TNCC NOTES FOR WRITTEN EXAM, TNCC
PREP, TNCC EXAM, TNCC 8TH EDITION
1. globe rupture - ANSWER-A 35 y/o M presents with facial trauma after
being struck in the face with a baseball. A teardrop-shaped left pupil is
noted on exam. What type of injury is suspected?
2. compensated - ANSWER-A trauma pt is restless and repeatedly asking
"where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool
and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is
demonstrating s/sx of which stage of shock?
3. ventilate with a bag mask device - ANSWER-An unresponsive trauma pt
has an oropharygeal airway in place, shallow and labored respirations,
and dusky skin. The trauma team has administered medications for
drug-assisted intubation and attempted intubation but was
unsuccessful. What is the most appropriate immediate next step?
4. within 24 hrs of trauma - ANSWER-When is the tertiary survey
completed fora trauma pt?
5. pressure - ANSWER-An intubated and sedated pt in the ED has multiple
extremity injuries with the potential for causing compartment
syndrome. What is the most reliable indication of compartment
syndrome in a patient who is unconscious?
6. worsening pneumothorax - ANSWER-Which of the following is possible
complication of positive-pressure ventilation?
7. pelvic stability - ANSWER-the most reassuring finding for a male pt with
hip pain after a fall is which of the following?
,8. narrowed - ANSWER-Which of the following pulse pressures indicate
early hypovolemic shock?
9. dysrhythmias - ANSWER-Patients with a crush injury should be
monitored for which of the following conditions?
10. subdural hematoma - ANSWER-Tearing of the bridging veins is
most frequently associated with which brain injury?
11. straight cath for urine sample - ANSWER-A 20 y/o M presents to
the ED complaining of severe lower abd pain after landing hard on the
bicycle cross bars while preforming an aerial BMX maneuver.
Secondary assessment reveals lower abd tenderness and scrotal
ecchymosis. Which of the following orders would the RN question?
12. placental abruption - ANSWER-You are caring for a pt who was
involved in a MVC and is 32 weeks pregnant. Findings of your
secondary survey include abd pain on palpation, fundal ht at the costal
margin, and some dark bloody show. Varying accelerations and
decelerations are noted on cariocgraphy. These findings are most
consistent with which of the following?
13. it can worsen cord damage from an unstable spinal injury -
ANSWER-Which of the following is true about the log-roll?
14. defusings - ANSWER-All of these are considered a critical
communication point in trauma care EXCEPT which of the following?
15. pulse oximetry and capnography - ANSWER-What bedside
monitoring parameters are used to assess for adequacy of O2 and
effectiveness of ventilation?
,16. padding the upper back while stabilizing the cervical spine -
ANSWER-Caregivers carry in a 2 y/o into the ED who fell out of a
second-story window. The pt is awake and crying with increased work
of breathing and pale skin. Which of the following interventions has the
highest priority?
17. bowel - ANSWER-Which of the following injuries is LEAST likely to
be promptly identified?
18. Initiate transfer to a trauma center - ANSWER-A pt is brought to
the ED of a rural hospital following a high-speed MVC. When significant
abd and pelvic injuries are noted in the primary survey, which of the
following is the priority interventions?
19. Expedite transfer to the closest trauma center - ANSWER-A 56
y/o M pt involved in a motor vehicle crash is brought to the ED of a
rural critical access facility. He complains of neck pain, SOB, and
diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2
94% on high-flow O2 via NRB mask. Which of the following is the
priority intervention for this patient?
20. a pertinent medical hx is crucial - ANSWER-Which of the following
considerations is the most important when caring for a geriatric trauma
pt?
21. Mitigation - ANSWER-Following a review of recent drills and a real
disaster event, a hospital has identified deficiencies and is taking steps
to minimize the impact of a future disaster . Which phase of the
disaster life cycle does this describe?
22. Multiple requests for water - ANSWER-EMS brings a pt who fell
while riding his bicycle. Using the American College of Surgeobs
, screening guidelines, which assessment finding would prompt the RN
to prepare the pt for a radiologic spine clearance?
23. hemoglobin does not readily release O2 for use by the tissues -
ANSWER-What is the effect of hypothermia on the oxyhemoglobin
dissociation curve?
24. acidosis - ANSWER-Which of the following is a component of the
trauma triad of death?
25. Complete - ANSWER-EMS brings a pt from MVC. VS: BP 90/49, HR
48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary incontinence
and priapism. These assessment findings are most consistent with
which of the following types of spinal cord injury?
26. flucuation in the water seal chamber - ANSWER-Which of the
following is an expected finding in a pt with a tube thoracstomy
connected to a chest drainage system?
27. insert an oropharyngeal airway if there is no gag reflex -
ANSWER-During the primary survey of an unconscious pt with multi-
system trauma, the nurse notes snoring respirations. What priority
nursing interventions should be preformed next?
28. bardycardia and absent motor function below the level of injury -
ANSWER-A pt with a complete spinal cord injury in neurogenic shock
will demonstrate hypotension and which other clinical signs?
29. apply splint and elevate above the level of the heart - ANSWER-a
37 y/o F has a deformity of the L wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most
appropriate intervention?
