Page 1 of 120
TNCC 9TH EDITION EXAM AND STUDY GUIDE NEWEST 2025
TEST BANK| COMPLETE 350 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (MOST RECENT!!)
Which of the following assessment findings differentiates a tension
pneumothorax from a simple pneumothorax?
A. Increased work of breathing
B. Unilaterally diminished breath sounds
C. Tachycardia
D. Hypotension - Correct Answer - D. Hypotension
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, what is
the priority intervention?
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter - Correct Answer - A. Initiate
transfer to a trauma center
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
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,Page 2 of 120
C. Apply direct pressure to the wound
D. Use a tourniquet to control the bleeding - Correct Answer - C. Apply
direct pressure to the wound
A trauma patient involved in a fall from 25 feet has a traumatic brain
injury, three anterior rib fractures on the right side, a small
pneumothorax on the right, and a Grade III liver injury. The patient was
intubated and placed on a ventilator with PEEP. Chest tube was deferred
at this time. Upon reassessment, which finding is most concerning?
A. Severely diminished breath sounds on the right
B. Guarding in the right upper quadrant
C. Ecchymosis in the right upper quadrant
D. Crepitus to the right chest - Correct Answer - A. Severely diminished
breath sounds on the right
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. Increased respiratory effort
B. Widening pulse pressure
C. Reflex tachycardia
D. Reflex hypotension - Correct Answer - B. Widening pulse pressure
Rationale: Head and Torso Trauma\Head Trauma
This patient has a CPP (MAP − ICP) of less than 60 mm Hg (8 kPa)
which is associated with poor outcomes. When the CPP falls below
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normal levels, the central nervous system initiates the Cushing response
in an attempt to increase mean arterial pressure and improve CPP.
Cushing response assessment findings include widening pulse pressure,
reflex bradycardia, and irregular, decreased respiratory effort.
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?
A. Surgical intervention
B. Chest tube insertion
C. Needle decompression
D. Airway and ventilation support - Correct Answer - D. Airway and
ventilation support
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
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 - Correct Answer - C.
Disseminated intravascular coagulopathy
An older adult presents to the emergency department with complaints of
dizziness, headache, and nausea. The patient was involved in a motor
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, Page 4 of 120
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 - Correct Answer - D. Post-concussive
syndrome
Rationale: Special Populations\Older Adult
Post-concussive syndrome can occur days to weeks after injury or
trauma. The other three conditions present as a more rapid decline,
especially in patients who are on anticoagulants.
Your patient was the unrestrained driver involved in a moderate speed
motor vehicle collision. Assessment reveals tenderness in the upper right
quadrant, crepitus in the lower right ribs, and ecchymosis around the
umbilicus. The nurse is concerned about injury to which organ?
A. Transverse colon
B. Pancreas
C. Liver
D. Spleen - Correct Answer - C. Liver
Rationale: Head and Torso Trauma\Abdominal and Pelvic Trauma
Liver injuries are associated with right, lower rib fractures. They also
can present with tenderness, guarding, or rigidity in the right upper
quadrant, along with ecchymosis of the right upper quadrant or around
the umbilicus, known as Cullen's sign
pg. 4
TNCC 9TH EDITION EXAM AND STUDY GUIDE NEWEST 2025
TEST BANK| COMPLETE 350 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (MOST RECENT!!)
Which of the following assessment findings differentiates a tension
pneumothorax from a simple pneumothorax?
A. Increased work of breathing
B. Unilaterally diminished breath sounds
C. Tachycardia
D. Hypotension - Correct Answer - D. Hypotension
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, what is
the priority intervention?
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter - Correct Answer - A. Initiate
transfer to a trauma center
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
pg. 1
,Page 2 of 120
C. Apply direct pressure to the wound
D. Use a tourniquet to control the bleeding - Correct Answer - C. Apply
direct pressure to the wound
A trauma patient involved in a fall from 25 feet has a traumatic brain
injury, three anterior rib fractures on the right side, a small
pneumothorax on the right, and a Grade III liver injury. The patient was
intubated and placed on a ventilator with PEEP. Chest tube was deferred
at this time. Upon reassessment, which finding is most concerning?
A. Severely diminished breath sounds on the right
B. Guarding in the right upper quadrant
C. Ecchymosis in the right upper quadrant
D. Crepitus to the right chest - Correct Answer - A. Severely diminished
breath sounds on the right
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. Increased respiratory effort
B. Widening pulse pressure
C. Reflex tachycardia
D. Reflex hypotension - Correct Answer - B. Widening pulse pressure
Rationale: Head and Torso Trauma\Head Trauma
This patient has a CPP (MAP − ICP) of less than 60 mm Hg (8 kPa)
which is associated with poor outcomes. When the CPP falls below
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,Page 3 of 120
normal levels, the central nervous system initiates the Cushing response
in an attempt to increase mean arterial pressure and improve CPP.
Cushing response assessment findings include widening pulse pressure,
reflex bradycardia, and irregular, decreased respiratory effort.
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?
A. Surgical intervention
B. Chest tube insertion
C. Needle decompression
D. Airway and ventilation support - Correct Answer - D. Airway and
ventilation support
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
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 - Correct Answer - C.
Disseminated intravascular coagulopathy
An older adult presents to the emergency department with complaints of
dizziness, headache, and nausea. The patient was involved in a motor
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, Page 4 of 120
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 - Correct Answer - D. Post-concussive
syndrome
Rationale: Special Populations\Older Adult
Post-concussive syndrome can occur days to weeks after injury or
trauma. The other three conditions present as a more rapid decline,
especially in patients who are on anticoagulants.
Your patient was the unrestrained driver involved in a moderate speed
motor vehicle collision. Assessment reveals tenderness in the upper right
quadrant, crepitus in the lower right ribs, and ecchymosis around the
umbilicus. The nurse is concerned about injury to which organ?
A. Transverse colon
B. Pancreas
C. Liver
D. Spleen - Correct Answer - C. Liver
Rationale: Head and Torso Trauma\Abdominal and Pelvic Trauma
Liver injuries are associated with right, lower rib fractures. They also
can present with tenderness, guarding, or rigidity in the right upper
quadrant, along with ecchymosis of the right upper quadrant or around
the umbilicus, known as Cullen's sign
pg. 4
