TNCC 8TH EDITION PROVIDER EXAM
EMS6brings6a6patient6who6fell6while6riding6his6bicycle.6Using6the6American6College6of6Su
rgeons6screening6guidelines,6which6assessment6finding6would6prompt6the6nurse6to6prep
are6the6patient6for6radiologic6spine6clearance?6-6ans--Alert6with6no6neurological6deficits
The6trauma6nurse6knows6that6placing6a6bariatric6patient6in6a6"ramped6position"6provides6
better6visualization6during6the6insertion6of6which6device?6-6ans--Endotracheal6tube
A635-year-
old6male6presents6with6facial6trauma6after6being6struck6in6the6face6with6a6baseball.6A6tear
drop-shaped6left6pupil6is6noted6on6exam.6What6type6of6injury6is6suspected?6-6ans--
Globe6rupture
Caregivers6carry6a62-year-old6into6the6emergency6department6who6fell6out6of6a6second-
story6window.6The6patient6is6awake6and6crying6with6increased6work6of6breathing6and6pal
e6skin.6Which6of6the6following6interventions6has6the6highest6priority?6-6ans--
Padding6the6upper6back6while6stabilizing6the6cervical6spine
Which6of6the6following6injuries6is6LEAST6likely6to6be6promptly6identified?6-6ans--Bowel
A649-year-
old6restrained6driver6involved6in6a6motor6vehicle6collision6presents6to6the6trauma6center6c
omplaining6of6abdominal,6pelvic,6and6bilateral6lower6extremity6pain.6Vital6signs6are6stable
.6The6nurse6can6anticipate6all6of6these6after6a6negative6FAST6exam6EXCEPT6which6of6th
e6following?6-6ans--Diagnostic6peritoneal6lavage
Why6is6a6measure6of6serum6lactate6obtained6in6the6initial6assessment6of6a6trauma6patien
t?6-6ans--To6gauge6end-organ6perfusion6and6tissue6hypoxia
During6the6primary6survey6of6an6unconscious6patient6with6multi-
system6trauma,6the6nurse6notes6snoring6respirations.6Which6priority6nursing6intervention6
should6be6performed6next?6-6ans--
Insert6an6oropharyngeal6airway6if6there6is6no6gag6reflex
Which6of6the6following6assessment6findings6differentiates6a6tension6pneumothorax6from6
a6simple6pneumothorax?6-6ans--
Hypotension6that6worsens6with6inspiration6(pulsus6paradoxus)
What6is6the6effect6of6hypothermia6on6the6oxyhemoglobin6dissociation6curve?6-6ans--
Hemoglobin6does6not6readily6release6oxygen6for6use6by6the6tissues6(Left6shift)
, A6trauma6patient6is6en6route6to6a6rural6emergency6department.6Radiology6notifies6the6ch
arge6nurse6that6the6computed6tomography6(CT)6scanner6will6be6out6of6service6for6several
6hours.6The6team6gathers6to6plan6accordingly.6Which6of6the6following6terms6best6describ
es6this6trauma6team's6communication?6-6ans--Huddle
What6finding6raises6suspicion6of6a6complete6spinal6cord6injury?6-6ans--Priapism
A6patient6is6thrown6against6a6car6during6a6tornado6and6presents6with6obvious6bilateral6fe
moral6fractures.6The6patient6is6pale,6alert,6disoriented,6and6has6delayed6capillary6refill.6W
hich6of6the6following6interventions6would6be6most6appropriate6for6this6patient6based6on6th
e6disaster6triage6principles?6-6ans--Initiate6two6large-
caliber6intravenous6lines6for6Ringer's6lactate6solution6administration.
A636-year-
old6female6has6a6deformity6of6the6left6wrist6after6a6fall.6She6is6reluctant6to6move6her6hand6
due6to6pain.6Which6of6the6following6is6the6most6appropriate6intervention?6-6ans--
Apply6a6splint6and6elevate6the6extremity6above6the6level6of6the6heart
Which6of6the6following6is6a6late6sign6of6increased6intracranial6pressure?6-6ans--
Decreased6respiratory6effort
Tearing6of6the6bridging6veins6is6most6frequently6associated6with6which6brain6injury?6-
6ans--Subdural6hematoma
You6are6caring6for6a6patient6who6was6involved6in6a6motor6vehicle6crash6and6is6326weeks6
pregnant.6Findings6of6your6secondary6survey6include6abdominal6pain6on6palpation,6fund
al6height6at6the6costal6margin,6and6some6dark6bloody6show.6Varying6accelerations6and6d
ecelerations6are6noted6on6cardiotocography.6These6findings6are6most6consistent6with6wh
ich6of6the6following?6-6ans--Placental6abruption
A6patient6with6a6complete6spinal6cord6injury6in6neurogenic6shock6will6demonstrate6hypote
nsion6and6which6other6clinical6signs?6-6ans--
Bradycardia6and6absent6motor6function6below6the6level6of6injury
Following6a6review6of6recent6drills6and6a6real6disaster6event,6a6hospital6has6identified6defi
ciencies6and6is6taking6steps6to6minimize6the6impact6of6a6future6disaster.6Which6phase6of6t
he6disaster6life6cycle6does6this6describe?6-6ans--Mitigation
Which6of6the6following6considerations6is6most6important6when6caring6for6a6geriatric6traum
a6patient?6-6ans--Medical6history
The6nurse6is6caring6for6a61206kg6male6brought6in6after6a6warehouse6fire6and6is6calculatin
g6the6patient's6fluid6resuscitation6needs.6He6has6painful6red6blistering6to6the6entire6surfac
e6of6both6upper6extremities6and6superficial6burns6to6the6anterior6chest.6Using6the6modifie
