TNCC Exam 8th edition study
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ✔✔✔Hemoglobin does
not readily release oxygen for use by the tissues A shift to the left occurs in an environment of low
metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant
damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When it
is appropriate to remove the cervical collar? - ✔✔✔After a physical examination if the patient has no
radiologic abnormalities on CT A CT is recommended for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the
total body surface area burned, how much IV fluid would be administered in the first 8 hours? - ✔✔✔
2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2 * 120 =
4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA calculation
for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system - ✔✔✔Fluctuation in the water seal chamber Fluctuation in the water seal
chamber indicates the tube is placed correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam. What type of injury is suspected? - ✔✔✔Globe rupture A
teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ✔✔✔Bradycardia and absent motor function below the level of injury
Patients with a complete spinal cord injury will have absent motor function below the level of the lesion.
They become hypotensive and bradycardic due to loss of autonomic nervous system function.
, Which of the following patients warrants referral to a burn center? - ✔✔✔A 52-year-old diabetic male
with a partial-thickness burn to the left lower leg This patient has a 7% TBSA burn with a preexisting
medical history that could complicate management, prolong recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - ✔✔✔Placental
abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal distress
are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on
the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower
abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question?
- ✔✔✔Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - ✔✔✔The aorta is
torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ✔✔✔Defusings A defusing is part of critical incident stress management but is not
considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage? - ✔✔✔MARCH The MARCH mnemonic stands for massive hemorrhage,
airway, respiration, circulation, and head injury/hypothermia. The MARCH mnemonic recognizes
uncontrolled hemorrhage as the major cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house fire. Calculating
total body surface area (TBSA) burned is deferred due to the need for emergent intubation. At what rate
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ✔✔✔Hemoglobin does
not readily release oxygen for use by the tissues A shift to the left occurs in an environment of low
metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports significant
damage to the driver's side of the car. The patient is asking to have the cervical collar removed. When it
is appropriate to remove the cervical collar? - ✔✔✔After a physical examination if the patient has no
radiologic abnormalities on CT A CT is recommended for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate the
total body surface area burned, how much IV fluid would be administered in the first 8 hours? - ✔✔✔
2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2 * 120 =
4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA calculation
for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system - ✔✔✔Fluctuation in the water seal chamber Fluctuation in the water seal
chamber indicates the tube is placed correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam. What type of injury is suspected? - ✔✔✔Globe rupture A
teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ✔✔✔Bradycardia and absent motor function below the level of injury
Patients with a complete spinal cord injury will have absent motor function below the level of the lesion.
They become hypotensive and bradycardic due to loss of autonomic nervous system function.
, Which of the following patients warrants referral to a burn center? - ✔✔✔A 52-year-old diabetic male
with a partial-thickness burn to the left lower leg This patient has a 7% TBSA burn with a preexisting
medical history that could complicate management, prolong recovery, or affect mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - ✔✔✔Placental
abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal distress
are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard on
the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals lower
abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse question?
- ✔✔✔Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - ✔✔✔The aorta is
torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ✔✔✔Defusings A defusing is part of critical incident stress management but is not
considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage? - ✔✔✔MARCH The MARCH mnemonic stands for massive hemorrhage,
airway, respiration, circulation, and head injury/hypothermia. The MARCH mnemonic recognizes
uncontrolled hemorrhage as the major cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house fire. Calculating
total body surface area (TBSA) burned is deferred due to the need for emergent intubation. At what rate
