TNCC 20th Edition TNP LATEST 2023-2024
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority
intervention?
A.Initiate two intravenous access sites
B.Place the patient on supplemental oxygen
C.Apply direct pressure to the wound
D.Use a tourniquet to control the bleeding - ansC.Apply direct pressure to the wound
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?
A.Severe left-sided abdominal pain
B.Bowel sounds heard in the left lower chest
C.Pain radiating to the left shoulder.
D.Decreased breath sounds on the left side - ansBowel sounds heard in the left lower chest
A patient is brought to the emergency department following a snowmobile crash with prolonged exposure
time prior to transport. The patient is confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR
24 breaths/minute, T 34.6oC (94.2oF) and an SpO2 of 90% on oxygen at 15L per non-rebreather mask.
Other findings include ETCO2 24, serum lactate of 6 mmol/L, and a pH of 6.8. Based on these findings,
what is the most appropriate intervention?
A.Initiate warming measures
B.Titrate oxygen to - ansA.Initiate warming measures
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?
A.Cardiogenic
B.Neuroge - ansA.Cardiogenic
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is consistent
with spinal shock?
A.Bradycardia
B.Loss of reflexes
C.Widened pulse pressure
D.Warm skin - ansB.Loss of reflexes
A patient is thrown against a car during a tornado and presents with obvious bilateral femur 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?
A.Initiate two large-caliber intravenous lines for isotonic crystalloid administration.
B.Administer intravenous medications for pain.
,TNCC 20th Edition TNP LATEST 2023-2024
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
C.Place the patient in an observation area for care within the n - ansInitiate two large-caliber intravenous
lines for isotonic crystalloid administration.
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?
A.Acidosis
B.Hypothermia
C.Hypocalcemia
D.Coagulopathy - ansD.Coagulopathy
A patient who weighs 120 kg is brought to the emergency department after sustaining partial thickness
burns to both upper extremities and chest with a total body surface area burned of 27%. How much
intravenous fluid should be administered in the first 8 hours?
A.1620 mL
B.2160 mL
C.3240 mL
D.6480 mL - ansC.3240 mL
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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg - ansC.Elevating the leg to the level of the heart
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 finding is most likely an indication of the body's
response to these findings?
A.Reflex hypotension
B.Increased respiratory effort
C.Reflex tachycardia
D.Widening pulse pressure - ansD.Widening pulse pressure
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?
A.Decreased pH
B.Elevated carbon dioxide level
C.Decreased body temperature
D.Increased metabolic demand - ansC.Decreased body temperature
A trauma patient is being held in the emergency department because there are no available inpatient
beds. The patient sustained a femur fracture and required multiple blood products. The patient now has
,TNCC 20th Edition TNP LATEST 2023-2024
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
blood oozing from abrasions, IV sites, the nose, and gums. What condition is most consistent with these
findings?
A.Rhabdomyolysis
B.Fat embolism
C.Disseminated intravascular coagulopathy
D.Multiple organ dysfunctions syndrome - ansC.Disseminated intravascular coagulopathy
A trauma patient who is 30-weeks pregnant arrives at the emergency department following a motor
vehicle collision. Which normal physiologic change should be considered when assessing ventilatory
status?
A.Increased functional reserve capacity
B.Increased oxygen consumption
C.Decreased minute ventilation
D.Slower desaturation rates with apnea - ansB.Increased oxygen consumption
An adult patient involved in a motor vehicle collision is brought to the emergency department of a rural
critical access facility. They complain of neck pain, shortness of breath, and diffuse abdominal pain. The
Glasgow Coma Score is 15. Vital signs are: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute,
and SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the following is the priority
intervention for this patient?
A.Expedite transport to the CT scanner
B.Prepare the pati - ansC.Expedite transfer to the closest trauma center
An adult patient was brought to the emergency department following a motorcycle crash. On arrival, the
patient is only responsive to pain, has bleeding from the nose, and multiple abrasions and contusions to
the face. What is the priority intervention?
A.Use a bulb syringe to suction out secretions from the mouth.
B.Insert a nasopharyngeal airway to maintain an open airway.
C.Use a jaw thrust to open the airway and look for signs of obstruction.
D.Ask the patient to open their mouth to inspect - ansC.Use a jaw thrust to open the airway and look for
signs of obstruction.
