TNCC 9TH EDITION FINAL EXAM NEWEST
ACTUAL EXAM COMPLETE ALL 110 QUESTIONS
AND CORRECT DETAILED ANSWERSTNCC 9TH
EDITION FINAL EXAM NEWEST UPDATE!!!
Question 1
A patient arrives at triage with a high fever and a new, unexplained petechial rash.
What is the priority intervention?
A) Obtain a full set of vital signs
B) Administer a cooling blanket
C) Immediately initiate isolation precautions
D) Draw blood for a complete blood count
E) Perform a head-to-toe assessment
Correct Answer: C) Immediately initiate isolation precautions
Rationale: In the triage setting, a fever combined with a rash is a high-risk
indicator for contagious and life-threatening conditions such as meningococcemia.
The priority is to protect other patients and staff by initiating isolation before
proceeding with further assessment.
Question 2
During the assessment of a patient with significant facial trauma, the nurse notes a
teardrop-shaped pupil. What does this finding suggest?
A) Normal variant
B) Oculomotor nerve palsy
C) Suspected retrobulbar hematoma or globe rupture
D) Increased intracranial pressure
E) Acute glaucoma
,Correct Answer: C) Suspected retrobulbar hematoma
Rationale: A teardrop-shaped pupil in the context of facial or ocular trauma is a
classic sign of globe rupture or a retrobulbar hematoma. This is an ocular
emergency that requires immediate consultation with ophthalmology to prevent
permanent vision loss.
Question 3
Which finding would lead the nurse to suspect an incomplete spinal cord injury at
the L1 level rather than a complete injury?
A) Loss of all motor function in the legs
B) Presence of voluntary anal sphincter tone
C) Urinary incontinence
D) Loss of sensation below the waist
E) Flaccid paralysis
Correct Answer: B) Indicated by voluntary anal sphincter tone
Rationale: Sacral sparing, which includes voluntary anal sphincter tone or
sensation at the anal mucocutaneous junction, is a hallmark indicator of an
incomplete spinal cord injury. A complete injury would result in the total loss of all
motor and sensory function in the lowest sacral segments.
Question 4
Which assessment finding is most consistent with a suspicion of a complete spinal
cord injury?
A) Intact deep tendon reflexes
B) Voluntary movement of the toes
C) Urinary incontinence and loss of sacral sensation
D) Sharp-dull discrimination at the groin
E) Reflexive withdrawal to pain
Correct Answer: C) Urinary incontinence as a finding
,Rationale: In a complete spinal cord injury, there is a total absence of sensory and
motor function in the lowest sacral segments (S4–S5). This manifests as a lack of
voluntary anal contraction and total urinary incontinence/lack of bladder control.
Question 5
In the early stages of hypovolemic shock, what change in blood pressure is
typically observed?
A) Falling systolic blood pressure
B) Rising systolic blood pressure
C) Narrowing pulse pressure
D) Rising diastolic blood pressure
E) Both B and D
Correct Answer: E) Both B and D
(Note: TNCC focuses on the narrowing pulse pressure, but compensatory
mechanisms initially may cause a slight rise or maintenance of systolic pressure
and a rise in diastolic pressure.)
Rationale: During early compensatory hypovolemic shock, the body releases
catecholamines, causing vasoconstriction. This often results in a narrowing pulse
pressure (the difference between systolic and diastolic pressure) and can lead to a
transient rise or maintenance of systolic pressure and a rise in diastolic pressure
before the patient eventually decompensates.
Question 6
A patient is suspected of having an unstable pelvic fracture. Which maneuver
should the nurse avoid or perform only with extreme caution?
A) Palpating the abdomen
B) The log-roll maneuver
C) Placing a urinary catheter
D) Auscultating lung sounds
E) Applying a pulse oximeter
, Correct Answer: B) Log-roll maneuver
Rationale: Log-rolling a patient with an unstable pelvic fracture can lead to further
displacement of the fracture, increased internal hemorrhage, and damage to
surrounding structures. If the pelvis is unstable, the log-roll should be avoided until
the pelvis is stabilized (e.g., with a pelvic binder).
Question 7
What is the priority intervention for a trauma patient with massive, uncontrolled
external bleeding?
A) Start two large-bore IVs
B) Apply a tourniquet immediately
C) Apply direct pressure to the wound
D) Obtain a type and cross-match
E) Administer Tranexamic Acid (TXA)
Correct Answer: C) Apply direct pressure to the wound
Rationale: According to the TNCC "C-ABC" (Catastrophic hemorrhage, Airway,
Breathing, Circulation) sequence, life-threatening external bleeding must be
addressed first. Direct pressure is the initial gold standard for controlling external
hemorrhage, followed by a tourniquet if pressure is insufficient.
Question 8
When managing a patient with severe head trauma and signs of herniation, which
adjustment to manual ventilation is appropriate?
A) Increase the rate to achieve a CO₂ of 25 mmHg
B) Decrease the rate of manual ventilation to prevent hypocapnia
C) Stop ventilation to allow the patient to trigger the vent
D) Provide 100% oxygen with a rate of 30 breaths per minute
E) Use only a non-rebreather mask
Correct Answer: B) Decrease the rate of manual ventilation
ACTUAL EXAM COMPLETE ALL 110 QUESTIONS
AND CORRECT DETAILED ANSWERSTNCC 9TH
EDITION FINAL EXAM NEWEST UPDATE!!!
