TNCC TRAUMA NURSING CORE
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
ACRP CP FINAL EXAM LATEST VERSION ACTUAL 150 QUESTION AND CORRECT ANSWERS AGRADE.1. Which of
the following requires you to develop a plan of action, initiate the plan, reassess the plan as
care for the patient moves forward, and adjust the plan as the patient's condition or
circumstances change?
A. Principles of PHTLS
B. The Golden Period
C. The XABCDE assessment
D. Critical thinking process - ansQuestion 1: D
To help achieve the PHTLS goals, you will apply your critical thinking skills in the field. Critical
thinking in medicine is a process in which the healthcare practitioner assesses the situation, the
patient, and the resources available and uses the information to decide on and provide the best
care for the patient.
1. You and your partner are responding to a call for a 2-year-old patient with a burn injury to
the hand. He has a visible burn to the left hand, ending at the level above the wrist, red color,
and wet in appearance. What type of burn do you suspect the patient has sustained?
A. Superficial (first degree)
B. Partial thickness (second degree)
C. Full thickness (third degree)
D. Subdermal (fourth degree) - ansQuestion 1: B
Scald burns are the most common burns seen in the pediatric population ages 1 to 5 years. Scalds
are partial thickness burns. The dermal layer is damaged, and blisters are present or popped. It
is also the most painful type of burn.
1. You are called to the scene of a possible mass casualty motor vehicle collision on the
highway. Once you arrive on scene, what is your first priority?
A. Immediately begin triaging patients.
B. Treat the patient with the most visible blood loss.
C. Determine the need for additional resources.
D. Assess the scene and ensure it is safe. - ansQuestion 1: D
Ensure safety for responders, bystanders, and patient(s). The first consideration when
approaching any scene is the safety of all emergency responders. When EMS personnel become
victims, they not only can no longer assist others, but also add to the number of patients.
1. You are called to the scene of an explosion and fire at a chemical plant where you find
multiple casualties.Triage has begun. Your first patient is a 40-year-old man who was near the
source of the explosion. He is unconscious and has extensive injuries. You note gurgling
respirations. Why should you use the trauma jaw thrust maneuver first when dealing with a
trauma patient?
A. It's an easy technique that always works to open the airway.
B. It allows you to open the airway with little or no movement of the head and cervical spine.
C. Other techniques and interventions don't work as well.
D. It can relieve a variety of anatomic airway obstructions in patients who are breathing
spontaneously. - ansQuestion 1: B
Manual maneuvers like the trauma jaw thrust or chin lift are always the first airway
maneuver you should make when treating a trauma patient. In patients with suspected head,
,TNCC TRAUMA NURSING CORE
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
neck, orfacial trauma, the cervical spine is maintained in a neutral in-line position.The trauma
jaw thrust maneuver allows you to open the airway with little or no movement of the head and
cervical spine.
1. You are responding to a call for 25-year-old, fit and healthy female who fell off a mountain
bike. Upon arrival, you find the patient walking around. She is alert but complaining of pain in
her clavicle and on her right side when she inhales. You notice that her helmet is split in two.
What is the first thing you need to do?
A. Complete a review of the ABCs.
B. Check motor and sensory function.
C. Perform manual in-line stabilization.
D. Place her on a backboard. - ansQuestion 1: C
Because there's a possibility of spinal injury, you should bring the patient's head into a neutral
in-line position.
1. You have been performing ongoing management on a 35-year-old female patient who sustained
thoracic trauma when a car hit her as she crossed the street. Originally, your electronic
monitoring devices all produce results consistent with your patient's clinical condition. However,
en route the trauma center, the monitors start to differ from your patient's current clinical
condition each time you reassess. How should you handle this situation?
A. Treat the patient's condition, not the monitor results.
B. Continue to reassess the patient and record the results for the trauma center.
C. Treat your patient based on the test results.
D. Stop testing and wait until you arrive at the trauma center for them to perform an
assessment. - ansQuestion 1: A
If there are inconsistent data from electronic monitoring devices, reassess to be sure the
monitor matches the patient's current clinical condition. However, it is most important to treat
the patient, not the monitor, so use other signs and symptoms of potential patient deterioration.
