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Summary 150+ TNCC Exam Questions 2024 A+ Graded
150+ TNCC Exam Questions 2024 A+ Graded. All you need to have to pass the exam!
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150+ TNCC Exam 2024 Questions withAnswers and Explanations
1. Which of the following is true about the log-roll maneuver?
A) It causes less spinal motion than the lift-and-slide maneuver
B) It is recommended for patients with unstable pelvic fractures
C) It should be avoided with a suspected spine injury prior to imaging
D) It decreases the risk of hemorrhage from unstable pelvic injuries
Answer: C
Explanation: The log-roll maneuver should be avoided with suspected spine injuries prior to
imaging because it can potentially worsen cord damage from an unstable spinal injury. The lift-
and-slide maneuver is generally preferred for patients with suspected spinal injuries as it causes
less spinal motion. This caution is especially important before imaging has confirmed the absence
of spinal instability.
2. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the
priority intervention?
A) Initiate two intravenous access sites
B) Place the patient on supplemental oxygen
C) Apply direct pressure to the wound
D) Use a tourniquet to control the bleeding
Answer: C
Explanation: In cases of uncontrolled external bleeding, the priority intervention is to apply direct
pressure to the wound. This is the most immediate and effective way to control bleeding and is
always the first step before considering more invasive measures like tourniquets. Establishing IV
access and providing supplemental oxygen are important, but controlling the bleeding takes
precedence to prevent further blood loss and potential shock.
3. A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed capillary refill.
Which of the following interventions would be most appropriate for this patient based on the
disaster triage principles?
A) Initiate two large-caliber intravenous lines for isotonic crystalloid administration
B) Administer intravenous medications for pain
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for personnel to notify next of kin
Answer: A
Explanation: In a disaster triage situation, the priority for a patient with bilateral femur fractures
and signs of shock (pale, disoriented, delayed capillary refill) is to initiate fluid resuscitation.
Establishing large-caliber IV lines for fluid administration is crucial to address potential
hypovolemic shock and stabilize the patient's condition. Pain management, observation, and
notifying next of kin are important but secondary to addressing life-threatening circulatory issues
in a disaster scenario.
, 4. A patient arrives with a large open chest wound after being assaulted with a machete.
Prehospital providers placed a nonporous dressing over the chest wound and taped it on
three sides. The patient is now showing signs of anxiety, restlessness, severe respiratory
distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST
appropriate immediate intervention?
A) Needle decompression
B) Tube thoracostomy
C) Dressing removal
D) Surgical repair
Answer: C
Explanation: The most appropriate immediate intervention is to remove the dressing. The
symptoms described suggest the development of a tension pneumothorax, likely due to the
nonporous dressing acting as a one-way valve, allowing air to enter the pleural space but not
escape. Removing the dressing will immediately relieve the pressure and improve the patient's
condition, after which the patient can be reassessed for the need for further interventions like
needle decompression or tube thoracostomy.
5. A driver involved in a high-speed motor vehicle collision arrives in the emergency
department. The vehicle's air-bag failed to deploy. The patient is drowsy but arousable and
complaining of chest pain with ecchymosis noted to the chest. The patient is tachycardic and
hypotensive with no evidence of uncontrolled bleeding. Cardiac monitor shows premature
ventricular contractions. Which of the following is the most appropriate intervention for this
patient?
A) Rapid fluid boluses
B) Tranexamic acid administration
C) Inotropic support
D) Hemostatic resuscitation
Answer: A
Explanation: Given the patient's presentation (hypotension, tachycardia, chest pain, and
ecchymosis to the chest), the most appropriate initial intervention is rapid fluid boluses. This
patient is likely experiencing hypovolemic shock due to internal bleeding, possibly from thoracic
injuries. Rapid fluid resuscitation is crucial to stabilize the patient's hemodynamic status before
considering other interventions like inotropic support or hemostatic resuscitation.
6. A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is
consistent with spinal shock?
A) Bradycardia
B) Loss of reflexes
C) Widened pulse pressure
D) Warm skin
Answer: B
Explanation: Spinal shock is characterized by a temporary loss of all spinal cord function below the
level of injury, including the loss of reflexes. Loss of reflexes (B) is the most consistent finding with
spinal shock. Bradycardia is more associated with neurogenic shock, while widened pulse
pressure and warm skin are not typical findings in spinal shock.