Question 1
A patient arrives at triage with a high fever and a new, unexplained petechial rash.
What is the priority intervention?
A) Obtain a full set of vital signs
B) Administer a cooling blanket
C) Immediately initiate isolation precautions
D) Draw blood for a complete blood count
E) Perform a head-to-toe assessment
Correct Answer: C) Immediately initiate isolation precautions
Rationale: In the triage setting, a fever combined with a rash is a high-risk
indicator for contagious and life-threatening conditions such as meningococcemia.
The priority is to protect other patients and staff by initiating isolation before
proceeding with further assessment.
Question 2
During the assessment of a patient with significant facial trauma, the nurse notes a
teardrop-shaped pupil. What does this finding suggest?
A) Normal variant
B) Oculomotor nerve palsy
C) Suspected retrobulbar hematoma or globe rupture
D) Increased intracranial pressure
E) Acute glaucoma
,Correct Answer: C) Suspected retrobulbar hematoma
Rationale: A teardrop-shaped pupil in the context of facial or ocular trauma is a
classic sign of globe rupture or a retrobulbar hematoma. This is an ocular
emergency that requires immediate consultation with ophthalmology to prevent
permanent vision loss.
Question 3
Which finding would lead the nurse to suspect an incomplete spinal cord injury at
the L1 level rather than a complete injury?
A) Loss of all motor function in the legs
B) Presence of voluntary anal sphincter tone
C) Urinary incontinence
D) Loss of sensation below the waist
E) Flaccid paralysis
Correct Answer: B) Indicated by voluntary anal sphincter tone
Rationale: Sacral sparing, which includes voluntary anal sphincter tone or
sensation at the anal mucocutaneous junction, is a hallmark indicator of an
incomplete spinal cord injury. A complete injury would result in the total loss of all
motor and sensory function in the lowest sacral segments.
Question 4
Which assessment finding is most consistent with a suspicion of a complete spinal
cord injury?
A) Intact deep tendon reflexes
B) Voluntary movement of the toes
C) Urinary incontinence and loss of sacral sensation
D) Sharp-dull discrimination at the groin
E) Reflexive withdrawal to pain
Correct Answer: C) Urinary incontinence as a finding
,Rationale: In a complete spinal cord injury, there is a total absence of sensory and
motor function in the lowest sacral segments (S4–S5). This manifests as a lack of
voluntary anal contraction and total urinary incontinence/lack of bladder control.
Question 5
In the early stages of hypovolemic shock, what change in blood pressure is
typically observed?
A) Falling systolic blood pressure
B) Rising systolic blood pressure
C) Narrowing pulse pressure
D) Rising diastolic blood pressure
E) Both B and D
Correct Answer: E) Both B and D
(Note: TNCC focuses on the narrowing pulse pressure, but compensatory
mechanisms initially may cause a slight rise or maintenance of systolic pressure
and a rise in diastolic pressure.)
Rationale: During early compensatory hypovolemic shock, the body releases
catecholamines, causing vasoconstriction. This often results in a narrowing pulse
pressure (the difference between systolic and diastolic pressure) and can lead to a
transient rise or maintenance of systolic pressure and a rise in diastolic pressure
before the patient eventually decompensates.
Question 6
A patient is suspected of having an unstable pelvic fracture. Which maneuver
should the nurse avoid or perform only with extreme caution?
A) Palpating the abdomen
B) The log-roll maneuver
C) Placing a urinary catheter
D) Auscultating lung sounds
E) Applying a pulse oximeter
, Correct Answer: B) Log-roll maneuver
Rationale: Log-rolling a patient with an unstable pelvic fracture can lead to further
displacement of the fracture, increased internal hemorrhage, and damage to
surrounding structures. If the pelvis is unstable, the log-roll should be avoided until
the pelvis is stabilized (e.g., with a pelvic binder).
Question 7
What is the priority intervention for a trauma patient with massive, uncontrolled
external bleeding?
A) Start two large-bore IVs
B) Apply a tourniquet immediately
C) Apply direct pressure to the wound
D) Obtain a type and cross-match
E) Administer Tranexamic Acid (TXA)
Correct Answer: C) Apply direct pressure to the wound
Rationale: According to the TNCC "C-ABC" (Catastrophic hemorrhage, Airway,
Breathing, Circulation) sequence, life-threatening external bleeding must be
addressed first. Direct pressure is the initial gold standard for controlling external
hemorrhage, followed by a tourniquet if pressure is insufficient.
Question 8
When managing a patient with severe head trauma and signs of herniation, which
adjustment to manual ventilation is appropriate?
A) Increase the rate to achieve a CO₂ of 25 mmHg
B) Decrease the rate of manual ventilation to prevent hypocapnia
C) Stop ventilation to allow the patient to trigger the vent
D) Provide 100% oxygen with a rate of 30 breaths per minute
E) Use only a non-rebreather mask
Correct Answer: B) Decrease the rate of manual ventilation
