TNCC 9 TH EDITION FINAL ACTUAL EXAM
NEWEST VERSION 2025/2026 QUESTION AND
CORRECT DETAILED VERIFIED ANSWERS FROM
VERIFIED SOURCES RATED A GRADE.
You are caring for a patient who was thrown C. Notify the physician
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.
A patient is brought to the emergency A. Initiate transfer to a trauma center
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
An adult who fell from a second story roof is A. Initiate cervical spine stabilization
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
,An adult patient who sustained a severe A. Decrease the rate of manual ventilation.
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.
An adult patient is brought to the emergency B. Application of a pelvic binder
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)
2. Which of the following situations could B. Amputation of a limb
cause functional grief? Rationale: Preparation and Ongoing Care\Psychosocial
A. Inability to live at home Aspects
B. Amputation of a limb Functional grief relates to the loss of body function or body
C. Loss of one's self-image parts such as amputation of a limb, paralysis, or loss of sight.
D. Destruction of the patient's car
3. What is the most important consideration B. Medical history including current medications
during the initial assessment when caring for
an older adult who has sustained serious
injuries?
A. They are likely to be fearful in the
emergency department
B. Medical history including current
medications
C. Availability of support systems after
discharge
D. Accessibility to a primary care physician
, 4. You are caring for a patient who was C. Notify the physician
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.
5. When should the definitive calculation for B. After removal of clothing
intravenous fluid resuscitation rate be Rationale: Musculoskeletal and Wounds\Burns
performed for a patient with burns? Some fluid will be given initially, but an accurate fluid total is
A. As soon as the patient arrives based on percentage of total body surface area which requires
B. After removal of clothing a good skin assessment and is calculated after clothing is
C. Only at a burn center removed.
D. During the circulation assessment
6. In a motor vehicle collision, which injury B. Ejection
pathway is most likely to increase the
patient's morbidity and mortality?
A. Rotational
B. Ejection
C. Lateral
D. Rollover
7. A patient with a lower extremity fracture C. Elevating the leg to the level of the heart
complains of severe pain and tightness in his Rationale: Musculoskeletal and Wounds\Musculoskeletal
calf, minimally relieved by pain medications. This patient is exhibiting signs of possible compartment
Which of the following is the priority nursing syndrome which is a dangerous complication of fractured
intervention? extremities. The pain is often out of proportion to the injury and
A. Elevating the leg above the level of the might not respond to pain medications. Elevate the limb to the
heart level of the heart to decrease dependent edema but not above
B. Repositioning the leg and applying ice the heart, which can cause increased venous congestion and
C. Elevating the leg to the level of the heart pressure within the compartment.
D. Preparing the patient for ultrasound of the
leg
8. A teenaged patient presents to the D. Those experiencing human trafficking rarely self-
emergency department with left arm pain disclose.
after a ground level fall. The patient identifies
as transgender and shares they are
homeless. The ED staff are concerned the
patient is experiencing human trafficking.
What is most consistent with human
trafficking?
A. The individual appears well nourished.
B. Those who are being trafficked rarely seek
medical care.
C. It is infrequently associated with
substance abuse.
D. Those experiencing human trafficking
rarely self-disclose.
NEWEST VERSION 2025/2026 QUESTION AND
CORRECT DETAILED VERIFIED ANSWERS FROM
VERIFIED SOURCES RATED A GRADE.
You are caring for a patient who was thrown C. Notify the physician
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.
A patient is brought to the emergency A. Initiate transfer to a trauma center
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
An adult who fell from a second story roof is A. Initiate cervical spine stabilization
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
,An adult patient who sustained a severe A. Decrease the rate of manual ventilation.
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.
An adult patient is brought to the emergency B. Application of a pelvic binder
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)
2. Which of the following situations could B. Amputation of a limb
cause functional grief? Rationale: Preparation and Ongoing Care\Psychosocial
A. Inability to live at home Aspects
B. Amputation of a limb Functional grief relates to the loss of body function or body
C. Loss of one's self-image parts such as amputation of a limb, paralysis, or loss of sight.
D. Destruction of the patient's car
3. What is the most important consideration B. Medical history including current medications
during the initial assessment when caring for
an older adult who has sustained serious
injuries?
A. They are likely to be fearful in the
emergency department
B. Medical history including current
medications
C. Availability of support systems after
discharge
D. Accessibility to a primary care physician
, 4. You are caring for a patient who was C. Notify the physician
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.
5. When should the definitive calculation for B. After removal of clothing
intravenous fluid resuscitation rate be Rationale: Musculoskeletal and Wounds\Burns
performed for a patient with burns? Some fluid will be given initially, but an accurate fluid total is
A. As soon as the patient arrives based on percentage of total body surface area which requires
B. After removal of clothing a good skin assessment and is calculated after clothing is
C. Only at a burn center removed.
D. During the circulation assessment
6. In a motor vehicle collision, which injury B. Ejection
pathway is most likely to increase the
patient's morbidity and mortality?
A. Rotational
B. Ejection
C. Lateral
D. Rollover
7. A patient with a lower extremity fracture C. Elevating the leg to the level of the heart
complains of severe pain and tightness in his Rationale: Musculoskeletal and Wounds\Musculoskeletal
calf, minimally relieved by pain medications. This patient is exhibiting signs of possible compartment
Which of the following is the priority nursing syndrome which is a dangerous complication of fractured
intervention? extremities. The pain is often out of proportion to the injury and
A. Elevating the leg above the level of the might not respond to pain medications. Elevate the limb to the
heart level of the heart to decrease dependent edema but not above
B. Repositioning the leg and applying ice the heart, which can cause increased venous congestion and
C. Elevating the leg to the level of the heart pressure within the compartment.
D. Preparing the patient for ultrasound of the
leg
8. A teenaged patient presents to the D. Those experiencing human trafficking rarely self-
emergency department with left arm pain disclose.
after a ground level fall. The patient identifies
as transgender and shares they are
homeless. The ED staff are concerned the
patient is experiencing human trafficking.
What is most consistent with human
trafficking?
A. The individual appears well nourished.
B. Those who are being trafficked rarely seek
medical care.
C. It is infrequently associated with
substance abuse.
D. Those experiencing human trafficking
rarely self-disclose.