1. You're called out to an assisted living facility for a 72-year-old woman complaining of a
severe headache and experiencing increased confusion. Staff reports she fell out of her
wheelchair earlier in the week but didn't appear to be hurt; however, she's become increasingly
disoriented over the last day or so. Vital signs show: BP 110/90; heartrate 118 and irregularly
regular; ventilation rate 20 and slightly labored; SpO2 93% on room air. She is taking warfarin
for a clotting issue. Which of the following should you suspect?
A. Cerebral contusion
B. Epidural hematoma
C. Subarachnoid hemorrhage
D. Subdural hematoma - ansQuestion 1: D
The patient's age, use of a blood thinner, and the fact she fell recently point to a subdural
hematoma.
1. Your partner is compressing the bleeding site of a male patient who was stabbed multiple
times in the left chest. The bleeding seems to be controlled, yet the patient becomes combative.
He is pale and is breathing rapidly, yet states that he "can't breathe" and feels that he is about
to die. Your next step in patient management is to:
A. start assisted ventilation.
B. give high-flow oxygen.
C. decompress the left chest.
,TNCC TRAUMA NURSING CORE
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
D. give a 250-mL fluid bolus. - ansQuestion 1: C
After X come A and B. You can quickly auscultate the lungs (pneumothorax is almost certain
with multiple stabs in the chest) and decompress the chest. Decompressing a tension
pneumothorax is the quickest way to treat shock.
1. Your patient is experiencing severe pain after sustaining a femur fracture in a motorcycle
crash. You have a 20 minute transport to the nearest trauma center. There are no other injuries
noted on your primary and secondary assessments. Which of the following medications would be
the best pain management choice?
A. NSAIDs
B. Acetaminophen
C. Fentanyl
D. Morphine - ansQuestion 1: C
Fentanyl is often a first-line agent due to speed of onset, short duration of action, and minimal
effect on hemodynamics. Fentanyl can beadministered IN, IM, IO, or IV. The IV route provides effects
instantly whereasthe IN and IM route have an onset of <10 minutes. The duration of fentanyl is
short at 30 minutes to an hour. This will provide enough time to ease pain during transport and
let the traumacenter decide pain management upon arrival.
2. A trauma patient from the highway incident is holding her right arm, and you note a significant
amount of blood steadily flowing from a long gash. This is an example of what type of
hemorrhage?
A. Capillary bleeding
B. Venous bleeding
C. Arterial bleeding
D. Road rash - ansQuestion 2: B
Venous bleeding typically results in a steady flow of dark red blood.
2. During primary survey, you find the following:
. LOC: alert and oriented; speaking in full sentences
. GCS: 15
. Airway: good air entry to bases
. Breathing: bilateral
. Circulation: skin warm, flushed, dry
. Pulse rate: 112 bpm, strong andregular
. BP: 90/42 mm Hg
. Pain: Patient complains of severe pain at clavicle site and pain on inspiration at site of possible
fractured ribs. No other injuries detected. What is your next step?
A. Apply a cervical collar and in-line immobilization device.
B. Treat for hypovolemic shock.
C. Apply an arm sling for the clavicle injury.
D. Administer pain medication. - ansQuestion 2: A
Although the patient's GCS is normal, she does have a distracting injury, and the state of her
helmet indicates possible spinal compression/flexion, so you should immobilize the patient.
2. The patient becomes apneic. You suspect he has a cervical injury. Which type of airway should
you use?
A. Supraglottic airway
B. Blind nasotracheal intubation
, TNCC TRAUMA NURSING CORE
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
C. Oropharyngeal airway
D. Surgical airway - ansQuestion 2: A
The supraglottic airway's greatest advantage is that it can be inserted independent of the
patient's position, which may be especially important in trauma patients with high suspicion of
cervical injury.
2. The patient's care giver is a babysitter who reports the child was crawling on the counter and
placed his hand in a pot of water that was boiling on the stove. She is applying ice to the burn
and the child is shivering. What is your next step?
