TNCC ADVANCED TRAUMA NURSING
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A patient presents with a suspected tension pneumothorax. What is the priority
intervention after a needle decompression is performed?
A. Obtain a chest X-ray to confirm placement
B. Administer high-flow oxygen via non-rebreather mask
C. Assess for a tracheal shift to the unaffected side
D. Prepare for the insertion of a chest tube
Answer: D
Conceptual Explanation: Needle decompression is a temporary life-saving measure. It
must be followed by the definitive treatment, which is the insertion of a chest tube
(thoracostomy).
2. During the ‘Circulation’ phase of the primary survey, which assessment finding is the most
sensitive early indicator of hemorrhagic shock?
A. Narrowing pulse pressure
,B. Hypotension
C. Bradycardia
D. Decreased urine output
Answer: A
Conceptual Explanation: Narrowing pulse pressure (the difference between systolic and
diastolic pressure) is an early sign of compensatory shock, appearing before a significant
drop in systolic blood pressure occurs.
3. A trauma patient has a GCS of 7. What is the most appropriate immediate airway
management strategy?
A. Insertion of an oropharyngeal airway
B. Nasotracheal intubation
C. Definitive airway management via endotracheal intubation
D. Application of a high-flow nasal cannula
Answer: C
Conceptual Explanation: A GCS of 8 or less typically indicates that the patient cannot
protect their airway, necessitating a definitive airway (usually endotracheal intubation).
4. In a patient with a suspected pelvic fracture, which intervention is contraindicated during
the primary survey?
A. Application of a pelvic binder
, B. Checking for urethral meatus blood
C. Repeated rocking or palpation of the iliac crests
D. Obtaining a pelvic X-ray
Answer: C
Conceptual Explanation: Manually assessing pelvic stability by ‘rocking’ the pelvis should
be avoided as it can cause further bleeding or destabilize a fracture.
5. What is the target Mean Arterial Pressure (MAP) for a patient with a traumatic brain injury
to maintain cerebral perfusion pressure?
A. 80-90 mmHg
B. 50-60 mmHg
C. At least 100 mmHg
D. Higher than 120 mmHg
Answer: A
Conceptual Explanation: To ensure adequate cerebral perfusion pressure (CPP) while
preventing secondary injury, a MAP of 80-90 mmHg is generally targeted in TBI patients.
6. A patient in their third trimester of pregnancy is immobilized on a backboard. What is the
best action to prevent supine hypotensive syndrome?
A. Elevate the head of the bed 30 degrees
B. Tilt the backboard 15 to 30 degrees to the left
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A patient presents with a suspected tension pneumothorax. What is the priority
intervention after a needle decompression is performed?
A. Obtain a chest X-ray to confirm placement
B. Administer high-flow oxygen via non-rebreather mask
C. Assess for a tracheal shift to the unaffected side
D. Prepare for the insertion of a chest tube
Answer: D
Conceptual Explanation: Needle decompression is a temporary life-saving measure. It
must be followed by the definitive treatment, which is the insertion of a chest tube
(thoracostomy).
2. During the ‘Circulation’ phase of the primary survey, which assessment finding is the most
sensitive early indicator of hemorrhagic shock?
A. Narrowing pulse pressure
,B. Hypotension
C. Bradycardia
D. Decreased urine output
Answer: A
Conceptual Explanation: Narrowing pulse pressure (the difference between systolic and
diastolic pressure) is an early sign of compensatory shock, appearing before a significant
drop in systolic blood pressure occurs.
3. A trauma patient has a GCS of 7. What is the most appropriate immediate airway
management strategy?
A. Insertion of an oropharyngeal airway
B. Nasotracheal intubation
C. Definitive airway management via endotracheal intubation
D. Application of a high-flow nasal cannula
Answer: C
Conceptual Explanation: A GCS of 8 or less typically indicates that the patient cannot
protect their airway, necessitating a definitive airway (usually endotracheal intubation).
4. In a patient with a suspected pelvic fracture, which intervention is contraindicated during
the primary survey?
A. Application of a pelvic binder
, B. Checking for urethral meatus blood
C. Repeated rocking or palpation of the iliac crests
D. Obtaining a pelvic X-ray
Answer: C
Conceptual Explanation: Manually assessing pelvic stability by ‘rocking’ the pelvis should
be avoided as it can cause further bleeding or destabilize a fracture.
5. What is the target Mean Arterial Pressure (MAP) for a patient with a traumatic brain injury
to maintain cerebral perfusion pressure?
A. 80-90 mmHg
B. 50-60 mmHg
C. At least 100 mmHg
D. Higher than 120 mmHg
Answer: A
Conceptual Explanation: To ensure adequate cerebral perfusion pressure (CPP) while
preventing secondary injury, a MAP of 80-90 mmHg is generally targeted in TBI patients.
6. A patient in their third trimester of pregnancy is immobilized on a backboard. What is the
best action to prevent supine hypotensive syndrome?
A. Elevate the head of the bed 30 degrees
B. Tilt the backboard 15 to 30 degrees to the left
