TNS EXAM / TRAUMA NURSE SPECIALIST CERTIFICATION (TNS) ACTUAL
EXAM TEST BANK 2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM
1. A 27-year-old patient arrives after a high-speed motor-vehicle collision with
altered mental status, noisy respirations, and blood pooling around the
mouth. The cervical spine has not yet been cleared. Which intervention
should the trauma nurse prioritize during the initial assessment?
A. Apply a nonrebreather mask and obtain a chest radiograph
B. Perform a focused abdominal assessment
C. Open and maintain the airway with a jaw-thrust maneuver while
maintaining cervical spine protection
D. Obtain a complete neurologic history from the patient
Answer: C
2. A patient with multiple traumatic injuries arrives with severe external
bleeding from a lower-extremity wound. Direct pressure has been applied
continuously but the bleeding remains life-threatening. Which intervention
should the trauma nurse anticipate next?
A. Apply an appropriate tourniquet proximal to the bleeding site
B. Elevate the extremity above the level of the heart
C. Remove the existing dressing to inspect the wound repeatedly
D. Delay hemorrhage control until laboratory results are available
Answer: A
3. During the primary survey of a trauma patient, the nurse observes severe
respiratory distress, unilateral absent breath sounds, hypotension, and
distended neck veins. Which condition should the nurse recognize as the
immediate life-threatening problem?
A. Massive hemothorax
B. Pulmonary contusion
C. Cardiac tamponade
D. Tension pneumothorax
Answer: D
pg. 1
, 4. A trauma patient is initially alert but becomes increasingly restless,
tachycardic, cool, and pale while blood pressure remains within the normal
range. Which interpretation is most appropriate?
A. The patient has developed isolated neurogenic shock
B. The findings may represent early compensated hemorrhagic shock
C. The patient is demonstrating a normal response to pain
D. The findings confirm cardiogenic shock
Answer: B
5. A patient sustains blunt abdominal trauma during a motor-vehicle collision.
The nurse notes increasing abdominal distention, tachycardia, pallor, and
decreasing blood pressure. Which injury should be strongly suspected?
A. Internal hemorrhage
B. Simple constipation
C. Isolated abdominal wall bruising
D. Uncomplicated gastroenteritis
Answer: A
6. A patient with a suspected cervical spinal injury requires airway
management. Which maneuver is generally preferred when opening the
airway while minimizing cervical movement?
A. Head-tilt/chin-lift
B. Hyperextension of the neck
C. Jaw-thrust maneuver
D. Rotation of the head toward the injured side
Answer: C
7. A trauma patient suddenly develops severe dyspnea, unilateral absent
breath sounds, hypotension, and increasing respiratory distress. Which
action is most appropriate when tension pneumothorax is clinically
suspected?
A. Wait for a chest radiograph before intervening
B. Prepare for immediate decompression according to trauma protocol
C. Place the patient flat and reassess in 30 minutes
pg. 2
, D. Encourage coughing and deep breathing
Answer: B
8. A patient has a penetrating chest wound with a sucking sound and
respiratory distress. Which intervention should the trauma nurse
anticipate?
A. Application of an occlusive dressing appropriate for an open chest wound
B. Packing the chest wound deeply with gauze
C. Removing any dressing during inspiration
D. Applying circumferential abdominal pressure
Answer: A
9. A trauma patient has paradoxical movement of a portion of the chest wall
after multiple rib fractures. Which injury does this finding most strongly
indicate?
A. Simple pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Flail chest
Answer: D
10. A patient with severe chest trauma develops hypotension, distended neck
veins, and muffled heart sounds without another obvious source of shock.
Which condition should the trauma nurse suspect?
A. Massive hemothorax
B. Cardiac tamponade
C. Simple rib fracture
D. Pulmonary contusion
Answer: B
11. A patient with traumatic hemorrhage has persistent tachycardia, narrowing
pulse pressure, cool skin, and delayed capillary refill. Which physiologic
process best explains these findings?
A. Increased parasympathetic activity
B. Increased circulating blood volume
pg. 3
, C. Peripheral vasoconstriction with redistribution of blood flow
D. Isolated increased intracranial pressure
Answer: C
12. A trauma patient has a Glasgow Coma Scale score of 8 after a severe head
injury. Which nursing priority is most appropriate?
A. Protect the airway and anticipate definitive airway management
B. Begin oral fluids to prevent dehydration
C. Perform a complete dietary assessment
D. Place the patient in a seated position for comfort
Answer: A
13. A patient with a traumatic brain injury becomes progressively more difficult
to arouse and develops unequal pupils. Which change should the nurse
treat as particularly concerning?
A. Mild thirst
B. Increasing intracranial pressure with possible cerebral herniation
C. Temporary hunger
D. Mild localized bruising
Answer: B
14. A patient with head trauma has repeated vomiting, worsening headache,
declining level of consciousness, and a newly unequal pupil. What is the
nurse's priority?
A. Offer oral analgesics
B. Encourage ambulation
C. Delay reassessment until the next scheduled neurologic check
D. Immediately notify the trauma team and support airway, oxygenation,
and neurologic management
Answer: D
15. A trauma patient has a suspected basilar skull fracture. Which finding would
be most consistent with this injury?
