TNCC 9TH EDITION EXAM QUESTIONS WITH 100%
CORRECTLY SOLVED AND UPDATED ANSWERS .
1) "A patient is brought to the emergency department following a snowmobile crash
_ _ _ _ _ _ _ _ _ _ _ _
with prolonged exposure time prior to transport . The patient is confused . Vital
_ _ _ _ _ _ _ _ _ _ _ _ _ _
signs are BP 96/54 mm Hg , HR 114 beats / minute , RR 24 breaths / minute , T
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
34.60C ( 94.20F ) and an SpO2 of 90 % on oxygen at 15L per non - rebreather mask .
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Other findings include ETCO2 24 , scrum lactate of 6 mmol / L , and a pH of 6.8 .
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Based on these findings what is the most appropriate intervention -- Correct Answer
_ _ _ _ _ _ _ _ _ _ _ _
✔✔ Initiate warming measures"
_ _ _ _ _
2) An adult pt who sustained a severe head trauma has been intubated and is being
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The pt has
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
_ _ _ _ _ _ _ _ _ _ _ _
solution. the PaCO2 is 30mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
142/70 mmHg. What is the most important intervention to manage the cerebral
_ _ _ _ _ _ _ _ _ _ _ _
blood flow? -- Correct Answer ✔✔ Decrease the rate of manual ventilation"
_ _ _ _ _ _ _ _ _ _ _ _
3) "A 5 - year - old child presents to the emergency department with bruises to the
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
upper arms and buttocks in various stages of healing and multiple small clean , round
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
burns to the back . There are no abnormalities found based on the pediatric
_ _ _ _ _ _ _ _ _ _ _ _ _ _
assessment triangle or primary survey . Which of the following is the priority nursing
_ _ _ _ _ _ _ _ _ _ _ _ _ _
intervention ? -- Correct Answer ✔✔ Report your suspicion of maltreatment in _ _ _ _ _ _ _ _ _ _ _ _
accordance with local regulations" _ _ _ _
4) "An older adult presents to the emergency department with complaints of dizziness,
_ _ _ _ _ _ _ _ _ _ _ _
headache, and nausea. The pt was involved in a motor vehicle collision 10 days ago.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
There was no loss of consciousness and a hematoma is noted to the forehead. The pt
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
is currently on anticoagulant therapy. What is most likely the cause of their
_ _ _ _ _ _ _ _ _ _ _ _ _
symptoms? -- Correct Answer ✔✔ post-concussive syndrome" _ _ _ _ _ _ _
, 5) "A pt with a lower extremity fracture complains of severe pain and tightness in his
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
calf, minimally relieved by pain medication. Which of the following is the priority
_ _ _ _ _ _ _ _ _ _ _ _ _
nursing intervention? -- Correct Answer ✔✔ Elevating the leg to the LEVEL of the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
heart (compression/crush- level of the heart) (regular fracture- above the heart)"
_ _ _ _ _ _ _ _ _ _ _
6) "A seriously injured patient is noted to have a weak, thready pulse and cool, clammy
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
skin. There is instability of the pelvis on palpating and blood at the urinary meatus. A
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
pelvic binder is appropriately applied and balanced fluid resuscitation is being managed
_ _ _ _ _ _ _ _ _ _ _
_by the team. What would be the most appropriate next intervention for this patient?
_ _ _ _ _ _ _ _ _ _ _ _ _ _
-- Correct Answer ✔✔ Insertion of a suprapubic catheter"
_ _ _ _ _ _ _ _ _
7) "A pt involved in a high-speed rollover is complaining of increased difficulty breathing.