EMS6brings6a6patient6who6fell6while6riding6his6bicycle.6Using6the6American6College6of6Su
rgeons6screening6guidelines,6which6assessment6finding6would6prompt6the6nurse6to6prep
are6the6patient6for6radiologic6spine6clearance?6-6ans--Alert6with6no6neurological6deficits
The6trauma6nurse6knows6that6placing6a6bariatric6patient6in6a6"ramped6position"6provides6
better6visualization6during6the6insertion6of6which6device?6-6ans--Endotracheal6tube
A635-year-
old6male6presents6with6facial6trauma6after6being6struck6in6the6face6with6a6baseball.6A6tear
drop-shaped6left6pupil6is6noted6on6exam.6What6type6of6injury6is6suspected?6-6ans--
Globe6rupture
Caregivers6carry6a62-year-old6into6the6emergency6department6who6fell6out6of6a6second-
story6window.6The6patient6is6awake6and6crying6with6increased6work6of6breathing6and6pal
e6skin.6Which6of6the6following6interventions6has6the6highest6priority?6-6ans--
Padding6the6upper6back6while6stabilizing6the6cervical6spine
Which6of6the6following6injuries6is6LEAST6likely6to6be6promptly6identified?6-6ans--Bowel
A649-year-
old6restrained6driver6involved6in6a6motor6vehicle6collision6presents6to6the6trauma6center6c
omplaining6of6abdominal,6pelvic,6and6bilateral6lower6extremity6pain.6Vital6signs6are6stable
.6The6nurse6can6anticipate6all6of6these6after6a6negative6FAST6exam6EXCEPT6which6of6th
e6following?6-6ans--Diagnostic6peritoneal6lavage
Why6is6a6measure6of6serum6lactate6obtained6in6the6initial6assessment6of6a6trauma6patien
t?6-6ans--To6gauge6end-organ6perfusion6and6tissue6hypoxia
During6the6primary6survey6of6an6unconscious6patient6with6multi-
system6trauma,6the6nurse6notes6snoring6respirations.6Which6priority6nursing6intervention6
should6be6performed6next?6-6ans--
Insert6an6oropharyngeal6airway6if6there6is6no6gag6reflex
Which6of6the6following6assessment6findings6differentiates6a6tension6pneumothorax6from6
a6simple6pneumothorax?6-6ans--
Hypotension6that6worsens6with6inspiration6(pulsus6paradoxus)
What6is6the6effect6of6hypothermia6on6the6oxyhemoglobin6dissociation6curve?6-6ans--
Hemoglobin6does6not6readily6release6oxygen6for6use6by6the6tissues6(Left6shift)
, A6trauma6patient6is6en6route6to6a6rural6emergency6department.6Radiology6notifies6the6ch
arge6nurse6that6the6computed6tomography6(CT)6scanner6will6be6out6of6service6for6several
6hours.6The6team6gathers6to6plan6accordingly.6Which6of6the6following6terms6best6describ
es6this6trauma6team's6communication?6-6ans--Huddle
What6finding6raises6suspicion6of6a6complete6spinal6cord6injury?6-6ans--Priapism
A6patient6is6thrown6against6a6car6during6a6tornado6and6presents6with6obvious6bilateral6fe
moral6fractures.6The6patient6is6pale,6alert,6disoriented,6and6has6delayed6capillary6refill.6W
hich6of6the6following6interventions6would6be6most6appropriate6for6this6patient6based6on6th
e6disaster6triage6principles?6-6ans--Initiate6two6large-
caliber6intravenous6lines6for6Ringer's6lactate6solution6administration.
A636-year-
old6female6has6a6deformity6of6the6left6wrist6after6a6fall.6She6is6reluctant6to6move6her6hand6
due6to6pain.6Which6of6the6following6is6the6most6appropriate6intervention?6-6ans--
Apply6a6splint6and6elevate6the6extremity6above6the6level6of6the6heart
Which6of6the6following6is6a6late6sign6of6increased6intracranial6pressure?6-6ans--
Decreased6respiratory6effort
Tearing6of6the6bridging6veins6is6most6frequently6associated6with6which6brain6injury?6-
6ans--Subdural6hematoma
You6are6caring6for6a6patient6who6was6involved6in6a6motor6vehicle6crash6and6is6326weeks6
pregnant.6Findings6of6your6secondary6survey6include6abdominal6pain6on6palpation,6fund
al6height6at6the6costal6margin,6and6some6dark6bloody6show.6Varying6accelerations6and6d
ecelerations6are6noted6on6cardiotocography.6These6findings6are6most6consistent6with6wh
ich6of6the6following?6-6ans--Placental6abruption
A6patient6with6a6complete6spinal6cord6injury6in6neurogenic6shock6will6demonstrate6hypote
nsion6and6which6other6clinical6signs?6-6ans--
Bradycardia6and6absent6motor6function6below6the6level6of6injury
Following6a6review6of6recent6drills6and6a6real6disaster6event,6a6hospital6has6identified6defi
ciencies6and6is6taking6steps6to6minimize6the6impact6of6a6future6disaster.6Which6phase6of6t
he6disaster6life6cycle6does6this6describe?6-6ans--Mitigation
Which6of6the6following6considerations6is6most6important6when6caring6for6a6geriatric6traum
a6patient?6-6ans--Medical6history
The6nurse6is6caring6for6a61206kg6male6brought6in6after6a6warehouse6fire6and6is6calculatin
g6the6patient's6fluid6resuscitation6needs.6He6has6painful6red6blistering6to6the6entire6surfac
e6of6both6upper6extremities6and6superficial6burns6to6the6anterior6chest.6Using6the6modifie
