Test Bank for TNCC 9th Edition 2025/2026 –
Trauma Nursing Core Course Exam
Questions and Study Guide
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 with a spinal cord injuryt 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 for this patient?
a. maintain adequate respiratory status
b. administer balanced fluid resucscitation
c. perform serial assessment of neurological function
d. maintain core temperature
A. Maintain respiratory status- injuries at C3-C5 can cause loss of phrenic nerve
function, resulting in a paralyzed diaphragm and inability to breathe. Maintenance of
respiratory function is the highest priority.
What is the best position for maintaining an open airway in the obese
patient?
a. Prone
b. Supine
c. Reverse trendelenburg
d. right lateral recumbent
c. Reverse trendelenburg
,An adult patient sustained a knife injury to the neck. The airway is intact
and the patient is hemodynamically stable. they complain of difficulty
swallowing and speaking. What is the most likely cause of these symptoms.
a. damage to the cervical spine
b. an expanding pneumothorax
c.laceration of the carotid artery
d. injury to the thyroid gland
a. damage to the cervical spine-penetrating neck trauma may include concurrent
injuries to the cervical spine and cord, airway. or vascular neck structures. With an
intact airway and hemodynamic stability, the other common concurrent injury is to the
cervical spine.
The general impression step in the initail assessment provides the
opportunity to do which of the following?
a. assess for uncontrolled internal hemorrhage
b. accurately triage the patient
c.Reprioritize circulation before airway and breathing
d. activate the trauma team
c. reprioritize circulation before airway and breathing
the general impression is formed in the beginning of the primary survey to rapidly
assess the need to reprioritize before airway or breathing. This is done id uncontolled
external hemorrhage is identified.
A trauma nurse cared for a child with devastating burns two weeks ago. The
nurse called in sick for a couple of days and is now back working on the
team. Which of the following behaviors indicate the nurse is coll.
a. they are talking about taking the emergency nurse certification exam
b. they keep requesting to be assigned to the walk-in ambulatory area
c.they are impaiient and snap at thier coworkers.
d. they are thinking about transferring out of the department
a. this is an indication that the nurse is taking positive steps ti advance thier own
practice, a sign of resilience.
Treatment for frostbite can include which of the following interventions?
a. warm the affected part over 30-60 minutes
b. use gentle friction to improve circulation
c.administer tissue plasminogen activator
d. drainage of all large and small blisters
c. admin tpa- with frostbite thrombus formation is a risk. TPA has been effective in
maintaining perfusion and decreasing the need for amputation when administered
within 24 hours of rewarming.
,what is the leading cause of preventable death for the trauma patient in the
prehospital environment.
a. airway compromise
b. ineffective ventilation
c. secondary head injury
d. uncontrolled external hemmorage
d. uncontrolled external hemmorage
A patient arrives at the emergency department by private vehicle after
sustaining an injury to the right lower extremity while using a saw. There is
a large gaping wound to the right thigh area with signifigant bleeding, what
is the priority intervention?
a. elevate the etremeity to the level of the heart
b. initate direct pressure
c. apply a tourniquet
d. cover the open wound with sterile saline dressings
b. initate direct pressure
what is the appropriate technique for palpating the pelvis for stability?
a. apply gentle pressure over the illiac crests, downward and laterally
b. apply gentle pressure over the iliac crests, downward and medially
c. apply firm pressure over the iliac crests downward and laterally
d. apply firm pressure over the iliac crests downward and medially
b. apply GENTLE pressure, downward and medially
The vital signs of a pregnant trauma patient at 30 weeks 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?
a. decompensated shock
b. normal vitalsigns in pregnancy
c. compensated shock
d. supine hypotension syndrome
b. Normal vital signs in pregnancy
resting hr increases 10-20 bpm
small decrease in sbp and a larger decrease in dbp d/t decreased peripheral resistance.
normal fetal heart rate is between 120-160 bpm.
Following a bomb explosion, fragmentation injuries from the bomb or
objects in the environment are examples of which phase of injury?
, a. primary
b. secondary
c. tertiary
b. quaternary
a. the primary phase-impact of the pressurization wave on body surfaces. Injuries
include blast lung, tympanic membrane rupture, abdominal hemmorrhage, globe
rupture. and mild traumatic brain injury.
b. the seconday phase results from flying debris, projectiles, and bomb fragments
causing lacerations or penetrating injuries.
c. tertiary phase-results from individuals being thrown by the blast and impacting walls,
ground or any hard object.
d. quartenary phase-results from any explosion-related illness or injury including
hyperglycemia, hypertension, andina, asthma, COPD or sepsis.
A patient involved in an MVC has sustained a fracture to the second rib of
the anterior left chest. Which concurrent injury is most commonly
associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax
b. first and second rib fractures are commonly associated with great vessel, head and
spinal cord and brachial plexus injuries.
a. blunt cardiac injury-sternal fractures;
c. pneumothorax is most commonly associated with sternal fractures, multiple rib
fractures, flail chest
d. Hemothorax is most commonly associated with flail chest of multiple rib fractures
Understanding the kinematic concepts associated with the mechanism of
injury and energy transfer can initially assist the trauma care provider in
which of the following?
a. anticipating the types of injuries that may be present
b. deciding whether law enforcement should be notified
c. determining the need for lab tests
d. predicting the need for a surgical procedure
a. anticipating the types of injuries that may be present
mechanism of injury and energy transfer can assist the provider in anticipating the types
of injuries that may be present and their severity
Trauma Nursing Core Course Exam
Questions and Study Guide
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 with a spinal cord injuryt 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 for this patient?
a. maintain adequate respiratory status
b. administer balanced fluid resucscitation
c. perform serial assessment of neurological function
d. maintain core temperature
A. Maintain respiratory status- injuries at C3-C5 can cause loss of phrenic nerve
function, resulting in a paralyzed diaphragm and inability to breathe. Maintenance of
respiratory function is the highest priority.
