TNCC 9TH EDITION TRAUMA NURSING
CORE COURSE COMPREHENSIVE TEST
PAPER 2026 FULL QUESTION COLLECTION
ACCURATE SOLUTIONS EXPERT REVIEW
PREPARATION RESOURCE GRADED A+
⩥ *A patient who sustained severe injuries was brought to the
emergency department following a high-speed motor vehicle collision.
Interventions for hypovolemic shock have been initiated. What
component of the trauma triad of death is most likely to have begun at
the time of injury? Answer: D.Coagulopathy
⩥ An adult patient involved in a motor vehicle collision is brought to the
emergency department of a rural critical access facility. They complain
of neck pain, shortness of breath, and diffuse abdominal pain. The
Glasgow Coma Score is 15. Vital signs are: BP 98/71 mm Hg, HR 125
beats/minute, RR 26 breaths/minute, and SpO2 94% on high-flow
oxygen via non-rebreather mask. Which of the following is the priority
intervention for this patient? Answer: C.Expedite transfer to the closest
trauma center
⩥ *A patient who weighs 120 kg is brought to the emergency
department after sustaining partial thickness burns to both upper
extremities and chest with a total body surface area burned of 27%. How
much intravenous fluid should be administered in the first 8 hours?
,Answer: C.3240 mL (2ml LR x kg x %TBSA) = total volume in 24
hours. Half of calculated total should be given in first 8 hours.
⩥ *A patient presents with chest pain and shortness of breath, following
a motor vehicle collision. An electrocardiogram shows sinus tachycardia
and ischemic changes within an elevated troponin. The nurse should be
highly suspicious for which injury? Answer: B. Blunt cardiac injury
⩥ PRIMARY ASSESSMENT/AIRWAY AND VENTILATION Answer:
Pre-oxygenation for at least 3 minutes (not 1 minute) with high flow
oxygen prior to intubation attempts, prolong the time to hypoxia when
bag-mask ventilations are stopped for insertion of the endotracheal tube
⩥ PRIMARY ASSESSMENT/AIRWAY AND VENTILATION Answer:
If the blood is not sufficiently warmed when transfused, it can produce
hypothermia. In the oxyhemoglobin dissociation curve, a shift to the left
increases the affinity of hemoglobin for oxygen making it harder to
release for use by the tissues. Factors that can cause this shift include an
elevated pH, decreased carbon dioxide, decreased temperature, and low
metabolic demand.
⩥ PRIMARY ASSESSMENT/INITIAL ASSESSMENT Answer:
Approximately one third of trauma patients arrive in the emergency
department with some degree of coagulopathy due to depletion of
clotting factors from whole blood loss. Some may also have been on
medications that can impair platelet function or anticoagulation prior to
their injury.
, ⩥ SPECIAL POPULATIONS/LGTBQ+ Answer: A person who is in the
process of transitioning from male to female will usually be taking
female hormones such as estrogen/estradiol to assist with the transition.
This can cause a decrease in muscle mass, increased risk of
thromboembolism, and possibly increased bone density. These patients
would not be taking testosterone.
⩥ PRIMARY ASSESSMENT/SHOCK Answer: Diltiazem is a calcium
channel blocker and in combination with the citrate used as a
preservative in blood products, put the patient at a higher risk for
significant hypocalcemia and cardiac dysrhythmias.
⩥ 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 piles of debris from the wound?
A. Low pressure irrigation
B. High pressure irrigation
C. Scrubbing with normal saline
D. Scrubbing with tap water Answer: B. High pressure irrigation
High-pressure irrigation is the best method to remove smaller
contaminants and bacteria from a wound. Low pressure can be used for
larger contaminants.
CORE COURSE COMPREHENSIVE TEST
PAPER 2026 FULL QUESTION COLLECTION
ACCURATE SOLUTIONS EXPERT REVIEW
PREPARATION RESOURCE GRADED A+
⩥ *A patient who sustained severe injuries was brought to the
emergency department following a high-speed motor vehicle collision.
Interventions for hypovolemic shock have been initiated. What
component of the trauma triad of death is most likely to have begun at
the time of injury? Answer: D.Coagulopathy
⩥ An adult patient involved in a motor vehicle collision is brought to the
emergency department of a rural critical access facility. They complain
of neck pain, shortness of breath, and diffuse abdominal pain. The
Glasgow Coma Score is 15. Vital signs are: BP 98/71 mm Hg, HR 125
beats/minute, RR 26 breaths/minute, and SpO2 94% on high-flow
oxygen via non-rebreather mask. Which of the following is the priority
intervention for this patient? Answer: C.Expedite transfer to the closest
trauma center
⩥ *A patient who weighs 120 kg is brought to the emergency
department after sustaining partial thickness burns to both upper
extremities and chest with a total body surface area burned of 27%. How
much intravenous fluid should be administered in the first 8 hours?
,Answer: C.3240 mL (2ml LR x kg x %TBSA) = total volume in 24
hours. Half of calculated total should be given in first 8 hours.
⩥ *A patient presents with chest pain and shortness of breath, following
a motor vehicle collision. An electrocardiogram shows sinus tachycardia
and ischemic changes within an elevated troponin. The nurse should be
highly suspicious for which injury? Answer: B. Blunt cardiac injury
⩥ PRIMARY ASSESSMENT/AIRWAY AND VENTILATION Answer:
Pre-oxygenation for at least 3 minutes (not 1 minute) with high flow
oxygen prior to intubation attempts, prolong the time to hypoxia when
bag-mask ventilations are stopped for insertion of the endotracheal tube
⩥ PRIMARY ASSESSMENT/AIRWAY AND VENTILATION Answer:
If the blood is not sufficiently warmed when transfused, it can produce
hypothermia. In the oxyhemoglobin dissociation curve, a shift to the left
increases the affinity of hemoglobin for oxygen making it harder to
release for use by the tissues. Factors that can cause this shift include an
elevated pH, decreased carbon dioxide, decreased temperature, and low
metabolic demand.
⩥ PRIMARY ASSESSMENT/INITIAL ASSESSMENT Answer:
Approximately one third of trauma patients arrive in the emergency
department with some degree of coagulopathy due to depletion of
clotting factors from whole blood loss. Some may also have been on
medications that can impair platelet function or anticoagulation prior to
their injury.
, ⩥ SPECIAL POPULATIONS/LGTBQ+ Answer: A person who is in the
process of transitioning from male to female will usually be taking
female hormones such as estrogen/estradiol to assist with the transition.
This can cause a decrease in muscle mass, increased risk of
thromboembolism, and possibly increased bone density. These patients
would not be taking testosterone.
⩥ PRIMARY ASSESSMENT/SHOCK Answer: Diltiazem is a calcium
channel blocker and in combination with the citrate used as a
preservative in blood products, put the patient at a higher risk for
significant hypocalcemia and cardiac dysrhythmias.
⩥ 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 piles of debris from the wound?
A. Low pressure irrigation
B. High pressure irrigation
C. Scrubbing with normal saline
D. Scrubbing with tap water Answer: B. High pressure irrigation
High-pressure irrigation is the best method to remove smaller
contaminants and bacteria from a wound. Low pressure can be used for
larger contaminants.