A. Administer analgesia for pain.
B. Cover the patient with a blanket to stop the shivering.
C. Start IV for fluid resuscitation.
D. Stop the burning process and remove the ice pack. - ansQuestion 2: D
A common error that results in damage to the zone of stasis is the application of ice by a
bystander or prehospital care practitioner. When ice is applied to a burn, the patient will
experience some reduction in pain; however, the pain relief will be at the expense of additional
tissue destruction.
2. The patient's respiration improves markedly, but he remains confused. He has an absent radial
pulse, and his carotid pulse is fast and thready. Your partner asks if he can let the compression
go to put in an IV. How should you respond?
A. "Oh yes, that's a great idea!"
B. "Yes, but we have to immobilize him first"
C. "Take a blood pressure first to see if he needs an IV."
D. "No, keep the pressure and let's get out of here!" - ansQuestion 2: D
This patient is likely in decompensated shock with internal bleeding, so rapid transport is the
next priority. You should maintain pressure on the wound, because having massive external
bleeding start up again is the last thing you want in this situation.
2. Upon examination, you find the patient responsive to your presence, although she is clearly
confused. Motor response shows reduced pain response but normal flexion. What's her GCS score?
A. 15
B. 12
C. 10
D. 8 - ansQuestion 2: B
Eye opening: 4; verbal response: 4; motor response: 4 = 12
2. When using the XABCDE assessment, which of the following takes precedence over all other
actions?
A. Controlling severe bleeding from a limb or other compressible site
B. Airway stabilization and assessing circulatory status
C. Exposing the body to allow a thorough evaluation
D. Ensuring adequate breathing - ansQuestion 2: A
The "X" placed before "ABCDE" in the primary survey refers to the need to address exsanguinating
hemorrhage immediately after establishing scene safety and before addressing airway. Severe
exsanguinating hemorrhage, particularly arterial bleeding, has the potential to lead to loss
of total or near total blood volume in a relatively short period of time.
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
ACRP CP FINAL EXAM LATEST VERSION ACTUAL 150 QUESTION AND CORRECT ANSWERS AGRADE.1. Which of
the following requires you to develop a plan of action, initiate the plan, reassess the plan as
care for the patient moves forward, and adjust the plan as the patient's condition or
circumstances change?
A. Principles of PHTLS
B. The Golden Period
C. The XABCDE assessment
D. Critical thinking process - ansQuestion 1: D
To help achieve the PHTLS goals, you will apply your critical thinking skills in the field. Critical
thinking in medicine is a process in which the healthcare practitioner assesses the situation, the
patient, and the resources available and uses the information to decide on and provide the best
care for the patient.
1. You and your partner are responding to a call for a 2-year-old patient with a burn injury to
the hand. He has a visible burn to the left hand, ending at the level above the wrist, red color,
and wet in appearance. What type of burn do you suspect the patient has sustained?
A. Superficial (first degree)
B. Partial thickness (second degree)
C. Full thickness (third degree)
D. Subdermal (fourth degree) - ansQuestion 1: B
Scald burns are the most common burns seen in the pediatric population ages 1 to 5 years. Scalds
are partial thickness burns. The dermal layer is damaged, and blisters are present or popped. It
is also the most painful type of burn.
1. You are called to the scene of a possible mass casualty motor vehicle collision on the
highway. Once you arrive on scene, what is your first priority?
A. Immediately begin triaging patients.
B. Treat the patient with the most visible blood loss.
C. Determine the need for additional resources.
D. Assess the scene and ensure it is safe. - ansQuestion 1: D
Ensure safety for responders, bystanders, and patient(s). The first consideration when
approaching any scene is the safety of all emergency responders. When EMS personnel become
victims, they not only can no longer assist others, but also add to the number of patients.
1. You are called to the scene of an explosion and fire at a chemical plant where you find
multiple casualties.Triage has begun. Your first patient is a 40-year-old man who was near the
source of the explosion. He is unconscious and has extensive injuries. You note gurgling
respirations. Why should you use the trauma jaw thrust maneuver first when dealing with a
trauma patient?
