TNCC Practice Exam with Rationale
A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm Hg
and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The
emergency nurse interprets the patient's hemodynamic findings as an indication of which of
the following? - correct answer-normal vital signs in pregnancy
rationale: in pregnancy, the resting heart rate increases by 10 to 20 bpm and a small
decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to
a decrease in peripheral resistance. Normal fetal rate is between 120 and 160 bpm
A patient fell two weeks ago, striking his head. He came to the emergency department with a
persistent headache and nausea. He was diagnosed with a small subdural hematoma and
has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports he
has been anxious, restless, and shaky. he vomited twice during the night. He tells the day
shift nurse he couldn't sleep because a young child kept coming into his room. What is a
likely cause for these signs and symptoms? - correct answer-alcohol withdrawal
rationale: alcohol withdrawal is a common delayed condition because symptoms are difficult
to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or vomiting,
psychomotor agitation, anxiety, insomnia, hallucinations, or seizures.
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? - correct answer-damage to 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
a patient with a spinal cord injury at C5 is being cared for in the emergency department while
awaiting transport to a trauma center. which of the following represents the highest priority
for ongoing assessment and management? - correct answer-maintain adequate respiratory
status
rationale: spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function,
resulting in a paralyzed diaphragm and inability to breathe
A trauma nurse cared for a child with devasting burns 2 weeks ago. She called in sick for a
couple of days and is now back working on the team. Which of the following behaviors would
indicate this nurse is coping well? - correct answer-she is talking about taking the emergency
nursing certification examination
rationale: this is an indication she is taking positive steps to advance her own practice, a sign
of resilience
A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm Hg
and a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The
emergency nurse interprets the patient's hemodynamic findings as an indication of which of
the following? - correct answer-normal vital signs in pregnancy
rationale: in pregnancy, the resting heart rate increases by 10 to 20 bpm and a small
decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to
a decrease in peripheral resistance. Normal fetal rate is between 120 and 160 bpm
A patient fell two weeks ago, striking his head. He came to the emergency department with a
persistent headache and nausea. He was diagnosed with a small subdural hematoma and
has been in the ED for 24 hours awaiting an inpatient bed. The night shift nurse reports he
has been anxious, restless, and shaky. he vomited twice during the night. He tells the day
shift nurse he couldn't sleep because a young child kept coming into his room. What is a
likely cause for these signs and symptoms? - correct answer-alcohol withdrawal
rationale: alcohol withdrawal is a common delayed condition because symptoms are difficult
to identify early. Signs include autonomic hyperactivity, hand tremors, nausea or vomiting,
psychomotor agitation, anxiety, insomnia, hallucinations, or seizures.
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? - correct answer-damage to 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
a patient with a spinal cord injury at C5 is being cared for in the emergency department while
awaiting transport to a trauma center. which of the following represents the highest priority
for ongoing assessment and management? - correct answer-maintain adequate respiratory
status
rationale: spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function,
resulting in a paralyzed diaphragm and inability to breathe
A trauma nurse cared for a child with devasting burns 2 weeks ago. She called in sick for a
couple of days and is now back working on the team. Which of the following behaviors would
indicate this nurse is coping well? - correct answer-she is talking about taking the emergency
nursing certification examination
rationale: this is an indication she is taking positive steps to advance her own practice, a sign
of resilience
