TNCC 9TH EDITION EXAM QUESTIONS AND VERIFIED
ANSWERS GRADE A+
"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 B) apply a
splint and ELEVATE ABOVE THE LEVEL OF THE HEART"
"A patient is thrown against a car during a tornado and presents with obvious bilateral femoral
fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the
following interventions would be most appropriate for this patient based on the disaster triage
principle?
A) initiate two large bore intravenous lines for Ringers lactate solution administration
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin. - Correct answer A)
initiate two large bore intravenous lines for Ringers lactate solution administration"
"ITEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant
damage to the drivers side of the car. The patient is asking to have the cervical color removed.
when is it appropriate to remove the cervical collar?
A) after a physical examination if the patient has no radiologic abnormalities on a computed
tomography scan
B) after physician evaluation if the patient has not neurologic abnormalities on exam
C) after palpation of the spine if the patient has no point tenderness the the vertebral column
D) after physical examination if the patient has not neck pain with movement - Correct answer
A) after a physical examination if the patient has no radiologic abnormalities on a computed
tomography scan"
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. - Correct answer 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 - Correct answer A. Initiate transfer to a trauma center"
"An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored
respiratory, and dusky skin. the trauma team has administered medications for drug assisted
intubation and attempted intubation but was unsuccessful. What is the most appropriate
immediate next step?
A) Ventilate with a BVM
B) Prepare for cricothyroidotomy
C) administer reversal medications
D) contact anesthesia for assistance - Correct answer A) Ventilate with a BVM"
"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 - Correct answer 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. - Correct answer 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) - Correct answer B.
Application of a pelvic binder"
You are treating a 27-year old male in respiratory distress who was involved in a house fire.
Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should
you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr - Correct answer B) 500 mL/hr"
"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
B) fat embolism
C) PTX
D) pulmonary contusion - Correct answer B) fat embolism"
"Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
ANSWERS GRADE A+
"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 B) apply a
splint and ELEVATE ABOVE THE LEVEL OF THE HEART"
"A patient is thrown against a car during a tornado and presents with obvious bilateral femoral
fractures. The patient is pale, alert, disoriented, and has delayed cap refill. Which of the
following interventions would be most appropriate for this patient based on the disaster triage
principle?
A) initiate two large bore intravenous lines for Ringers lactate solution administration
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
D) Contact the command center for the personnel to notify next of kin. - Correct answer A)
initiate two large bore intravenous lines for Ringers lactate solution administration"
"ITEMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant
damage to the drivers side of the car. The patient is asking to have the cervical color removed.
when is it appropriate to remove the cervical collar?
A) after a physical examination if the patient has no radiologic abnormalities on a computed
tomography scan
B) after physician evaluation if the patient has not neurologic abnormalities on exam
C) after palpation of the spine if the patient has no point tenderness the the vertebral column
D) after physical examination if the patient has not neck pain with movement - Correct answer
A) after a physical examination if the patient has no radiologic abnormalities on a computed
tomography scan"
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. - Correct answer 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 - Correct answer A. Initiate transfer to a trauma center"
"An unresponsive trauma patient has an oropharyngeal airway in place, shallow and labored
respiratory, and dusky skin. the trauma team has administered medications for drug assisted
intubation and attempted intubation but was unsuccessful. What is the most appropriate
immediate next step?
A) Ventilate with a BVM
B) Prepare for cricothyroidotomy
C) administer reversal medications
D) contact anesthesia for assistance - Correct answer A) Ventilate with a BVM"
"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 - Correct answer 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. - Correct answer 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) - Correct answer B.
Application of a pelvic binder"
You are treating a 27-year old male in respiratory distress who was involved in a house fire.
Calculating TBSA burned is deferred d/t the need for emergent intubation. At what rate should
you begin fluid resuscitation?
A) 1000 mL/hr
B) 500 mL/hr
C) 250 mL/hr
D) 125 mL/hr - Correct answer B) 500 mL/hr"
"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
B) fat embolism
C) PTX
D) pulmonary contusion - Correct answer B) fat embolism"
"Which pulse pressure description is an indication of early hypovolemic shock?
A) widened
B) narrowed
C) bounding
