TNCC 9TH EDITION EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS |ALREADY
GRADED A+
What intravascular solution is most commonly used for patients who have sustained burns?
A. Lactated ringer's
B. Normal saline
C. D5/normal saline
D. Hypertonic saline
A. Lactated ringer's
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
B. High pressure irrigation
An adult patient was a restrained passenger involved in a high speed motor vehicle collision. The
patient complained of generalized abdominal and left leg pain. A FAST exam was negative for fluid in
the abdominal cavity. While awaiting inpatient bed placement, the patient develops increased
abdominal pain 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
C. Small bowel
Which blood pressure finding is associated with early or compensated hypovolemic shock?
A. Rising systolic
B. Rising diastolic
C. Decreasing diastolic
D. Decreasing systolic
,B. Rising diastolic
A patient involved in a fall from 25 feet has a traumatic brain injury, three anterior rib fractures on the
right, and a grade III liver injury. The patient was intubated and placed on a ventilator with PEEP.
Chest tube was deferred at this time. Upon reassessment, which finding is most concerning?
A. Severely diminished breath sounds on the right
B. Guarding in the right upper quadrant
C. Ecchymosis in the right upper quadrant
D. Crepitus to the right chest
A. Severely diminished breath sounds on the right
A patient presents, after a 25 foot fall, with paradoxical chest wall movement to the right lower chest
and complaints of shortness of breath. What is the priority intervention?
A. Surgical intervention
B. Chest tube insertion
C. Needle decompression
D. Airway and ventilation support
D. Airway and ventilation support
An adult presents to the emergency department after sustaining severe facial injuries during an
altercation. The patient is awake, confused, and smells heavily of alcohol. Pulse oximetry is 94% on
room air. Immediate intubation should be anticipated based on which
clinical indicator?
A. Confusion
B. Pulse oximetry reading
C. Severe facial injuries
D. Smell of alcohol on breath
C. Severe facial injuries
An adult who fell from a second story roof is brought to the emergency department by private vehicle.
The patient is confused with unlabored respirations and has strong, palpable radial pulses. There is an
open wound in proximity to an obvious deformity of the left lower extremity. What is the priority
intervention?
A. Initiate cervical spine stabilization
B. Apply a splint to the lower extremity
C. Put the patient on portable oxygen
D. Log roll the patient onto a spine board
A. Initiate cervical spine stabilization
,A trauma patient is en route to a rural emergency department Radiology notifies the charge nurse
that the computed tomography (ct) scanner will be out of service for several hours. The team gathers
to plan accordingly. Which of the following terms best describes this trauma team's communication?
A. Brief
B. Closed loop
C. Debrief
D. Huddle
D. Huddle
1. A seriously injured patient is noted to have weak, thready pulse and cool, clammy skin. There is
instability of the pelvis on palpating and blood on the urinary meatus. A pelvic binder is appropriately
applied and balanced fluid resuscitation is being managed by the
team. What is most likely to be ordered next?
A. Insert a urinary catheter
B. Bolus with 2L isotonic crystalloid solution
C. Diagnostic peritoneal lavage
D. Insertion of a Supra public catheter
D. Insertion of a Supra public catheter
Patients with a crush injury should be monitored for which of the following conditions?
A. Hypermatremia
B. Hypercalcemia
C. Dysrhythmias
D. Polyuria
C. Dysrhythmias
Which commonly prescribed medication may worsen a complication that is associated with massive
transfusion?
A. Lisinopril
B. Metformin
C. Metoprolol
D. Diltiazem
D. Diltiazem
A 36-year-old patient has a deformity of the left wrist after a fall. The patient is reluctant to move
their hand due to pain. Which of the following is the most appropriate intervention?
A. Apply a sling and elevate the extremity to the level of the heart
B. Apply a splint and elevate the extremity above the level of the heart
, C. Apply a sling and elevate the extremity above the level of the heart
D. Apply a splint and elevate the extremity to the level of the heart
B. Apply a splint and elevate the extremity above the level of the heart
A patient is brought to the emergency department of a rural hospital following a high-speed motor
vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, what
is the priority intervention?
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter
A. Initiate transfer to a trauma center
Following a review of recent drills and a real disaster event, a hospital has identified deficiencies and
is taking steps to minimize the impact of a future disaster. Which phase of the disaster life cycle does
this describe?
A. Mitigation
B. Preparedness
C. Response
D. Recovery
A. Mitigation
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were BP
110/60 mm Hg, HR 96 beats/minute, and RR 24 breaths/minute. Skin is cool and moist. Current vital
signs are BP 86/68 mm Hg, HR 118 beats/minute, and RR 28 breaths/minute. The patient is
demonstrating signs and symptoms of which stage of shock?
A. Compensated
B. Refractory
C. Irreversible
D. Decompensated
D. Decompensated
An adult arrives at the emergency department with superficial burns to the extremities following a
house fire. The patient is reporting a headache with nausea and is drowsy and confused. What is the
most likely cause of these symptoms?
