TNCC Practice Exam Questions and
Answers 2023
What is the key to a high-performance trauma team?
a. Individual goals
b. Use of Team STEPPS
c. Identification of a single decision maker
d. Effective communication - Answer-d. Effective communication Rationale: Skilled
communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care (p. 5).
When obtaining a history for an injured patient, understanding the kinematic concepts
associated with the mechanism of injury and energy transfer can initially assist the
trauma provider in:
a. Evaluating and anticipating the types of injury that may be present
b. Deciding whether law enforcement should be notified
c. Determining needed laboratory tests
d. Predicting the need for a surgical procedure - Answer-a. Evaluating and anticipating
the types of injury that may be present Rationale: Mechanism of injury and energy
transfer can assist the provider in evaluating and anticipating damage (p. 23).
The major preventable cause of death in the trauma patient is:
a. Airway compromise
b. Ineffective ventilation
c. Secondary head injury
d. Uncontrolled hemorrhage - Answer-d. Uncontrolled hemorrhage Rationale:
Uncontrolled hemorrhage is the major cause of preventable death after injury, so
assessment to identify uncontrolled hemorrhage is key to the initial assessment process
(p. 29).
The across-the-room observation step in the initial assessment provides the opportunity
to:
a. Assess for uncontrolled internal hemorrhage
b. Accurately triage the patient
c. Reprioritize circulation before airway or breathing
d. Activate the trauma team - Answer-c. Reprioritize circulation before airway or
breathing. Rationale: The across-the-room observation is done at the beginning of the
primary survey to rapidly assess the need to reprioritize circulation before airway or
breathing. This is done if uncontrolled external hemorrhage is identified (p. 28).
Which of the following accurately describes ventilation principles associated with a bag-
mask device?
a. Ventilate at a rate of 10 to 12 breaths/minute
b. Deliver 100% oxygen
, c. Compress the bag-mask device completely
d. Maintain the oxygen saturation level between 92% and 94% - Answer-a. Ventilate at
a rate of 10 to 12 breaths/minute Rationale: If ventilation is ineffective, assist
ventilations at 10 to 12 breaths/minute or one every 5 to 6 seconds (p. 32).
Which of the following is the best measure of the adequacy of cellular perfusion and
helps to predict the outcome of resuscitation?
a. End-tidal carbon dioxide
b. Hypoxia
c. Base deficit
d. Oxygen saturation - Answer-c. Base deficit Rationale: Base deficit serves as an
endpoint measurement of the adequacy of cellular perfusion and when used in
conjunction with serum lactate helps predict the success of the resuscitation (p. 57).
What is a safe pharmacological alternative to opioids for rib fracture pain management
in the anticoagulated patient?
a. Corticosteroids
b. Intercostal nerve blocks
c. Nonsteroidal anti-inflammatory drugs
d. Epidural anesthetics - Answer-b. Intercostal nerve blocks Rationale: Continuous
intercostal nerve blocks use long-acting anesthetics and can provide safe and effective
pain management for the anticoagulated patient (pp. 271, 273).
In a patient with severe traumatic brain injury, hypocapnia causes:
a. Respiratory acidosis
b. Metabolic acidosis
c. Neurogenic shock
d. Cerebral vasoconstriction - Answer-d. Cerebral vasoconstriction Rationale:
Hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in
the cerebral vasculature (p. 98).
A patient with a knife injury to the neck has an intact airway and is hemodynamically
stable. He complains of difficulty swallowing and speaking. Further assessment is
indicated next for which of the following conditions?
a. Damage to the spinal cord
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - Answer-a. Damage to the spinal cord Rationale:
Penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or
vascular neck structures. With an intact airway and hemodynamic stability, the other
common concurrent injury is to the spinal cord (pp. 124, 126).
What is the appropriate technique for palpating the pelvis for stability?
a. Apply gentle pressure over the iliac crests downward and laterally
b. Apply gentle pressure over the iliac crests downward and medially
c. Apply firm pressure over the iliac crests downward and laterally
Answers 2023
What is the key to a high-performance trauma team?
a. Individual goals
b. Use of Team STEPPS
c. Identification of a single decision maker
d. Effective communication - Answer-d. Effective communication Rationale: Skilled
communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care (p. 5).
