TNCC test prepA, TNCC Notes for
Written Exam, TNCC Notes for
Written Exam, TNCC Prep, TNCC
EXAM, TNCC 8th Edition
Course
TNCC
1. A trauma patient arrives after a high-speed motor vehicle collision. Which assessment
should the nurse prioritize first?
A. Obtain a complete medical history
B. Assess airway and cervical spine protection
C. Determine the patient's last oral intake
D. Obtain a detailed family history
Answer: B. Assess airway and cervical spine protection
Rationale: The initial trauma assessment prioritizes immediately life-threatening problems.
Airway assessment is performed while protecting the cervical spine when spinal injury is
possible.
2. During the primary survey, a patient is unable to speak normally and has gurgling
respirations. What is the priority intervention?
A. Obtain a chest x-ray
B. Establish and maintain a patent airway
C. Assess urine output
D. Obtain a complete neurological history
Answer: B. Establish and maintain a patent airway
Rationale: Gurgling suggests airway obstruction by secretions, blood, or other material. Airway
compromise must be addressed immediately.
3. Which finding most strongly suggests an immediately life-threatening airway problem?
A. Mild facial bruising
B. Hoarse voice with increasing respiratory distress
C. Small scalp abrasion
D. Mild shoulder pain
Answer: B. Hoarse voice with increasing respiratory distress
,Rationale: Hoarseness can indicate airway injury or edema. When accompanied by worsening
respiratory distress, rapid airway intervention may be necessary.
4. A trauma patient has severe respiratory distress, absent breath sounds on the left,
hypotension, and distended neck veins. Which condition should the nurse suspect?
A. Simple rib fracture
B. Tension pneumothorax
C. Pulmonary contusion only
D. Isolated clavicle fracture
Answer: B. Tension pneumothorax
Rationale: Severe respiratory distress, unilateral absent breath sounds, and obstructive shock
findings are highly concerning for tension pneumothorax. This is an immediate life threat
requiring rapid intervention.
5. A patient with penetrating chest trauma develops hypotension, muffled heart sounds, and
jugular venous distention. Which condition is most concerning?
A. Cardiac tamponade
B. Simple pneumothorax
C. Flail chest
D. Pulmonary embolism
Answer: A. Cardiac tamponade
Rationale: The combination of hypotension, muffled heart sounds, and jugular venous distention
is classically associated with cardiac tamponade.
6. Which finding is most characteristic of flail chest?
A. One isolated rib fracture
B. Paradoxical movement of a segment of the chest wall
C. Bilateral leg swelling
D. Absent bowel sounds
Answer: B. Paradoxical movement of a segment of the chest wall
Rationale: Flail chest occurs when multiple adjacent ribs are fractured in multiple places,
producing an unstable chest-wall segment that may move paradoxically during respiration.
7. A trauma patient has paradoxical chest movement and increasing respiratory distress.
What is the nurse's priority?
A. Encourage vigorous coughing
B. Support oxygenation and ventilation
,C. Place the patient in Trendelenburg position
D. Delay treatment until x-ray results are available
Answer: B. Support oxygenation and ventilation
Rationale: Respiratory compromise is the immediate concern. Oxygenation and ventilation
should be supported while the patient receives definitive trauma management.
8. A patient with major trauma is pale, cool, diaphoretic, tachycardic, and anxious. Which
condition should the nurse suspect?
A. Hemorrhagic shock
B. Stable neurological injury
C. Hyperthyroidism
D. Chronic hypertension
Answer: A. Hemorrhagic shock
Rationale: These findings are consistent with poor perfusion and sympathetic activation
associated with hypovolemic/hemorrhagic shock.
9. Which finding can occur early in hemorrhagic shock?
A. Tachycardia
B. Severe bradycardia in every patient
C. Increased urine output
D. Warm, dry skin in all cases
Answer: A. Tachycardia
Rationale: Tachycardia is an important compensatory response to reduced circulating volume.
