TNCC Written Exam Notes – TNCC Test
Prep A (8th Edition) 2025!!
A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He
complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2
94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? -
ANSWER ✨✔---Expedite trANSWERfer to the closest trauma center
Which of the following considerations is the most important when caring for a geriatric trauma pt? -
ANSWER ✨✔---a pertinent medical hx is crucial
Following a review of recent drills and a real disaster event, a hospital has identified deficiencies and is
taking steps to minimize the impact of a future disaster . Which phase of the disaster life cycle does this
describe? - ANSWER ✨✔---Mitigation
EMS brings a pt who fell while riding his bicycle. Using the American College of Surgeobs screening
guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine
clearance? - ANSWER ✨✔---Multiple requests for water
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? - ANSWER ✨✔---
hemoglobin does not readily release O2 for use by the tissues
Which of the following is a component of the trauma triad of death? - ANSWER ✨✔---acidosis
,EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary
incontinence and priapism. These assessment findings are most consistent with which of the following
types of spinal cord injury? - ANSWER ✨✔---Complete
Which of the following is an expected finding in a pt with a tube thoracstomy connected to a chest
drainage system? - ANSWER ✨✔---flucuation in the water seal chamber
During the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring
respirations. What priority nursing interventions should be preformed next? - ANSWER ✨✔---
insert an oropharyngeal airway if there is no gag reflex
A 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped
left pupil is noted on exam. What type of injury is suspected? - ANSWER ✨✔---globe rupture
A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24.
Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which
stage of shock? - ANSWER ✨✔---compensated
An unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, 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? -
ANSWER ✨✔---ventilate with a bag mask device
When is the tertiary survey completed fora trauma pt? - ANSWER ✨✔---within 24 hrs of trauma
An intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing
compartment syndrome. What is the most reliable indication of compartment syndrome in a patient
who is unconscious? - ANSWER ✨✔---pressure
Which of the following is possible complication of positive-pressure ventilation? - ANSWER ✨✔---
worsening pneumothorax
,the most reassuring finding for a male pt with hip pain after a fall is which of the following? -
ANSWER ✨✔---pelvic stability
Which of the following pulse pressures indicate early hypovolemic shock? - ANSWER ✨✔---
narrowed
Patients with a crush injury should be monitored for which of the following conditions? -
ANSWER ✨✔---dysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? - ANSWER ✨✔-
--subdural hematoma
A 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle
cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd
tenderness and scrotal ecchymosis. Which of the following orders would the RN question? -
ANSWER ✨✔---straight cath for urine sample
You are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary
survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show.
Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent
with which of the following? - ANSWER ✨✔---placental abruption
Which of the following is true about the log-roll? - ANSWER ✨✔---it can worsen cord damage from
an unstable spinal injury
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ANSWER ✨✔---defusings
What bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of
ventilation? - ANSWER ✨✔---pulse oximetry and capnography
, Caregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake and crying
with increased work of breathing and pale skin. Which of the following interventions has the highest
priority? - ANSWER ✨✔---padding the upper back while stabilizing the cervical spine
Which of the following injuries is LEAST likely to be promptly identified? - ANSWER ✨✔---bowel
A pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic
injuries are noted in the primary survey, which of the following is the priority interventions? -
ANSWER ✨✔---Initiate trANSWERfer to a trauma center
A pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which
other clinical signs? - ANSWER ✨✔---bardycardia and absent motor function below the level of
injury
a 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain.
Which of the following is the most appropriate intervention? - ANSWER ✨✔---apply splint and
elevate above the level of the heart
which of the following occurs during the third impact of a motor vehicle crash? - ANSWER ✨✔---
the aorta is torn at its attachment with the ligamentum arteriosum
a 5 y/o child presents to the ED with bruises to the upper arm 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 survey. Which of
the following is the priority nursing intervention? - ANSWER ✨✔---Report your suspicion of
maltreatment in accordance with local regulations
Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? -
ANSWER ✨✔---to guage end-organ perfusion and tissue hypoxia
A pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain
medications. Which of the following is the priority nursing intervention? - ANSWER ✨✔---elevating
the extremity to the level of the heart
Prep A (8th Edition) 2025!!