_ _ _ _ _ _ _ _ _ _ _ _ _
There is a small penetrating wound to the 6th intercostal space in the left lateral
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
chest. Which finding is most consistent with an injury to the diaphragm? -- Correct
_ _ _ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ Bowel sounds heard in the lower left chest"
_ _ _ _ _ _ _ _ _ _
8) "A pt has been in the emergency department for several hours waiting to be
_ _ _ _ _ _ _ _ _ _ _ _ _ _
admitted. They sustained multiple rib fractures and a femur fracture after a fall. The pt
_ _ _ _ _ _ _ _ _ _ _ _ _ _
_has been awake, alert, and complaining of leg pain. Their spouse reported that the pt
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
suddenly became anxious and confused. Upon reassessment, the pt is restless, with
_ _ _ _ _ _ _ _ _ _ _ _
respiratory distress and petechiae to his neck. The pt is exhibiting signs and
_ _ _ _ _ _ _ _ _ _ _ _ _
symptoms most commonly associated with which of the following conditions? --
_ _ _ _ _ _ _ _ _ _ _
Correct Answer ✔✔ Fat embolism" _ _ _ _ _
9) "3 adult pts present at different times during a 1-hour period with a high fever, fatigue,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_and headache. All 3 pts have a rash which started on their mouth, face, and arms with
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_progression to the chest and abdomen. They all visited the same grocery store within
_ _ _ _ _ _ _ _ _ _ _ _ _
_the last week. What is the most appropriate intervention from triage for these pts? --
_ _ _ _ _ _ _ _ _ _ _ _ _ _
_Correct Answer ✔✔ Immediately initiate contact precautions"
_ _ _ _ _ _ _
10) "A patient arrives with a large open chest wound after being assaulted with a
_ _ _ _ _ _ _ _ _ _ _ _ _ _
machete. Prehospital providers placed nonporous dressing over the chest wound and
_ _ _ _ _ _ _ _ _ _ _
taped it on three sides. The patient is now showing signs of anxiety, restlessness,
_ _ _ _ _ _ _ _ _ _ _ _ _ _
severe respiratory distress, cyanosis, and decreasing blood pressure. Which of the
_ _ _ _ _ _ _ _ _ _ _
following is the MOST appropriate immediate intervention? -- Correct Answer ✔✔
_ _ _ _ _ _ _ _ _ _ _
Dressing removal" _ _
CORRECTLY SOLVED AND UPDATED ANSWERS .
1) "A patient is brought to the emergency department following a snowmobile crash
_ _ _ _ _ _ _ _ _ _ _ _
with prolonged exposure time prior to transport . The patient is confused . Vital
_ _ _ _ _ _ _ _ _ _ _ _ _ _
signs are BP 96/54 mm Hg , HR 114 beats / minute , RR 24 breaths / minute , T
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
34.60C ( 94.20F ) and an SpO2 of 90 % on oxygen at 15L per non - rebreather mask .
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Other findings include ETCO2 24 , scrum lactate of 6 mmol / L , and a pH of 6.8 .
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Based on these findings what is the most appropriate intervention -- Correct Answer
_ _ _ _ _ _ _ _ _ _ _ _
✔✔ Initiate warming measures"
_ _ _ _ _
2) An adult pt who sustained a severe head trauma has been intubated and is being
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The pt has
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid
_ _ _ _ _ _ _ _ _ _ _ _
solution. the PaCO2 is 30mmHg (4.0 kPa), and the pulse oximetry is 92%. BP is
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
142/70 mmHg. What is the most important intervention to manage the cerebral
_ _ _ _ _ _ _ _ _ _ _ _
blood flow? -- Correct Answer ✔✔ Decrease the rate of manual ventilation"
_ _ _ _ _ _ _ _ _ _ _ _
3) "A 5 - year - old child presents to the emergency department with bruises to the
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
upper arms and buttocks in various stages of healing and multiple small clean , round
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
burns to the back . There are no abnormalities found based on the pediatric
_ _ _ _ _ _ _ _ _ _ _ _ _ _
assessment triangle or primary survey . Which of the following is the priority nursing