Other findings may include cool skin, delayed capillary refill, anxiety, and decreasing urine
output.
10. A trauma patient has uncontrolled external bleeding from an extremity. What is the
priority?
A. Obtain a detailed history first
B. Control the hemorrhage
C. Perform a secondary survey first
D. Wait for laboratory results
Answer: B. Control the hemorrhage
Rationale: Life-threatening external hemorrhage must be controlled immediately rather than
delayed for completion of the secondary assessment.
11. Which finding may indicate significant internal abdominal bleeding after blunt trauma?
, A. Increasing abdominal distention with hypotension
B. Improved appetite
C. Clear lung sounds only
D. Isolated finger pain
Answer: A. Increasing abdominal distention with hypotension
Rationale: Abdominal distention, tenderness, or rigidity combined with signs of shock can
indicate significant intra-abdominal bleeding.
12. A trauma patient has pelvic instability and signs of shock. Which complication is the
nurse particularly concerned about?
A. Massive pelvic hemorrhage
B. Mild dehydration only
C. Isolated wrist injury
D. Otitis media
Answer: A. Massive pelvic hemorrhage
Rationale: Pelvic fractures can cause significant internal bleeding. Hemodynamic instability in a
patient with suspected pelvic injury requires urgent trauma management.
13. Which action should be avoided when a pelvic fracture is suspected?
A. Following institutional pelvic stabilization protocols
B. Repeatedly manipulating the pelvis to test stability
C. Monitoring hemodynamic status
D. Assessing distal pulses and neurologic function
Answer: B. Repeatedly manipulating the pelvis to test stability
Rationale: Repeated pelvic movement can potentially worsen bleeding and injury. Assessment
should be performed carefully and stabilization measures implemented according to protocol.
14. A patient involved in a motor vehicle crash has midline cervical tenderness. What is the
priority nursing consideration?
A. Encourage neck rotation
B. Maintain spinal precautions
C. Have the patient walk to assess gait
D. Place a pillow under the neck and encourage movement
Answer: B. Maintain spinal precautions
Written Exam, TNCC Notes for
Written Exam, TNCC Prep, TNCC
EXAM, TNCC 8th Edition
Course
TNCC
1. A trauma patient arrives after a high-speed motor vehicle collision. Which assessment
should the nurse prioritize first?
A. Obtain a complete medical history
B. Assess airway and cervical spine protection
C. Determine the patient's last oral intake
D. Obtain a detailed family history
Answer: B. Assess airway and cervical spine protection
Rationale: The initial trauma assessment prioritizes immediately life-threatening problems.
Airway assessment is performed while protecting the cervical spine when spinal injury is
possible.
2. During the primary survey, a patient is unable to speak normally and has gurgling
respirations. What is the priority intervention?
A. Obtain a chest x-ray
B. Establish and maintain a patent airway
C. Assess urine output
D. Obtain a complete neurological history
Answer: B. Establish and maintain a patent airway
Rationale: Gurgling suggests airway obstruction by secretions, blood, or other material. Airway
compromise must be addressed immediately.
3. Which finding most strongly suggests an immediately life-threatening airway problem?
A. Mild facial bruising
B. Hoarse voice with increasing respiratory distress
C. Small scalp abrasion
D. Mild shoulder pain
Answer: B. Hoarse voice with increasing respiratory distress
,Rationale: Hoarseness can indicate airway injury or edema. When accompanied by worsening
respiratory distress, rapid airway intervention may be necessary.
4. A trauma patient has severe respiratory distress, absent breath sounds on the left,
hypotension, and distended neck veins. Which condition should the nurse suspect?
A. Simple rib fracture
B. Tension pneumothorax
C. Pulmonary contusion only
D. Isolated clavicle fracture
Answer: B. Tension pneumothorax
Rationale: Severe respiratory distress, unilateral absent breath sounds, and obstructive shock
findings are highly concerning for tension pneumothorax. This is an immediate life threat
requiring rapid intervention.