A. Bilateral lower-extremity edema
B. Clear drainage from the nose or ears that may contain cerebrospinal fluid
pg. 4
EXAM TEST BANK 2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM
1. A 27-year-old patient arrives after a high-speed motor-vehicle collision with
altered mental status, noisy respirations, and blood pooling around the
mouth. The cervical spine has not yet been cleared. Which intervention
should the trauma nurse prioritize during the initial assessment?
A. Apply a nonrebreather mask and obtain a chest radiograph
B. Perform a focused abdominal assessment
C. Open and maintain the airway with a jaw-thrust maneuver while
maintaining cervical spine protection
D. Obtain a complete neurologic history from the patient
Answer: C
2. A patient with multiple traumatic injuries arrives with severe external
bleeding from a lower-extremity wound. Direct pressure has been applied
continuously but the bleeding remains life-threatening. Which intervention
should the trauma nurse anticipate next?
A. Apply an appropriate tourniquet proximal to the bleeding site
B. Elevate the extremity above the level of the heart
C. Remove the existing dressing to inspect the wound repeatedly
D. Delay hemorrhage control until laboratory results are available
Answer: A
3. During the primary survey of a trauma patient, the nurse observes severe
respiratory distress, unilateral absent breath sounds, hypotension, and
distended neck veins. Which condition should the nurse recognize as the
immediate life-threatening problem?
A. Massive hemothorax
B. Pulmonary contusion
C. Cardiac tamponade
D. Tension pneumothorax
Answer: D
pg. 1
, 4. A trauma patient is initially alert but becomes increasingly restless,
tachycardic, cool, and pale while blood pressure remains within the normal
range. Which interpretation is most appropriate?
A. The patient has developed isolated neurogenic shock
B. The findings may represent early compensated hemorrhagic shock
C. The patient is demonstrating a normal response to pain
D. The findings confirm cardiogenic shock
Answer: B
5. A patient sustains blunt abdominal trauma during a motor-vehicle collision.
The nurse notes increasing abdominal distention, tachycardia, pallor, and
decreasing blood pressure. Which injury should be strongly suspected?
A. Internal hemorrhage
B. Simple constipation
C. Isolated abdominal wall bruising
D. Uncomplicated gastroenteritis
Answer: A
6. A patient with a suspected cervical spinal injury requires airway
management. Which maneuver is generally preferred when opening the
airway while minimizing cervical movement?
A. Head-tilt/chin-lift
B. Hyperextension of the neck
C. Jaw-thrust maneuver
D. Rotation of the head toward the injured side
Answer: C
7. A trauma patient suddenly develops severe dyspnea, unilateral absent
breath sounds, hypotension, and increasing respiratory distress. Which
action is most appropriate when tension pneumothorax is clinically
suspected?
A. Wait for a chest radiograph before intervening
B. Prepare for immediate decompression according to trauma protocol
C. Place the patient flat and reassess in 30 minutes
pg. 2
, D. Encourage coughing and deep breathing
Answer: B
8. A patient has a penetrating chest wound with a sucking sound and
respiratory distress. Which intervention should the trauma nurse
anticipate?
A. Application of an occlusive dressing appropriate for an open chest wound
B. Packing the chest wound deeply with gauze
C. Removing any dressing during inspiration
D. Applying circumferential abdominal pressure
Answer: A
9. A trauma patient has paradoxical movement of a portion of the chest wall
after multiple rib fractures. Which injury does this finding most strongly
indicate?
A. Simple pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Flail chest
Answer: D
10. A patient with severe chest trauma develops hypotension, distended neck
veins, and muffled heart sounds without another obvious source of shock.
Which condition should the trauma nurse suspect?
A. Massive hemothorax
B. Cardiac tamponade
C. Simple rib fracture
D. Pulmonary contusion
Answer: B
11. A patient with traumatic hemorrhage has persistent tachycardia, narrowing
pulse pressure, cool skin, and delayed capillary refill. Which physiologic
process best explains these findings?
A. Increased parasympathetic activity
B. Increased circulating blood volume
pg. 3
, C. Peripheral vasoconstriction with redistribution of blood flow
D. Isolated increased intracranial pressure
Answer: C
12. A trauma patient has a Glasgow Coma Scale score of 8 after a severe head
injury. Which nursing priority is most appropriate?
A. Protect the airway and anticipate definitive airway management
B. Begin oral fluids to prevent dehydration
C. Perform a complete dietary assessment
D. Place the patient in a seated position for comfort
Answer: A
13. A patient with a traumatic brain injury becomes progressively more difficult
to arouse and develops unequal pupils. Which change should the nurse
treat as particularly concerning?
A. Mild thirst
B. Increasing intracranial pressure with possible cerebral herniation
C. Temporary hunger
D. Mild localized bruising
Answer: B
14. A patient with head trauma has repeated vomiting, worsening headache,
declining level of consciousness, and a newly unequal pupil. What is the
nurse's priority?
A. Offer oral analgesics
B. Encourage ambulation
C. Delay reassessment until the next scheduled neurologic check
D. Immediately notify the trauma team and support airway, oxygenation,
and neurologic management
Answer: D
15. A trauma patient has a suspected basilar skull fracture. Which finding would
be most consistent with this injury?
A. Bilateral lower-extremity edema
B. Clear drainage from the nose or ears that may contain cerebrospinal fluid
pg. 4
