22 Trauma Practice Questions & Answers

Every Trauma practice question from the EMT (NREMT) Practice Test, with the correct answer and a short explanation.

1. A 30-year-old has spurting bright red blood from a deep forearm laceration. You apply firm direct pressure but bleeding continues to soak through. What is the MOST appropriate next action?
- A.Apply a tourniquet distal to the wound over the laceration
- B.Loosen pressure briefly to check whether bleeding has slowed
- C.Elevate the arm and wait several minutes before reassessing
- D.Apply a tourniquet proximal to the wound and tighten until bleeding stops, then note the time✓ Answer
When direct pressure fails to rapidly control life-threatening extremity hemorrhage, a tourniquet is applied proximal (toward the torso) to the wound and tightened until bleeding and the distal pulse stop; the time is noted and it is not loosened, because arterial inflow must be occluded above the injury.
Source: National EMS Education Standards — Trauma; TCCC/committee external hemorrhage control guidelinesReport a problem with this question
2. A trauma patient is anxious and restless with a heart rate of 122, respirations of 26, and pale, cool, clammy skin, but a blood pressure of 118/76. This presentation is BEST described as:
- A.No shock, because the blood pressure is normal
- B.Compensated (early) hypovolemic shock✓ Answer
- C.Decompensated (late) shock
- D.Neurogenic shock
Tachycardia, tachypnea, anxiety, and pale/cool/clammy skin with a still-normal blood pressure define compensated (early) shock: the body maintains BP through vasoconstriction and increased heart rate. A falling BP marks the later decompensated stage, so a normal BP does not rule out shock.
Source: National EMS Education Standards — Shock and Resuscitation; AAOS Emergency Care 12eReport a problem with this question
3. You are managing a patient in hemorrhagic shock after controlling external bleeding. In addition to high-flow oxygen and supine positioning, which intervention is MOST important?
- A.Give the patient oral fluids to replace lost volume
- B.Keep the patient warm to prevent hypothermia and transport rapidly✓ Answer
- C.Actively cool the patient to reduce metabolic demand
- D.Delay transport until vital signs normalize on scene
Hypothermia worsens coagulopathy and outcomes in hemorrhagic shock, so keeping the patient warm and transporting rapidly to definitive care is critical; the underlying blood loss cannot be fixed in the field, so on-scene time must be minimized.
Source: National EMS Education Standards — Shock; PHTLS trauma triad of deathReport a problem with this question
4. A patient struck in the neck has severe bleeding at the base of the neck (a junctional area) where a tourniquet cannot be placed. Direct pressure alone is not controlling it. What is the BEST option?
- A.Apply a tourniquet around the neck above the wound
- B.Pack the wound with a hemostatic dressing and hold firm direct pressure✓ Answer
- C.Elevate the head of the stretcher to reduce blood flow
- D.Apply a loose gauze dressing and transport without pressure
Junctional wounds (neck, groin, axilla) cannot be tourniqueted, so a hemostatic dressing packed into the wound plus sustained direct pressure is the recommended method; a tourniquet around the neck would occlude the airway and cerebral circulation and is never done.
Source: National EMS Education Standards — Hemorrhage control; hemostatic dressing / wound packing guidelinesReport a problem with this question
5. A 6-year-old fell from a second-story window. He has a heart rate of 140 and is quiet but responsive, with a normal blood pressure. Which statement should MOST guide your management?
- A.A heart rate of 140 is dangerous only in adults, not children
- B.The normal blood pressure confirms the child is hemodynamically stable
- C.Shock can be ruled out because the child is still responsive
- D.Children compensate well then crash suddenly, so treat for shock and transport despite the normal BP✓ Answer
Pediatric patients maintain blood pressure through strong compensatory mechanisms and can appear stable until they abruptly decompensate; tachycardia after a significant fall signals early shock, so you must treat aggressively and not be reassured by a normal BP.
Source: National EMS Education Standards — Pediatric trauma / shock; PALS compensated shockReport a problem with this question
6. A patient with a stab wound to the left chest develops increasing dyspnea, absent breath sounds on the left, distended neck veins, and hypotension. What condition is MOST likely developing?
- A.Hyperventilation syndrome
- B.Acute asthma attack
- C.Tension pneumothorax✓ Answer
- D.Simple rib fracture
Air trapped under pressure in the pleural space collapses the lung and shifts mediastinal structures, producing absent breath sounds on the affected side, jugular venous distension, hypotension, and severe dyspnea — the classic picture of a tension pneumothorax.
Source: National EMS Education Standards — Thoracic traumaReport a problem with this question
7. You applied a three-sided occlusive dressing to an open chest wound. The patient now shows rising respiratory distress, JVD, and falling blood pressure. What should you do FIRST?
- A.Seal the dressing on all four sides to make it airtight
- B.Begin chest compressions immediately
- C.Remove the dressing permanently and pack the wound with gauze
