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Exam (elaborations)

TNCC 10th Edition Exam Test Bank — Complete 200 Questions and Correct Detailed Answers with Rationales (Verified Answers, Versions A & B)

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This is a TNCC (Trauma Nursing Core Course) 10th Edition exam test bank covering Versions A and B, containing approximately 200 questions with correct detailed answers and rationales, marked as verified answers and graded A+. The document is organized as questions followed by the correct answer with supporting rationale, and it also includes a large set of fill-in-style key concept prompts covering the step-by-step primary survey sequence. Content spans the full TNCC primary survey framework, including Alertness and Airway with Simultaneous Cervical Spinal Stabilization (anticipating intubation, OPA/NPA insertion, removal of loose teeth or foreign objects, and suctioning), Breathing and Ventilation (anticipating chest tube, intubation, pneumothorax decompression, oxygen, and BVMs), and Circulation and Control of Hemorrhage (inspection and palpation of skin color, temperature, moisture, and pulse; establishing two IV sites; applying a cardiac monitor; controlling bleeding with direct pressure). The document details intubation and ventilation assessment, including attaching a CO2 detector and assessing for exhaled CO2, observing chest rise and fall with assisted ventilations, auscultating over the epigastrium for gurgling and lungs for bilateral breath sounds, assessing ETT position by noting the number at the teeth or gums, securing the ETT, and verbalizing the move from assisted ventilation to mechanical ventilation. It also covers Disability assessment including glucose checks for altered patients, Exposure and Environment interventions such as blankets, increased room temperature, warmed fluids, and warming lights, and the Get Adjuncts step including cardiac monitor and EKG, plus the LMNOP and VIPP framework (vital signs, injuries and interventions, primary survey, pain) and the pertinent history components of medical records, prehospital report, and SAMPLE. Additional question content includes shock recognition and management such as cardiogenic shock, compensated and early hypovolemic shock with rising diastolic pressure, neurogenic shock, the trauma triad of death components including coagulopathy, and serum lactate rationale for gauging end-organ perfusion and tissue hypoxia, plus burn fluid resuscitation calculations using the modified Lund and Browder chart including 3240 mL in the first 8 hours for a 120 kg patient with 27% TBSA, decreased body temperature impairing hemoglobin oxygen release, and the oxyhemoglobin dissociation curve effect of hypothermia. It covers spinal cord injury topics including spinal shock with loss of reflexes, anterior spinal cord injury at C6 with increasing work of breathing, sacral sparing indicated by voluntary anal sphincter tone, urinary incontinence as a suspicion of complete spinal cord injury, and the log-roll maneuver caution in suspected spine injury, along with American College of Surgeons cervical spine imaging screening guidelines, cervical collar removal criteria, and maintaining spinal motion restriction in atlanto-occipital dislocation. Also included are traumatic brain injury topics including late signs of increased intracranial pressure such as decreased respiratory effort and widening pulse pressure, subdural hematoma, post-concussive syndrome, globe rupture with teardrop-shaped pupil, and GCS change notification; thoracic and abdominal trauma including tension versus simple pneumothorax, open chest wound dressing removal, diaphragm injury with bowel sounds heard in the left lower chest, liver injury with upper right quadrant tenderness and Cullen's sign at the umbilicus, and Grey-Turner's sign at the flank; and musculoskeletal and soft tissue topics including fat embolism with petechiae and respiratory distress, disseminated intravascular coagulopathy with oozing from abrasions and IV sites, crush injury monitoring, rhabdomyolysis with elevated creatine kinase, compartment syndrome with elevation to the level of the heart, frostbite rewarming over 15 to 30 minutes, and a large embedded object managed by preparing the patient for surgery. The document further covers special populations and professional topics including geriatric trauma medical history, pregnant trauma patients with increased oxygen consumption, pediatric trauma with suspected maltreatment reporting and family-centered care, disaster triage and blast injury levels including tertiary blast trauma, fall mechanism prehospital transfer criteria, functional grief and moral injury, nonpharmacologic comfort measures such as distraction, family presence, padding bony prominences, repositioning, splinting, and verbal reassurance, and communication terms including huddle, brief, and debrief. Students can use this test bank for TNCC exam preparation, trauma nursing certification review, and self-testing by working through the questions and checking responses against the verified answers and rationales.

