TNCC 9TH EDITION STUDY GUIDE 2026
ACTUAL TEST PAPER COMPLETE SOLUTIONS
VERIFIED
◉ Which normal anatomic or physiologic change in an older adult
places them at a higher risk for aspiration? Answer: Relaxed muscles of
the oropharynx
◉ A patient has been diagnosed with an incomplete spinal cord injury at
L1. Which finding would indicate sacral sparing? Answer: Voluntary
anal sphincter tone
◉ An adult patient weighing 75 kg sustained partial and full thickness
burns to 32% of their body 2 hours prior to arrival. Intravenous fluid
resuscitation was calculated to be 400 mL/hour. The urine output over
the last hour was 15mL. What intervention should the nurse anticipate?
Answer: Increase isotonic crystalloid infusion rate
◉ A patient is diagnosed with a T12 spinal cord injury following a 20-
foot fall. Which finding is consistent with spinal shock? Answer: Loss of
reflexes
◉ A patient is brought to the emergency department 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? Answer: Spleen
, ◉ An adult patient is brought to the emergency department following a
motor vehicle collision with complaints of neck pain. They have
identified as a person in the process of transitioning from male to
female. What effect of hormone therapy should be considered when
planning care for this patient? Answer: Testosterone therapy may
decrease blood pressure
Correct rationale: 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.
◉ An adult patient 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? Answer: Severe facial injuries
◉ A patient involved in a high-speed rollover is complaining of
increased difficulty breathing. There is a small penetrating wound to the
sixth intercostal space in the left lateral chest. Which finding is most
consistent with an injury to the diaphragm? Answer: Bowel sounds
heard in the left lower chest
ACTUAL TEST PAPER COMPLETE SOLUTIONS
VERIFIED
◉ Which normal anatomic or physiologic change in an older adult
places them at a higher risk for aspiration? Answer: Relaxed muscles of
the oropharynx
◉ A patient has been diagnosed with an incomplete spinal cord injury at
L1. Which finding would indicate sacral sparing? Answer: Voluntary
anal sphincter tone
◉ An adult patient weighing 75 kg sustained partial and full thickness
burns to 32% of their body 2 hours prior to arrival. Intravenous fluid
resuscitation was calculated to be 400 mL/hour. The urine output over
the last hour was 15mL. What intervention should the nurse anticipate?
Answer: Increase isotonic crystalloid infusion rate
◉ A patient is diagnosed with a T12 spinal cord injury following a 20-
foot fall. Which finding is consistent with spinal shock? Answer: Loss of
reflexes
◉ A patient is brought to the emergency department 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? Answer: Spleen
, ◉ An adult patient is brought to the emergency department following a
motor vehicle collision with complaints of neck pain. They have
identified as a person in the process of transitioning from male to
female. What effect of hormone therapy should be considered when
planning care for this patient? Answer: Testosterone therapy may
decrease blood pressure
Correct rationale: 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.
◉ An adult patient 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? Answer: Severe facial injuries
◉ A patient involved in a high-speed rollover is complaining of
increased difficulty breathing. There is a small penetrating wound to the
sixth intercostal space in the left lateral chest. Which finding is most
consistent with an injury to the diaphragm? Answer: Bowel sounds
heard in the left lower chest
