Trauma Nursing Process - TNP - TNCC
Exam Questions and Answers
What should you ask yourself after completing all of your interventions and
reassessments? - Answer-Does this patient need to be transferred to another hospital,
to surgery, or to critical care?
What happens prior to patient arrival? 1-3 - Answer-1. Activate trauma team
2. Prepare trauma room
3. Don PPE
What happens following patient arrival but before a decision to intubate has been
made? 4-8
may change based on C-ABC - Answer-4. Assess for obvious uncontrolled external
hemorrhage or unresponsiveness/apnea and the need to reprioritize to C-ABC
5**. Assess level of consciousness using AVPU
6. Open the airway
7**. Assess the patency and protection of the airway
8**. Assess breathing effectiveness
Continue the TNP assuming the patient was intubated. 9-11 - Answer-9**. If intubated,
assess endotracheal tube placement
10. If intubated, assess ETT position and securement
11. If intubated, state the need to begin mechanical ventilation or continue assisted
ventilation
Continue the TNP following assessments of ETT. 12-15
**12, 13, and 15 are double-starred - Answer-12**. Assess circulation
13**. Assess neurologic status using GCS
14. Assess pupils
15**. Remove all clothing AND inspect for obvious abnormalities or injuries
Continue the TNP following assessments of circulation, neuro status, and removal of
clothing to inspect for injury. 16-18 - Answer-16. Provide warmth
17. Obtain a full set of vital signs and weight in kilograms (if not determined earlier)
18. Facilitate family presence
Continue the TNP using the LMNOP mnemonic. 19-23 - Answer-19. L - trauma panel
labs
20. M - monitor (Cardiac, consider EKG)
21. N - consider need for NG/OG
22. O - assess O2 and end-tidal capnography
23**. P - assess pain using appropriate pain scale
, Continue TNP after LMNOP (so after pain has been assessed). 24-26 - Answer-24.
Non-pharmacological comfort measures
25. Consider analgesic med order
26. Obtain pertinent history
Head-to-Toe 27-43 - Answer-27. Inspect and palpate head for injuries
28. Inspect and palpate face for injuries
29. Inspect and palpate neck for injuries
-- Demonstrate removal AND reapplication of cervical collar for assessment (if
indicated).
30. Inspect and palpate chest for injuries
31. Auscultate breath sounds
32. Auscultate heart sounds
33. Inspect the abdomen for injuries
34. Auscultate bowel sounds
35. Palpate all four quadrants of the abdomen for injuries
36. Inspect and palpate the flanks for injuries
37. Inspect the pelvis for injuries
38. Apply gentle pressure over iliac crests downward and medially
39. Apply gentle pressure on the symphysis pubis (if iliac crests are stable)
40. Inspect the perineum for injuries
41. Consider GU - urinary output
42. Inspect and palpate all four extremities for neurovascular status and injuries
43. Inspect and palpate posterior surfaces -- NOT if the patient has suspected spinal or
pelvic injuries
After the head-to-toe, the learner should summarize injuries identified throughout the
scenario and ask themselves: - Answer-"What interventions or diagnostics can you
anticipate for this patient?"
Following the completion of head-to-toe assessment in TNP, you must do what? 44 -
Answer-44. Identify at least THREE interventions or diagnostics
these may include the following:
Antibiotics
Consults
Head CT for any alterations in mental status
Imaging (other radiographs, CT, ultrasound, interventional radiology as indicated)
Law enforcement
Mandatory reporting
Psychosocial support
Social services
Splinting
Tetanus immunization
Wound care
Exam Questions and Answers
What should you ask yourself after completing all of your interventions and
reassessments? - Answer-Does this patient need to be transferred to another hospital,
to surgery, or to critical care?
What happens prior to patient arrival? 1-3 - Answer-1. Activate trauma team
2. Prepare trauma room
3. Don PPE
What happens following patient arrival but before a decision to intubate has been
made? 4-8
may change based on C-ABC - Answer-4. Assess for obvious uncontrolled external
hemorrhage or unresponsiveness/apnea and the need to reprioritize to C-ABC
5**. Assess level of consciousness using AVPU
6. Open the airway
7**. Assess the patency and protection of the airway
8**. Assess breathing effectiveness
Continue the TNP assuming the patient was intubated. 9-11 - Answer-9**. If intubated,
assess endotracheal tube placement
10. If intubated, assess ETT position and securement
11. If intubated, state the need to begin mechanical ventilation or continue assisted
ventilation
Continue the TNP following assessments of ETT. 12-15
**12, 13, and 15 are double-starred - Answer-12**. Assess circulation
13**. Assess neurologic status using GCS
14. Assess pupils
15**. Remove all clothing AND inspect for obvious abnormalities or injuries
Continue the TNP following assessments of circulation, neuro status, and removal of
clothing to inspect for injury. 16-18 - Answer-16. Provide warmth
17. Obtain a full set of vital signs and weight in kilograms (if not determined earlier)
18. Facilitate family presence
Continue the TNP using the LMNOP mnemonic. 19-23 - Answer-19. L - trauma panel
labs
20. M - monitor (Cardiac, consider EKG)
21. N - consider need for NG/OG
22. O - assess O2 and end-tidal capnography
23**. P - assess pain using appropriate pain scale
, Continue TNP after LMNOP (so after pain has been assessed). 24-26 - Answer-24.
Non-pharmacological comfort measures
25. Consider analgesic med order
26. Obtain pertinent history
Head-to-Toe 27-43 - Answer-27. Inspect and palpate head for injuries
28. Inspect and palpate face for injuries
29. Inspect and palpate neck for injuries
-- Demonstrate removal AND reapplication of cervical collar for assessment (if
indicated).
30. Inspect and palpate chest for injuries
31. Auscultate breath sounds
32. Auscultate heart sounds
33. Inspect the abdomen for injuries
34. Auscultate bowel sounds
35. Palpate all four quadrants of the abdomen for injuries
36. Inspect and palpate the flanks for injuries
37. Inspect the pelvis for injuries
38. Apply gentle pressure over iliac crests downward and medially
39. Apply gentle pressure on the symphysis pubis (if iliac crests are stable)
40. Inspect the perineum for injuries
41. Consider GU - urinary output
42. Inspect and palpate all four extremities for neurovascular status and injuries
43. Inspect and palpate posterior surfaces -- NOT if the patient has suspected spinal or
pelvic injuries
After the head-to-toe, the learner should summarize injuries identified throughout the
scenario and ask themselves: - Answer-"What interventions or diagnostics can you
anticipate for this patient?"
Following the completion of head-to-toe assessment in TNP, you must do what? 44 -
Answer-44. Identify at least THREE interventions or diagnostics
these may include the following:
Antibiotics
Consults
Head CT for any alterations in mental status
Imaging (other radiographs, CT, ultrasound, interventional radiology as indicated)
Law enforcement
Mandatory reporting
Psychosocial support
Social services
Splinting
Tetanus immunization
Wound care
