TNCC FINAL EXAM COMPREHENSIVE
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A 35-year-old male arrives after a high-speed motor vehicle collision. The patient is found
to have decreased breath sounds on the right and tracheal deviation to the left. What is the
immediate priority intervention?
A. Obtain a portable chest X-ray
B. Administer 100% oxygen via non-rebreather
C. Prepare for emergency tracheostomy
D. Perform needle decompression
Answer: D
Conceptual Explanation: The symptoms of decreased breath sounds and tracheal
deviation indicate a tension pneumothorax, which requires immediate needle
decompression before diagnostic imaging to prevent cardiovascular collapse.
,2. When assessing a trauma patient, which component of the ‘Trauma Neurological
Assessment’ includes the patient’s ability to follow commands and their motor response?
A. AVPU Scale
B. Glasgow Coma Scale (GCS)
C. Four Score
D. RASS Scale
Answer: B
Conceptual Explanation: The GCS is the gold standard for assessing neurological status in
trauma, measuring eye opening, verbal response, and motor response.
3. In the ‘C’ (Circulation) phase of the primary survey, which of the following is the most
reliable early indicator of compensated shock?
A. Hypotension
B. Decreased urine output
C. Bradycardia
D. Narrowed pulse pressure
Answer: D
Conceptual Explanation: Narrowed pulse pressure is an early sign of compensated shock
as the body attempts to maintain perfusion, occurring before a drop in systolic blood
pressure.
, 4. The ‘Lethal Triad’ in trauma patients consists of which three conditions?
A. Hypothermia, Coagulopathy, Acidosis
B. Hyperthermia, Alkalosis, Tachycardia
C. Hypotension, Bradycardia, Hypoxia
D. Hypoglycemia, Hypokalemia, Hypovolemia
Answer: A
Conceptual Explanation: The lethal triad includes hypothermia, coagulopathy, and
metabolic acidosis, which exacerbate one another and significantly increase mortality.
5. A patient presents with a ‘flail chest’ following a blunt force injury. What is the definitive
management strategy for the respiratory compromise associated with this injury?
A. Positive pressure ventilation and adequate pain control
B. Internal fixation of all ribs
C. Chest tube insertion
D. Aggressive fluid resuscitation
Answer: A
Conceptual Explanation: Management of flail chest focuses on ensuring adequate
ventilation (often through positive pressure) and providing pain control to prevent
splinting and atelectasis.
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A 35-year-old male arrives after a high-speed motor vehicle collision. The patient is found
to have decreased breath sounds on the right and tracheal deviation to the left. What is the
immediate priority intervention?
A. Obtain a portable chest X-ray
B. Administer 100% oxygen via non-rebreather
C. Prepare for emergency tracheostomy
D. Perform needle decompression
Answer: D
Conceptual Explanation: The symptoms of decreased breath sounds and tracheal
deviation indicate a tension pneumothorax, which requires immediate needle
decompression before diagnostic imaging to prevent cardiovascular collapse.
,2. When assessing a trauma patient, which component of the ‘Trauma Neurological
Assessment’ includes the patient’s ability to follow commands and their motor response?
A. AVPU Scale
B. Glasgow Coma Scale (GCS)
C. Four Score
D. RASS Scale
Answer: B
Conceptual Explanation: The GCS is the gold standard for assessing neurological status in
trauma, measuring eye opening, verbal response, and motor response.
3. In the ‘C’ (Circulation) phase of the primary survey, which of the following is the most
reliable early indicator of compensated shock?
A. Hypotension
B. Decreased urine output
C. Bradycardia
D. Narrowed pulse pressure
Answer: D
Conceptual Explanation: Narrowed pulse pressure is an early sign of compensated shock
as the body attempts to maintain perfusion, occurring before a drop in systolic blood
pressure.
, 4. The ‘Lethal Triad’ in trauma patients consists of which three conditions?
A. Hypothermia, Coagulopathy, Acidosis
B. Hyperthermia, Alkalosis, Tachycardia
C. Hypotension, Bradycardia, Hypoxia
D. Hypoglycemia, Hypokalemia, Hypovolemia
Answer: A
Conceptual Explanation: The lethal triad includes hypothermia, coagulopathy, and
metabolic acidosis, which exacerbate one another and significantly increase mortality.
5. A patient presents with a ‘flail chest’ following a blunt force injury. What is the definitive
management strategy for the respiratory compromise associated with this injury?
A. Positive pressure ventilation and adequate pain control
B. Internal fixation of all ribs
C. Chest tube insertion
D. Aggressive fluid resuscitation
Answer: A
Conceptual Explanation: Management of flail chest focuses on ensuring adequate
ventilation (often through positive pressure) and providing pain control to prevent
splinting and atelectasis.