When obtaining a history for an injured patient, understanding the kinematic concepts
associated with the mechanism of injury and energy transfer can initially assist the
trauma provider in:
a. Evaluating and anticipating the types of injury that may be present
b. Deciding whether law enforcement should be notified
c. Determining needed laboratory tests
d. Predicting the need for a surgical procedure - Answer-a. Evaluating and anticipating
the types of injury that may be present Rationale: Mechanism of injury and energy
transfer can assist the provider in evaluating and anticipating damage (p. 23).
The major preventable cause of death in the trauma patient is:
a. Airway compromise
b. Ineffective ventilation
c. Secondary head injury
d. Uncontrolled hemorrhage - Answer-d. Uncontrolled hemorrhage Rationale:
Uncontrolled hemorrhage is the major cause of preventable death after injury, so
assessment to identify uncontrolled hemorrhage is key to the initial assessment process
(p. 29).
The across-the-room observation step in the initial assessment provides the opportunity
to:
a. Assess for uncontrolled internal hemorrhage
b. Accurately triage the patient
c. Reprioritize circulation before airway or breathing
d. Activate the trauma team - Answer-c. Reprioritize circulation before airway or
breathing. Rationale: The across-the-room observation is done at the beginning of the
primary survey to rapidly assess the need to reprioritize circulation before airway or
breathing. This is done if uncontrolled external hemorrhage is identified (p. 28).
Which of the following accurately describes ventilation principles associated with a bag-
mask device?
a. Ventilate at a rate of 10 to 12 breaths/minute
b. Deliver 100% oxygen
, c. Compress the bag-mask device completely
d. Maintain the oxygen saturation level between 92% and 94% - Answer-a. Ventilate at
a rate of 10 to 12 breaths/minute Rationale: If ventilation is ineffective, assist
ventilations at 10 to 12 breaths/minute or one every 5 to 6 seconds (p. 32).
Which of the following is the best measure of the adequacy of cellular perfusion and
helps to predict the outcome of resuscitation?
a. End-tidal carbon dioxide
b. Hypoxia
c. Base deficit
d. Oxygen saturation - Answer-c. Base deficit Rationale: Base deficit serves as an
endpoint measurement of the adequacy of cellular perfusion and when used in
conjunction with serum lactate helps predict the success of the resuscitation (p. 57).
What is a safe pharmacological alternative to opioids for rib fracture pain management
in the anticoagulated patient?
a. Corticosteroids
b. Intercostal nerve blocks
c. Nonsteroidal anti-inflammatory drugs
d. Epidural anesthetics - Answer-b. Intercostal nerve blocks Rationale: Continuous
intercostal nerve blocks use long-acting anesthetics and can provide safe and effective
pain management for the anticoagulated patient (pp. 271, 273).
In a patient with severe traumatic brain injury, hypocapnia causes:
a. Respiratory acidosis
b. Metabolic acidosis
c. Neurogenic shock
d. Cerebral vasoconstriction - Answer-d. Cerebral vasoconstriction Rationale:
Hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially in
the cerebral vasculature (p. 98).
A patient with a knife injury to the neck has an intact airway and is hemodynamically
stable. He complains of difficulty swallowing and speaking. Further assessment is
indicated next for which of the following conditions?
a. Damage to the spinal cord
b. An expanding pneumothorax
c. Laceration of the carotid artery
d. Injury to the thyroid gland - Answer-a. Damage to the spinal cord Rationale:
Penetrating neck trauma may include concurrent injuries to the spinal cord, airway, or
vascular neck structures. With an intact airway and hemodynamic stability, the other
common concurrent injury is to the spinal cord (pp. 124, 126).
What is the appropriate technique for palpating the pelvis for stability?
a. Apply gentle pressure over the iliac crests downward and laterally
b. Apply gentle pressure over the iliac crests downward and medially
c. Apply firm pressure over the iliac crests downward and laterally
