TNCC ENA 9th Edition Study Guide And
Complete Answers.
A patient arrives at the emergency department by private vehicle after sustaining an injury to the right
lower extremity while using a saw. There is a large gaping wound to the right thigh area with significant
bleeding. What is the priority intervention?
A. Elevate the extremity to the level of the heart
B. Initiate direct pressure
C. Apply a tourniquet
D. Cover the open wound with sterile saline dressings - Answer B. Initiate direct pressure
Rationale: The first step inn controlling any bleeding is application of direct pressure.
What technique is most appropriate when obtaining a history from a patient who has experienced a
sexual assault?
A. Sitting next to the patient
B. Ensuring the patient answers all the questions
C. Asking for information only related to the assault
D. Applying active listening - Answer D. Applying active listening
Rationale: Therapeutic communication techniques such as active listening decrease unintentional
distress during the interaction.
What is the appropriate technique for palpating the pelvis for stability?
A. Apply gentle pressure over the iliac crests, downward and laterally
B. Apply gentle pressure over the iliac crests, downward and medially
C. Apply firm pressure over the iliac crests, downward and laterally
, D. Apply firm pressure over the iliac crests, downward and medially - Answer B. Apply gentle pressure
over the iliac crests, downward and medially
Rationale: To assess for pelvic instability, gentle pressure is applied over the iliac crests, downward and
medially.
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sick for a
couple of days and is now back working on the team. Which of the following would indicate this nurse is
coping well?
A. They are talking about taking the emergency nursing certification exam
B. They keep requesting to be assigned to the walk-in/ambulatory area
C. They are impatient and snap at their coworkers
D. They are thinking about transferring out of the emergency department - Answer A. They are talking
about taking the emergency nursing certification exam
Rationale: This is an indication the nurse is taking positive steps to advance their own practice, a sign of
resilience. B indicates the nurse is still not ready to return to their previous level of engagement in their
job. C shows signs of burnout, irritability and frustration. D shows decreased satisfaction with the job, a
sign of burnout.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mmHg and a
heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets
the patient's hemodynamic findings as an indication of which of the following?
A. Decompensated shock
B. Normal vital signs in pregnancy
C. Compensated shock
D. Supine hypotension syndrome - Answer B. Normal vital signs in pregnancy
Rationale: In pregnancy, the resting heart rate increases by 10 to 20 beats/minute. This is also a small
decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease in
peripheral resistance. Normal fetal heart rate is between 120 and 160 beats/minute.
Complete Answers.
A patient arrives at the emergency department by private vehicle after sustaining an injury to the right
lower extremity while using a saw. There is a large gaping wound to the right thigh area with significant
bleeding. What is the priority intervention?
A. Elevate the extremity to the level of the heart
B. Initiate direct pressure
C. Apply a tourniquet
D. Cover the open wound with sterile saline dressings - Answer B. Initiate direct pressure
Rationale: The first step inn controlling any bleeding is application of direct pressure.
What technique is most appropriate when obtaining a history from a patient who has experienced a
sexual assault?
A. Sitting next to the patient
B. Ensuring the patient answers all the questions
C. Asking for information only related to the assault
D. Applying active listening - Answer D. Applying active listening
Rationale: Therapeutic communication techniques such as active listening decrease unintentional
distress during the interaction.
What is the appropriate technique for palpating the pelvis for stability?
A. Apply gentle pressure over the iliac crests, downward and laterally
B. Apply gentle pressure over the iliac crests, downward and medially
C. Apply firm pressure over the iliac crests, downward and laterally
, D. Apply firm pressure over the iliac crests, downward and medially - Answer B. Apply gentle pressure
over the iliac crests, downward and medially
Rationale: To assess for pelvic instability, gentle pressure is applied over the iliac crests, downward and
medially.
A trauma nurse cared for a child with devastating burns two weeks ago. The nurse called in sick for a
couple of days and is now back working on the team. Which of the following would indicate this nurse is
coping well?
A. They are talking about taking the emergency nursing certification exam
B. They keep requesting to be assigned to the walk-in/ambulatory area
C. They are impatient and snap at their coworkers
D. They are thinking about transferring out of the emergency department - Answer A. They are talking
about taking the emergency nursing certification exam
Rationale: This is an indication the nurse is taking positive steps to advance their own practice, a sign of
resilience. B indicates the nurse is still not ready to return to their previous level of engagement in their
job. C shows signs of burnout, irritability and frustration. D shows decreased satisfaction with the job, a
sign of burnout.
The vital signs of a pregnant trauma patient at 30 weeks include a blood pressure of 94/62 mmHg and a
heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency nurse interprets
the patient's hemodynamic findings as an indication of which of the following?
A. Decompensated shock
B. Normal vital signs in pregnancy
C. Compensated shock
D. Supine hypotension syndrome - Answer B. Normal vital signs in pregnancy
Rationale: In pregnancy, the resting heart rate increases by 10 to 20 beats/minute. This is also a small
decrease in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease in
peripheral resistance. Normal fetal heart rate is between 120 and 160 beats/minute.