- D.Briefly lift (burp) the dressing to release trapped air, then reassess✓ Answer
These signs indicate a tension pneumothorax forming under the seal; briefly lifting one edge of the occlusive dressing lets the trapped pressurized air escape, decompressing the chest, after which the dressing is replaced and the patient reassessed.
Source: National EMS Education Standards — Open chest wound / vented occlusive dressing managementReport a problem with this question
8. During assessment of a chest-trauma patient, you note a segment of the chest wall that moves inward during inspiration and outward during expiration. This finding indicates:
- A.Normal accessory muscle use
- B.Subcutaneous emphysema
- C.Simple pneumothorax
- D.Flail chest with paradoxical movement✓ Answer
When two or more adjacent ribs are each fractured in two or more places, a free-floating segment moves opposite to the rest of the chest — paradoxical motion — which is the defining sign of flail chest and impairs ventilation.
Source: National EMS Education Standards — Thoracic trauma / flail chestReport a problem with this question
9. What is the current recommended EMT management of a flail chest segment?
- A.Encourage shallow breathing to reduce paradoxical motion
- B.Support oxygenation/ventilation with positive-pressure ventilation as needed✓ Answer
- C.Have the patient lie on the uninjured side to stabilize the flail
- D.Tape a bulky dressing tightly over the segment to splint it
Current practice treats flail chest by supporting oxygenation and ventilation — including positive-pressure ventilation when respiratory compromise develops — because the injury impairs the mechanics of breathing; taping bulky dressings to splint the segment is no longer recommended as it restricts chest expansion.
Source: National EMS Education Standards — Flail chest management (updated practice)Report a problem with this question
10. A patient with a severe head injury develops hypertension, bradycardia, and irregular respirations. This triad indicates:
- A.Neurogenic shock
- B.Rising intracranial pressure (Cushing triad), a late ominous sign✓ Answer
- C.Normal response to pain
- D.Compensated hypovolemic shock
The combination of hypertension, bradycardia, and irregular respirations is Cushing's triad, the body's response to rising intracranial pressure; it is a late and ominous sign of brain herniation requiring airway support and rapid transport.
Source: National EMS Education Standards — Traumatic brain injury / Cushing triadReport a problem with this question
11. For a patient with a suspected traumatic brain injury, which principle MOST reduces secondary brain injury?
- A.Maintain oxygenation and avoid hypotension; ventilate at a normal rate✓ Answer
- B.Withhold oxygen to avoid raising intracranial pressure
- C.Keep the patient hypotensive to reduce cerebral bleeding
- D.Routinely hyperventilate all TBI patients to lower CO2
Hypoxia and hypotension are the two biggest drivers of secondary brain injury, so maintaining oxygenation and adequate blood pressure while ventilating at a normal rate is essential; routine hyperventilation causes cerebral vasoconstriction and is reserved only for active herniation signs.
Source: National EMS Education Standards — TBI management; Brain Trauma Foundation prehospital guidelinesReport a problem with this question
12. You find clear fluid draining from the ears and bruising behind both ears (Battle sign) in a head-injury patient. These findings suggest:
- A.Basilar skull fracture✓ Answer
- B.Simple scalp laceration
- C.Nasal fracture only
- D.Mandible fracture
Cerebrospinal fluid leaking from the ears or nose, along with Battle sign (mastoid bruising) and raccoon eyes, are classic indicators of a basilar skull fracture; you should not pack the ears/nose but allow drainage.
Source: National EMS Education Standards — Head/face trauma; basilar skull fracture signsReport a problem with this question
13. A patient with suspected spinal injury needs an airway opened. Which technique is preferred?
- A.Turning the head to the side to open the airway
- B.Jaw-thrust maneuver while maintaining in-line stabilization✓ Answer
- C.Head-tilt/chin-lift to fully extend the neck
- D.Hyperextending the neck to align the airway
The jaw-thrust opens the airway without moving the cervical spine, so it is preferred when spinal injury is suspected; the head-tilt/chin-lift extends the neck and risks worsening a cord injury.
Source: National EMS Education Standards — Airway with suspected spinal injuryReport a problem with this question
14. A patient thrown from a motorcycle is hypotensive with a heart rate of 52 and warm, dry, pink skin below the injury. Which type of shock does this BEST describe?
- A.Anaphylactic shock
- B.Hypovolemic shock
- C.Neurogenic shock✓ Answer
- D.Cardiogenic shock
Neurogenic shock from spinal cord injury causes loss of sympathetic tone, producing hypotension WITH bradycardia and warm, dry, pink skin — the opposite of the tachycardia and cool, clammy skin of hypovolemic shock, which helps distinguish the two.
Source: National EMS Education Standards — Spinal trauma / neurogenic shockReport a problem with this question
15. Which approach reflects current best practice for a patient with a possible spinal injury?
- A.Spinal motion restriction with a cervical collar and securing to the stretcher✓ Answer
- B.Routine full immobilization on a long backboard for all trauma patients
