TNCC 9TH EDITION EXAM PREPARATION GUIDE COMPLETE
TEST BANK WITH 200 VERIFIED QUESTIONS COVERING
PRIMARY SURVEY, SHOCK RESUSCITATION, SPINAL CORD
INJURY, BLUNT & PENETRATING TRAUMA, MASSIVE
TRANSFUSION, AND EMERGENCY NURSING INTERVENTIONS
WITH DETAILED RATIONALES
1. A trauma patient arrives following a high-speed motor vehicle
collision. What is the first priority in the primary survey?
A) Circulation with hemorrhage control
B) Disability (neurologic assessment)
C) Exposure and environmental control
D) Airway with cervical spine protection
Correct Answer: D) Airway with cervical spine protection
Rationale: In TNCC, the ABCDE approach begins with Airway
management while protecting the cervical spine because airway
compromise is the most immediate life-threatening condition in
trauma. Airway obstruction can lead to death within minutes.
,2. Which finding is most consistent with a complete transection of the
spinal cord?
A) Loss of motor function with preserved sensation below the injury
B) Absence of sensory and motor function below the level of injury
C) Unilateral loss of sensation on the contralateral side
D) Hyperreflexia below the level of injury
Correct Answer: B) Absence of sensory and motor function below the
level of injury
Rationale: Complete spinal cord transection results in total loss of both
sensory and motor function below the level of injury. This is a hallmark
finding indicating complete disruption of spinal cord pathways.
3. Your patient is a pedestrian struck by a car and thrown 35 feet. They
were unconscious at the scene but became responsive with initial and
subsequent GCS scores of 13 (E-3, V-4, M-6). The patient has bilateral
subdural hematomas and is awaiting transfer to the ICU. Your next
assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority
nursing intervention?
A) Repeat the GCS assessment in 15 minutes
B) Notify the provider of the change
,C) Increase the rate of IV fluids
D) Prepare for immediate intubation
Correct Answer: B) Notify the provider of the change
Rationale: A decrease in GCS from 13 to 9 represents a significant
neurologic deterioration. The provider must be notified immediately to
reassess the plan of care, which may include repeat imaging or surgical
intervention.
4. While caring for a child who has been injured, what nursing
intervention is consistent with a family-centered approach?
A) Limiting family presence to visiting hours only
B) Allowing family to participate in the care of the patient
C) Asking the family to wait in the waiting room during procedures
D) Providing updates only to the primary caregiver
Correct Answer: B) Allowing family to participate in the care of the
patient
Rationale: Family-centered care recognizes the family as essential
partners in care. Allowing family participation reduces anxiety, supports
the child's emotional needs, and improves outcomes.
, 5. Identification of delayed complications following blunt abdominal
trauma is best accomplished by which method?
A) Serial abdominal examinations
B) Repeat computerized tomography with contrast
C) Focused Assessment with Sonography for Trauma (FAST)
D) Diagnostic peritoneal lavage
Correct Answer: B) Repeat computerized tomography with contrast
Rationale: Delayed complications such as solid organ injuries or ongoing
hemorrhage may not be apparent on initial CT. Repeat CT with contrast
provides the most accurate identification of evolving abdominal
injuries.
6. Three adults present at different times during a one-hour period
with a high fever, fatigue, and headache. All three patients have a rash
which started on their mouth, face, and arms with progression to the
chest and abdomen. They all visited the same grocery store within the
last week. What is the most appropriate intervention from triage for
these patients?
A) Send all patients to the main waiting room
B) Immediately initiate isolation precautions
TEST BANK WITH 200 VERIFIED QUESTIONS COVERING
PRIMARY SURVEY, SHOCK RESUSCITATION, SPINAL CORD
INJURY, BLUNT & PENETRATING TRAUMA, MASSIVE
TRANSFUSION, AND EMERGENCY NURSING INTERVENTIONS
WITH DETAILED RATIONALES
1. A trauma patient arrives following a high-speed motor vehicle
collision. What is the first priority in the primary survey?
A) Circulation with hemorrhage control
B) Disability (neurologic assessment)
C) Exposure and environmental control
D) Airway with cervical spine protection
Correct Answer: D) Airway with cervical spine protection
Rationale: In TNCC, the ABCDE approach begins with Airway
management while protecting the cervical spine because airway
compromise is the most immediate life-threatening condition in
trauma. Airway obstruction can lead to death within minutes.
,2. Which finding is most consistent with a complete transection of the
spinal cord?
A) Loss of motor function with preserved sensation below the injury
B) Absence of sensory and motor function below the level of injury
C) Unilateral loss of sensation on the contralateral side
D) Hyperreflexia below the level of injury
Correct Answer: B) Absence of sensory and motor function below the
level of injury
Rationale: Complete spinal cord transection results in total loss of both
sensory and motor function below the level of injury. This is a hallmark
finding indicating complete disruption of spinal cord pathways.
3. Your patient is a pedestrian struck by a car and thrown 35 feet. They
were unconscious at the scene but became responsive with initial and
subsequent GCS scores of 13 (E-3, V-4, M-6). The patient has bilateral
subdural hematomas and is awaiting transfer to the ICU. Your next
assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority
nursing intervention?
A) Repeat the GCS assessment in 15 minutes
B) Notify the provider of the change
,C) Increase the rate of IV fluids
D) Prepare for immediate intubation
Correct Answer: B) Notify the provider of the change
Rationale: A decrease in GCS from 13 to 9 represents a significant
neurologic deterioration. The provider must be notified immediately to
reassess the plan of care, which may include repeat imaging or surgical
intervention.
4. While caring for a child who has been injured, what nursing
intervention is consistent with a family-centered approach?
A) Limiting family presence to visiting hours only
B) Allowing family to participate in the care of the patient
C) Asking the family to wait in the waiting room during procedures
D) Providing updates only to the primary caregiver
Correct Answer: B) Allowing family to participate in the care of the
patient
Rationale: Family-centered care recognizes the family as essential
partners in care. Allowing family participation reduces anxiety, supports
the child's emotional needs, and improves outcomes.
, 5. Identification of delayed complications following blunt abdominal
trauma is best accomplished by which method?
A) Serial abdominal examinations
B) Repeat computerized tomography with contrast
C) Focused Assessment with Sonography for Trauma (FAST)
D) Diagnostic peritoneal lavage
Correct Answer: B) Repeat computerized tomography with contrast
Rationale: Delayed complications such as solid organ injuries or ongoing
hemorrhage may not be apparent on initial CT. Repeat CT with contrast
provides the most accurate identification of evolving abdominal
injuries.
6. Three adults present at different times during a one-hour period
with a high fever, fatigue, and headache. All three patients have a rash
which started on their mouth, face, and arms with progression to the
chest and abdomen. They all visited the same grocery store within the
last week. What is the most appropriate intervention from triage for
these patients?
A) Send all patients to the main waiting room
B) Immediately initiate isolation precautions
