TNCC FINAL EXAM TEST 2027
QUESTIONS AND ANSWERS
1. A patient with a suspected spinal cord injury is experiencing a sudden decrease in blood
pressure, bradycardia, and warm, dry skin. Which type of shock should the trauma nurse
suspect?
A. Neurogenic shock
B. Obstructive shock
C. Hypovolemic shock
D. Cardiogenic shock
Answer: A
Conceptual Explanation: Neurogenic shock is characterized by loss of sympathetic tone,
leading to vasodilation (warm skin), hypotension, and a loss of compensatory tachycardia
(bradycardia).
2. During the primary survey, a patient is found to have a GCS of 7. Which intervention is the
highest priority?
A. Insertion of an oropharyngeal airway
,B. Preparation for definitive airway management
C. Immediate CT scan of the head
D. Administration of IV mannitol
Answer: B
Conceptual Explanation: A GCS of 8 or less typically indicates the need for a definitive
airway (intubation) to protect the patient’s airway and ensure adequate ventilation.
3. Which of the following is the most sensitive indicator of early hypovolemic shock in a
pediatric patient?
A. Hypotension
B. Decreased skin turgor
C. Tachycardia
D. Widening pulse pressure
Answer: C
Conceptual Explanation: In children, blood pressure is maintained until late stages of
shock. Tachycardia is one of the earliest signs of compensation for decreased stroke
volume.
4. A patient presents with muffled heart sounds, jugular venous distension, and hypotension.
What is the definitive treatment for this condition?
A. Needle decompression
, B. Pericardiocentesis
C. Tube thoracostomy
D. Aggressive fluid resuscitation
Answer: B
Conceptual Explanation: These signs constitute Beck’s Triad, indicating cardiac
tamponade. Pericardiocentesis or a pericardial window is required to remove fluid from
the pericardial sac.
5. In the ‘Exposure and Environmental Control’ phase of the primary survey, what is the
primary goal besides visualizing all injuries?
A. Initiating massive transfusion
B. Checking blood glucose levels
C. Preventing hypothermia
D. Calculating the Rule of Nines
Answer: C
Conceptual Explanation: Prevention of hypothermia is critical in trauma to avoid the
‘lethal triad’ (acidosis, coagulopathy, hypothermia).
6. A 35-week pregnant trauma patient is positioned supine. She becomes hypotensive. What
is the most appropriate immediate action?
A. Displace the uterus manually to the left
QUESTIONS AND ANSWERS
1. A patient with a suspected spinal cord injury is experiencing a sudden decrease in blood
pressure, bradycardia, and warm, dry skin. Which type of shock should the trauma nurse
suspect?
A. Neurogenic shock
B. Obstructive shock
C. Hypovolemic shock
D. Cardiogenic shock
Answer: A
Conceptual Explanation: Neurogenic shock is characterized by loss of sympathetic tone,
leading to vasodilation (warm skin), hypotension, and a loss of compensatory tachycardia
(bradycardia).
2. During the primary survey, a patient is found to have a GCS of 7. Which intervention is the
highest priority?
A. Insertion of an oropharyngeal airway
,B. Preparation for definitive airway management
C. Immediate CT scan of the head
D. Administration of IV mannitol
Answer: B
Conceptual Explanation: A GCS of 8 or less typically indicates the need for a definitive
airway (intubation) to protect the patient’s airway and ensure adequate ventilation.
3. Which of the following is the most sensitive indicator of early hypovolemic shock in a
pediatric patient?
A. Hypotension
B. Decreased skin turgor
C. Tachycardia
D. Widening pulse pressure
Answer: C
Conceptual Explanation: In children, blood pressure is maintained until late stages of
shock. Tachycardia is one of the earliest signs of compensation for decreased stroke
volume.
4. A patient presents with muffled heart sounds, jugular venous distension, and hypotension.
What is the definitive treatment for this condition?
A. Needle decompression
, B. Pericardiocentesis
C. Tube thoracostomy
D. Aggressive fluid resuscitation
Answer: B
Conceptual Explanation: These signs constitute Beck’s Triad, indicating cardiac
tamponade. Pericardiocentesis or a pericardial window is required to remove fluid from
the pericardial sac.
5. In the ‘Exposure and Environmental Control’ phase of the primary survey, what is the
primary goal besides visualizing all injuries?
A. Initiating massive transfusion
B. Checking blood glucose levels
C. Preventing hypothermia
D. Calculating the Rule of Nines
Answer: C
Conceptual Explanation: Prevention of hypothermia is critical in trauma to avoid the
‘lethal triad’ (acidosis, coagulopathy, hypothermia).
6. A 35-week pregnant trauma patient is positioned supine. She becomes hypotensive. What
is the most appropriate immediate action?
A. Displace the uterus manually to the left
