TNCC 9th Edition EXAM, Complete Test Questions
and Answers (Verified Answers) (Latest Update )
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An adult pt who sustained a severe head trauma has been intubated and is being
manually ventilated via bag-mask device at a rate of 18 bpm. The pt has received
one IV fluid bolus of 500 mL of warm isotonic crystalloid solution. The PaCO2 is
30 mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is
the most important intervention to manage the cerebral blood flow?
a) decrease the rate of manual ventilation
b) initiate another fluid bolus
c) recheck endotracheal tube placement
d) increase the amount of oxygen delivered
Correct Answer: a) decrease the rate of manual ventilation
Rationale: CO2 is the primary regulator of blood flow to the brain. Aggro manual
ventilation results in decreased PaCO2 levels, which results in vasoconstriction,
which then leads to decreased ICP and inadequate delivery of O2 and glucose to
the brain. Bagging should be at a rate of one breath every 6 or 10 seconds
Three adults present at different times during a one-hour period with high fever,
fatigue, and headache. All three patients have a rash which started on their
mouth, face, and arms with progression to the chest and abdomen. They all
visited the same grocery store within the last week. What is the most
appropriate intervention from the triage of these patients?
a) move them to a decontamination area
b) mask the patients and send them to the waiting room
c) immediately initiate isolation precautions
d) send them to the waiting room without a mask
,Correct Answer: c) immediately initiate isolation precautions
Rationale: The fact that mult people with different demographics are appearing
with similar signs and symptoms would alear the nurse to a possible biological
exposure. These patients should be placed in isolation to prevent the possible
spread and further determination can be made.
A patient with a chest tube transported to the ICU and fluctuation is noted in the
water seal chamber during inspiration and expiration. What is the best action for
the nurse to take?
a) clamp the chest tube
b) return to the ED
c) assist with ventilation via bag-mask device
d) continue to ICU
Correct Answer: d) continue to ICU
Rationale: fluctuation of the water seal chamber during insp and expr is a normal
finding
Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The
patient is awake and crying with increased work of breathing and pale skin.
which of the following interventions has the highest priority?
a) stabilizing the cervical spine
b) applying a nonrebreather mask
c) establishing IV access
d) preparing for drug-assisted intubation
Correct Answer: a) stabilizing the cervical spine
A retained driver involved in a motor vehicle collision is being brought to the ED
with abdominal, pelvic, and bilateral lower extremity pain. Vital signs are BP
147/78, HR 98 bpm. A FAST exam is negative for fluid in the abdominal and
peritoneal cavities. Which of the following should the nurse anticipate?
a) diagnostic peritoneal lavage
b) angiography
c) non-contrast abdominal CT
d) serial abdominal assessments
Correct Answer: d) serial abdominal assessments
Rationale: The FAST exam is done at the bedside to identify pathological fluid in
the abdominal and pelvic cavities and reduces the need for more invasive
,testing. However, a negative FAST exam does not rule out injury, so serial
abdominal assessments should occur. If a CT scan is indicated, it should be
done with contrast
A patient arrives with a 3-inch laceration to their forearm from a tree branch.
Which of the following methods will the nurse use to remove small pieces of bark
and debris from the wound?
a) low pressure irrigation
b) high pressure irrigation
c) scrubbing with normal saline
d) scrubbing with tap water
Correct Answer: b) high pressure irrigation
Rationale: low pressure irrigation used for larger wounds
What is the most important consideration during the initial assessment when
caring for an older adult who has sustained serious injuries?
a) they are likely to be fearful in the ED
b) medical history including current medications
c) availability of support systems after discharge
d) accessibility to a primary care physician
Correct Answer: b) medical history including current medications
An adult patient involved in a motor vehicle collision is brought to the ED of a
rural critical access facility. They complain of neck pain, shortness of breath,
and diffuse abdominal pain. The Glasgow Coma Scale is 15. Vital signs are BP
98/71, HR 125 bpm, RR 26 bpm, and SpO2 94% on a high-flow oxygen via non-
rebreather mask. Which of the following is the priority intervention for this
patient?
