TNCC – TRAUMA NURSING CORE COURSE EXAM
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1:
A 32-year-old male arrives at the emergency department after a high-speed motor
vehicle collision. He is conscious but pale, diaphoretic, and tachycardic (HR 132
bpm). Blood pressure is 88/56 mmHg. Which is the priority nursing
intervention?
A. Administer IV antibiotics
B. Obtain a detailed history of the accident
C. Initiate rapid IV fluid resuscitation
D. Apply a cervical collar
Answer: C. Initiate rapid IV fluid resuscitation
Rationale: This patient shows signs of hypovolemic shock (tachycardia,
hypotension, pallor, diaphoresis). Rapid fluid resuscitation is critical to restore
perfusion. Cervical collar can be applied after ensuring hemodynamic stability.
Question 2:
A patient presents with a flail chest after a fall. Which clinical finding would you
expect?
A. Hyperresonance on percussion
B. Paradoxical chest movement
C. Absent breath sounds unilaterally
D. Stridor
Answer: B. Paradoxical chest movement
Rationale: Flail chest occurs when a segment of the rib cage breaks and moves
independently. During inspiration, the segment moves inward while the rest of the
chest expands—this is paradoxical movement.
,Question 3:
During the primary survey, the nurse notes gurgling sounds in the airway of an
unconscious trauma patient. What is the immediate action?
A. Suction the airway
B. Administer oxygen via nasal cannula
C. Prepare for intubation
D. Perform jaw-thrust maneuver
Answer: A. Suction the airway
Rationale: The presence of gurgling sounds indicates airway obstruction due to
secretions. Suctioning immediately clears the airway, which is the first step in the
ABCDE primary survey.
Question 4:
A patient with a pelvic fracture is hypotensive. Which intervention is most
appropriate?
A. Apply a pelvic binder
B. Start oral hydration
C. Immobilize the lower extremities only
D. Place the patient in Trendelenburg position
Answer: A. Apply a pelvic binder
Rationale: Pelvic fractures can cause massive internal bleeding. A pelvic binder
stabilizes the fracture and helps control hemorrhage. Trendelenburg is no longer
recommended for shock.
Question 5:
A trauma patient with suspected tension pneumothorax shows tracheal deviation
to the left, absent breath sounds on the right, and hypotension. What is the priority
action?
A. Prepare for chest tube insertion in the right lung
B. Apply high-flow oxygen
,C. Needle decompression of the right chest
D. Position the patient on the affected side
Answer: C. Needle decompression of the right chest
Rationale: Tension pneumothorax is life-threatening. Immediate needle
decompression is required before chest tube placement to relieve pressure and
prevent cardiovascular collapse.
Question 6:
Which of the following is most indicative of neurogenic shock in a spinal cord
injury patient?
A. Hypotension with bradycardia
B. Hypertension with tachycardia
C. Hypotension with tachycardia
D. Hypertension with bradycardia
Answer: A. Hypotension with bradycardia
Rationale: Neurogenic shock results from loss of sympathetic tone, causing
vasodilation and bradycardia, unlike hypovolemic shock, which usually causes
tachycardia.
Question 7:
A trauma patient has a large, open abdominal wound with evisceration. The
nurse should:
A. Push the organs back into the abdomen
B. Cover with a sterile, moist dressing
C. Apply a dry sterile dressing
D. Apply direct pressure to control bleeding
Answer: B. Cover with a sterile, moist dressing
Rationale: Do not attempt to replace organs. Covering with a sterile, moist
dressing prevents contamination and drying of tissues while maintaining moisture
for tissue viability.
, Question 8:
Which lab finding is most critical to monitor in a patient with crush injuries from a
motor vehicle accident?
A. Blood glucose
B. Serum potassium
C. Hemoglobin A1c
D. Sodium
Answer: B. Serum potassium
Rationale: Crush injuries can cause rhabdomyolysis, leading to hyperkalemia,
which is life-threatening and can cause cardiac dysrhythmias.
Question 9:
A patient presents with bilateral lower extremity paralysis after a fall. Sensory is
intact. What is the likely location of injury?
A. Cervical spine
B. Thoracic spine
C. Lumbar spine
D. Sacral spine
Answer: B. Thoracic spine
Rationale: Bilateral paralysis with intact sensation below the waist suggests
thoracic spinal cord injury. Cervical injury would affect upper extremities.
Question 10:
Which of the following is the best indicator of ongoing internal bleeding in
trauma?
