TNCC PRACTICE EXAM WITH
VERIFIED QUESTIONS AND
CORRECT ANSWERS.
1. A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm
Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The
emergency nurse interprets the patient's hemodynamic findings as an indication of
which of the following?
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Abruptio placentae
d. Supine hypotension syndrome - ANSWER-b. Normal vital signs in pregnancy
Rationale: In pregnancy, the resting heart rate increases by 10 to 20
beats/minute and a small decrease in systolic blood pressure and a larger
decrease in diastolic blood pressure due to a decrease in peripheral
resistance (p. 294). Normal fetal heart rate is between 120 and 160
beats/minute (p. 297).
2. A patient fell two weeks ago, striking his head. He came to the emergency department
with a persistent headache and nausea. He was diagnosed with a small subdural
hematoma and has been in the ED for 24 hours awaiting an inpatient bed. The night shift
nurse reports that he has been anxious, restless, and shaky. He vomited twice during the
night. He tells the day shift nurse that he couldn't sleep because a young child kept
coming into his room. What is a likely cause for these signs and symptoms?
a. Increased intracranial pressure
b. Alcohol withdrawal
c. Rhabdomyolysis
d. Pulmonary embolus - ANSWER-b. Alcohol withdrawal Rationale: Alcohol
withdrawal is a common delayed condition because symptoms are difficult to
identify early. Signs include autonomic hyperactivity, hand tremors, nausea or
, vomiting, psychomotor agitation, anxiety, insomnia, hallucinations, or
seizures (p. 397).
3. A patient with a knife injury to the neck has an intact airway and is hemodynamically
stable. He complains of difficulty swallowing and speaking. Further assessment is
indicated next for which of the following conditions?
a. Damage to the spinal cord
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - ANSWER-a. Damage to the spinal cord Rationale:
Penetrating neck trauma may include concurrent injuries to the spinal cord,
airway, or vascular neck structures. With an intact airway and hemodynamic
stability, the other common concurrent injury is to the spinal cord (pp. 124,
126).
4. A patient with a spinal cord injury at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. Which of the following represents the
highest priority for ongoing assessment and management?
a. Maintain adequate respiratory status
b. Administer balanced resuscitation fluid
c. Perform serial assessments of neurologic function
d. Maintain core temperature - ANSWER-a. Maintain adequate respiratory
status Rationale: Spinal cord injuries at C3 to C5 can cause the loss of phrenic
nerve function, resulting in a paralyzed diaphragm and inability to breathe (p.
173, 179).
5. A trauma nurse cared for a child with devastating burns two weeks ago. She called in sick
for a couple of days and is now back working on the team. Which of the following
behaviors would indicate this nurse is coping well?
a. She is talking about taking the emergency nursing certification examination
b. She keeps requesting to be assigned to the walk-in/ambulatory area
c. She is impatient and snaps at coworkers
d. She is thinking about transferring out of the emergency department -
ANSWER-a. She is talking about taking the emergency nursing certification
VERIFIED QUESTIONS AND
CORRECT ANSWERS.
1. A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm
Hg and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The
emergency nurse interprets the patient's hemodynamic findings as an indication of
which of the following?
a. Decompensated shock
b. Normal vital signs in pregnancy
c. Abruptio placentae
d. Supine hypotension syndrome - ANSWER-b. Normal vital signs in pregnancy
Rationale: In pregnancy, the resting heart rate increases by 10 to 20
beats/minute and a small decrease in systolic blood pressure and a larger
decrease in diastolic blood pressure due to a decrease in peripheral
resistance (p. 294). Normal fetal heart rate is between 120 and 160
beats/minute (p. 297).
2. A patient fell two weeks ago, striking his head. He came to the emergency department
with a persistent headache and nausea. He was diagnosed with a small subdural
hematoma and has been in the ED for 24 hours awaiting an inpatient bed. The night shift
nurse reports that he has been anxious, restless, and shaky. He vomited twice during the
night. He tells the day shift nurse that he couldn't sleep because a young child kept
coming into his room. What is a likely cause for these signs and symptoms?
a. Increased intracranial pressure
b. Alcohol withdrawal
c. Rhabdomyolysis
d. Pulmonary embolus - ANSWER-b. Alcohol withdrawal Rationale: Alcohol
withdrawal is a common delayed condition because symptoms are difficult to
identify early. Signs include autonomic hyperactivity, hand tremors, nausea or
, vomiting, psychomotor agitation, anxiety, insomnia, hallucinations, or
seizures (p. 397).
3. A patient with a knife injury to the neck has an intact airway and is hemodynamically
stable. He complains of difficulty swallowing and speaking. Further assessment is
indicated next for which of the following conditions?
a. Damage to the spinal cord
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - ANSWER-a. Damage to the spinal cord Rationale:
Penetrating neck trauma may include concurrent injuries to the spinal cord,
airway, or vascular neck structures. With an intact airway and hemodynamic
stability, the other common concurrent injury is to the spinal cord (pp. 124,
126).
4. A patient with a spinal cord injury at C5 is being cared for in the emergency department
while awaiting transport to a trauma center. Which of the following represents the
highest priority for ongoing assessment and management?
a. Maintain adequate respiratory status
b. Administer balanced resuscitation fluid
c. Perform serial assessments of neurologic function
d. Maintain core temperature - ANSWER-a. Maintain adequate respiratory
status Rationale: Spinal cord injuries at C3 to C5 can cause the loss of phrenic
nerve function, resulting in a paralyzed diaphragm and inability to breathe (p.
173, 179).
5. A trauma nurse cared for a child with devastating burns two weeks ago. She called in sick
for a couple of days and is now back working on the team. Which of the following
behaviors would indicate this nurse is coping well?
a. She is talking about taking the emergency nursing certification examination
b. She keeps requesting to be assigned to the walk-in/ambulatory area
c. She is impatient and snaps at coworkers
d. She is thinking about transferring out of the emergency department -
ANSWER-a. She is talking about taking the emergency nursing certification
