lOMoARcPSD|43502630
lOMoARcPSD|43502630
TNCC Study Guide 8th Edition Questions with Verified Answers
Trauma Nursing Core Course - 8th Edition Provider
Course
GENERAL COURSE INFORMATION
Printing and reviewing this material will be extremely helpful during class and while testing.
Improve trauma patient outcomes by providing nurses with foundational trauma knowledge, skills, and a systematic Trauma
Nursing Process (TNP) to guide trauma patient careProgram purpose
After taking TNCC, nurses will be able to systematically assess the trauma patient, intervene and/or assist with interventions, and
provide evidence-based trauma nursing care within the context of a trauma team
1. Completion of online modules
Requirements for Successful Completion
2. Attendance during the entire educational session
3. Successful performance of psychomotor skills
4. ONLINE EXAM:
5. Use the email you used to access the online modules.
6. Exam deadline is 7 days for both attempts.
7. Must be completed in one sitting in less than 2 hours
8. At 2 hours, the exam will be graded.
9. If you close your browser {Goggle Chrome recom}, the exam will be graded.
10. Successful completion of online exam w/ minimum score 80% (2 attempts in 7 days)
11. Completion and submission of the online course evaluation
• Save the provided Evaluation Information to complete the course and instructor evaluation.
• Certificate and card available immediately in your ENA account.
After successful course completion, RN participants are verified as TNCC providers for 4 yrs
Continuing nursing education certificates provided to all participants who complete course
Certificates and cards may be reprinted from www.ena.org
Page 1 of 28
, lOMoARcPSD|43502630
ONLINE PRECOURSE MODULE REVIEW
Recommend take notes during class to use later as test reference.
Chapter 2: Biomechanics page 9
Mechanism of injury (pg 10)
̴ TYPES: Blunt, penetrating, thermal, blast
̴ Definition: how external energy forces are transferred to the body
Kinetic energy (pg 11)
̴ Definition: energy of a body in motion
̴ ½mv2 (1/2 mass x velocity squared)
Velocity (pg 18)
̴ Definition: speed of something in a given direction
̴ When velocity is doubled, energy is quadrupled!
Motor vehicle impact sequence (pg 14)
̴ First impact: car hits tree (auto collision w/ object)
̴ Second impact: chest hits steering wheel (external body collision)
̴ Third impact: heart hits sternum (internal organ collision)
MVC patterns of pathway (pg15)
5 levels of blast effect on the body (Table 2-5 pg 20); explosion-related injuries. (Table 2-6 pg 22)
Chapter 12: The Pediatric Trauma Patient pg
231 Pediatric Assessment Triangle (PAT) (pg 234)
Airway/breathing considerations
a. The tongue is proportionally larger in relation to the oral cavity in infants and more likely to
obstruct the airway.
b. Assess for a gag reflex prior to inserting the OPA. Be aware that
stimulation of the gag reflex is more likely to cause bradycardia in
the pediatric patient.
Circulation considerations
• Compare quality of central & peripheral pulses
• Check cap refill
• Consider use of IO access early.
1. All meds and equipment sizes based on weight KILOGRAMS ONLY. (length-based resus tape)
2. Review signs of child abuse and reporting laws. (pg 244-245; 303)
3. Review importance of bedside BLOOD GLUCOSE measurement and avoiding hypoglycemia.
4. Hypotension is late sx of hypovolemic shock in peds and reflects more than 30% of total blood
volume loss. (Indicates high potential for insufficient organ perfusion)
Page 2 of 28
, lOMoARcPSD|43502630
Chapter 13: The Geriatric Trauma Patient pg 261
Mechanism of injury 3 most common in elderly and why (pg 263)
Comorbidities Diminished physiologic reserve (ex: inadequate oxygenation/vent r/t
decr pulmonary reserves associated w/ lung disease and aging) may contribute
considerably to a higher morbidity and mortality in a geriatric trauma patient.
Polypharmacy - Do not rely on tachycardia as a sign of shock. (sympathetic response
may be affected by cardiac disease, pacemakers, or medications.)
