1
TNCC (TRAUMA NURSING CORE COURSE) EXAM 2025– 2026
ACCURATE REAL EXAM QUESTIONS AND VERIFIED CORRECT
ANSWERS JUST RELEASED WALDEN UNIVERSITY)
Which abdominal organs are most susceptible to tearing or shearing from sudden deceleration or
acceleration forces resulting in a tearing or avulsion injury? - Correct Answer ✅ Small
bowel
- Large bowel
- Ureters
- Urethra
- Esophagus
What is cavatation? - - Correct Answer ✅ As a missile passes through tissue, it decelerates,
dissipating and transferring kinetic energy to the tissues; this is what causes the injury. ...
Temporary cavitation can be especially damaging when it affects delicate tissues such as the
brain, as occurs in penetrating head trauma..
What is kinetic energy (KE)? - - Correct Answer ✅ KE equals 1/2 the mass (M) multiplied
by the velocity squared.
What is the likely cause of open book fracture? - Correct Answer ✅ direct crush
- MVC vs Pedestrian
-Fall from greater than 12 feet (adults)
Explain Hepatic Response. - - Correct Answer ✅ Liver can store excess glucose as
glycogen.
As shock progresses, glycogenolysis is activated by epi to break down glycogen into glucose.
pg. 1
, 2
In a compensatory response to shock, hepatic vessels constrict to redirect blood flow to other
vital areas.
Explain Pulmonary Response. - - Correct Answer ✅ Tachypnea happens for 2 reasons:
1. Maintain acid-base balance
2. Maintain increased supply of oxygen
* Metabolic acidosis from anaerobic metabolism will be a stimulus for the lungs to increase rate
of ventilation. Increased RR is an attempt to correct acidosis + augments oxygen supply to
maximize oxygen delivery to alveoli.
Explain Irreversible Shock. - - Correct Answer ✅ Shock uncompensated or irreversible
stages will cause compromises to most body systems.
- Inadequate venous return
- inadequate cardiac filling
- decreased coronary artery perfusion
- Membranes of lysosomes breakdown within cells and release digestive enzymes that cause
intracellular damage.
ICP is a reflection of what three volumes? What happens when one increases? - - Correct
Answer ✅ 1. Brain
2. CSF
3. Blood within the nonexpansible cranial vault
As volume of one increases, the volume of another decreases to maintain ICP within normal
range.
What are the early signs and symptoms of increased ICP? - Correct Answer ✅
Headache - N/V
- Amnesia regarding events around the injury
pg. 2
, 3
- Altered LOC
- Restlessness, drowsiness, changes in speech, or loss of judgement
What is indicated by unilaterally fixed and dilated pupils? - - Correct Answer ✅ Oculomotor
nerve compression from increased ICP & Heniation syndrome
What is indicated by bilaterally fixed and pinpoint pupils? - - Correct Answer ✅ Injury at
the pons or Opioid use
What is indicated by moderately dilated pupil with sluggish response? - - Correct Answer ✅
Early sign of herniation syndrome
What are the late observable signs of symptoms of increased ICP? - Correct Answer ✅
Dilated, nonreactive pupil
- Unresponsiveness to verbal or painful stimuli
- Abnormal motor posturing patterns
- Widening pulse pressure (Cushing response)
- Changes in RR and pattern (Cushing response)
- Bradycardia (Cushing response)
What is Cushing's phenomenon or Cushing's Reflex? - - Correct Answer ✅ Triad of
progressive HTN, bradycardia and diminished respiratory effort.
What are the two types of herniation that occurs with ICP? - - Correct Answer ✅ 1. Uncal
herniation
2. Central or transtentorial herniation
Why does herniation occur? What are the symptoms? - - Correct Answer ✅ Because of
uncontrolled increases in ICP.
pg. 3
TNCC (TRAUMA NURSING CORE COURSE) EXAM 2025– 2026
ACCURATE REAL EXAM QUESTIONS AND VERIFIED CORRECT
ANSWERS JUST RELEASED WALDEN UNIVERSITY)
Which abdominal organs are most susceptible to tearing or shearing from sudden deceleration or
acceleration forces resulting in a tearing or avulsion injury? - Correct Answer ✅ Small
bowel
- Large bowel
- Ureters
- Urethra
- Esophagus
What is cavatation? - - Correct Answer ✅ As a missile passes through tissue, it decelerates,
dissipating and transferring kinetic energy to the tissues; this is what causes the injury. ...
Temporary cavitation can be especially damaging when it affects delicate tissues such as the
brain, as occurs in penetrating head trauma..
What is kinetic energy (KE)? - - Correct Answer ✅ KE equals 1/2 the mass (M) multiplied
by the velocity squared.
What is the likely cause of open book fracture? - Correct Answer ✅ direct crush
- MVC vs Pedestrian
-Fall from greater than 12 feet (adults)
Explain Hepatic Response. - - Correct Answer ✅ Liver can store excess glucose as
glycogen.
As shock progresses, glycogenolysis is activated by epi to break down glycogen into glucose.
pg. 1
, 2
In a compensatory response to shock, hepatic vessels constrict to redirect blood flow to other
vital areas.
Explain Pulmonary Response. - - Correct Answer ✅ Tachypnea happens for 2 reasons:
1. Maintain acid-base balance
2. Maintain increased supply of oxygen
* Metabolic acidosis from anaerobic metabolism will be a stimulus for the lungs to increase rate
of ventilation. Increased RR is an attempt to correct acidosis + augments oxygen supply to
maximize oxygen delivery to alveoli.
Explain Irreversible Shock. - - Correct Answer ✅ Shock uncompensated or irreversible
stages will cause compromises to most body systems.
- Inadequate venous return
- inadequate cardiac filling
- decreased coronary artery perfusion
- Membranes of lysosomes breakdown within cells and release digestive enzymes that cause
intracellular damage.
ICP is a reflection of what three volumes? What happens when one increases? - - Correct
Answer ✅ 1. Brain
2. CSF
3. Blood within the nonexpansible cranial vault
As volume of one increases, the volume of another decreases to maintain ICP within normal
range.
What are the early signs and symptoms of increased ICP? - Correct Answer ✅
Headache - N/V
- Amnesia regarding events around the injury
pg. 2
, 3
- Altered LOC
- Restlessness, drowsiness, changes in speech, or loss of judgement
What is indicated by unilaterally fixed and dilated pupils? - - Correct Answer ✅ Oculomotor
nerve compression from increased ICP & Heniation syndrome
What is indicated by bilaterally fixed and pinpoint pupils? - - Correct Answer ✅ Injury at
the pons or Opioid use
What is indicated by moderately dilated pupil with sluggish response? - - Correct Answer ✅
Early sign of herniation syndrome
What are the late observable signs of symptoms of increased ICP? - Correct Answer ✅
Dilated, nonreactive pupil
- Unresponsiveness to verbal or painful stimuli
- Abnormal motor posturing patterns
- Widening pulse pressure (Cushing response)
- Changes in RR and pattern (Cushing response)
- Bradycardia (Cushing response)
What is Cushing's phenomenon or Cushing's Reflex? - - Correct Answer ✅ Triad of
progressive HTN, bradycardia and diminished respiratory effort.
What are the two types of herniation that occurs with ICP? - - Correct Answer ✅ 1. Uncal
herniation
2. Central or transtentorial herniation
Why does herniation occur? What are the symptoms? - - Correct Answer ✅ Because of
uncontrolled increases in ICP.
pg. 3