5. A patient with penetrating chest trauma develops hypotension, muffled heart sounds, and
jugular venous distention. Which condition is most concerning?
A. Cardiac tamponade
B. Simple pneumothorax
C. Flail chest
D. Pulmonary embolism
Answer: A. Cardiac tamponade
Rationale: The combination of hypotension, muffled heart sounds, and jugular venous distention
is classically associated with cardiac tamponade.
6. Which finding is most characteristic of flail chest?
A. One isolated rib fracture
B. Paradoxical movement of a segment of the chest wall
C. Bilateral leg swelling
D. Absent bowel sounds
Answer: B. Paradoxical movement of a segment of the chest wall
Rationale: Flail chest occurs when multiple adjacent ribs are fractured in multiple places,
producing an unstable chest-wall segment that may move paradoxically during respiration.
7. A trauma patient has paradoxical chest movement and increasing respiratory distress.
What is the nurse's priority?
A. Encourage vigorous coughing
B. Support oxygenation and ventilation
,C. Place the patient in Trendelenburg position
D. Delay treatment until x-ray results are available
Answer: B. Support oxygenation and ventilation
Rationale: Respiratory compromise is the immediate concern. Oxygenation and ventilation
should be supported while the patient receives definitive trauma management.
8. A patient with major trauma is pale, cool, diaphoretic, tachycardic, and anxious. Which
condition should the nurse suspect?
A. Hemorrhagic shock
B. Stable neurological injury
C. Hyperthyroidism
D. Chronic hypertension
Answer: A. Hemorrhagic shock
Rationale: These findings are consistent with poor perfusion and sympathetic activation
associated with hypovolemic/hemorrhagic shock.
9. Which finding can occur early in hemorrhagic shock?
A. Tachycardia
B. Severe bradycardia in every patient
C. Increased urine output
D. Warm, dry skin in all cases
Answer: A. Tachycardia
Rationale: Tachycardia is an important compensatory response to reduced circulating volume.
Other findings may include cool skin, delayed capillary refill, anxiety, and decreasing urine
output.
10. A trauma patient has uncontrolled external bleeding from an extremity. What is the
priority?
A. Obtain a detailed history first
B. Control the hemorrhage
C. Perform a secondary survey first
D. Wait for laboratory results
Answer: B. Control the hemorrhage
Rationale: Life-threatening external hemorrhage must be controlled immediately rather than
delayed for completion of the secondary assessment.
11. Which finding may indicate significant internal abdominal bleeding after blunt trauma?
, A. Increasing abdominal distention with hypotension
B. Improved appetite
C. Clear lung sounds only
D. Isolated finger pain
Answer: A. Increasing abdominal distention with hypotension
Rationale: Abdominal distention, tenderness, or rigidity combined with signs of shock can
indicate significant intra-abdominal bleeding.
12. A trauma patient has pelvic instability and signs of shock. Which complication is the
nurse particularly concerned about?
A. Massive pelvic hemorrhage
B. Mild dehydration only
C. Isolated wrist injury
D. Otitis media
Answer: A. Massive pelvic hemorrhage
Rationale: Pelvic fractures can cause significant internal bleeding. Hemodynamic instability in a
patient with suspected pelvic injury requires urgent trauma management.
13. Which action should be avoided when a pelvic fracture is suspected?
A. Following institutional pelvic stabilization protocols
B. Repeatedly manipulating the pelvis to test stability
C. Monitoring hemodynamic status
D. Assessing distal pulses and neurologic function
Answer: B. Repeatedly manipulating the pelvis to test stability
Rationale: Repeated pelvic movement can potentially worsen bleeding and injury. Assessment
should be performed carefully and stabilization measures implemented according to protocol.
14. A patient involved in a motor vehicle crash has midline cervical tenderness. What is the
priority nursing consideration?
A. Encourage neck rotation
B. Maintain spinal precautions
C. Have the patient walk to assess gait
D. Place a pillow under the neck and encourage movement
Answer: B. Maintain spinal precautions