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TNCC 10TH EDITION EXAM 3 LATEST VERSIONS (VERSION A & B) COMPLETE 200 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) TESTBANK
|ALREADY GRADED A+|100 % COMPLETE

"Breathing and Ventilation" - ansDuring which part of the primary survey would you
anticipate the need for a chest tube, intubation, decompression of pneumothorax,
oxygen, or BVMs?

1. attach CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and
fall of the chest w/ assisted ventilations; 3. auscultate over epigastrium for gurgling AND
lungs for bilateral breath sounds - ansWhat three assessments must be done if the
patient is intubated?

1. inspect AND palpate skin color, temp, moisture and 2. palpate a pulse - ansTo
assess circulation, you must do these two main tasks:

A.Alert with no neurologic deficits - ansUsing the American College of Surgeons
screening guidelines, what assessment finding would prompt the nurse to prepare a
patient for cervical spine imaging?

A.Alert with no neurologic deficits
B.Multiple abrasions to the extremities
C.Ecchymosis to the flank
D.Responds to verbal stimulation

A.Cardiogenic - ansA patient is brought to the emergency department with chest pain
and shortness of breath following a high-speed motor vehicle collision in which they
were the unrestrained driver. There is crepitus to the left chest with clear and equal
breath sounds. The vital signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40
breaths/minute. Cardiac monitor shows sinus tachycardia with premature ventricular
contractions. These findings are most consistent with which type of shock?

A.Cardiogenic
B.Neurogenic
C.Hypovolemic
D.Obstructive

A.Decrease the rate of manual ventilation. - ansAn adult patient who sustained a severe
head trauma has been intubated and is being manually ventilated via a bag-mask
device at a rate of 18 breaths/minute. The patient has received one intravenous fluid
bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0
kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important
intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.

A.Initiate warming measures - ansA patient is brought to the emergency department
following a snowmobile crash with prolonged exposure time prior to transport. The




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,TNCC 10TH EDITION EXAM 3 LATEST VERSIONS (VERSION A & B) COMPLETE 200 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) TESTBANK
|ALREADY GRADED A+|100 % COMPLETE

patient is confused. Vital signs are BP 96/54 mm Hg, HR 114 beats/minute, RR 24
breaths/minute, T 34.6oC (94.2oF) and an SpO2 of 90% on oxygen at 15L per non-
rebreather mask. Other findings include ETCO2 24, serum lactate of 6 mmol/L, and a
pH of 6.8. Based on these findings, what is the most appropriate intervention?

A.Initiate warming measures
B.Titrate oxygen to 6 L per nasal cannula
C.Bolus with 500 mL isotonic crystalloids
D.Vigorously massage the extremities

A.Report your suspicion of maltreatment in accordance with local regulations - ansA 5-
year-old child presents to the emergency department with bruises to the upper arms
and buttocks in various stages of healing and multiple small, clean, round burns to the
back. There are no abnormalities found based on the pediatric assessment triangle or
primary survey. Which of the following is the priority nursing intervention?

A.Report your suspicion of maltreatment in accordance with local regulations
B.Apply ice to the bruises and provide wound care
C.Engage in therapeutic communication to determine the mechanism of injury
D.Provide the family with injury prevention resources

A.Reverse Trendelenburg - ansWhat position optimizes ventilation in the obese patient
with a lumbar fracture?

A.Reverse Trendelenburg
B.Supine
C.Prone
D.Fowler's

AFTER head-to-toe, BEFORE J (VIPP) - ansAntibiotics, consults, head CT, imaging,
law enforcement, mandatory reporting, psychosocial support, social services, splinting,
tetanus, and wound care are all interventions that you do AFTER and before WHAT?

all patients - ansFor whom is capnography highly recommended?

Apply a pelvic binder - ansAn adult pedestrian was struck on the right side by a sport
utility vehicle traveling at 40 mph. The patient is awake and alert and the right leg is
shortened. Following initial resuscitation with fluids, the patient remains hypotensive.
What would be the priority intervention?