- C.No cervical collar if the patient can walk to the ambulance
- D.Forcing the head into neutral alignment even if it causes pain
Modern practice favors spinal motion restriction — a cervical collar plus securing the patient to the stretcher — over routine long-backboard immobilization, because prolonged backboard use causes harm and offers little benefit; the head is never forced into alignment if it causes pain or resistance.
Source: National EMS Education Standards — Spinal motion restriction (updated practice)Report a problem with this question
16. A knife is impaled in a patient's thigh and is still in place. There is no airway involvement. What is the correct management?
- A.Push the knife in further to prevent movement
- B.Remove the knife only if bleeding is minor
- C.Stabilize the object in place and control bleeding around it✓ Answer
- D.Remove the knife and pack the wound
Impaled objects are stabilized in place and bleeding is controlled around them, because removal can trigger uncontrolled hemorrhage and further tissue damage; exceptions are objects in the cheek causing airway obstruction or those interfering with CPR.
Source: National EMS Education Standards — Soft-tissue trauma / impaled objectsReport a problem with this question
17. A patient's finger has been completely amputated. How should the amputated part be cared for during transport?
- A.Wrap it in dry gauze and keep it warm
- B.Wrap it in moist sterile gauze, seal in a bag, and keep it cool on ice✓ Answer
- C.Place it directly on ice to freeze it
- D.Submerge it in a container of water
An amputated part is wrapped in moist sterile gauze, sealed in a bag, and kept cool on ice (not directly on ice or submerged in water), because direct ice contact freezes tissue and water soaking macerates it, both destroying the part's viability for reimplantation.
Source: National EMS Education Standards — Amputation careReport a problem with this question
18. A patient has an abdominal evisceration with a loop of bowel protruding. What is the correct EMT care?
- A.Cover with a moist sterile dressing, then an occlusive dressing; do not push organs back in✓ Answer
- B.Gently push the bowel back into the abdomen and bandage
- C.Leave the bowel exposed and transport without covering
- D.Cover with dry gauze and apply firm pressure
An evisceration is covered with a moist sterile dressing and then an occlusive dressing to keep the organs moist and protected; the organs are never pushed back in, as doing so risks contamination and further injury.
Source: National EMS Education Standards — Abdominal trauma / eviscerationReport a problem with this question
19. Using the Rule of Nines for an adult, a patient with burns to the entire front of the chest and abdomen (anterior trunk) has approximately what percentage of total body surface area burned?
- A.9%
- B.4.5%
- C.36%
- D.18%✓ Answer
In the adult Rule of Nines the anterior trunk (chest plus abdomen) equals 18% of total body surface area — each of the two regions is 9%, together forming the front of the torso.
Source: National EMS Education Standards — Burns / Rule of NinesReport a problem with this question
20. A patient pulled from a house fire has singed nasal hairs, soot around the mouth, hoarseness, and facial burns. What is the PRIMARY concern?
- A.Impending airway compromise from inhalation injury✓ Answer
- B.The exact percentage of skin surface burned
- C.Applying cool water to the facial burns first
- D.Pain control before anything else
Singed nasal hair, soot, hoarseness, and facial burns signal inhalation injury with impending airway swelling; the airway is the priority because progressive edema can occlude it, so early aggressive airway management and oxygen come first.
Source: National EMS Education Standards — Burns / inhalation injury airway priorityReport a problem with this question
21. You are splinting a patient's angulated forearm fracture. When should you assess pulse, motor function, and sensation (PMS) distal to the injury?
- A.Only after the splint is applied
- B.Both before and after applying the splint✓ Answer
- C.Only before applying the splint
- D.Only if the patient complains of numbness
PMS (pulse, motor, sensation) distal to the injury must be checked before and after splinting, because splinting can compromise circulation or nerve function, and comparing the two assessments confirms the limb was not made worse.
Source: National EMS Education Standards — Musculoskeletal trauma / splinting principlesReport a problem with this question
22. A restrained driver in a high-speed crash is alert with stable vital signs but has abdominal bruising across the lower abdomen and mild tenderness. What is the BEST management approach?
- A.Since vitals are stable, release the patient after a brief exam
- B.Suspect occult internal bleeding, treat for shock, and transport rapidly✓ Answer
- C.Have the patient walk around to confirm there is no serious injury
- D.Delay transport and recheck the abdomen in 30 minutes on scene
Blunt abdominal trauma can cause hidden internal bleeding that a patient tolerates while looking stable; the seatbelt bruising and mechanism warrant a high index of suspicion, so you treat for shock and transport rapidly rather than being reassured by normal vitals.
Source: National EMS Education Standards — Abdominal trauma / occult hemorrhageReport a problem with this question