a) expedite transport to the CT scanner
b) prepare the patient for spinal radiographs
c) expedite transfer to the closest trauma center
d) notify the patient's family
Correct Answer: c) expedite transfer to the closest trauma center
While caring for a trauma patient in the ED, what finding raises suspicion of
complete spinal cord injury?
a) weakness in the lower extremities
b) urinary incontinence
, c) sacral sparing
d) spastic paralysis of the legs
Correct Answer: b) urinary incontinence
Rationale: with complete spinal lesion, all motor and sensory function below the
level of the lesion is lost. Loss of autonomic nervous system response leads to
bradycardia, hypotension, and loss of bowel and bladder function
A patient is brought to the ED following a motor vehicle rollover and is
complaining of left upper abdominal pain and left shoulder pain. This
presentation is most consistent with an injury to which organ?
a) kidney
b) liver
c) spleen
d) pancreas
Correct Answer: c) spleen
An adult patient was a restrained passenger involved in a high-speed motor
vehicle collision. The patient complained of a generalized abdominal and left leg
pain. A FAST exam was negative for fluid in the abdominal cavity with rebound
tenderness, fever, and an elevated white blood cell count. These findings are
most consistent with an injury to which organ?
a) spleen
b) kidney
c) small bowel
d) liver
Correct Answer: c) small bowel
Rationale: Hollow organs such as the small bowel are susceptible to blunt
trauma and can leak contents into the peritoneum. Restrained occupants of
motor vehicles are at a higher risk from seatbelts, which compress the anterior-
lying hollow organs. Diagnosis is often delayed until symptoms of peritoneal
irritation develop, which include fever, leukocytosis, and rebound tenderness
A patient has uncontrolled bleeding from a wound to his right upper extremity.
What is the priority intervention?
a) initiate two IV access sites
b) place the patient on supplemental oxygen
c) apply direct pressure to the wound
d) use a tourniquet to control the bleeding
and Answers (Verified Answers) (Latest Update )
UPDATE!! TNCC exam| Frequently Most Tested
Questions and Expert Guarantee Pass| 100%
Accurate ,Graded A+ And Brand New Version!!!
An adult pt who sustained a severe head trauma has been intubated and is being
manually ventilated via bag-mask device at a rate of 18 bpm. The pt has received
one IV fluid bolus of 500 mL of warm isotonic crystalloid solution. The PaCO2 is
30 mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mmHg. What is
the most important intervention to manage the cerebral blood flow?
a) decrease the rate of manual ventilation
b) initiate another fluid bolus
c) recheck endotracheal tube placement
d) increase the amount of oxygen delivered
Correct Answer: a) decrease the rate of manual ventilation
Rationale: CO2 is the primary regulator of blood flow to the brain. Aggro manual
ventilation results in decreased PaCO2 levels, which results in vasoconstriction,
which then leads to decreased ICP and inadequate delivery of O2 and glucose to
the brain. Bagging should be at a rate of one breath every 6 or 10 seconds
Three adults present at different times during a one-hour period with high fever,
fatigue, and headache. All three patients have a rash which started on their
mouth, face, and arms with progression to the chest and abdomen. They all
visited the same grocery store within the last week. What is the most
appropriate intervention from the triage of these patients?
a) move them to a decontamination area
b) mask the patients and send them to the waiting room
c) immediately initiate isolation precautions
d) send them to the waiting room without a mask
,Correct Answer: c) immediately initiate isolation precautions
Rationale: The fact that mult people with different demographics are appearing
with similar signs and symptoms would alear the nurse to a possible biological
exposure. These patients should be placed in isolation to prevent the possible
spread and further determination can be made.
