Trauma Nursing Core Course (TNCC) 8th Edition Exam Prep
2026–2027 Complete Study Guide
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - correct answers -
Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in an
environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant
damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When it
is appropriate to remove the cervical collar? - correct answers -After a physical examination if the
patient has no radiologic abnormalities on CT A CT is recommended for spinal clearance in an impaired
patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the
total body surface area burned, how much IV fluid would be administered in the first 8 hours? - correct
answers -2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2 *
120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA
calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system - correct answers -Fluctuation in the water seal chamber Fluctuation in the water
seal chamber indicates the tube is placed correctly in the pleural space.
.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? - correct answers -Globe
rupture A teardrop-shaped pupil suggests a globe rupture.
1
, .A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - correct answers -Bradycardia and absent motor function below the level of
injury Patients with a complete spinal cord injury will have absent motor function below the level of the
lesion. They become hypotensive and bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - correct answers -A 52-year-old
diabetic male with a partial-thickness burn to the left lower leg This patient has a 7% TBSA burn with a
preexisting medical history that could complicate management, prolong recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - correct answers -
Placental abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal
distress are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on
the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower
abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question?
- correct answers -Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if
urethral transection is suspected. Signs and symptoms of urethral injury include blood at the meatus,
perineal ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - correct answers -The
aorta is torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - correct answers -Defusings A defusing is part of critical incident stress management but is
not considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage? - correct answers -MARCH The MARCH mnemonic stands for massive
2
2026–2027 Complete Study Guide
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - correct answers -
Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in an
environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant
damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When it
is appropriate to remove the cervical collar? - correct answers -After a physical examination if the
patient has no radiologic abnormalities on CT A CT is recommended for spinal clearance in an impaired
patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the
total body surface area burned, how much IV fluid would be administered in the first 8 hours? - correct
answers -2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2 *
120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA
calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system - correct answers -Fluctuation in the water seal chamber Fluctuation in the water
seal chamber indicates the tube is placed correctly in the pleural space.
.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? - correct answers -Globe
rupture A teardrop-shaped pupil suggests a globe rupture.
1
, .A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - correct answers -Bradycardia and absent motor function below the level of
injury Patients with a complete spinal cord injury will have absent motor function below the level of the
lesion. They become hypotensive and bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - correct answers -A 52-year-old
diabetic male with a partial-thickness burn to the left lower leg This patient has a 7% TBSA burn with a
preexisting medical history that could complicate management, prolong recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - correct answers -
Placental abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal
distress are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on
the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower
abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question?
- correct answers -Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if
urethral transection is suspected. Signs and symptoms of urethral injury include blood at the meatus,
perineal ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - correct answers -The
aorta is torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - correct answers -Defusings A defusing is part of critical incident stress management but is
not considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage? - correct answers -MARCH The MARCH mnemonic stands for massive
2
