TNCC FINAL EXAM COMPREHENSIVE
TEST QUESTIONS AND ANSWERS
1. A patient presents with a suspected spinal cord injury. Which assessment finding is most
characteristic of neurogenic shock compared to hypovolemic shock?
A. Tachycardia and cool skin
B. Increased systemic vascular resistance
C. Narrowing pulse pressure
D. Bradycardia and warm, dry skin
Answer: D
Conceptual Explanation: Neurogenic shock results from loss of sympathetic tone, leading
to bradycardia and vasodilation, which presents as warm, dry skin, unlike the tachycardia
and vasoconstriction seen in hypovolemic shock.
2. During the primary survey, a patient is found to have absent breath sounds on the right
side, tracheal deviation to the left, and severe respiratory distress. What is the immediate
priority intervention?
A. Obtain a portable chest X-ray
,B. Perform needle thoracocentesis
C. Perform endotracheal intubation
D. Insert a large-bore chest tube
Answer: B
Conceptual Explanation: These are classic signs of a tension pneumothorax, which is a
clinical diagnosis requiring immediate needle decompression before imaging or definitive
chest tube insertion.
3. A trauma patient has a Glasgow Coma Scale (GCS) score of 7. According to TNCC guidelines,
what is the priority management for this patient’s airway?
A. Insert an oropharyngeal airway
B. Perform definitive airway management (intubation)
C. Apply high-flow oxygen via non-rebreather mask
D. Monitor closely with frequent GCS checks
Answer: B
Conceptual Explanation: A GCS of 8 or less generally indicates the need for a definitive
airway (intubation) to protect the airway and ensure adequate oxygenation and
ventilation.
4. Which of the following findings is part of Beck’s Triad, suggesting cardiac tamponade?
A. Muffled heart sounds, JVD, and hypotension
, B. Hypertension, bradycardia, and irregular respirations
C. Tachycardia, tachypnea, and clear lung sounds
D. Tracheal deviation, diminished breath sounds, and hyperresonance
Answer: A
Conceptual Explanation: Beck’s Triad consists of muffled heart sounds, jugular venous
distention (JVD), and hypotension, indicative of cardiac tamponade.
5. In a pediatric trauma patient, which of the following is the most sensitive early sign of
compensated shock?
A. Tachycardia
B. Bradycardia
C. Hypotension
D. Decreased skin turgor
Answer: A
Conceptual Explanation: Tachycardia is often the first sign of shock in children as they
increase heart rate to maintain cardiac output; hypotension is a very late and ominous sign
in pediatrics.
6. A patient with a pelvic fracture is hemodynamically unstable. Where should a pelvic binder
be ideally placed?
A. Over the iliac crests
TEST QUESTIONS AND ANSWERS
1. A patient presents with a suspected spinal cord injury. Which assessment finding is most
characteristic of neurogenic shock compared to hypovolemic shock?
A. Tachycardia and cool skin
B. Increased systemic vascular resistance
C. Narrowing pulse pressure
D. Bradycardia and warm, dry skin
Answer: D
Conceptual Explanation: Neurogenic shock results from loss of sympathetic tone, leading
to bradycardia and vasodilation, which presents as warm, dry skin, unlike the tachycardia
and vasoconstriction seen in hypovolemic shock.
2. During the primary survey, a patient is found to have absent breath sounds on the right
side, tracheal deviation to the left, and severe respiratory distress. What is the immediate
priority intervention?
A. Obtain a portable chest X-ray
,B. Perform needle thoracocentesis
C. Perform endotracheal intubation
D. Insert a large-bore chest tube
Answer: B
Conceptual Explanation: These are classic signs of a tension pneumothorax, which is a
clinical diagnosis requiring immediate needle decompression before imaging or definitive
chest tube insertion.
3. A trauma patient has a Glasgow Coma Scale (GCS) score of 7. According to TNCC guidelines,
what is the priority management for this patient’s airway?
A. Insert an oropharyngeal airway
B. Perform definitive airway management (intubation)
C. Apply high-flow oxygen via non-rebreather mask
D. Monitor closely with frequent GCS checks
Answer: B
Conceptual Explanation: A GCS of 8 or less generally indicates the need for a definitive
airway (intubation) to protect the airway and ensure adequate oxygenation and
ventilation.
4. Which of the following findings is part of Beck’s Triad, suggesting cardiac tamponade?
A. Muffled heart sounds, JVD, and hypotension
, B. Hypertension, bradycardia, and irregular respirations
C. Tachycardia, tachypnea, and clear lung sounds
D. Tracheal deviation, diminished breath sounds, and hyperresonance
Answer: A
Conceptual Explanation: Beck’s Triad consists of muffled heart sounds, jugular venous
distention (JVD), and hypotension, indicative of cardiac tamponade.
5. In a pediatric trauma patient, which of the following is the most sensitive early sign of
compensated shock?
A. Tachycardia
B. Bradycardia
C. Hypotension
D. Decreased skin turgor
Answer: A
Conceptual Explanation: Tachycardia is often the first sign of shock in children as they
increase heart rate to maintain cardiac output; hypotension is a very late and ominous sign
in pediatrics.
6. A patient with a pelvic fracture is hemodynamically unstable. Where should a pelvic binder
be ideally placed?
A. Over the iliac crests
