TNCC 14TH EDITION QUESTIONS AND ANSWERS GRADED
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A adult patient with a knife injury to the neck has an intact airway and is hemodynamically
stable. They complain of difficulty swallowing and speaking. In the primary survey, further
assessment is indicated next for which of the following conditions?
a. Damage to the cervical spine
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - ansa. Damage to the cervical spine
A patient arrives at the emergency department by private vehicle after sustaining an injury to the
right lower extremity while using a saw. There is a large gaping wound to the right thigh area
with significant bleeding. What is the priority intervention?
a. Elevate the extremity to the level of the heart
b. Initiate direct pressure
c. Apply a tourniquet
d. Cover the open wound with sterile saline dressings - ansb. Initiate direct pressure
A patient fell two weeks ago, striking their head. Today, the patient presented with a persistent
headache and nausea and was diagnosed with a small subdural hematoma. The patient has been
in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports the patient has
been anxious, restless, shaky, and vomited twice during the night. The patient states they couldn't
sleep because a young child kept coming into the room. What is the most likely cause for these
signs and symptoms?
a. increase intracranial pressure
b. alcohol withdrawal
c. rhabdomyolysis
d. pulmonary embolus - ansb. alcohol withdrawal
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A patient involved in a MVC has sustained a fracture to the second rib of the anterior left chest.
Which concurrent injury is most commonly associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax - ansb. Brachial plexus injury
A patient with a spinal cord injury at C5 is being cared for in the emergency department while
awaiting transport to a trauma center. Which of the following represents the highest priority for
ongoing assessment and management for this patient?
a. maintain adequate respiratory status.
b. administer balanced resuscitation fluid
c. perform serial assessments of neurologic function
d. maintain core temperature - ansa. maintain adequate respiratory status
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sick
for a couple of days and is now back working on the team. Which of the following behaviors
would indicate this nurse is coping well?
a. They are talking about taking the emergency nursing certification examination.
b. They keep requesting to be assigned to the walk-in/ambulatory area
c. They are impatient and snap at their coworkers.
d. They are thinking about transferring out of the emergency department. - ansa. They are talking
about taking the emergency nursing certification examination.
Following a bomb explosion, fragmentation injuries from the bomb or objects in the environment
are examples of which phase of injury?
a. primary
b. secondary
c. tertiary
d. quaternary - ansb. secondary
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In a patient with severe traumatic brain injury, hypocapnia causes which condition?
a. Respiratory acidosis
b. Metabolic acidosis
c. Neurogenic shock
d. Cerebral vasoconstriction - ansd. Cerebral vasoconstriction
The general impression step in the initial assessment provides the opportunity to do which of the
following?
a. Assess for uncontrolled internal hemorrhage
b. Accurately triage the patient
c. Reprioritize circulation before airway or breathing.
d. Activate the trauma team - ansc. Reprioritize circulation before airway or breathing.
The nurse is obtaining a history for a patient who presents following sexual assault. This history
is completed using which of the following techniques?
a. Bring the family in to the interview room.
b. Use direct quotes to record information.
c. Obtain information specific only to the assault.
d. Provide food and drink to help create rapport. - ansb. Use direct quotes to record information.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mm
Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency
nurse interprets the patient's hemodynamic findings as an indication of which of the following?
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Compensated shock
d. Supine hypotension syndrome - ansb. Normal vital signs in pregnancy
Treatment for frostbite can include which of the following interventions?
a. warm the affected part over 30-60 minutes
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b. use gentle friction to improve circulation
c. administer tissue plasminogen activator
d. leave all of the blisters intact - ansc. administer tissue plasminogen activator
Understanding the kinematic concepts associated with the mechanism of injury and energy
transfer can initially assist the trauma care provider in which of the following?
a. Anticipating the types of injuries that may be present
b. Deciding whether law enforcement should be notified
c. Determining needed laboratory tests
d. Predicting the need for a surgical procedure - ansa. Anticipating the types of injuries that may
be present
What is the appropriate technique for palpating the pelvis for stability?
a. Apply gentle pressure over the iliac crests, downward and laterally.
b. Apply gentle pressure over the iliac crests, downward and medially.
c. Apply firm pressure over the iliac crests, downward and laterally.
d. Apply firm pressure over the iliac crests, downward and medially. - ansb. Apply gentle
pressure over the iliac crests, downward and medially.
What is the best measure of the adequacy of cellular perfusion and can help to predict the
outcome of resuscitation?
a. End-tidal carbon dioxide
b. Hematocrit level
c. Base deficit
d. Oxygen saturation - ansc. Base deficit
What is the best position for maintaining an open airway in the obese patient?
a. Prone
b. Supine
c. Reverse Trendelenburg
d. Right lateral recumbent - ansc. Reverse Trendelenburg
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