_ _ _ _ _ _ _ _ _ _ _ _ _ _
intervention ? -- Correct Answer ✔✔ Report your suspicion of maltreatment in _ _ _ _ _ _ _ _ _ _ _ _
accordance with local regulations" _ _ _ _
4) "An older adult presents to the emergency department with complaints of dizziness,
_ _ _ _ _ _ _ _ _ _ _ _
headache, and nausea. The pt was involved in a motor vehicle collision 10 days ago.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
There was no loss of consciousness and a hematoma is noted to the forehead. The pt
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
is currently on anticoagulant therapy. What is most likely the cause of their
_ _ _ _ _ _ _ _ _ _ _ _ _
symptoms? -- Correct Answer ✔✔ post-concussive syndrome" _ _ _ _ _ _ _
, 5) "A pt with a lower extremity fracture complains of severe pain and tightness in his
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
calf, minimally relieved by pain medication. Which of the following is the priority
_ _ _ _ _ _ _ _ _ _ _ _ _
nursing intervention? -- Correct Answer ✔✔ Elevating the leg to the LEVEL of the
_ _ _ _ _ _ _ _ _ _ _ _ _ _
heart (compression/crush- level of the heart) (regular fracture- above the heart)"
_ _ _ _ _ _ _ _ _ _ _
6) "A seriously injured patient is noted to have a weak, thready pulse and cool, clammy
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
skin. There is instability of the pelvis on palpating and blood at the urinary meatus. A
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
pelvic binder is appropriately applied and balanced fluid resuscitation is being managed
_ _ _ _ _ _ _ _ _ _ _
_by the team. What would be the most appropriate next intervention for this patient?
_ _ _ _ _ _ _ _ _ _ _ _ _ _
-- Correct Answer ✔✔ Insertion of a suprapubic catheter"
_ _ _ _ _ _ _ _ _
7) "A pt involved in a high-speed rollover is complaining of increased difficulty breathing.
_ _ _ _ _ _ _ _ _ _ _ _ _
There is a small penetrating wound to the 6th intercostal space in the left lateral
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
chest. Which finding is most consistent with an injury to the diaphragm? -- Correct
_ _ _ _ _ _ _ _ _ _ _ _ _ _
Answer ✔✔ Bowel sounds heard in the lower left chest"
_ _ _ _ _ _ _ _ _ _
8) "A pt has been in the emergency department for several hours waiting to be
_ _ _ _ _ _ _ _ _ _ _ _ _ _
admitted. They sustained multiple rib fractures and a femur fracture after a fall. The pt
_ _ _ _ _ _ _ _ _ _ _ _ _ _
_has been awake, alert, and complaining of leg pain. Their spouse reported that the pt
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
suddenly became anxious and confused. Upon reassessment, the pt is restless, with
_ _ _ _ _ _ _ _ _ _ _ _
respiratory distress and petechiae to his neck. The pt is exhibiting signs and
_ _ _ _ _ _ _ _ _ _ _ _ _
symptoms most commonly associated with which of the following conditions? --
_ _ _ _ _ _ _ _ _ _ _
Correct Answer ✔✔ Fat embolism" _ _ _ _ _
9) "3 adult pts present at different times during a 1-hour period with a high fever, fatigue,
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_and headache. All 3 pts have a rash which started on their mouth, face, and arms with
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_progression to the chest and abdomen. They all visited the same grocery store within
_ _ _ _ _ _ _ _ _ _ _ _ _
_the last week. What is the most appropriate intervention from triage for these pts? --
_ _ _ _ _ _ _ _ _ _ _ _ _ _
_Correct Answer ✔✔ Immediately initiate contact precautions"
_ _ _ _ _ _ _
10) "A patient arrives with a large open chest wound after being assaulted with a
_ _ _ _ _ _ _ _ _ _ _ _ _ _
machete. Prehospital providers placed nonporous dressing over the chest wound and
_ _ _ _ _ _ _ _ _ _ _
taped it on three sides. The patient is now showing signs of anxiety, restlessness,
_ _ _ _ _ _ _ _ _ _ _ _ _ _
severe respiratory distress, cyanosis, and decreasing blood pressure. Which of the
_ _ _ _ _ _ _ _ _ _ _
following is the MOST appropriate immediate intervention? -- Correct Answer ✔✔
_ _ _ _ _ _ _ _ _ _ _
Dressing removal" _ _