PREP, TNCC EXAM, TNCC 8TH EDITION
1. globe rupture - ANSWER-A 35 y/o M presents with facial trauma after
being struck in the face with a baseball. A teardrop-shaped left pupil is
noted on exam. What type of injury is suspected?
2. compensated - ANSWER-A trauma pt is restless and repeatedly asking
"where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool
and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is
demonstrating s/sx of which stage of shock?
3. ventilate with a bag mask device - ANSWER-An unresponsive trauma pt
has an oropharygeal airway in place, shallow and labored respirations,
and dusky skin. The trauma team has administered medications for
drug-assisted intubation and attempted intubation but was
unsuccessful. What is the most appropriate immediate next step?
4. within 24 hrs of trauma - ANSWER-When is the tertiary survey
completed fora trauma pt?
5. pressure - ANSWER-An intubated and sedated pt in the ED has multiple
extremity injuries with the potential for causing compartment
syndrome. What is the most reliable indication of compartment
syndrome in a patient who is unconscious?
6. worsening pneumothorax - ANSWER-Which of the following is possible
complication of positive-pressure ventilation?
7. pelvic stability - ANSWER-the most reassuring finding for a male pt with
hip pain after a fall is which of the following?
,8. narrowed - ANSWER-Which of the following pulse pressures indicate
early hypovolemic shock?
9. dysrhythmias - ANSWER-Patients with a crush injury should be
monitored for which of the following conditions?
10. subdural hematoma - ANSWER-Tearing of the bridging veins is
most frequently associated with which brain injury?
11. straight cath for urine sample - ANSWER-A 20 y/o M presents to
the ED complaining of severe lower abd pain after landing hard on the
bicycle cross bars while preforming an aerial BMX maneuver.
Secondary assessment reveals lower abd tenderness and scrotal
ecchymosis. Which of the following orders would the RN question?
12. placental abruption - ANSWER-You are caring for a pt who was
involved in a MVC and is 32 weeks pregnant. Findings of your
secondary survey include abd pain on palpation, fundal ht at the costal
margin, and some dark bloody show. Varying accelerations and
decelerations are noted on cariocgraphy. These findings are most
consistent with which of the following?
13. it can worsen cord damage from an unstable spinal injury -
ANSWER-Which of the following is true about the log-roll?
14. defusings - ANSWER-All of these are considered a critical
communication point in trauma care EXCEPT which of the following?
15. pulse oximetry and capnography - ANSWER-What bedside
monitoring parameters are used to assess for adequacy of O2 and
effectiveness of ventilation?
,16. padding the upper back while stabilizing the cervical spine -
ANSWER-Caregivers carry in a 2 y/o into the ED who fell out of a
second-story window. The pt is awake and crying with increased work
of breathing and pale skin. Which of the following interventions has the
highest priority?
17. bowel - ANSWER-Which of the following injuries is LEAST likely to
be promptly identified?
18. Initiate transfer to a trauma center - ANSWER-A pt is brought to
the ED of a rural hospital following a high-speed MVC. When significant
abd and pelvic injuries are noted in the primary survey, which of the
following is the priority interventions?
19. Expedite transfer to the closest trauma center - ANSWER-A 56
y/o M pt involved in a motor vehicle crash is brought to the ED of a
rural critical access facility. He complains of neck pain, SOB, and
diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2
94% on high-flow O2 via NRB mask. Which of the following is the
priority intervention for this patient?
20. a pertinent medical hx is crucial - ANSWER-Which of the following
considerations is the most important when caring for a geriatric trauma
pt?
21. Mitigation - ANSWER-Following a review of recent drills and a real
disaster event, a hospital has identified deficiencies and is taking steps
to minimize the impact of a future disaster . Which phase of the
disaster life cycle does this describe?
22. Multiple requests for water - ANSWER-EMS brings a pt who fell
while riding his bicycle. Using the American College of Surgeobs
, screening guidelines, which assessment finding would prompt the RN
to prepare the pt for a radiologic spine clearance?
23. hemoglobin does not readily release O2 for use by the tissues -
ANSWER-What is the effect of hypothermia on the oxyhemoglobin
dissociation curve?
24. acidosis - ANSWER-Which of the following is a component of the
trauma triad of death?
25. Complete - ANSWER-EMS brings a pt from MVC. VS: BP 90/49, HR
48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary incontinence
and priapism. These assessment findings are most consistent with
which of the following types of spinal cord injury?
26. flucuation in the water seal chamber - ANSWER-Which of the
following is an expected finding in a pt with a tube thoracstomy
connected to a chest drainage system?
27. insert an oropharyngeal airway if there is no gag reflex -
ANSWER-During the primary survey of an unconscious pt with multi-
system trauma, the nurse notes snoring respirations. What priority
nursing interventions should be preformed next?
28. bardycardia and absent motor function below the level of injury -
ANSWER-A pt with a complete spinal cord injury in neurogenic shock
will demonstrate hypotension and which other clinical signs?
29. apply splint and elevate above the level of the heart - ANSWER-a
37 y/o F has a deformity of the L wrist after a fall. She is reluctant to
move her hand due to pain. Which of the following is the most
appropriate intervention?
