Trauma Nursing Core Course (TNCC) Provider
Examination – Practice Exam: Verified
Questions and Answers | Instant PDF Study
Guide
1. A trauma patient arrives after a high-speed motor vehicle
collision. The patient is speaking in complete sentences but
has soot around the mouth and singed nasal hairs. Which
action is the priority?
A. Obtain a chest x-ray
B. Administer antibiotics
C. Prepare for early definitive airway management
D. Insert a nasogastric tube
Rationale: Facial burns, soot, and singed facial hair can indicate
inhalation injury. Airway edema may progress rapidly and make
later intubation extremely difficult or impossible. A patient who
is currently speaking may still develop significant airway
compromise. Early recognition and preparation for definitive
airway management are therefore priorities.
,2. During the primary assessment of a trauma patient, which
sequence best reflects the initial priorities?
A. Disability, Exposure, Airway, Breathing, Circulation
B. Circulation, Airway, Disability, Exposure, Breathing
C. Airway, Breathing, Circulation, Disability, Exposure
D. Exposure, Circulation, Airway, Disability, Breathing
Rationale: The primary survey systematically identifies and
treats immediate life threats. Airway is assessed while
protecting the cervical spine, followed by breathing and
ventilation, circulation and hemorrhage control, neurologic
status, and exposure/environmental control. Life-threatening
abnormalities should be treated as soon as they are identified
rather than waiting until the entire assessment is completed.
3. A trauma patient has severe external bleeding from the
thigh that is not controlled by direct pressure. What should
the nurse do next?
A. Elevate the extremity
B. Apply a cold compress
C. Apply a tourniquet according to protocol
D. Wait for a surgical consultation
Rationale: Life-threatening extremity hemorrhage that cannot
be rapidly controlled with direct pressure requires prompt
,tourniquet application when appropriate. Uncontrolled
hemorrhage can rapidly lead to shock and death. The
tourniquet should be applied correctly and the time documented
according to institutional protocol.
4. A patient with blunt chest trauma develops hypotension,
distended neck veins, and muffled heart sounds. Which
condition should the nurse suspect?
A. Hemothorax
B. Simple pneumothorax
C. Cardiac tamponade
D. Pulmonary contusion
Rationale: Hypotension, jugular venous distention, and muffled
heart sounds are classically associated with Beck's triad of
cardiac tamponade. Blood accumulating in the pericardial space
restricts cardiac filling and decreases cardiac output. Trauma
patients may not always demonstrate all three classic findings,
so a high index of suspicion is essential.
5. A trauma patient suddenly becomes severely dyspneic.
Breath sounds are absent on the right, blood pressure is
falling, and the trachea appears deviated away from the right
side. What is the most likely diagnosis?
, A. Pulmonary contusion
B. Massive hemothorax
C. Tension pneumothorax
D. Cardiac tamponade
Rationale: Severe respiratory distress, unilateral absent breath
sounds, hypotension, and mediastinal/tracheal shift are highly
concerning for tension pneumothorax. Rising intrathoracic
pressure compromises venous return and cardiac output. This is
a clinical emergency requiring immediate decompression rather
than waiting for definitive imaging.
6. Which finding is most concerning for inadequate ventilation
during the primary survey?
A. Respiratory rate of 18/minute
B. Oxygen saturation of 98%
C. Increasingly altered level of consciousness with shallow
respirations
D. Mild anxiety
Rationale: Altered mental status accompanied by shallow
respirations can indicate inadequate ventilation and rising
carbon dioxide levels or hypoxemia. Respiratory rate alone does
not establish adequate ventilation. Trauma assessment requires
evaluation of respiratory effort, depth, oxygenation, ventilation,
and overall clinical condition.
Examination – Practice Exam: Verified
Questions and Answers | Instant PDF Study
Guide
1. A trauma patient arrives after a high-speed motor vehicle
collision. The patient is speaking in complete sentences but
has soot around the mouth and singed nasal hairs. Which
action is the priority?
A. Obtain a chest x-ray
B. Administer antibiotics
C. Prepare for early definitive airway management
D. Insert a nasogastric tube
Rationale: Facial burns, soot, and singed facial hair can indicate
inhalation injury. Airway edema may progress rapidly and make
later intubation extremely difficult or impossible. A patient who
is currently speaking may still develop significant airway
compromise. Early recognition and preparation for definitive
airway management are therefore priorities.
,2. During the primary assessment of a trauma patient, which
sequence best reflects the initial priorities?
A. Disability, Exposure, Airway, Breathing, Circulation
B. Circulation, Airway, Disability, Exposure, Breathing
C. Airway, Breathing, Circulation, Disability, Exposure
D. Exposure, Circulation, Airway, Disability, Breathing
Rationale: The primary survey systematically identifies and
treats immediate life threats. Airway is assessed while
protecting the cervical spine, followed by breathing and
ventilation, circulation and hemorrhage control, neurologic
status, and exposure/environmental control. Life-threatening
abnormalities should be treated as soon as they are identified
rather than waiting until the entire assessment is completed.
3. A trauma patient has severe external bleeding from the
thigh that is not controlled by direct pressure. What should
the nurse do next?
A. Elevate the extremity
B. Apply a cold compress
C. Apply a tourniquet according to protocol
D. Wait for a surgical consultation
Rationale: Life-threatening extremity hemorrhage that cannot
be rapidly controlled with direct pressure requires prompt
,tourniquet application when appropriate. Uncontrolled
hemorrhage can rapidly lead to shock and death. The
tourniquet should be applied correctly and the time documented
according to institutional protocol.
4. A patient with blunt chest trauma develops hypotension,
distended neck veins, and muffled heart sounds. Which
condition should the nurse suspect?
A. Hemothorax
B. Simple pneumothorax
C. Cardiac tamponade
D. Pulmonary contusion
Rationale: Hypotension, jugular venous distention, and muffled
heart sounds are classically associated with Beck's triad of
cardiac tamponade. Blood accumulating in the pericardial space
restricts cardiac filling and decreases cardiac output. Trauma
patients may not always demonstrate all three classic findings,
so a high index of suspicion is essential.
5. A trauma patient suddenly becomes severely dyspneic.
Breath sounds are absent on the right, blood pressure is
falling, and the trachea appears deviated away from the right
side. What is the most likely diagnosis?
, A. Pulmonary contusion
B. Massive hemothorax
C. Tension pneumothorax
D. Cardiac tamponade
Rationale: Severe respiratory distress, unilateral absent breath
sounds, hypotension, and mediastinal/tracheal shift are highly
concerning for tension pneumothorax. Rising intrathoracic
pressure compromises venous return and cardiac output. This is
a clinical emergency requiring immediate decompression rather
than waiting for definitive imaging.
6. Which finding is most concerning for inadequate ventilation
during the primary survey?
A. Respiratory rate of 18/minute
B. Oxygen saturation of 98%
C. Increasingly altered level of consciousness with shallow
respirations
D. Mild anxiety
Rationale: Altered mental status accompanied by shallow
respirations can indicate inadequate ventilation and rising
carbon dioxide levels or hypoxemia. Respiratory rate alone does
not establish adequate ventilation. Trauma assessment requires
evaluation of respiratory effort, depth, oxygenation, ventilation,
and overall clinical condition.