A. Tachycardia and hypotension
B. Decreased respiratory rate
C. Hyperthermia
D. Dilated pupils
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1:
A 32-year-old male arrives at the emergency department after a high-speed motor
vehicle collision. He is conscious but pale, diaphoretic, and tachycardic (HR 132
bpm). Blood pressure is 88/56 mmHg. Which is the priority nursing
intervention?
A. Administer IV antibiotics
B. Obtain a detailed history of the accident
C. Initiate rapid IV fluid resuscitation
D. Apply a cervical collar
Answer: C. Initiate rapid IV fluid resuscitation
Rationale: This patient shows signs of hypovolemic shock (tachycardia,
hypotension, pallor, diaphoresis). Rapid fluid resuscitation is critical to restore
perfusion. Cervical collar can be applied after ensuring hemodynamic stability.
Question 2:
A patient presents with a flail chest after a fall. Which clinical finding would you
expect?
A. Hyperresonance on percussion
B. Paradoxical chest movement
C. Absent breath sounds unilaterally
D. Stridor
Answer: B. Paradoxical chest movement
Rationale: Flail chest occurs when a segment of the rib cage breaks and moves
independently. During inspiration, the segment moves inward while the rest of the
chest expands—this is paradoxical movement.
,Question 3:
During the primary survey, the nurse notes gurgling sounds in the airway of an
unconscious trauma patient. What is the immediate action?
A. Suction the airway
B. Administer oxygen via nasal cannula
C. Prepare for intubation
D. Perform jaw-thrust maneuver
Answer: A. Suction the airway
Rationale: The presence of gurgling sounds indicates airway obstruction due to
secretions. Suctioning immediately clears the airway, which is the first step in the
ABCDE primary survey.
Question 4:
A patient with a pelvic fracture is hypotensive. Which intervention is most
appropriate?
A. Apply a pelvic binder
B. Start oral hydration
C. Immobilize the lower extremities only
D. Place the patient in Trendelenburg position
Answer: A. Apply a pelvic binder
Rationale: Pelvic fractures can cause massive internal bleeding. A pelvic binder
stabilizes the fracture and helps control hemorrhage. Trendelenburg is no longer
recommended for shock.
Question 5:
A trauma patient with suspected tension pneumothorax shows tracheal deviation
to the left, absent breath sounds on the right, and hypotension. What is the priority
action?
A. Prepare for chest tube insertion in the right lung
B. Apply high-flow oxygen
,C. Needle decompression of the right chest
D. Position the patient on the affected side
Answer: C. Needle decompression of the right chest
Rationale: Tension pneumothorax is life-threatening. Immediate needle
decompression is required before chest tube placement to relieve pressure and
prevent cardiovascular collapse.
Question 6:
Which of the following is most indicative of neurogenic shock in a spinal cord
injury patient?
A. Hypotension with bradycardia
B. Hypertension with tachycardia
C. Hypotension with tachycardia
D. Hypertension with bradycardia
Answer: A. Hypotension with bradycardia
Rationale: Neurogenic shock results from loss of sympathetic tone, causing
vasodilation and bradycardia, unlike hypovolemic shock, which usually causes
tachycardia.
Question 7:
A trauma patient has a large, open abdominal wound with evisceration. The
nurse should:
A. Push the organs back into the abdomen
B. Cover with a sterile, moist dressing
C. Apply a dry sterile dressing
D. Apply direct pressure to control bleeding
Answer: B. Cover with a sterile, moist dressing
Rationale: Do not attempt to replace organs. Covering with a sterile, moist
dressing prevents contamination and drying of tissues while maintaining moisture
for tissue viability.
, Question 8:
Which lab finding is most critical to monitor in a patient with crush injuries from a
motor vehicle accident?
A. Blood glucose
B. Serum potassium
C. Hemoglobin A1c
D. Sodium
Answer: B. Serum potassium
Rationale: Crush injuries can cause rhabdomyolysis, leading to hyperkalemia,
which is life-threatening and can cause cardiac dysrhythmias.
Question 9:
A patient presents with bilateral lower extremity paralysis after a fall. Sensory is
intact. What is the likely location of injury?
A. Cervical spine
B. Thoracic spine
C. Lumbar spine
D. Sacral spine
Answer: B. Thoracic spine
Rationale: Bilateral paralysis with intact sensation below the waist suggests
thoracic spinal cord injury. Cervical injury would affect upper extremities.
Question 10:
Which of the following is the best indicator of ongoing internal bleeding in
trauma?
A. Tachycardia and hypotension
B. Decreased respiratory rate
C. Hyperthermia
D. Dilated pupils