A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He
complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2
94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? -
ANSWER ✨✔---Expedite trANSWERfer to the closest trauma center
Which of the following considerations is the most important when caring for a geriatric trauma pt? -
ANSWER ✨✔---a pertinent medical hx is crucial
Following a review of recent drills and a real disaster event, a hospital has identified deficiencies and is
taking steps to minimize the impact of a future disaster . Which phase of the disaster life cycle does this
describe? - ANSWER ✨✔---Mitigation
EMS brings a pt who fell while riding his bicycle. Using the American College of Surgeobs screening
guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine
clearance? - ANSWER ✨✔---Multiple requests for water
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? - ANSWER ✨✔---
hemoglobin does not readily release O2 for use by the tissues
Which of the following is a component of the trauma triad of death? - ANSWER ✨✔---acidosis
,EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary
incontinence and priapism. These assessment findings are most consistent with which of the following
types of spinal cord injury? - ANSWER ✨✔---Complete
Which of the following is an expected finding in a pt with a tube thoracstomy connected to a chest
drainage system? - ANSWER ✨✔---flucuation in the water seal chamber
During the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring
respirations. What priority nursing interventions should be preformed next? - ANSWER ✨✔---
insert an oropharyngeal airway if there is no gag reflex
A 35 y/o M presents with facial trauma after being struck in the face with a baseball. A teardrop-shaped
left pupil is noted on exam. What type of injury is suspected? - ANSWER ✨✔---globe rupture
A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24.
Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which
stage of shock? - ANSWER ✨✔---compensated
An unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, 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? -
ANSWER ✨✔---ventilate with a bag mask device
When is the tertiary survey completed fora trauma pt? - ANSWER ✨✔---within 24 hrs of trauma
An intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing
compartment syndrome. What is the most reliable indication of compartment syndrome in a patient
who is unconscious? - ANSWER ✨✔---pressure
Which of the following is possible complication of positive-pressure ventilation? - ANSWER ✨✔---
worsening pneumothorax
,the most reassuring finding for a male pt with hip pain after a fall is which of the following? -
ANSWER ✨✔---pelvic stability
Which of the following pulse pressures indicate early hypovolemic shock? - ANSWER ✨✔---
narrowed
Patients with a crush injury should be monitored for which of the following conditions? -
ANSWER ✨✔---dysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? - ANSWER ✨✔-
--subdural hematoma
A 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle
cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd
tenderness and scrotal ecchymosis. Which of the following orders would the RN question? -
ANSWER ✨✔---straight cath for urine sample
You are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary
survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show.
Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent
with which of the following? - ANSWER ✨✔---placental abruption
Which of the following is true about the log-roll? - ANSWER ✨✔---it can worsen cord damage from
an unstable spinal injury
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ANSWER ✨✔---defusings
What bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of
ventilation? - ANSWER ✨✔---pulse oximetry and capnography
, Caregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt is awake and crying
with increased work of breathing and pale skin. Which of the following interventions has the highest
priority? - ANSWER ✨✔---padding the upper back while stabilizing the cervical spine
Which of the following injuries is LEAST likely to be promptly identified? - ANSWER ✨✔---bowel
A pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic
injuries are noted in the primary survey, which of the following is the priority interventions? -
ANSWER ✨✔---Initiate trANSWERfer to a trauma center
A pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which
other clinical signs? - ANSWER ✨✔---bardycardia and absent motor function below the level of
injury
a 37 y/o F has a deformity of the L wrist after a fall. She is reluctant to move her hand due to pain.
Which of the following is the most appropriate intervention? - ANSWER ✨✔---apply splint and
elevate above the level of the heart
which of the following occurs during the third impact of a motor vehicle crash? - ANSWER ✨✔---
the aorta is torn at its attachment with the ligamentum arteriosum
a 5 y/o child presents to the ED with bruises to the upper arm 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 survey. Which of
the following is the priority nursing intervention? - ANSWER ✨✔---Report your suspicion of
maltreatment in accordance with local regulations
Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? -
ANSWER ✨✔---to guage end-organ perfusion and tissue hypoxia
A pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain
medications. Which of the following is the priority nursing intervention? - ANSWER ✨✔---elevating
the extremity to the level of the heart