A. Capillary leak syndrome
B. Rhabdomyolysis
C. Carbon monoxide poisoning
D. Hypothermia
CORRECT DETAILED ANSWERS |ALREADY
GRADED A+
What intravascular solution is most commonly used for patients who have sustained burns?
A. Lactated ringer's
B. Normal saline
C. D5/normal saline
D. Hypertonic saline
A. Lactated ringer's
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
B. High pressure irrigation
An adult patient was a restrained passenger involved in a high speed motor vehicle collision. The
patient complained of generalized abdominal and left leg pain. A FAST exam was negative for fluid in
the abdominal cavity. While awaiting inpatient bed placement, the patient develops increased
abdominal pain 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
C. Small bowel
Which blood pressure finding is associated with early or compensated hypovolemic shock?
A. Rising systolic
B. Rising diastolic
C. Decreasing diastolic
D. Decreasing systolic
,B. Rising diastolic
A patient involved in a fall from 25 feet has a traumatic brain injury, three anterior rib fractures on the
right, and a grade III liver injury. The patient was intubated and placed on a ventilator with PEEP.
Chest tube was deferred at this time. Upon reassessment, which finding is most concerning?
A. Severely diminished breath sounds on the right
B. Guarding in the right upper quadrant
C. Ecchymosis in the right upper quadrant
D. Crepitus to the right chest
A. Severely diminished breath sounds on the right
A patient presents, after a 25 foot fall, with paradoxical chest wall movement to the right lower chest
and complaints of shortness of breath. What is the priority intervention?
A. Surgical intervention
B. Chest tube insertion
C. Needle decompression
D. Airway and ventilation support
D. Airway and ventilation support
An adult presents to the emergency department after sustaining severe facial injuries during an
altercation. The patient is awake, confused, and smells heavily of alcohol. Pulse oximetry is 94% on
room air. Immediate intubation should be anticipated based on which
clinical indicator?
A. Confusion
B. Pulse oximetry reading
C. Severe facial injuries
D. Smell of alcohol on breath
C. Severe facial injuries
An adult who fell from a second story roof is brought to the emergency department by private vehicle.
The patient is confused with unlabored respirations and has strong, palpable radial pulses. There is an
open wound in proximity to an obvious deformity of the left lower extremity. What is the priority
intervention?
A. Initiate cervical spine stabilization
B. Apply a splint to the lower extremity
C. Put the patient on portable oxygen
D. Log roll the patient onto a spine board
A. Initiate cervical spine stabilization
,A trauma patient is en route to a rural emergency department Radiology notifies the charge nurse
that the computed tomography (ct) scanner will be out of service for several hours. The team gathers
to plan accordingly. Which of the following terms best describes this trauma team's communication?
A. Brief
B. Closed loop
C. Debrief
D. Huddle
D. Huddle
1. A seriously injured patient is noted to have weak, thready pulse and cool, clammy skin. There is
instability of the pelvis on palpating and blood on the urinary meatus. A pelvic binder is appropriately
applied and balanced fluid resuscitation is being managed by the
team. What is most likely to be ordered next?
A. Insert a urinary catheter
B. Bolus with 2L isotonic crystalloid solution
C. Diagnostic peritoneal lavage
D. Insertion of a Supra public catheter
D. Insertion of a Supra public catheter
Patients with a crush injury should be monitored for which of the following conditions?
A. Hypermatremia
B. Hypercalcemia
C. Dysrhythmias
D. Polyuria
C. Dysrhythmias
Which commonly prescribed medication may worsen a complication that is associated with massive
transfusion?
A. Lisinopril
B. Metformin
C. Metoprolol
D. Diltiazem
D. Diltiazem
A 36-year-old patient has a deformity of the left wrist after a fall. The patient is reluctant to move
their hand due to pain. Which of the following is the most appropriate intervention?
A. Apply a sling and elevate the extremity to the level of the heart
B. Apply a splint and elevate the extremity above the level of the heart
, C. Apply a sling and elevate the extremity above the level of the heart
D. Apply a splint and elevate the extremity to the level of the heart
B. Apply a splint and elevate the extremity above the level of the heart
A patient is brought to the emergency department of a rural hospital following a high-speed motor
vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, what
is the priority intervention?
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter
A. Initiate transfer to a trauma center
Following a review of recent drills and a real disaster event, a hospital has identified deficiencies and
is taking steps to minimize the impact of a future disaster. Which phase of the disaster life cycle does
this describe?
A. Mitigation
B. Preparedness
C. Response
D. Recovery
A. Mitigation
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were BP
110/60 mm Hg, HR 96 beats/minute, and RR 24 breaths/minute. Skin is cool and moist. Current vital
signs are BP 86/68 mm Hg, HR 118 beats/minute, and RR 28 breaths/minute. The patient is
demonstrating signs and symptoms of which stage of shock?
A. Compensated
B. Refractory
C. Irreversible
D. Decompensated
D. Decompensated
An adult arrives at the emergency department with superficial burns to the extremities following a
house fire. The patient is reporting a headache with nausea and is drowsy and confused. What is the
most likely cause of these symptoms?
A. Capillary leak syndrome
B. Rhabdomyolysis
C. Carbon monoxide poisoning
D. Hypothermia
