TNCC 8th Edition Provider Exam
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on
the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower
abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question?
- ANS-Straight catheter for urine sample
A 35-year-old male 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? - ANS-Globe rupture
A 36-year-old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due
to pain. Which of the following is the most appropriate intervention? - ANS-Apply a splint and elevate
the extremity above the level of the heart
A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center
complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs are stable. The nurse can
anticipate all of these after a negative FAST exam EXCEPT which of the following? - ANS-Diagnostic
peritoneal lavage
A 5-year-old child presents to the ED with bruises to the upper arms and buttocks in various stages of
healing and multiple small, clean, round burns to the back. There are no abnormalities found based on
the pediatric assessment triangle or primary survey. Which of the following is the priority nursing
intervention? - ANS-Report your suspicion of maltreatment in accordance with local regulations
A 56-year-old male patient involved in a motor vehicle crash is brought to the emergency department of
a rural critical access facility. He complains of neck pain, shortness of breath, and diffuse abdominal pain.
His Glasgow Coma Score is 15. His vital signs are as follows: BP 98/71 mm Hg, HR 125 beats/minute, RR
26 breaths/minute, SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the following is
the priority intervention for this patient? - ANS-Expedite transfer to the closest trauma center
A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital
providers placed a nonporous dressing over the chest wound and taped it on three sides. He is now
showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood
pressure. Which of the following is the MOST appropriate immediate intervention? - ANS-Dressing
removal
, A patient has been in the emergency department for several hours waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg
pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the patient
is restless, with respiratory distress and petechiae to his neck. The patient is exhibiting signs and
symptoms most commonly associated with which of the following conditions? - ANS-Fat embolism
A patient is brought to the emergency department of a rural hospital following a high-speed motor
vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, which
of the following is the priority intervention? - ANS-Initiate transfer to a trauma center
A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory values is
expected with a musculoskeletal complication associated with this presentation? - ANS-Elevated creatine
kinase
A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures.
The patient is pale, alert, disoriented, and has delayed capillary refill. Which of the following
interventions would be most appropriate for this patient based on the disaster triage principles? - ANS-
Initiate two large-caliber intravenous lines for Ringer's lactate solution administration.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ANS-Bradycardia and absent motor function below the level of injury
A patient with a lower extremity fracture complains of severe pain and tightness in his calf, minimally
relieved by pain medications. Which of the following is the priority nursing intervention? - ANS-Elevating
the extremity to the level of the heart
A trauma patient is en route to a rural emergency department. Radiology notifies the charge nurse that
the computed tomography (CT) scanner will be out of service for several hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma team's communication? - ANS-
Huddle
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were BP 110/60
mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry. Current vital signs are
BP 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The patient is demonstrating signs
and symptoms of which stage of shock? - ANS-Compensated
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on
the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower
abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question?
- ANS-Straight catheter for urine sample
A 35-year-old male 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? - ANS-Globe rupture
A 36-year-old female has a deformity of the left wrist after a fall. She is reluctant to move her hand due
to pain. Which of the following is the most appropriate intervention? - ANS-Apply a splint and elevate
the extremity above the level of the heart
A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center
complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs are stable. The nurse can
anticipate all of these after a negative FAST exam EXCEPT which of the following? - ANS-Diagnostic
peritoneal lavage
A 5-year-old child presents to the ED with bruises to the upper arms and buttocks in various stages of
healing and multiple small, clean, round burns to the back. There are no abnormalities found based on
the pediatric assessment triangle or primary survey. Which of the following is the priority nursing
intervention? - ANS-Report your suspicion of maltreatment in accordance with local regulations
A 56-year-old male patient involved in a motor vehicle crash is brought to the emergency department of
a rural critical access facility. He complains of neck pain, shortness of breath, and diffuse abdominal pain.
His Glasgow Coma Score is 15. His vital signs are as follows: BP 98/71 mm Hg, HR 125 beats/minute, RR
26 breaths/minute, SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the following is
the priority intervention for this patient? - ANS-Expedite transfer to the closest trauma center
A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital
providers placed a nonporous dressing over the chest wound and taped it on three sides. He is now
showing signs of anxiety, restlessness, severe respiratory distress, cyanosis and decreasing blood
pressure. Which of the following is the MOST appropriate immediate intervention? - ANS-Dressing
removal
, A patient has been in the emergency department for several hours waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and complaining of leg
pain. His wife reported that he suddenly became anxious and confused. Upon reassessment, the patient
is restless, with respiratory distress and petechiae to his neck. The patient is exhibiting signs and
symptoms most commonly associated with which of the following conditions? - ANS-Fat embolism
A patient is brought to the emergency department of a rural hospital following a high-speed motor
vehicle collision. When significant abdominal and pelvic injuries are noted in the primary survey, which
of the following is the priority intervention? - ANS-Initiate transfer to a trauma center
A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory values is
expected with a musculoskeletal complication associated with this presentation? - ANS-Elevated creatine
kinase
A patient is thrown against a car during a tornado and presents with obvious bilateral femoral fractures.
The patient is pale, alert, disoriented, and has delayed capillary refill. Which of the following
interventions would be most appropriate for this patient based on the disaster triage principles? - ANS-
Initiate two large-caliber intravenous lines for Ringer's lactate solution administration.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ANS-Bradycardia and absent motor function below the level of injury
A patient with a lower extremity fracture complains of severe pain and tightness in his calf, minimally
relieved by pain medications. Which of the following is the priority nursing intervention? - ANS-Elevating
the extremity to the level of the heart
A trauma patient is en route to a rural emergency department. Radiology notifies the charge nurse that
the computed tomography (CT) scanner will be out of service for several hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma team's communication? - ANS-
Huddle
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were BP 110/60
mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry. Current vital signs are
BP 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The patient is demonstrating signs
and symptoms of which stage of shock? - ANS-Compensated
