TNCC 9TH EDITION FINAL EXAM (2025/2026): LATEST VERSION WITH VERIFIED QUESTIONS AND ACCURATE, DETAILED ANSWERS FROM TRUSTED SOURCES.

TNCC 9TH EDITION FINAL EXAM (2025/2026): LATEST VERSION WITH VERIFIED QUESTIONS AND ACCURATE, DETAILED ANSWERS FROM TRUSTED SOURCES. 1. What is the best measure of the adequacy of cellular perfusion and helps predict the outcome of resuscitation? - ANSWER Base deficit used in conjunction with serum lactate 2. Will hypocapnia cause vasoconstriction or vasodilation, especially in the cerebral vasculature? - ANSWER Vasoconstriction 3. What results from tissue hypo perfusion and oxygen deficit? - ANSWER Metabolic acidosis 4. What type of shock results in generalized vasodilation? - ANSWER Neurogenic shock 5. Spinal cord injuries at C3-C5 causes loss of what nerves function, resulting in what? - ANSWER Phrenic nerve; paralyzed diaphragm and inability to breath 6. Extremity elevation AT the level of the heart is beneficial for what type of injury? - ANSWER Compartment Syndrome 7. Which commonly prescribed medication may worsen a complication that is associated with massive blood transfusion? a) lisinopril b) metformin c) metoprolol d) diltiazem - ANSWER d) diltiazem diltiazem is a CCB and, in combination with the citrate used as a preservative in blood products, puts the patient at a higher risk for significant hypocalcemia and cardiac dysrhythmias 8. An adult patient involved in an assault presents with shortness of breath, Bp 88/50, HR of 130 bpm, and RR 32. The patient has muffle heart sounds and is cyanotic. What is the primary intervention? a) needle thoracostomy b) chest tube insertion c) pericardiocentesis d) tracheal intubation - ANSWER c) pericardiocentesis 9. Which blood pressure finding is associated with early or compenstated hypovolemic shock? a) rising systolic b) rising diastolic c) decreasing diastolic d decreasing systolic - ANSWER b) rising diastolic 10. A patient has received multiple transfusions of banked blood in the past 2 hours. The patient has now developed muscle tremors, and short runs of ventricular tachycardia. Which of the following medications does the nurse anticipate administering? a) hypertonic saline b) calcitonin c) insulin and glucose d) calcium gluconate - ANSWER d) calcium gluconate 11. Based on fall mechanism, which patient warrants prehospital transfer to a trauma center? A.A 35-year-old lands on a wooden porch from an 8-foot ladder B.A 2-year-old lands on grass from a second-story balcony C.A 14-year-old forcefully pushed onto cement from standing D.A 50-year-old lands on a carpeted floor after tripping - ANSWER B.A 2-year-old lands on grass from a second-story balcony 12. The trauma nurse is caring for an unrestrained driver who struck their head on the windshield following a high-speed MVC. The patient has been diagnosed with an anterior spinal cord injury at the level of C6. Which assessment finding would be most concerning? A.Distension of the bladder B.Incontinence of stool C.Increasing work of breathing D.Inability to move the legs - ANSWER C.Increasing work of breathing 13. *While caring for a child who has been injured, what nursing intervention is consistent with a family-center approach? A.Identifying a single family member to speak with B.Having the family make all the care decisions C.Allowing family to participate in the care of the patient D.Limiting dissemination of complex information - ANSWER C.Allowing family to participate in the care of the patient A patient is brought to the emergency department with chest pain and shortness of breath following a high-speed motor vehicle collision in which they were the unrestrained driver. There is crepitus to the left chest with clear and equal breath sounds. The vital signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40 breaths/minute. Cardiac monitor shows sinus tachycardia with premature ventricular contractions. These findings are most consistent with which type of shock? A.Cardiogenic B.Neuroge - ANSWER A.Cardiogenic A trauma patient who is 30-weeks pregnant arrives at the emergency department following a motor vehicle collision. Which normal physiologic change should be considered when assessing ventilatory status? A.Increased functional reserve capacity B.Increased oxygen consumption C.Decreased minute ventilation D.Slower desaturation rates with apnea - ANSWER B.Increased oxygen consumption *A patient who sustained severe injuries was brought to the emergency department following a high-speed motor vehicle collision. Interventions for hypovolemic shock have been initiated. What component of the trauma triad of death is most likely to have begun at the time of injury? - ANSWER D.Coagulopathy An adult patient involved in a motor vehicle collision is brought to the emergency department of a rural critical access facility. They complain of neck pain, shortness of breath, and diffuse abdominal pain. The Glasgow Coma Score is 15. Vital signs are: BP 98/71 mm Hg, HR 125 beats/minute, RR 26 breaths/minute, and SpO2 94% on high-flow oxygen via non-rebreather mask. Which of the following is the priority intervention for this patient? - ANSWER C.Expedite transfer to the closest trauma center *A patient who weighs 120 kg is brought to the emergency department after sustaining partial thickness burns to both upper extremities and chest with a total body surface area burned of 27%. How much intravenous fluid should be administered in the first 8 hours? - ANSWER C.3240 mL (2ml LR x kg x %TBSA) = total volume in 24 hours. Half of calculated total should be given in first 8 hours. *A patient presents with chest pain and shortness of breath, following a motor vehicle collision. An electrocardiogram shows sinus tachycardia and ischemic changes within an elevated troponin. The nurse should be highly suspicious for which injury? - ANSWER B. Blunt cardiac injury PRIMARY ASSESSMENT/AIRWAY AND VENTILATION - ANSWER Pre-oxygenation for at least 3 minutes (not 1 minute) with high flow oxygen prior to intubation attempts, prolong the time to hypoxia when bag-mask ventilations are stopped for insertion of the endotracheal tube PRIMARY ASSESSMENT/AIRWAY AND VENTILATION - ANSWER If the blood is not sufficiently warmed when transfused, it can produce hypothermia. In the oxyhemoglobin dissociation curve, a shift to the left increases the affinity of hemoglobin for oxygen making it harder to release for use by the tissues. Factors that can cause this shift include an elevated pH, decreased carbon dioxide, decreased temperature, and low metabolic demand. PRIMARY ASSESSMENT/INITIAL ASSESSMENT - ANSWER Approximately one third of trauma patients arrive in the emergency department with some degree of coagulopathy due to depletion of clotting factors from whole blood loss. Some may also have been on medications that can impair platelet function or anticoagulation prior to their injury. SPECIAL POPULATIONS/LGTBQ+ - ANSWER A person who is in the process of transitioning from male to female will usually be taking female hormones such as estrogen/estradiol to assist with the transition. This can cause a decrease in muscle mass, increased risk of thromboembolism, and possibly increased bone density. These patients would not be taking testosterone. PRIMARY ASSESSMENT/SHOCK - ANSWER Diltiazem is a calcium channel blocker and in combination with the citrate used as a preservative in blood products, put the patient at a higher risk for significant hypocalcemia and cardiac dysrhythmias. A patient arrives with a 3-inch laceration to their forearm from a tree branch. Which of the following methods will the nurse use to remove small piles of debris from the wound?