TNCC final exam test 2022 open book
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the
bicycle cross bars which performing an aerial BMX maneuver. Secondary assessment
reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would
the nurse questions?
A) Fast exam
B) CT scan
C) straight cath for urine sample
D) ice and elevation of the scrotum - correct answer-Answer: C
A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a
tear-drop shaped left pupil is noted on exam. What type of injury is suspected?
A) oculomotor nerve palsy
B) globe rupture
C) uncal herniation
D) retinal detachment - correct answer-Answer: B
A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her
hand due to pain. Which of the following is the most appropriate intervention?
A) apply a sling and elevate the extremity to the level of the heart.
B) apply a splint and elevate above the level of the heart
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart. - correct answer-Answer:
B
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd,
pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all of
these negative fast exam except which of the following?
A) diagnostic peritoneal lavage
B) serial fast exams
C) abdominal and pelvic CT scans
D) serial abdominal assessments - correct answer-Answer: A
The FAST exam is done at the bedside to identify pathological fluid in the abdominal and
pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage
and can be repeated if clinical changes or hemodynamic changes occur. A negative FAST
study does not rule out injury and may warrant a follow-up computed tomography scan.
Serial FAST exams can identify increasing abdominal fluid collections from hemorrhage.
Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is performed by the surgical
team to rapidly identify the presence of hemorrhage in patients who are hemodynamically
unstable after trauma.
, A 5-year old child presents to the ED with bruises to the upper arms and buttocks in various
stages of healing and multiple small, clean, round burns to the back. There are no
abnormalities found based on the pediatric assessment triangle or primary survey. Which of
the following is the priority nursing intervention?
A) report your suspicion of the maltreatment in accordance with local regulations
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse - correct answer-Answer: A
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center
D) notify the patients family - correct answer-Answer: C
A passenger is brought to the emergency department of a rural hospital following a
high-speed MVC. When significant abdominal and pelvic injuries are noted in the primary
survey, which of the following is the priority interventions?
A) initiate transfer to a trauma center
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube - correct answer-Answer: A
A patient arrives with a large open chest wound after being assault ed with a machete,
Prehospital providers placed a nonporous dressing over the chest wound and tapes it on 3
sides. He is now showing signs of anxiety, restlessness, severe respiratory distress,
cyanosis, and decreasing blood pressure. Which of the following is the MOST appropriate
interventions?
A) needle decompression
B) tube thoracostomy
C) dressing removal
D) surgical repair - correct answer-Answer: C
A patient has been in the ED for several hours waiting to be admitted. He sustained multiple
rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His
wife reported suddenly becoming anxious and confused. Upon reassessment, the patient is
restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of
symptoms commonly associated with which of the following conditions?
A) acute lung injury
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on the
bicycle cross bars which performing an aerial BMX maneuver. Secondary assessment
reveals lower abd tenderness and scrotal ecchymosis. Which of the following orders would
the nurse questions?
A) Fast exam
B) CT scan
C) straight cath for urine sample
D) ice and elevation of the scrotum - correct answer-Answer: C
A 35-year old male presents with facial trauma after bring struck inthe face with a baseball. a
tear-drop shaped left pupil is noted on exam. What type of injury is suspected?
A) oculomotor nerve palsy
B) globe rupture
C) uncal herniation
D) retinal detachment - correct answer-Answer: B
A 36-year old female has a deformity of the left wrist after a fall. She is reluctant to move her
hand due to pain. Which of the following is the most appropriate intervention?
A) apply a sling and elevate the extremity to the level of the heart.
B) apply a splint and elevate above the level of the heart
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart. - correct answer-Answer:
B
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd,
pelvic, and bil lower extremity pain Vitals signs are stable. The nurse can anticipate all of
these negative fast exam except which of the following?
A) diagnostic peritoneal lavage
B) serial fast exams
C) abdominal and pelvic CT scans
D) serial abdominal assessments - correct answer-Answer: A
The FAST exam is done at the bedside to identify pathological fluid in the abdominal and
pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal lavage
and can be repeated if clinical changes or hemodynamic changes occur. A negative FAST
study does not rule out injury and may warrant a follow-up computed tomography scan.
Serial FAST exams can identify increasing abdominal fluid collections from hemorrhage.
Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is performed by the surgical
team to rapidly identify the presence of hemorrhage in patients who are hemodynamically
unstable after trauma.
, A 5-year old child presents to the ED with bruises to the upper arms and buttocks in various
stages of healing and multiple small, clean, round burns to the back. There are no
abnormalities found based on the pediatric assessment triangle or primary survey. Which of
the following is the priority nursing intervention?
A) report your suspicion of the maltreatment in accordance with local regulations
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse - correct answer-Answer: A
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
A) Expedite transport to the CT scanner
B) prepare the patient for spinal radiographs
C) expedite transfer to the closest trauma center
D) notify the patients family - correct answer-Answer: C
A passenger is brought to the emergency department of a rural hospital following a
high-speed MVC. When significant abdominal and pelvic injuries are noted in the primary
survey, which of the following is the priority interventions?
A) initiate transfer to a trauma center
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube - correct answer-Answer: A
A patient arrives with a large open chest wound after being assault ed with a machete,
Prehospital providers placed a nonporous dressing over the chest wound and tapes it on 3
sides. He is now showing signs of anxiety, restlessness, severe respiratory distress,
cyanosis, and decreasing blood pressure. Which of the following is the MOST appropriate
interventions?
A) needle decompression
B) tube thoracostomy
C) dressing removal
D) surgical repair - correct answer-Answer: C
A patient has been in the ED for several hours waiting to be admitted. He sustained multiple
rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o leg pain. His
wife reported suddenly becoming anxious and confused. Upon reassessment, the patient is
restless, with respiratory distress and petechiae to his neck. the patient is exhibiting signs of
symptoms commonly associated with which of the following conditions?
A) acute lung injury