A. It's an easy technique that always works to open the airway.
B. It allows you to open the airway with little or no movement of the head and cervical spine.
C. Other techniques and interventions don't work as well.
D. It can relieve a variety of anatomic airway obstructions in patients who are breathing
spontaneously. - ansQuestion 1: B
Manual maneuvers like the trauma jaw thrust or chin lift are always the first airway
maneuver you should make when treating a trauma patient. In patients with suspected head,
,TNCC TRAUMA NURSING CORE
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
neck, orfacial trauma, the cervical spine is maintained in a neutral in-line position.The trauma
jaw thrust maneuver allows you to open the airway with little or no movement of the head and
cervical spine.
1. You are responding to a call for 25-year-old, fit and healthy female who fell off a mountain
bike. Upon arrival, you find the patient walking around. She is alert but complaining of pain in
her clavicle and on her right side when she inhales. You notice that her helmet is split in two.
What is the first thing you need to do?
A. Complete a review of the ABCs.
B. Check motor and sensory function.
C. Perform manual in-line stabilization.
D. Place her on a backboard. - ansQuestion 1: C
Because there's a possibility of spinal injury, you should bring the patient's head into a neutral
in-line position.
1. You have been performing ongoing management on a 35-year-old female patient who sustained
thoracic trauma when a car hit her as she crossed the street. Originally, your electronic
monitoring devices all produce results consistent with your patient's clinical condition. However,
en route the trauma center, the monitors start to differ from your patient's current clinical
condition each time you reassess. How should you handle this situation?
A. Treat the patient's condition, not the monitor results.
B. Continue to reassess the patient and record the results for the trauma center.
C. Treat your patient based on the test results.
D. Stop testing and wait until you arrive at the trauma center for them to perform an
assessment. - ansQuestion 1: A
If there are inconsistent data from electronic monitoring devices, reassess to be sure the
monitor matches the patient's current clinical condition. However, it is most important to treat
the patient, not the monitor, so use other signs and symptoms of potential patient deterioration.
1. You're called out to an assisted living facility for a 72-year-old woman complaining of a
severe headache and experiencing increased confusion. Staff reports she fell out of her
wheelchair earlier in the week but didn't appear to be hurt; however, she's become increasingly
disoriented over the last day or so. Vital signs show: BP 110/90; heartrate 118 and irregularly
regular; ventilation rate 20 and slightly labored; SpO2 93% on room air. She is taking warfarin
for a clotting issue. Which of the following should you suspect?
A. Cerebral contusion
B. Epidural hematoma
C. Subarachnoid hemorrhage
D. Subdural hematoma - ansQuestion 1: D
The patient's age, use of a blood thinner, and the fact she fell recently point to a subdural
hematoma.
1. Your partner is compressing the bleeding site of a male patient who was stabbed multiple
times in the left chest. The bleeding seems to be controlled, yet the patient becomes combative.
He is pale and is breathing rapidly, yet states that he "can't breathe" and feels that he is about
to die. Your next step in patient management is to:
A. start assisted ventilation.
B. give high-flow oxygen.
C. decompress the left chest.
,TNCC TRAUMA NURSING CORE
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
D. give a 250-mL fluid bolus. - ansQuestion 1: C
After X come A and B. You can quickly auscultate the lungs (pneumothorax is almost certain
with multiple stabs in the chest) and decompress the chest. Decompressing a tension
pneumothorax is the quickest way to treat shock.
1. Your patient is experiencing severe pain after sustaining a femur fracture in a motorcycle
crash. You have a 20 minute transport to the nearest trauma center. There are no other injuries
noted on your primary and secondary assessments. Which of the following medications would be
the best pain management choice?
A. NSAIDs
B. Acetaminophen
C. Fentanyl
D. Morphine - ansQuestion 1: C
Fentanyl is often a first-line agent due to speed of onset, short duration of action, and minimal
effect on hemodynamics. Fentanyl can beadministered IN, IM, IO, or IV. The IV route provides effects
instantly whereasthe IN and IM route have an onset of <10 minutes. The duration of fentanyl is
short at 30 minutes to an hour. This will provide enough time to ease pain during transport and
let the traumacenter decide pain management upon arrival.
