TNCC ENA 9TH EDITION PRE TEST
WITH COMPLETE SOLUTIONS
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.
Following a bomb explosion, fragmentation injuries from the bomb or objects in the
environment are examples of which phase of injury?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary - ANSWER-B. Secondary
Rationale: The secondary phase of a blast results from flying debris, projectiles, and
bomb fragments causing lacerations or penetrating injuries.
An adult patient with a knife injury to the neck has an intact airway and is
hemodynamically stable. They complain of difficulty swallowing and speaking. In the
primary survey, further assessment is indicated next for which of the following
conditions?
A. Damage to the cervical spine
B. An expanding pneumothorax
C. Laceration of the carotid artery
D. Injury of the thyroid gland - ANSWER-A. Damage to the cervical spine
Rationale: Penetrating neck trauma may include concurrent injuries to the cervical spine
and cord, airway, or vascular neck structures. With an intact airway and hemodynamic
stability, the other common concurrent injury is to the cervical spine.
What is the best position for maintaining an open airway in the obese patient?
A. Prone
B. Supine
C. Reverse Trendelenburg
D. Right lateral recumbent - ANSWER-C. Reverse Trendelenburg
Rationale: The reverse Trendelenburg position will benefit both airway maintenance and
work of breathing in the obese patient.
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
WITH COMPLETE SOLUTIONS
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.
Following a bomb explosion, fragmentation injuries from the bomb or objects in the
environment are examples of which phase of injury?
A. Primary
B. Secondary
C. Tertiary
D. Quaternary - ANSWER-B. Secondary
Rationale: The secondary phase of a blast results from flying debris, projectiles, and
bomb fragments causing lacerations or penetrating injuries.
An adult patient with a knife injury to the neck has an intact airway and is
hemodynamically stable. They complain of difficulty swallowing and speaking. In the
primary survey, further assessment is indicated next for which of the following
conditions?
A. Damage to the cervical spine
B. An expanding pneumothorax
C. Laceration of the carotid artery
D. Injury of the thyroid gland - ANSWER-A. Damage to the cervical spine
Rationale: Penetrating neck trauma may include concurrent injuries to the cervical spine
and cord, airway, or vascular neck structures. With an intact airway and hemodynamic
stability, the other common concurrent injury is to the cervical spine.
What is the best position for maintaining an open airway in the obese patient?
A. Prone
B. Supine
C. Reverse Trendelenburg
D. Right lateral recumbent - ANSWER-C. Reverse Trendelenburg
Rationale: The reverse Trendelenburg position will benefit both airway maintenance and
work of breathing in the obese patient.
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