Physiological / anatomical changes (pg 265-267)
̴ occur normally w/ aging; put elderly patient at higher risk for injury and
challenges medical intervention. (examples: arthritis, skin breakdown due to
loss of subcutaneous fat, brain shrinkage, polypharmacy).
Which type of brain injury are the elderly more likely to suffer and why?
Chapter 14: The Bariatric Trauma Patient pg 279
(Reverse Trendelenburg) Ramped position (Pg 285)
̴ benefits both intubation (airway maintenance) and work of breathing.
̴ Intubation - Place patient with head elevated during intubation to allow for better visualization
of pharyngeal landmarks.
̴ In supine position, chest and diaphragm can become obstructed due to excess abdominal mass,
hindering effective ventilation.
̴ Gastric Tube placement - may be safely placed using fluoroscopy
• Recent bariatric surgery contraindication to blind insertion! (may disrupt suture lines of new
stomach or perforate the smaller stomach) tubes.
Chapter 15: The Pregnant Trauma Patient pg 293
1. Prioritize care of mother to best support baby <Save momma, save baby=
2. Supine hypotension syndrome (aortocaval compression) (pg 296)
a. Aorta and inferior vena cava are compressed by the uterus and its contents when patient supine
b. Venous return decreases, and cardiac output falls
c. Pt may report acute nausea and dizziness, appearing pale and diaphoretic.
d. Intervention: left lateral position is preferred but tilting to either side may be beneficial if
the patient has injuries that interfere with left lateral positioning.
3. S/S of complications to pregnancy related to trauma (pg 295-296)
a. Placenta abruptio (placental abruption) 3 rising fundal height, dark bloody vaginal bleeding
(80%), rapid contractions, abdominal/uterine pain, FHR abnormalities (varying rate acceleration
/deceleration)
b. Uterine rupture - Sudden, severe uterine pain; contractions that don't cease; decreased FHR
w/ fetal distress; severe vaginal bleeding or hemorrhaging.
c. Pre-term labor 3 uterine contractions that start before 37 completed weeks of pregnancy.
Page 3 of 28
lOMoARcPSD|43502630
TNCC Study Guide 8th Edition Questions with Verified Answers
Trauma Nursing Core Course - 8th Edition Provider
Course
GENERAL COURSE INFORMATION
Printing and reviewing this material will be extremely helpful during class and while testing.
Improve trauma patient outcomes by providing nurses with foundational trauma knowledge, skills, and a systematic Trauma
Nursing Process (TNP) to guide trauma patient careProgram purpose
After taking TNCC, nurses will be able to systematically assess the trauma patient, intervene and/or assist with interventions, and
provide evidence-based trauma nursing care within the context of a trauma team
1. Completion of online modules
Requirements for Successful Completion
2. Attendance during the entire educational session
3. Successful performance of psychomotor skills
4. ONLINE EXAM:
5. Use the email you used to access the online modules.
6. Exam deadline is 7 days for both attempts.
7. Must be completed in one sitting in less than 2 hours
8. At 2 hours, the exam will be graded.
9. If you close your browser {Goggle Chrome recom}, the exam will be graded.
10. Successful completion of online exam w/ minimum score 80% (2 attempts in 7 days)
11. Completion and submission of the online course evaluation
• Save the provided Evaluation Information to complete the course and instructor evaluation.
• Certificate and card available immediately in your ENA account.
After successful course completion, RN participants are verified as TNCC providers for 4 yrs
Continuing nursing education certificates provided to all participants who complete course
Certificates and cards may be reprinted from www.ena.org
Page 1 of 28
, lOMoARcPSD|43502630
ONLINE PRECOURSE MODULE REVIEW
Recommend take notes during class to use later as test reference.
Chapter 2: Biomechanics page 9
Mechanism of injury (pg 10)
̴ TYPES: Blunt, penetrating, thermal, blast
̴ Definition: how external energy forces are transferred to the body
Kinetic energy (pg 11)
̴ Definition: energy of a body in motion
̴ ½mv2 (1/2 mass x velocity squared)
Velocity (pg 18)
̴ Definition: speed of something in a given direction
̴ When velocity is doubled, energy is quadrupled!