What is the best position for maintaining an open airway in the obese
patient?
a. Prone
b. Supine
c. Reverse trendelenburg
d. right lateral recumbent
c. Reverse trendelenburg
,An adult patient sustained a knife injury to the neck. The airway is intact
and the patient is hemodynamically stable. they complain of difficulty
swallowing and speaking. What is the most likely cause of these symptoms.
a. damage to the cervical spine
b. an expanding pneumothorax
c.laceration of the carotid artery
d. injury to the thyroid gland
a. damage to the cervical spine-penetrating neck trauma may include concurrent
injuries to the cervical spine and cord, airway. or vascular neck structures. With an
intact airway and hemodynamic stability, the other common concurrent injury is to the
cervical spine.
The general impression step in the initail assessment provides the
opportunity to do which of the following?
a. assess for uncontrolled internal hemorrhage
b. accurately triage the patient
c.Reprioritize circulation before airway and breathing
d. activate the trauma team
c. reprioritize circulation before airway and breathing
the general impression is formed in the beginning of the primary survey to rapidly
assess the need to reprioritize before airway or breathing. This is done id uncontolled
external hemorrhage is identified.
A trauma nurse cared for a child with devastating burns two weeks ago. The
nurse called in sick for a couple of days and is now back working on the
team. Which of the following behaviors indicate the nurse is coll.
a. they are talking about taking the emergency nurse certification exam
b. they keep requesting to be assigned to the walk-in ambulatory area
c.they are impaiient and snap at thier coworkers.
d. they are thinking about transferring out of the department
a. this is an indication that the nurse is taking positive steps ti advance thier own
practice, a sign of resilience.
Treatment for frostbite can include which of the following interventions?
a. warm the affected part over 30-60 minutes
b. use gentle friction to improve circulation
c.administer tissue plasminogen activator
d. drainage of all large and small blisters
c. admin tpa- with frostbite thrombus formation is a risk. TPA has been effective in
maintaining perfusion and decreasing the need for amputation when administered
within 24 hours of rewarming.
,what is the leading cause of preventable death for the trauma patient in the
prehospital environment.
a. airway compromise
b. ineffective ventilation
c. secondary head injury
d. uncontrolled external hemmorage
d. uncontrolled external hemmorage
A patient arrives at the emergency department by private vehicle after
sustaining an injury to the right lower extremity while using a saw. There is
a large gaping wound to the right thigh area with signifigant bleeding, what
is the priority intervention?
a. elevate the etremeity to the level of the heart
b. initate direct pressure
c. apply a tourniquet
d. cover the open wound with sterile saline dressings
b. initate direct pressure
what is the appropriate technique for palpating the pelvis for stability?
a. apply gentle pressure over the illiac crests, downward and laterally
b. apply gentle pressure over the iliac crests, downward and medially
c. apply firm pressure over the iliac crests downward and laterally
d. apply firm pressure over the iliac crests downward and medially
b. apply GENTLE pressure, downward and medially
The vital signs of a pregnant trauma patient at 30 weeks 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?
a. decompensated shock
b. normal vitalsigns in pregnancy
c. compensated shock
d. supine hypotension syndrome
b. Normal vital signs in pregnancy
resting hr increases 10-20 bpm
small decrease in sbp and a larger decrease in dbp d/t decreased peripheral resistance.
normal fetal heart rate is between 120-160 bpm.
Following a bomb explosion, fragmentation injuries from the bomb or
objects in the environment are examples of which phase of injury?
, a. primary
b. secondary
c. tertiary
b. quaternary
a. the primary phase-impact of the pressurization wave on body surfaces. Injuries
include blast lung, tympanic membrane rupture, abdominal hemmorrhage, globe
rupture. and mild traumatic brain injury.
b. the seconday phase results from flying debris, projectiles, and bomb fragments
causing lacerations or penetrating injuries.
c. tertiary phase-results from individuals being thrown by the blast and impacting walls,
ground or any hard object.
d. quartenary phase-results from any explosion-related illness or injury including
hyperglycemia, hypertension, andina, asthma, COPD or sepsis.
A patient involved in an MVC has sustained a fracture to the second rib of
the anterior left chest. Which concurrent injury is most commonly
associated with this fracture?
a. Blunt cardiac injury
b. Brachial plexus injury
c. Pneumothorax
d. Hemothorax
b. first and second rib fractures are commonly associated with great vessel, head and
spinal cord and brachial plexus injuries.
a. blunt cardiac injury-sternal fractures;
c. pneumothorax is most commonly associated with sternal fractures, multiple rib
fractures, flail chest
d. Hemothorax is most commonly associated with flail chest of multiple rib fractures
Understanding the kinematic concepts associated with the mechanism of
injury and energy transfer can initially assist the trauma care provider in
which of the following?
a. anticipating the types of injuries that may be present
b. deciding whether law enforcement should be notified
c. determining the need for lab tests
d. predicting the need for a surgical procedure
a. anticipating the types of injuries that may be present
mechanism of injury and energy transfer can assist the provider in anticipating the types
of injuries that may be present and their severity
