TNCC Exam 8th edition study
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ✔✔Hemoglobin does
not readily release oxygen for use by the tissues A shift to the left occurs in an environment of low
metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports
significant damage to the driver's side of the car. The patient is asking to have the cervical collar
removed. When it is appropriate to remove the cervical collar? - ✔✔After a physical examination if
the patient has no radiologic abnormalities on CT A CT is recommended for spinal clearance in an
impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate
the total body surface area burned, how much IV fluid would be administered in the first 8 hours? -
✔✔2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2 *
120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA
calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system - ✔✔Fluctuation in the water seal chamber Fluctuation in the water seal
chamber indicates the tube is placed correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam. What type of injury is suspected? - ✔✔Globe rupture A
teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ✔✔Bradycardia and absent motor function below the level of injury
Patients with a complete spinal cord injury will have absent motor function below the level of the
lesion. They become hypotensive and bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - ✔✔A 52-year-old diabetic male
with a partial-thickness burn to the left lower leg This patient has a 7% TBSA burn with a preexisting
medical history that could complicate management, prolong recovery, or affect mortality.
, You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - ✔✔Placental
abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal
distress are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard
on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals
lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse
question? - ✔✔Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if
urethral transection is suspected. Signs and symptoms of urethral injury include blood at the meatus,
perineal ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - ✔✔The aorta is
torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ✔✔Defusings A defusing is part of critical incident stress management but is not
considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage? - ✔✔MARCH The MARCH mnemonic stands for massive
hemorrhage, airway, respiration, circulation, and head injury/hypothermia. The MARCH mnemonic
recognizes uncontrolled hemorrhage as the major cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house fire.
Calculating total body surface area (TBSA) burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation? - ✔✔500 mL/hour Prior to calculating
TBSA, this is the recommended starting point for fluid resuscitation for patients 14 years of age and
older
A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center
complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs are stable. The nurse
can anticipate all of these after a negative FAST exam EXCEPT which of the following? - ✔✔Diagnostic
peritoneal lavage Diagnostic peritoneal lavage is indicated for hemodynamically unstable patients or
if FAST and CT are not available.
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - ✔✔Hemoglobin does
not readily release oxygen for use by the tissues A shift to the left occurs in an environment of low
metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports
significant damage to the driver's side of the car. The patient is asking to have the cervical collar
removed. When it is appropriate to remove the cervical collar? - ✔✔After a physical examination if
the patient has no radiologic abnormalities on CT A CT is recommended for spinal clearance in an
impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate
the total body surface area burned, how much IV fluid would be administered in the first 8 hours? -
✔✔2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2 *
120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA
calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system - ✔✔Fluctuation in the water seal chamber Fluctuation in the water seal
chamber indicates the tube is placed correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam. What type of injury is suspected? - ✔✔Globe rupture A
teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs? - ✔✔Bradycardia and absent motor function below the level of injury
Patients with a complete spinal cord injury will have absent motor function below the level of the
lesion. They become hypotensive and bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - ✔✔A 52-year-old diabetic male
with a partial-thickness burn to the left lower leg This patient has a 7% TBSA burn with a preexisting
medical history that could complicate management, prolong recovery, or affect mortality.
, You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following? - ✔✔Placental
abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal
distress are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard
on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals
lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse
question? - ✔✔Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if
urethral transection is suspected. Signs and symptoms of urethral injury include blood at the meatus,
perineal ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? - ✔✔The aorta is
torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following? - ✔✔Defusings A defusing is part of critical incident stress management but is not
considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage? - ✔✔MARCH The MARCH mnemonic stands for massive
hemorrhage, airway, respiration, circulation, and head injury/hypothermia. The MARCH mnemonic
recognizes uncontrolled hemorrhage as the major cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house fire.
Calculating total body surface area (TBSA) burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation? - ✔✔500 mL/hour Prior to calculating
TBSA, this is the recommended starting point for fluid resuscitation for patients 14 years of age and
older
A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center
complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs are stable. The nurse
can anticipate all of these after a negative FAST exam EXCEPT which of the following? - ✔✔Diagnostic
peritoneal lavage Diagnostic peritoneal lavage is indicated for hemodynamically unstable patients or
if FAST and CT are not available.
