an unstable spinal fracture that becomes catastrophic with movement. Document midline tenderness in your assessment and strongly advise against driving.

5. Question 5

   You respond to a 33-year-old male who was struck in the right eye by a racquetball at close range. He reports immediate severe pain and vision loss. On inspection the right eye is very soft to gentle palpation compared to the left and the anterior chamber appears to have collapsed. There is no visible protrusion of ocular contents. What does a soft eye with anterior chamber collapse after blunt trauma indicate?

   • A.Globe rupture requires immediate pressure to stop the bleeding
   • B.Apply pressure with a sterile pad to tamponade the injury
   • C.This is a hyphaema — blood in the anterior chamber
   • D.Ruptured globeCorrect

   Why:Correct. Ruptured globe signs: soft eye (reduced IOP from fluid loss), anterior chamber collapse, severe pain, vision loss. Blunt or penetrating trauma can cause scleral rupture. Critical management: NO pressure to the eye (forced expulsion of intraocular contents). Cover with a rigid shield (not a patch). Keep NPO (surgery likely). Never remove any impaled object. Immediate ophthalmological evaluation.

6. Question 6

   You respond to a 33-year-old male who was struck in the right temporal region by a baseball. He was briefly unconscious for approximately 1 minute. He has been fully awake for the past 20 minutes and is now talking normally to his teammates. On your assessment his GCS is 15, pupils are equal and reactive, and he has no focal deficits. He wants to return to the game. What is the most dangerous aspect of his presentation?

   • A.The lucid interval following loss of consciousnessCorrect
   • B.GCS 15 clears him to return to play
   • C.Pupils equal and reactive means he has no intracranial injury
   • D.He has a simple concussion

   Why:Correct. Brief LOC followed by a lucid interval (apparently normal recovery) is the hallmark of epidural hematoma. The middle meningeal artery runs through the temporal bone — a baseball to the temple can fracture it. Initial accommodation is followed by rapid deterioration. This patient requires Priority 1 transport and CT imaging — not return to play.

7. Question 7

   A motorcyclist has an open femur fracture with severe bleeding. What should you address first?

   • A.Life-threatening bleedingCorrect
   • B.Splint cosmetics
   • C.Insurance details
   • D.Full medication list

   Why:Correct. Severe bleeding is a life threat and must be controlled before lower-priority assessment steps.

8. Question 8

   You respond to a 38-year-old male who sustained a gunshot wound to his right anterior thigh. On arrival there is pulsatile bright red arterial hemorrhage from the wound. You apply direct pressure for 2 minutes but hemorrhage continues uncontrolled. What is the next intervention?

   • A.Continue direct pressure for 3 more minutes
   • B.Wound packing only — tourniquet is a last resort
   • C.Apply a pressure dressing and elevate the extremity
   • D.Apply a tourniquet 2-3 inches proximal to theCorrect

   Why:Correct. Uncontrolled arterial hemorrhage after direct pressure requires a tourniquet. The tourniquet is placed 2-3 inches proximal to the wound and tightened until bleeding stops. Time of application must be documented and communicated to the receiving facility. Tourniquet use in extremity arterial hemorrhage saves lives.