Motor vehicle impact sequence (pg 14)
̴ First impact: car hits tree (auto collision w/ object)
̴ Second impact: chest hits steering wheel (external body collision)
̴ Third impact: heart hits sternum (internal organ collision)
MVC patterns of pathway (pg15)
5 levels of blast effect on the body (Table 2-5 pg 20); explosion-related injuries. (Table 2-6 pg 22)
Chapter 12: The Pediatric Trauma Patient pg
231 Pediatric Assessment Triangle (PAT) (pg 234)
Airway/breathing considerations
a. The tongue is proportionally larger in relation to the oral cavity in infants and more likely to
obstruct the airway.
b. Assess for a gag reflex prior to inserting the OPA. Be aware that
stimulation of the gag reflex is more likely to cause bradycardia in
the pediatric patient.
Circulation considerations
• Compare quality of central & peripheral pulses
• Check cap refill
• Consider use of IO access early.
1. All meds and equipment sizes based on weight KILOGRAMS ONLY. (length-based resus tape)
2. Review signs of child abuse and reporting laws. (pg 244-245; 303)
3. Review importance of bedside BLOOD GLUCOSE measurement and avoiding hypoglycemia.
4. Hypotension is late sx of hypovolemic shock in peds and reflects more than 30% of total blood
volume loss. (Indicates high potential for insufficient organ perfusion)
Page 2 of 28
, lOMoARcPSD|43502630
Chapter 13: The Geriatric Trauma Patient pg 261
Mechanism of injury 3 most common in elderly and why (pg 263)
Comorbidities Diminished physiologic reserve (ex: inadequate oxygenation/vent r/t
decr pulmonary reserves associated w/ lung disease and aging) may contribute
considerably to a higher morbidity and mortality in a geriatric trauma patient.
Polypharmacy - Do not rely on tachycardia as a sign of shock. (sympathetic response
may be affected by cardiac disease, pacemakers, or medications.)
Physiological / anatomical changes (pg 265-267)
̴ occur normally w/ aging; put elderly patient at higher risk for injury and
challenges medical intervention. (examples: arthritis, skin breakdown due to
loss of subcutaneous fat, brain shrinkage, polypharmacy).
Which type of brain injury are the elderly more likely to suffer and why?
Chapter 14: The Bariatric Trauma Patient pg 279
(Reverse Trendelenburg) Ramped position (Pg 285)
̴ benefits both intubation (airway maintenance) and work of breathing.
̴ Intubation - Place patient with head elevated during intubation to allow for better visualization
of pharyngeal landmarks.
̴ In supine position, chest and diaphragm can become obstructed due to excess abdominal mass,
hindering effective ventilation.
̴ Gastric Tube placement - may be safely placed using fluoroscopy
• Recent bariatric surgery contraindication to blind insertion! (may disrupt suture lines of new
stomach or perforate the smaller stomach) tubes.
Chapter 15: The Pregnant Trauma Patient pg 293
1. Prioritize care of mother to best support baby <Save momma, save baby=
2. Supine hypotension syndrome (aortocaval compression) (pg 296)
a. Aorta and inferior vena cava are compressed by the uterus and its contents when patient supine
b. Venous return decreases, and cardiac output falls
c. Pt may report acute nausea and dizziness, appearing pale and diaphoretic.
d. Intervention: left lateral position is preferred but tilting to either side may be beneficial if
the patient has injuries that interfere with left lateral positioning.
3. S/S of complications to pregnancy related to trauma (pg 295-296)
a. Placenta abruptio (placental abruption) 3 rising fundal height, dark bloody vaginal bleeding
(80%), rapid contractions, abdominal/uterine pain, FHR abnormalities (varying rate acceleration
/deceleration)
b. Uterine rupture - Sudden, severe uterine pain; contractions that don't cease; decreased FHR
w/ fetal distress; severe vaginal bleeding or hemorrhaging.
c. Pre-term labor 3 uterine contractions that start before 37 completed weeks of pregnancy.
Page 3 of 28