A.Send blood for type and crossmatch
B.Apply a pelvic binder
C.Prepare the patient for surgery
D.Insert a urinary catheter




MEDSTUDY.COM

,TNCC 10TH EDITION EXAM 3 LATEST VERSIONS (VERSION A & B) COMPLETE 200 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) TESTBANK
|ALREADY GRADED A+|100 % COMPLETE

assess ETT position by noting the number at teeth/gums AND secure ETT - ansIf the
patient is intubated and you've already assessed ETT placement, what else needs to be
done with the ETT? (step 10)

Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization" - ansDuring
which part of the primary survey would there be anticipation for intubation, insertion of
OPA/NPA, removal of any loose teeth or foreign objects, or suctioning?

B. Rising diastolic - ansWhich blood pressure finding is associated with early or
compensated hypovolemic shock?
A.Rising systolic
B.Rising diastolic
C.Decreasing diastolic
D.Decreasing systolic

B.A 2-year-old lands on grass from a second-story balcony - ansBased on fall
mechanism, which patient warrants prehospital transfer to a trauma center?

A.A 35-year-old lands on a wooden porch from an 8-foot ladder
B.A 2-year-old lands on grass from a second-story balcony
C.A 14-year-old forcefully pushed onto cement from standing
D.A 50-year-old lands on a carpeted floor after tripping

B.Amputation of a limb - ansWhich of the following situations could cause functional
grief?

A.Inability to live at home
B.Amputation of a limb
C.Loss of one's self-image
D.Destruction of the patient's car

B.Control the bleeding - ansAn unconscious patient arrives following a motor vehicle
collision. The patient is on a backboard with a cervical collar in place and one
intravenous line running. Respirations are shallow and there is active brisk bleeding
from a large leg wound. What is the priority intervention for this patient?

A.Check for a patent airway
B.Control the bleeding
C.Start a second intravenous line
D.Ventilate with a bag-mask device

B.During the secondary surveyt - ansWhen should the definitive calculation for
intravenous fluid resuscitation rate be performed for a patient with burns?

A.As soon as the patient arrives




MEDSTUDY.COM

, TNCC 10TH EDITION EXAM 3 LATEST VERSIONS (VERSION A & B) COMPLETE 200 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) TESTBANK
|ALREADY GRADED A+|100 % COMPLETE

B.During the secondary survey
C.Should only be done at a burn center
D.During the primary survey

B.Increased oxygen consumption - ansA trauma patient who is 30-weeks pregnant
arrives at the emergency department following a motor vehicle collision. Which normal
physiologic change should be considered when assessing ventilatory status?

A.Increased functional reserve capacity
B.Increased oxygen consumption
C.Decreased minute ventilation
D.Slower desaturation rates with apnea

B.It can be used in hypotensive patients too unstable for computed tomography scan -
ansWhich of the following is true about use of the focused assessment sonography for
trauma exam for a patient with abdominal trauma?

A.It has a higher sensitivity than diagnostic peritoneal lavage for fluid detection
B.It can be used in hypotensive patients too unstable for computed tomography scan
C.It can detect as little as 30 mL of fluid in the abdominal cavity
D.It has high sensitivity in pediatric patients for identifying fluid in the peritoneum

B.Loss of reflexes - ansA patient is diagnosed with a T12 spinal cord injury following a
20-foot fall. Which finding is consistent with spinal shock?

A.Bradycardia
B.Loss of reflexes
C.Widened pulse pressure
D.Warm skin

B.Maintaining spinal motion restriction - ansWhat is the priority intervention for a child
who has been diagnosed with an atlanto-occipital dislocation following a high-speed
motor vehicle collision?

A.Initiating a second large caliber intravenous line
B.Maintaining spinal motion restriction
C.Placing the patient on pulse oximetry
D.Turning the patient to remove the backboard

B.Medical history including current medications - ansWhat is the most important
consideration during the initial assessment when caring for an older adult who has
sustained serious injuries?

A.They are likely to be fearful in the emergency department
B.Medical history including current medications
C.Availability of support systems after discharge





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