An adult patient who sustained a severe head trauma has been intubated and is being manually ventilated
via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus
of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse
oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage the cerebral
blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Re - ansA.Decrease the rate of manual ventilation.
An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph. The patient
is awake and alert and the right leg is shortened. Following initial resuscitation with fluids, the patient
remains hypotensive. What would be the priority intervention?
, TNCC 20th Edition TNP LATEST 2023-2024
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
A.Send blood for type and crossmatch
B.Apply a pelvic binder
C.Prepare the patient for surgery
D.Insert a urinary catheter - ansApply a pelvic binder
An adult was thrown against a concrete wall during a factory explosion and sustained a femur fracture,
liver laceration, and a small subdural hematoma. These injuries most likely occurred during what level of
blast trauma?
A.Primary
B.Secondary
C.Tertiary
D.Quaternary - ansC.Tertiary
An obese trauma patient requires intubation. Assuming there are no contraindications, which position will
provide the best visualization for insertion of the endotracheal tube?
A.Reverse Trendelenburg
B.Lying on side
C.Ramped
D.Supine - ansC.Ramped
An older adult presents to the emergency department with complaints of dizziness, headache, and
nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome - anspost-concussive syndrome
An unconscious patient arrives following a motor vehicle collision. The patient is on a backboard with a
cervical collar in place and one intravenous line running. Respirations are shallow and there is active
brisk bleeding from a large leg wound. What is the priority intervention for this patient?
A.Check for a patent airway
B.Control the bleeding
C.Start a second intravenous line
D.Ventilate with a bag-mask device - ansB.Control the bleeding
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting, psychosocial support,
social services, splinting, tetanus, and wound care are all interventions that you do AFTER and before
WHAT? - ansAFTER head-to-toe, BEFORE J (VIPP)
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries? - ansIn Step 15 of
"Exposure and Environment"
Based on fall mechanism, which patient warrants prehospital transfer to a trauma center?
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
A patient has uncontrolled bleeding from a wound to his right upper extremity. What is the priority
intervention?
A.Initiate two intravenous access sites
B.Place the patient on supplemental oxygen
C.Apply direct pressure to the wound
D.Use a tourniquet to control the bleeding - ansC.Apply direct pressure to the wound
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?
A.Severe left-sided abdominal pain
B.Bowel sounds heard in the left lower chest
C.Pain radiating to the left shoulder.
D.Decreased breath sounds on the left side - ansBowel sounds heard in the left lower chest
A patient is brought to the emergency department following a snowmobile crash with prolonged exposure
time prior to transport. The patient is confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR
24 breaths/minute, T 34.6oC (94.2oF) and an SpO2 of 90% on oxygen at 15L per non-rebreather mask.
Other findings include ETCO2 24, serum lactate of 6 mmol/L, and a pH of 6.8. Based on these findings,
what is the most appropriate intervention?
A.Initiate warming measures
B.Titrate oxygen to - ansA.Initiate warming measures
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?
A.Cardiogenic
B.Neuroge - ansA.Cardiogenic
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is consistent
with spinal shock?
A.Bradycardia
B.Loss of reflexes
C.Widened pulse pressure
D.Warm skin - ansB.Loss of reflexes
A patient is thrown against a car during a tornado and presents with obvious bilateral femur 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?
A.Initiate two large-caliber intravenous lines for isotonic crystalloid administration.
B.Administer intravenous medications for pain.
,TNCC 20th Edition TNP LATEST 2023-2024
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
C.Place the patient in an observation area for care within the n - ansInitiate two large-caliber intravenous
lines for isotonic crystalloid administration.
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?
A.Acidosis
B.Hypothermia
C.Hypocalcemia
D.Coagulopathy - ansD.Coagulopathy
A patient who weighs 120 kg is brought to the emergency department after sustaining partial thickness
burns to both upper extremities and chest with a total body surface area burned of 27%. How much
intravenous fluid should be administered in the first 8 hours?
A.1620 mL
B.2160 mL
C.3240 mL
D.6480 mL - ansC.3240 mL
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?
A.Elevating the leg above the level of the heart
B.Repositioning the leg and applying ice
C.Elevating the leg to the level of the heart
D.Preparing the patient for ultrasound of the leg - ansC.Elevating the leg to the level of the heart
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 finding is most likely an indication of the body's
response to these findings?
