TNCC 9th Edition 2024
You are caring for a patient who was thrown from a bike and was not wearing a helmet. While
performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the
following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam. - ✔✔✔C. Notify the physician
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 - ✔✔✔A. Initiate transfer to a trauma center
An adult who fell from a second story roof is brought to the emergency department by private vehicle.
The patient is confused with unlabored respirations and has strong, palpable radial pulses. There is an
open wound in proximity to an obvious deformity of the left lower extremity. What is the priority
intervention?
A. Initiate cervical spine stabilization
B. Apply a splint to the lower extremity
C. Put the patient on portable oxygen.
D. Log roll the patient onto a spine board - ✔✔✔A. Initiate cervical spine stabilization
, An adult patient who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0
kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to
manage the cerebral blood flow?
A. Decrease the rate of manual ventilation.
B. Initiate another fluid bolus.
C. Recheck endotracheal tube placement.
D. Increase the amount of oxygen delivered. - ✔✔✔A. Decrease the rate of manual ventilation.
An adult patient is brought to the emergency department following a vehicle "roll-over" with prolonged
extrication. Assessment reveals swelling and bruising to the right proximal thigh and a weak pedal pulse.
Skin is pale, cool, and moist. What is the most appropriate initial intervention?
A. Application of a tourniquet to the affected extremity
B. Application of a pelvic binder
C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour
D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa) - ✔✔✔B. Application of a pelvic
binder
An adult arrives at the emergency department with superficial burns to the extremities following a
house fire. The patient is reporting a headache with nausea and is drowsy and confused. What is the
most likely cause of these symptoms?
A. Capillary leak syndrome
B. Rhabdomyolysis
C. Carbon monoxide poisoning
You are caring for a patient who was thrown from a bike and was not wearing a helmet. While
performing the head-to-toe assessment, you note clear drainage from the right ear. Which of the
following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam. - ✔✔✔C. Notify the physician
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 - ✔✔✔A. Initiate transfer to a trauma center
An adult who fell from a second story roof is brought to the emergency department by private vehicle.
The patient is confused with unlabored respirations and has strong, palpable radial pulses. There is an
open wound in proximity to an obvious deformity of the left lower extremity. What is the priority
intervention?
A. Initiate cervical spine stabilization
B. Apply a splint to the lower extremity
C. Put the patient on portable oxygen.
D. Log roll the patient onto a spine board - ✔✔✔A. Initiate cervical spine stabilization
, An adult patient who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0
kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to
manage the cerebral blood flow?
A. Decrease the rate of manual ventilation.
B. Initiate another fluid bolus.
C. Recheck endotracheal tube placement.
D. Increase the amount of oxygen delivered. - ✔✔✔A. Decrease the rate of manual ventilation.
An adult patient is brought to the emergency department following a vehicle "roll-over" with prolonged
extrication. Assessment reveals swelling and bruising to the right proximal thigh and a weak pedal pulse.
Skin is pale, cool, and moist. What is the most appropriate initial intervention?
A. Application of a tourniquet to the affected extremity
B. Application of a pelvic binder
C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour
D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa) - ✔✔✔B. Application of a pelvic
binder
An adult arrives at the emergency department with superficial burns to the extremities following a
house fire. The patient is reporting a headache with nausea and is drowsy and confused. What is the
most likely cause of these symptoms?
A. Capillary leak syndrome
B. Rhabdomyolysis
C. Carbon monoxide poisoning
