TNCC 9TH EDITION EXAM QUESTIONS
AND CORRECT ANSWERS
A patient arrives with a large metal rod embedded in their left thigh and no active
bleeding. Which intervention is most appropriate for this patient?
- answers-Prepare the patient for surgery to remove the rod
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding
would indicate sacral sparing?
- answers-Voluntary anal sphincter tone
A patient involved in a high-speed rollover is complaining of increased difficulty
breathing. There is a small penetrating wound to the sixth intercostal space in the left
lateral chest. Which finding is most consistent with an injury to the diaphragm?
- answers-Bowel sounds heard in the left lower chest
A patient is brought to the emergency department following a motor vehicle rollover and
is complaining of left upper abdominal pain and left shoulder pain. This presentation is
most consistent with an injury to which organ?
- answers-Spleen
A patient is brought to the emergency department with chest pain and shortness of
breath following a high-speed motor vehicle collision in which they were the
unrestrained driver. There is crepitus to the left chest with clear and equal breath
sounds. The vital signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40
breaths/minute. Cardiac monitor shows sinus tachycardia with premature ventricular
contractions. These findings are most consistent with which type of shock?
- answers-Cardiogenic
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which
finding is consistent with spinal shock?
- answers-Loss of reflexes
A patient presents to the emergency department after jumping from a third story and
landing on their right foot then falling to the ground. There is pain and crepitus to the
right hip when applying gentle downward and medial pressure to the iliac crests. This
mechanism of injury is most consistent with what type of pelvic fracture?
- answers-Vertical shear fracture
, A patient presents to the emergency department with a degloving injury involving the
entire forearm. What should the nurse consider when planning care for a patient with
this injury?
- answers-Surgical intervention will be needed
A patient presents, after a 25-foot fall, with paradoxical chest wall movement to the right
lower chest and complaints of shortness of breath. What is the priority intervention?
- answers-Airway and ventilation support
A patient who jumped out of a second-floor window landing on their feet is diagnosed
with a lumbar spine fracture. What is the most likely concurrent injury to have occurred?
- answers-Calcaneus fracture
A patient who sustained severe injuries was brought to the emergency department
following a high-speed motor vehicle collision. Interventions for hypovolemic shock have
been initiated. What component of the trauma triad of death is most likely to have begun
at the time of injury?
- answers-Coagulopathy
A patient with a chest tube is being transported to the intensive care unit and fluctuation
is noted in the water seal chamber during inspiration and expiration. What is the best
action for the nurse to take?
- answers-Continue to the intensive care unit
A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg
(8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which additional
finding should also be anticipated?
- answers-Widening pulse pressure
A seriously injured patient is noted to have a weak, thready pulse and cool, clammy
skin. There is instability of the pelvis on palpation and blood at the urinary meatus. A
pelvic binder is appropriately applied and balanced fluid resuscitation is being managed
by the team. What is the priority diagnostic intervention?
- answers-Retrograde urethrogram
Correct rationale: The patient is hemodynamically unstable, so quick identification of
potential bleeding sources is imperative. A focused assessment sonography for trauma
(FAST) exam can be performed at the bedside to identify pathological fluid in the
abdominal and pelvic cavities.
A severely injured patient has been intubated and is being mechanically ventilated. The
patient has received a balanced resuscitation including multiple blood products. Under
which circumstance will it be harder for the hemoglobin to release oxygen to the
tissues?
- answers-Decreased body temperature
AND CORRECT ANSWERS
A patient arrives with a large metal rod embedded in their left thigh and no active
bleeding. Which intervention is most appropriate for this patient?
- answers-Prepare the patient for surgery to remove the rod
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding
would indicate sacral sparing?
- answers-Voluntary anal sphincter tone
A patient involved in a high-speed rollover is complaining of increased difficulty
breathing. There is a small penetrating wound to the sixth intercostal space in the left
lateral chest. Which finding is most consistent with an injury to the diaphragm?
- answers-Bowel sounds heard in the left lower chest
A patient is brought to the emergency department following a motor vehicle rollover and
is complaining of left upper abdominal pain and left shoulder pain. This presentation is
most consistent with an injury to which organ?
- answers-Spleen
A patient is brought to the emergency department with chest pain and shortness of
breath following a high-speed motor vehicle collision in which they were the
unrestrained driver. There is crepitus to the left chest with clear and equal breath
sounds. The vital signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40
breaths/minute. Cardiac monitor shows sinus tachycardia with premature ventricular
contractions. These findings are most consistent with which type of shock?
- answers-Cardiogenic
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which
finding is consistent with spinal shock?
- answers-Loss of reflexes
A patient presents to the emergency department after jumping from a third story and
landing on their right foot then falling to the ground. There is pain and crepitus to the
right hip when applying gentle downward and medial pressure to the iliac crests. This
mechanism of injury is most consistent with what type of pelvic fracture?
- answers-Vertical shear fracture
, A patient presents to the emergency department with a degloving injury involving the
entire forearm. What should the nurse consider when planning care for a patient with
this injury?
- answers-Surgical intervention will be needed
A patient presents, after a 25-foot fall, with paradoxical chest wall movement to the right
lower chest and complaints of shortness of breath. What is the priority intervention?
- answers-Airway and ventilation support
A patient who jumped out of a second-floor window landing on their feet is diagnosed
with a lumbar spine fracture. What is the most likely concurrent injury to have occurred?
- answers-Calcaneus fracture
A patient who sustained severe injuries was brought to the emergency department
following a high-speed motor vehicle collision. Interventions for hypovolemic shock have
been initiated. What component of the trauma triad of death is most likely to have begun
at the time of injury?
- answers-Coagulopathy
A patient with a chest tube is being transported to the intensive care unit and fluctuation
is noted in the water seal chamber during inspiration and expiration. What is the best
action for the nurse to take?
- answers-Continue to the intensive care unit
A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm Hg
(8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which additional
finding should also be anticipated?
- answers-Widening pulse pressure
A seriously injured patient is noted to have a weak, thready pulse and cool, clammy
skin. There is instability of the pelvis on palpation and blood at the urinary meatus. A
pelvic binder is appropriately applied and balanced fluid resuscitation is being managed
by the team. What is the priority diagnostic intervention?
- answers-Retrograde urethrogram
Correct rationale: The patient is hemodynamically unstable, so quick identification of
potential bleeding sources is imperative. A focused assessment sonography for trauma
(FAST) exam can be performed at the bedside to identify pathological fluid in the
abdominal and pelvic cavities.
A severely injured patient has been intubated and is being mechanically ventilated. The
patient has received a balanced resuscitation including multiple blood products. Under
which circumstance will it be harder for the hemoglobin to release oxygen to the
tissues?
- answers-Decreased body temperature
