TNCC HIGH-LEVEL ASSESSMENT
QUESTIONS AND ANSWERS
1. During the primary survey of a trauma patient, which assessment finding is the most
immediate priority for intervention?
A. Distended neck veins
B. Glasgow Coma Scale score of 12
C. Capillary refill of 4 seconds
D. Snoring respirations
Answer: D
Conceptual Explanation: Snoring respirations indicate a partial airway obstruction, which
is the ‘A’ in the ABCDE primary survey. Airway always takes priority over circulation or
disability findings.
2. A patient with a traumatic brain injury (TBI) presents with a blood pressure of 160/60
mmHg, a heart rate of 48 bpm, and irregular respirations. What does this triad indicate?
A. Beck’s Triad
B. Virchow’s Triad
,C. Cushing’s Triad
D. Trauma Triad of Death
Answer: C
Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure and impending
herniation.
3. In a patient with a suspected pelvic fracture who is hemodynamically unstable, what is the
priority intervention after the primary survey?
A. Immediate pelvic X-ray
B. Log-rolling to check for back injuries
C. Insertion of a Foley catheter
D. Application of a pelvic binder
Answer: D
Conceptual Explanation: A pelvic binder stabilizes the fracture and reduces pelvic volume
to control venous bleeding. Log-rolling is contraindicated in suspected pelvic fractures.
4. Which classification of shock is characterized by a decrease in systemic vascular resistance
(SVR) and an increase in cardiac output?
A. Hypovolemic shock
B. Early septic shock
, C. Neurogenic shock
D. Cardiogenic shock
Answer: B
Conceptual Explanation: Early (hyperdynamic) septic shock involves vasodilation leading
to decreased SVR and a compensatory increase in cardiac output. Neurogenic shock
typically features low HR and low SVR.
5. A patient sustains a fall and presents with ‘raccoon eyes’ and Battle’s sign. Which
diagnostic test is most likely to confirm the underlying injury?
A. Lumbar puncture
B. Non-contrast CT head
C. Skull X-ray
D. Cerebral angiography
Answer: B
Conceptual Explanation: Raccoon eyes and Battle’s sign indicate a basilar skull fracture. A
non-contrast CT head is the gold standard for identifying fractures and associated
intracranial hemorrhage.
6. When managing a patient with a flail chest, what is the primary cause of the associated
hypoxia?
A. Paradoxical chest wall movement
QUESTIONS AND ANSWERS
1. During the primary survey of a trauma patient, which assessment finding is the most
immediate priority for intervention?
A. Distended neck veins
B. Glasgow Coma Scale score of 12
C. Capillary refill of 4 seconds
D. Snoring respirations
Answer: D
Conceptual Explanation: Snoring respirations indicate a partial airway obstruction, which
is the ‘A’ in the ABCDE primary survey. Airway always takes priority over circulation or
disability findings.
2. A patient with a traumatic brain injury (TBI) presents with a blood pressure of 160/60
mmHg, a heart rate of 48 bpm, and irregular respirations. What does this triad indicate?
A. Beck’s Triad
B. Virchow’s Triad
,C. Cushing’s Triad
D. Trauma Triad of Death
Answer: C
Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure and impending
herniation.
3. In a patient with a suspected pelvic fracture who is hemodynamically unstable, what is the
priority intervention after the primary survey?
A. Immediate pelvic X-ray
B. Log-rolling to check for back injuries
C. Insertion of a Foley catheter
D. Application of a pelvic binder
Answer: D
Conceptual Explanation: A pelvic binder stabilizes the fracture and reduces pelvic volume
to control venous bleeding. Log-rolling is contraindicated in suspected pelvic fractures.
4. Which classification of shock is characterized by a decrease in systemic vascular resistance
(SVR) and an increase in cardiac output?
A. Hypovolemic shock
B. Early septic shock
, C. Neurogenic shock
D. Cardiogenic shock
Answer: B
Conceptual Explanation: Early (hyperdynamic) septic shock involves vasodilation leading
to decreased SVR and a compensatory increase in cardiac output. Neurogenic shock
typically features low HR and low SVR.
5. A patient sustains a fall and presents with ‘raccoon eyes’ and Battle’s sign. Which
diagnostic test is most likely to confirm the underlying injury?
A. Lumbar puncture
B. Non-contrast CT head
C. Skull X-ray
D. Cerebral angiography
Answer: B
Conceptual Explanation: Raccoon eyes and Battle’s sign indicate a basilar skull fracture. A
non-contrast CT head is the gold standard for identifying fractures and associated
intracranial hemorrhage.
6. When managing a patient with a flail chest, what is the primary cause of the associated
hypoxia?
A. Paradoxical chest wall movement
