TNCC 9th Edition Exam Prep 2026 (133 Q&A) | Trauma
Nursing Core Course | Latest Update 2026 |
Comprehensive Review
1. What is the primary concern indicated by unequal breath sounds in an
intubated trauma patient?
Airway obstruction
Pulmonary edema
Possible pneumothorax
Bronchospasm
2. Why is controlling bleeding prioritized over other interventions in trauma
care for unconscious patients?
It allows for a more accurate neurological assessment.
Controlling bleeding is crucial to prevent hypovolemic shock and
stabilize the patient.
It ensures that the patient remains unconscious during transport.
It is the only intervention that can be performed without additional
personnel.
3. Describe the significance of effective communication in trauma care as
illustrated by the team's response to the CT scanner issue.
Effective communication is crucial for coordinating care and
ensuring timely interventions in trauma situations.
Effective communication has little impact on patient outcomes in
trauma care.
Effective communication is primarily about sharing patient history.
Effective communication is only necessary for administrative tasks.
,4. Describe how anticoagulant therapy can contribute to complications
following a trauma such as a motor vehicle collision.
Anticoagulant therapy has no effect on trauma outcomes.
Anticoagulant therapy can lead to coagulopathy, increasing the risk
of internal bleeding and related symptoms.
Anticoagulant therapy prevents all forms of bleeding after trauma.
Anticoagulant therapy only affects blood pressure, not bleeding risk.
5. A 35-year-old male 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?
Retinal detachment
Oculomotor nerve palsy
Retrobulbar hematoma
Globe rupture
6. A patient is brought to the emergency department following a snowmobile
crash with prolonged exposure time prior to transport. The patient is
confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR 24
breaths/minute, T 34.6oC (94.2oF) and an SpO2 of 90% on oxygen at 15L per
non-rebreather mask. Other findings include ETCO2 24, serum lactate of 6
mmol/L, and a pH of 6.8. Based on these findings, what is the most
appropriate intervention?
Initiate warming measures
Bolus with 500 mL isotonic crystalloids
Titrate oxygen to 6 L per nasal cannula
Vigorously massage the extremities
,7. In a clinical scenario, if a patient with an incomplete spinal cord injury at L1
exhibits sacral sparing, what implications might this have for their
rehabilitation plan?
The presence of sacral sparing may allow for targeted rehabilitation
strategies to enhance recovery of lower limb function.
The patient is unlikely to regain any function and should be prepared
for long-term care.
Rehabilitation should focus solely on upper body strength.
The patient will require no rehabilitation due to the severity of the
injury.
8. Collective change in vital signs associated with the late stages of increasing
intracranial pressure are:
Increasing pulse rate, shallow respirations, and increasing blood
pressure.
Rapid and shallow pulse, deep respirations, and decreasing blood
pressure.
Quickening pulse rate, shallow respirations and decreasing blood
pressure.
Slowing pulse rate, deep or erratic respirations, and increasing
blood pressure.
9. What are the classic symptoms associated with compartment syndrome in a
patient with a closed fracture?
Numbness and tingling, swelling, discoloration
Pain, diminished pedal pulse, pressure
Increased range of motion, warmth, redness
, Severe pain only during movement
10. The mechanism of injury that suggests transport to a trauma center is:
extrication time of less than 20 minutes.
a fall from a distance twice the patient's height.
ejection from a vehicle.
auto collision at a speed greater than 20 mph.
11. What is the primary purpose of performing a jaw thrust maneuver in a trauma
patient?
To stabilize the cervical spine
To control external bleeding
To open the airway and look for signs of obstruction
To assess neurological function
12. Based on fall mechanism, which patient warrants prehospital transfer to a
trauma center?
A 35-year-old lands on a wooden porch from an 8-foot ladder
A 14-year-old forcefully pushed onto cement from standing
A 50-year-old lands on a carpeted floor after tripping
A 2-year-old lands on grass from a second-story balcony
13. What is a common medication that can exacerbate complications from
massive blood transfusions?