A.Reflex hypotension
B.Increased respiratory effort
C.Reflex tachycardia
D.Widening pulse pressure - ansD.Widening pulse pressure
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?
A.Decreased pH
B.Elevated carbon dioxide level
C.Decreased body temperature
D.Increased metabolic demand - ansC.Decreased body temperature
A trauma patient is being held in the emergency department because there are no available inpatient
beds. The patient sustained a femur fracture and required multiple blood products. The patient now has
,TNCC 20th Edition TNP LATEST 2023-2024
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
blood oozing from abrasions, IV sites, the nose, and gums. What condition is most consistent with these
findings?
A.Rhabdomyolysis
B.Fat embolism
C.Disseminated intravascular coagulopathy
D.Multiple organ dysfunctions syndrome - ansC.Disseminated intravascular coagulopathy
A trauma patient who is 30-weeks pregnant arrives at the emergency department following a motor
vehicle collision. Which normal physiologic change should be considered when assessing ventilatory
status?
A.Increased functional reserve capacity
B.Increased oxygen consumption
C.Decreased minute ventilation
D.Slower desaturation rates with apnea - ansB.Increased oxygen consumption
An adult patient involved in a motor vehicle collision is brought to the emergency department of a rural
critical access facility. They complain of neck pain, shortness of breath, and diffuse abdominal pain. The
Glasgow Coma Score is 15. Vital signs are: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute,
and SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the following is the priority
intervention for this patient?
A.Expedite transport to the CT scanner
B.Prepare the pati - ansC.Expedite transfer to the closest trauma center
An adult patient was brought to the emergency department following a motorcycle crash. On arrival, the
patient is only responsive to pain, has bleeding from the nose, and multiple abrasions and contusions to
the face. What is the priority intervention?
A.Use a bulb syringe to suction out secretions from the mouth.
B.Insert a nasopharyngeal airway to maintain an open airway.
C.Use a jaw thrust to open the airway and look for signs of obstruction.
D.Ask the patient to open their mouth to inspect - ansC.Use a jaw thrust to open the airway and look for
signs of obstruction.
An adult patient who sustained a severe head trauma has been intubated and is being manually ventilated
via a bag-mask device at a rate of 18 breaths/minute. The patient has received one intravenous fluid bolus
of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0 kPa), and the pulse
oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to manage the cerebral
blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Re - ansA.Decrease the rate of manual ventilation.
An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph. The patient
is awake and alert and the right leg is shortened. Following initial resuscitation with fluids, the patient
remains hypotensive. What would be the priority intervention?
, TNCC 20th Edition TNP LATEST 2023-2024
EXAM WITH COMPLETE 75 QUESTIONS AND
CORRECT ANSWERS-GRADED A+ pass
A.Send blood for type and crossmatch
B.Apply a pelvic binder
C.Prepare the patient for surgery
D.Insert a urinary catheter - ansApply a pelvic binder
An adult was thrown against a concrete wall during a factory explosion and sustained a femur fracture,
liver laceration, and a small subdural hematoma. These injuries most likely occurred during what level of
blast trauma?
A.Primary
B.Secondary
C.Tertiary
D.Quaternary - ansC.Tertiary
An obese trauma patient requires intubation. Assuming there are no contraindications, which position will
provide the best visualization for insertion of the endotracheal tube?
A.Reverse Trendelenburg
B.Lying on side
C.Ramped
D.Supine - ansC.Ramped
An older adult presents to the emergency department with complaints of dizziness, headache, and
nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
A.Intracerebral hemorrhage
B.Epidural hematoma
C.Diffuse axonal injury
D.Post-concussive syndrome - anspost-concussive syndrome
An unconscious patient arrives following a motor vehicle collision. The patient is on a backboard with a
cervical collar in place and one intravenous line running. Respirations are shallow and there is active
brisk bleeding from a large leg wound. What is the priority intervention for this patient?
A.Check for a patent airway
B.Control the bleeding
C.Start a second intravenous line
D.Ventilate with a bag-mask device - ansB.Control the bleeding
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting, psychosocial support,
social services, splinting, tetanus, and wound care are all interventions that you do AFTER and before
WHAT? - ansAFTER head-to-toe, BEFORE J (VIPP)
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries? - ansIn Step 15 of
"Exposure and Environment"
Based on fall mechanism, which patient warrants prehospital transfer to a trauma center?