, 7. A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg (8.66
kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is most likely an
indication of the body's response to these findings?
A) Reflex hypotension
B) Increased respiratory effort
C) Reflex tachycardia
D) Widening pulse pressure
Answer: C
Explanation: In this scenario, the patient's cerebral perfusion pressure (CPP) is dangerously low at
43 mm Hg (CPP = MAP - ICP). The body's response to inadequate cerebral perfusion is to increase
blood pressure to maintain adequate blood flow to the brain. This is achieved through reflex
tachycardia (C) and vasoconstriction, aiming to improve cerebral perfusion pressure.
8. An unconscious patient arrives following a motor vehicle collision. The patient is on a
backboard with a cervical collar in place and one intravenous line running. Respirations are
shallow and there is active brisk bleeding from a large leg wound. What is the priority
intervention for this patient?
A) Check for a patent airway
B) Control the bleeding
C) Start a second intravenous line
D) Ventilate with a bag-mask device
Answer: A
Explanation: In any trauma situation, the priority of care follows the ABCDE approach (Airway,
Breathing, Circulation, Disability, Exposure). For an unconscious patient, checking for a patent
airway is the first and most crucial step. Even though there is active bleeding (which falls under
Circulation), ensuring a patent airway takes precedence as all other interventions become futile if
the airway is compromised.
9. An obese trauma patient requires intubation. Assuming there are no contraindications, which
position will provide the best visualization for insertion of the endotracheal tube?
A) Reverse Trendelenburg
B) Lying on side
C) Ramped
D) Supine
Answer: C
Explanation: The ramped position is considered the best position for intubating obese patients.
This position involves elevating the patient's upper body and head so that the external auditory
meatus is level with the sternal notch. The ramped position improves laryngoscopic view and
facilitates easier tube passage by counteracting the anatomical challenges posed by obesity, such
as a larger tongue, increased soft tissue in the neck, and altered neck mobility.
10. Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the
scene but became responsive with initial and subsequent Glasgow Coma Scale (GCS) scores
of 13 (E-3, V-4, M-6). The patient has bilateral subdural hematomas and is awaiting transfer to
the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority nursing
intervention?
, A) Hold all pain medications
B) Notify the provider of the change
C) Repeat the GCS in 30 minutes
D) Place the patient in Trendelenburg position
Answer: B
Explanation: The priority nursing intervention in this case is to notify the provider of the change in
the patient's Glasgow Coma Scale (GCS) score. A drop in GCS from 13 to 9 represents a significant
neurological deterioration, especially in a patient with known bilateral subdural hematomas. This
change could indicate increasing intracranial pressure or expansion of the hematomas, both of
which require immediate medical attention and potential interventions to prevent further
neurological damage.
11. Which of the following situations could cause functional grief?
A) Inability to live at home
B) Amputation of a limb
C) Loss of one's self-image
D) Destruction of the patient's car
Answer: B
Explanation: Functional grief occurs when an individual experiences a loss of function or ability.
Amputation of a limb (B) is a clear example of functional grief as it involves the loss of a body part
and its associated functions, significantly impacting the person's daily life and self-image. This type
of loss often requires a period of adjustment and adaptation to new physical limitations, which
characterizes functional grief.
12. A patient arrives following prolonged exposure of their left hand to the cold. The patient is
awake and alert and complains of a tingling sensation to the fingers. Assessment reveals
swelling and bright red skin to the left hand and a 1-inch round clear blister to the dorsum of
that hand. Which of the following nursing interventions is most appropriate for this patient?
A) Massage the injured areas to promote circulation
B) Drain and debride the blister on the hand
C) Immerse in water between 37.5°C and 39.5°C (99.5°F to 103.1°F)
D) Gently rewarm over 15 to 30 minutes
Answer: C
Explanation: For a patient with frostbite, the most appropriate intervention is to immerse the
affected area in warm water between 37.5°C and 39.5°C (99.5°F to 103.1°F). This temperature
range is crucial as it provides rapid rewarming without causing further tissue damage. Massaging
the injured areas is contraindicated as it can cause additional tissue damage, while draining the
blister and gentle rewarming are less effective than rapid rewarming through water immersion at
the specified temperature range.
13. A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during
a staffing crisis. The nurse expresses anger stating that the patients did not receive quality
care and begins exhibiting aggression toward colleagues. This is most consistent with which
condition?
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