Practice questions modeled on the National EMS Education Standards and NREMT cognitive-exam content areas. Not medical advice and not affiliated with or endorsed by the National Registry of Emergency Medical Technicians (NREMT) or NHTSA. Always follow your instructor, medical director, and local protocols. Study the official materials at nremt.org. Official NREMT →

1. A 30-year-old has spurting bright red blood from a deep forearm laceration. You apply firm direct pressure but bleeding continues to soak through. What is the MOST appropriate next action?

2. A trauma patient is anxious and restless with a heart rate of 122, respirations of 26, and pale, cool, clammy skin, but a blood pressure of 118/76. This presentation is BEST described as:

3. You are managing a patient in hemorrhagic shock after controlling external bleeding. In addition to high-flow oxygen and supine positioning, which intervention is MOST important?

4. A patient struck in the neck has severe bleeding at the base of the neck (a junctional area) where a tourniquet cannot be placed. Direct pressure alone is not controlling it. What is the BEST option?

5. A 6-year-old fell from a second-story window. He has a heart rate of 140 and is quiet but responsive, with a normal blood pressure. Which statement should MOST guide your management?

6. A patient with a stab wound to the left chest develops increasing dyspnea, absent breath sounds on the left, distended neck veins, and hypotension. What condition is MOST likely developing?

7. You applied a three-sided occlusive dressing to an open chest wound. The patient now shows rising respiratory distress, JVD, and falling blood pressure. What should you do FIRST?

8. During assessment of a chest-trauma patient, you note a segment of the chest wall that moves inward during inspiration and outward during expiration. This finding indicates:

9. What is the current recommended EMT management of a flail chest segment?

10. A patient with a severe head injury develops hypertension, bradycardia, and irregular respirations. This triad indicates:

11. For a patient with a suspected traumatic brain injury, which principle MOST reduces secondary brain injury?

12. You find clear fluid draining from the ears and bruising behind both ears (Battle sign) in a head-injury patient. These findings suggest:

13. A patient with suspected spinal injury needs an airway opened. Which technique is preferred?

14. A patient thrown from a motorcycle is hypotensive with a heart rate of 52 and warm, dry, pink skin below the injury. Which type of shock does this BEST describe?

15. Which approach reflects current best practice for a patient with a possible spinal injury?

16. A knife is impaled in a patient's thigh and is still in place. There is no airway involvement. What is the correct management?

17. A patient's finger has been completely amputated. How should the amputated part be cared for during transport?

18. A patient has an abdominal evisceration with a loop of bowel protruding. What is the correct EMT care?

19. Using the Rule of Nines for an adult, a patient with burns to the entire front of the chest and abdomen (anterior trunk) has approximately what percentage of total body surface area burned?

20. A patient pulled from a house fire has singed nasal hairs, soot around the mouth, hoarseness, and facial burns. What is the PRIMARY concern?

21. You are splinting a patient's angulated forearm fracture. When should you assess pulse, motor function, and sensation (PMS) distal to the injury?

22. A restrained driver in a high-speed crash is alert with stable vital signs but has abdominal bruising across the lower abdomen and mild tenderness. What is the BEST management approach?