Citrate
Acetaminophen
Nursing Core Course | Latest Update 2026 |
Comprehensive Review
1. What is the primary concern indicated by unequal breath sounds in an
intubated trauma patient?
Airway obstruction
Pulmonary edema
Possible pneumothorax
Bronchospasm
2. Why is controlling bleeding prioritized over other interventions in trauma
care for unconscious patients?
It allows for a more accurate neurological assessment.
Controlling bleeding is crucial to prevent hypovolemic shock and
stabilize the patient.
It ensures that the patient remains unconscious during transport.
It is the only intervention that can be performed without additional
personnel.
3. Describe the significance of effective communication in trauma care as
illustrated by the team's response to the CT scanner issue.
Effective communication is crucial for coordinating care and
ensuring timely interventions in trauma situations.
Effective communication has little impact on patient outcomes in
trauma care.
Effective communication is primarily about sharing patient history.
Effective communication is only necessary for administrative tasks.
,4. Describe how anticoagulant therapy can contribute to complications
following a trauma such as a motor vehicle collision.
Anticoagulant therapy has no effect on trauma outcomes.
Anticoagulant therapy can lead to coagulopathy, increasing the risk
of internal bleeding and related symptoms.
Anticoagulant therapy prevents all forms of bleeding after trauma.
Anticoagulant therapy only affects blood pressure, not bleeding risk.
5. A 35-year-old male 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?
Retinal detachment
Oculomotor nerve palsy
Retrobulbar hematoma
Globe rupture
6. A patient is brought to the emergency department following a snowmobile
crash with prolonged exposure time prior to transport. The patient is
confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR 24
breaths/minute, T 34.6oC (94.2oF) and an SpO2 of 90% on oxygen at 15L per
non-rebreather mask. Other findings include ETCO2 24, serum lactate of 6
mmol/L, and a pH of 6.8. Based on these findings, what is the most
appropriate intervention?
Initiate warming measures
Bolus with 500 mL isotonic crystalloids
Titrate oxygen to 6 L per nasal cannula
Vigorously massage the extremities
,7. In a clinical scenario, if a patient with an incomplete spinal cord injury at L1
exhibits sacral sparing, what implications might this have for their
rehabilitation plan?
The presence of sacral sparing may allow for targeted rehabilitation
strategies to enhance recovery of lower limb function.
The patient is unlikely to regain any function and should be prepared
for long-term care.
Rehabilitation should focus solely on upper body strength.
The patient will require no rehabilitation due to the severity of the
injury.
8. Collective change in vital signs associated with the late stages of increasing
intracranial pressure are:
Increasing pulse rate, shallow respirations, and increasing blood
pressure.
Rapid and shallow pulse, deep respirations, and decreasing blood
pressure.
Quickening pulse rate, shallow respirations and decreasing blood
pressure.
Slowing pulse rate, deep or erratic respirations, and increasing
blood pressure.
9. What are the classic symptoms associated with compartment syndrome in a
patient with a closed fracture?
Numbness and tingling, swelling, discoloration
Pain, diminished pedal pulse, pressure
Increased range of motion, warmth, redness
, Severe pain only during movement
10. The mechanism of injury that suggests transport to a trauma center is:
extrication time of less than 20 minutes.
a fall from a distance twice the patient's height.
ejection from a vehicle.
auto collision at a speed greater than 20 mph.
11. What is the primary purpose of performing a jaw thrust maneuver in a trauma
patient?
To stabilize the cervical spine
To control external bleeding
To open the airway and look for signs of obstruction
To assess neurological function
12. Based on fall mechanism, which patient warrants prehospital transfer to a
trauma center?
A 35-year-old lands on a wooden porch from an 8-foot ladder
A 14-year-old forcefully pushed onto cement from standing
A 50-year-old lands on a carpeted floor after tripping
A 2-year-old lands on grass from a second-story balcony
13. What is a common medication that can exacerbate complications from
massive blood transfusions?
Citrate
Acetaminophen
