TNCC EXAM 8TH EDITION ACTUAL EXAM REVIEW
QUESTIONS AND CORRECT ANSWERS 2025
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve
Answer - Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in
an environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant
damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When it
is appropriate to remove the cervical collar?
Answer - After a physical examination if the patient has no radiologic abnormalities on CT A CT is
recommended for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the
total body surface area burned, how much IV fluid would be administered in the first 8 hours?
Answer - 2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2
* 120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA
calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected
to a chest drainage system
Answer - Fluctuation in the water seal chamber Fluctuation in the water seal chamber indicates the
tube is placed correctly in the pleural space.
.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?
Answer - Globe rupture A teardrop-shaped pupil suggests a globe rupture.
, A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension
and which other clinical signs?
Answer - Bradycardia and absent motor function below the level of injury Patients with a complete
spinal cord injury will have absent motor function below the level of the lesion. They become
hypotensive and bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center?
Answer - A 52-year-old diabetic male with a partial-thickness burn to the left lower leg This patient has
a 7% TBSA burn with a preexisting medical history that could complicate management, prolong
recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks
pregnant. Findings of your secondary survey include abdominal pain on palpation, fundal height
at the costal margin, and some dark bloody show. Varying accelerations and decelerations are
noted on cardiotocography. These findings are most consistent with which of the following?
Answer - Placental abruption The findings of abdominal pain, elevated fundal height, dark bloody
show, and fetal distress are most consistent with placental abruption.
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?
Answer - Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash?
Answer - The aorta is torn at its attachment with the ligamentum arteriosum This occurs during the
third impact.
QUESTIONS AND CORRECT ANSWERS 2025
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve
Answer - Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in
an environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant
damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When it
is appropriate to remove the cervical collar?
Answer - After a physical examination if the patient has no radiologic abnormalities on CT A CT is
recommended for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the
total body surface area burned, how much IV fluid would be administered in the first 8 hours?
Answer - 2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2
* 120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA
calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected
to a chest drainage system
Answer - Fluctuation in the water seal chamber Fluctuation in the water seal chamber indicates the
tube is placed correctly in the pleural space.
.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?
Answer - Globe rupture A teardrop-shaped pupil suggests a globe rupture.
, A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension
and which other clinical signs?
Answer - Bradycardia and absent motor function below the level of injury Patients with a complete
spinal cord injury will have absent motor function below the level of the lesion. They become
hypotensive and bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center?
Answer - A 52-year-old diabetic male with a partial-thickness burn to the left lower leg This patient has
a 7% TBSA burn with a preexisting medical history that could complicate management, prolong
recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks
pregnant. Findings of your secondary survey include abdominal pain on palpation, fundal height
at the costal margin, and some dark bloody show. Varying accelerations and decelerations are
noted on cardiotocography. These findings are most consistent with which of the following?
Answer - Placental abruption The findings of abdominal pain, elevated fundal height, dark bloody
show, and fetal distress are most consistent with placental abruption.
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?
Answer - Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash?
Answer - The aorta is torn at its attachment with the ligamentum arteriosum This occurs during the
third impact.