2. A trauma patient from the highway incident is holding her right arm, and you note a significant
amount of blood steadily flowing from a long gash. This is an example of what type of
hemorrhage?
A. Capillary bleeding
B. Venous bleeding
C. Arterial bleeding
D. Road rash - ansQuestion 2: B
Venous bleeding typically results in a steady flow of dark red blood.
2. During primary survey, you find the following:
. LOC: alert and oriented; speaking in full sentences
. GCS: 15
. Airway: good air entry to bases
. Breathing: bilateral
. Circulation: skin warm, flushed, dry
. Pulse rate: 112 bpm, strong andregular
. BP: 90/42 mm Hg
. Pain: Patient complains of severe pain at clavicle site and pain on inspiration at site of possible
fractured ribs. No other injuries detected. What is your next step?
A. Apply a cervical collar and in-line immobilization device.
B. Treat for hypovolemic shock.
C. Apply an arm sling for the clavicle injury.
D. Administer pain medication. - ansQuestion 2: A
Although the patient's GCS is normal, she does have a distracting injury, and the state of her
helmet indicates possible spinal compression/flexion, so you should immobilize the patient.
2. The patient becomes apneic. You suspect he has a cervical injury. Which type of airway should
you use?
A. Supraglottic airway
B. Blind nasotracheal intubation
, TNCC TRAUMA NURSING CORE
COURSE 17TH EDITION ENA TEST
BANK VERIFIED PASS
C. Oropharyngeal airway
D. Surgical airway - ansQuestion 2: A
The supraglottic airway's greatest advantage is that it can be inserted independent of the
patient's position, which may be especially important in trauma patients with high suspicion of
cervical injury.
2. The patient's care giver is a babysitter who reports the child was crawling on the counter and
placed his hand in a pot of water that was boiling on the stove. She is applying ice to the burn
and the child is shivering. What is your next step?
A. Administer analgesia for pain.
B. Cover the patient with a blanket to stop the shivering.
C. Start IV for fluid resuscitation.
D. Stop the burning process and remove the ice pack. - ansQuestion 2: D
A common error that results in damage to the zone of stasis is the application of ice by a
bystander or prehospital care practitioner. When ice is applied to a burn, the patient will
experience some reduction in pain; however, the pain relief will be at the expense of additional
tissue destruction.
2. The patient's respiration improves markedly, but he remains confused. He has an absent radial
pulse, and his carotid pulse is fast and thready. Your partner asks if he can let the compression
go to put in an IV. How should you respond?
A. "Oh yes, that's a great idea!"
B. "Yes, but we have to immobilize him first"
C. "Take a blood pressure first to see if he needs an IV."
D. "No, keep the pressure and let's get out of here!" - ansQuestion 2: D
This patient is likely in decompensated shock with internal bleeding, so rapid transport is the
next priority. You should maintain pressure on the wound, because having massive external
bleeding start up again is the last thing you want in this situation.
2. Upon examination, you find the patient responsive to your presence, although she is clearly
confused. Motor response shows reduced pain response but normal flexion. What's her GCS score?
A. 15
B. 12
C. 10
D. 8 - ansQuestion 2: B
Eye opening: 4; verbal response: 4; motor response: 4 = 12
2. When using the XABCDE assessment, which of the following takes precedence over all other
actions?
A. Controlling severe bleeding from a limb or other compressible site
B. Airway stabilization and assessing circulatory status
C. Exposing the body to allow a thorough evaluation
D. Ensuring adequate breathing - ansQuestion 2: A
The "X" placed before "ABCDE" in the primary survey refers to the need to address exsanguinating
hemorrhage immediately after establishing scene safety and before addressing airway. Severe
exsanguinating hemorrhage, particularly arterial bleeding, has the potential to lead to loss
of total or near total blood volume in a relatively short period of time.
