TNCC TEST PREPA, 8TH EDITION
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Expedite transfer to the closest trauma center - ANSWER A 56 y/o M pt involved in a motor vehicle crash
is brought to the ED of a rural critical access facility. He complains of neck pain, SOB, and diffuse abd
pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2 94% on high-flow O2 via NRB mask. Which of
the following is the priority intervention for this patient?
a pertinent medical hx is crucial - ANSWER Which of the following considerations is the most important
when caring for a geriatric trauma pt?
Mitigation - ANSWER Following a review of recent drills and a real disaster event, a hospital has
identified deficiencies and is taking steps to minimize the impact of a future disaster . Which phase of
the disaster life cycle does this describe?
Alcohol
All tools and guidelines require the patient to be awake, alert, not under the influence of any substances,
and without neurologic abnormalities - ANSWER EMS brings a pt who fell while riding his bicycle. Using
the American College of Surgeons screening guidelines, which assessment finding would prompt the RN
to prepare the pt for a radiologic spine clearance?
hemoglobin does not readily release O2 for use by the tissues - ANSWER What is the effect of
hypothermia on the oxyhemoglobin dissociation curve?
acidosis - ANSWER Which of the following is a component of the trauma triad of death?
Complete - ANSWER EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt
exhibits urinary incontinence and priapism. These assessment findings are most consistent with which of
the following types of spinal cord injury?
flucuation in the water seal chamber - ANSWER Which of the following is an expected finding in a pt with
a tube thoracstomy connected to a chest drainage system?
,insert an oropharyngeal airway if there is no gag reflex - ANSWER During the primary survey of an
unconscious pt with multi-system trauma, the nurse notes snoring respirations. What priority nursing
interventions should be preformed next?
globe rupture - ANSWER A 35 y/o M presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
compensated - ANSWER A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP
110/60, HR96, RR 24. Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is
demonstrating s/sx of which stage of shock?
ventilate with a bag mask device - ANSWER An unresponsive trauma pt has an oropharygeal airway in
place, shallow and labored respirations, and dusky skin. The trauma team has administered medications
for drug-assisted intubation and attempted intubation but was unsuccessful. What is the most
appropriate immediate next step?
within 24 hrs of trauma - ANSWER When is the tertiary survey completed fora trauma pt?
pressure - ANSWER An intubated and sedated pt in the ED has multiple extremity injuries with the
potential for causing compartment syndrome. What is the most reliable indication of compartment
syndrome in a patient who is unconscious?
worsening pneumothorax - ANSWER Which of the following is possible complication of positive-pressure
ventilation?
pelvic stability - ANSWER the most reassuring finding for a male pt with hip pain after a fall is which of
the following?
narrowed - ANSWER Which of the following pulse pressures indicate early hypovolemic shock?
dysrhythmias - ANSWER Patients with a crush injury should be monitored for which of the following
conditions?
,subdural hematoma - ANSWER Tearing of the bridging veins is most frequently associated with which
brain injury?
straight cath for urine sample - ANSWER A 20 y/o M presents to the ED complaining of severe lower abd
pain after landing hard on the bicycle cross bars while preforming an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would
the RN question?
placental abruption - ANSWER You are caring for a pt who was involved in a MVC and is 32 weeks
pregnant. Findings of your secondary survey include abd pain on palpation, fundal ht at the costal
margin, and some dark bloody show. Varying accelerations and decelerations are noted on cariocgraphy.
These findings are most consistent with which of the following?
it can worsen cord damage from an unstable spinal injury - ANSWER Which of the following is true about
the log-roll?
defusings - ANSWER All of these are considered a critical communication point in trauma care EXCEPT
which of the following?
pulse oximetry and capnography - ANSWER What bedside monitoring parameters are used to assess for
adequacy of O2 and effectiveness of ventilation?
padding the upper back while stabilizing the cervical spine - ANSWER Caregivers carry in a 2 y/o into the
ED who fell out of a second-story window. The pt is awake and crying with increased work of breathing
and pale skin. Which of the following interventions has the highest priority?
bowel - ANSWER Which of the following injuries is LEAST likely to be promptly identified?
Initiate transfer to a trauma center - ANSWER A pt is brought to the ED of a rural hospital following a
high-speed MVC. When significant abd and pelvic injuries are noted in the primary survey, which of the
following is the priority interventions?
bardycardia and absent motor function below the level of injury - ANSWER A pt with a complete spinal
cord injury in neurogenic shock will demonstrate hypotension and which other clinical signs?
, apply splint and elevate above the level of the heart - ANSWER a 37 y/o F has a deformity of the L wrist
after a fall. She is reluctant to move her hand due to pain. Which of the following is the most appropriate
intervention?
the aorta is torn at its attachment with the ligamentum arteriosum - ANSWER which of the following
occurs during the third impact of a motor vehicle crash?
Report your suspicion of maltreatment in accordance with local regulations - ANSWER a 5 y/o child
presents to the ED with bruises to the upper arm and buttocks in various stages of healing and multiple
small, clean, round burns to the back. There are no abnormalities found based on the pediatric
assessment triangle or primary survey. Which of the following is the priority survey. Which of the
following is the priority nursing intervention?
to guage end-organ perfusion and tissue hypoxia - ANSWER Why is a measure of serum lactate obtained
in the initial assessment of a trauma patient?
elevating the extremity to the level of the heart - ANSWER A pt with a lower extremity fracture
complains of severe pain and tightness in his calf, minimally by pain medications. Which of the following
is the priority nursing intervention?
velocity - ANSWER What factor contributes most to the kinetic energy of a body in motion?
subdural hematoma - ANSWER An elderly patient with a history of anticoagulant use presents after a fall
at home today. She denies any loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. What is the most likely cause of her symptoms?
fat embolism - ANSWER a pt has been in the ED for several hrs waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg
pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the pt is
restless with respiratory distress and petechiae to his neck. The pt is exhibiting s/sx most commonly
associated with which of the following conditions?
Late signs of increased intracranial pressure include: dilated nonreactive pupils, unresponsive to verbal
or painful stimuli, abnormal motor posturing, and Cushing response (widening pulse pressure, reflex
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