A patient with a chest tube transported to the ICU and fluctuation is noted in the
water seal chamber during inspiration and expiration. What is the best action for
the nurse to take?
a) clamp the chest tube
b) return to the ED
c) assist with ventilation via bag-mask device
d) continue to ICU
Correct Answer: d) continue to ICU
Rationale: fluctuation of the water seal chamber during insp and expr is a normal
finding
Caregivers carry a 2-year old into the ED who fell out of 2nd story window. The
patient is awake and crying with increased work of breathing and pale skin.
which of the following interventions has the highest priority?
a) stabilizing the cervical spine
b) applying a nonrebreather mask
c) establishing IV access
d) preparing for drug-assisted intubation
Correct Answer: a) stabilizing the cervical spine
A retained driver involved in a motor vehicle collision is being brought to the ED
with abdominal, pelvic, and bilateral lower extremity pain. Vital signs are BP
147/78, HR 98 bpm. A FAST exam is negative for fluid in the abdominal and
peritoneal cavities. Which of the following should the nurse anticipate?
a) diagnostic peritoneal lavage
b) angiography
c) non-contrast abdominal CT
d) serial abdominal assessments
Correct Answer: d) serial abdominal assessments
Rationale: The FAST exam is done at the bedside to identify pathological fluid in
the abdominal and pelvic cavities and reduces the need for more invasive
,testing. However, a negative FAST exam does not rule out injury, so serial
abdominal assessments should occur. If a CT scan is indicated, it should be
done with contrast
A patient arrives with a 3-inch laceration to their forearm from a tree branch.
Which of the following methods will the nurse use to remove small pieces of bark
and debris from the wound?
a) low pressure irrigation
b) high pressure irrigation
c) scrubbing with normal saline
d) scrubbing with tap water
Correct Answer: b) high pressure irrigation
Rationale: low pressure irrigation used for larger wounds
What is the most important consideration during the initial assessment when
caring for an older adult who has sustained serious injuries?
a) they are likely to be fearful in the ED
b) medical history including current medications
c) availability of support systems after discharge
d) accessibility to a primary care physician
Correct Answer: b) medical history including current medications
An adult patient involved in a motor vehicle collision is brought to the ED of a
rural critical access facility. They complain of neck pain, shortness of breath,
and diffuse abdominal pain. The Glasgow Coma Scale is 15. Vital signs are BP
98/71, HR 125 bpm, RR 26 bpm, and SpO2 94% on a high-flow oxygen via non-
rebreather mask. Which of the following is the priority intervention for this
patient?
a) expedite transport to the CT scanner
b) prepare the patient for spinal radiographs
c) expedite transfer to the closest trauma center
d) notify the patient's family
Correct Answer: c) expedite transfer to the closest trauma center
While caring for a trauma patient in the ED, what finding raises suspicion of
complete spinal cord injury?
a) weakness in the lower extremities
b) urinary incontinence
, c) sacral sparing
d) spastic paralysis of the legs
Correct Answer: b) urinary incontinence
Rationale: with complete spinal lesion, all motor and sensory function below the
level of the lesion is lost. Loss of autonomic nervous system response leads to
bradycardia, hypotension, and loss of bowel and bladder function
A patient is brought to the ED following a motor vehicle rollover and is
complaining of left upper abdominal pain and left shoulder pain. This
presentation is most consistent with an injury to which organ?
a) kidney
b) liver
c) spleen
d) pancreas
Correct Answer: c) spleen
An adult patient was a restrained passenger involved in a high-speed motor
vehicle collision. The patient complained of a generalized abdominal and left leg
pain. A FAST exam was negative for fluid in the abdominal cavity with rebound
tenderness, fever, and an elevated white blood cell count. These findings are
most consistent with an injury to which organ?
a) spleen
b) kidney
c) small bowel
d) liver
Correct Answer: c) small bowel
Rationale: Hollow organs such as the small bowel are susceptible to blunt
trauma and can leak contents into the peritoneum. Restrained occupants of
motor vehicles are at a higher risk from seatbelts, which compress the anterior-
lying hollow organs. Diagnosis is often delayed until symptoms of peritoneal
irritation develop, which include fever, leukocytosis, and rebound tenderness
A patient has uncontrolled bleeding from a wound to his right upper extremity.
What is the priority intervention?
a) initiate two IV access sites
b) place the patient on supplemental oxygen
c) apply direct pressure to the wound
d) use a tourniquet to control the bleeding
