TNCC 9th Edition Exam
Which intervention is recommended regarding the use of drug-assisted intubation and rapid
sequence intubation? - ANS -Pre-oxygenate to prolong the time to hypoxia
Which normal anatomic or physiologic change in an older adult places them at a higher risk for
aspiration? - ANS -Relaxed muscles of the oropharynx
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would
indicate sacral sparing? - ANS -Voluntary anal sphincter tone
An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their body 2
hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400 mL/hour. The
urine output over the last hour was 15mL. What intervention should the nurse anticipate? - ANS
-Increase isotonic crystalloid infusion rate
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is
consistent with spinal shock? - ANS -Loss of reflexes
A patient is brought to the emergency department following a motor vehicle rollover and is
complaining of left upper abdominal pain and left shoulder pain. This presentation is most
consistent with an injury to which organ? - ANS -Spleen
An adult patient is brought to the emergency department following a motor vehicle collision with
complaints of neck pain. They have identified as a person in the process of transitioning from
male to female. What effect of hormone therapy should be considered when planning care for
this patient? - ANS -Testosterone therapy may decrease blood pressure
Correct rationale: A person who is in the process of transitioning from male to female will usually
be taking female hormones such as estrogen/estradiol to assist with the transition. This can
cause a decrease in muscle mass, increased risk of thromboembolism, and possibly increased
bone density. These patients would not be taking testosterone.
An adult patient presents to the emergency department after sustaining severe facial injuries
during an altercation. The patient is awake, confused, and smells heavily of alcohol. Pulse
oximetry is 94% on room air. Immediate intubation should be anticipated based on which clinical
indicator? - ANS -Severe facial injuries
, A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There
is a small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding
is most consistent with an injury to the diaphragm? - ANS -Bowel sounds heard in the left lower
chest
A severely injured patient has been intubated and is being mechanically ventilated. The patient
has received a balanced resuscitation including multiple blood products. Under which
circumstance will it be harder for the hemoglobin to release oxygen to the tissues? - ANS
-Decreased body temperature
A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted
in the water seal chamber during inspiration and expiration. What is the best action for the nurse
to take? - ANS -Continue to the intensive care unit
An adult was thrown against a concrete wall during a factory explosion and sustained a femur
fracture, liver laceration, and a small subdural hematoma. These injuries most likely occurred
during what level of blast trauma? - ANS -Tertiary
An obese trauma patient requires intubation. Assuming there are no contraindications, which
position will provide the best visualization for insertion of the endotracheal tube? - ANS
-Ramped
A patient who jumped out of a second-floor window landing on their feet is diagnosed with a
lumbar spine fracture. What is the most likely concurrent injury to have occurred? - ANS
-Calcaneus fracture
A patient arrives with a large metal rod embedded in their left thigh and no active bleeding.
Which intervention is most appropriate for this patient? - ANS -Prepare the patient for surgery
to remove the rod
Which findings are most consistent with a complete transection of the spinal cord? - ANS
-Absence of sensory and motor function below the level of injury
Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the
scene but became responsive with initial and subsequent Glasgow Coma Scale (GCS) scores
of 13 (E-3, V-4, M-6). The patient has bilateral subdural hematomas and is awaiting transfer to
the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority nursing
intervention? - ANS -Notify the provider of the change
While caring for a child who has been injured, what nursing intervention is consistent with a
family-center approach? - ANS -Allowing family to participate in the care of the patient
Identification of delayed complications following blunt abdominal trauma is best accomplished
by which method? - ANS -Repeat computerized tomography with contrast
Which intervention is recommended regarding the use of drug-assisted intubation and rapid
sequence intubation? - ANS -Pre-oxygenate to prolong the time to hypoxia
Which normal anatomic or physiologic change in an older adult places them at a higher risk for
aspiration? - ANS -Relaxed muscles of the oropharynx
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would
indicate sacral sparing? - ANS -Voluntary anal sphincter tone
An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their body 2
hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400 mL/hour. The
urine output over the last hour was 15mL. What intervention should the nurse anticipate? - ANS
-Increase isotonic crystalloid infusion rate
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is
consistent with spinal shock? - ANS -Loss of reflexes
A patient is brought to the emergency department following a motor vehicle rollover and is
complaining of left upper abdominal pain and left shoulder pain. This presentation is most
consistent with an injury to which organ? - ANS -Spleen
An adult patient is brought to the emergency department following a motor vehicle collision with
complaints of neck pain. They have identified as a person in the process of transitioning from
male to female. What effect of hormone therapy should be considered when planning care for
this patient? - ANS -Testosterone therapy may decrease blood pressure
Correct rationale: A person who is in the process of transitioning from male to female will usually
be taking female hormones such as estrogen/estradiol to assist with the transition. This can
cause a decrease in muscle mass, increased risk of thromboembolism, and possibly increased
bone density. These patients would not be taking testosterone.
An adult patient presents to the emergency department after sustaining severe facial injuries
during an altercation. The patient is awake, confused, and smells heavily of alcohol. Pulse
oximetry is 94% on room air. Immediate intubation should be anticipated based on which clinical
indicator? - ANS -Severe facial injuries
, A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There
is a small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding
is most consistent with an injury to the diaphragm? - ANS -Bowel sounds heard in the left lower
chest
A severely injured patient has been intubated and is being mechanically ventilated. The patient
has received a balanced resuscitation including multiple blood products. Under which
circumstance will it be harder for the hemoglobin to release oxygen to the tissues? - ANS
-Decreased body temperature
A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted
in the water seal chamber during inspiration and expiration. What is the best action for the nurse
to take? - ANS -Continue to the intensive care unit
An adult was thrown against a concrete wall during a factory explosion and sustained a femur
fracture, liver laceration, and a small subdural hematoma. These injuries most likely occurred
during what level of blast trauma? - ANS -Tertiary
An obese trauma patient requires intubation. Assuming there are no contraindications, which
position will provide the best visualization for insertion of the endotracheal tube? - ANS
-Ramped
A patient who jumped out of a second-floor window landing on their feet is diagnosed with a
lumbar spine fracture. What is the most likely concurrent injury to have occurred? - ANS
-Calcaneus fracture
A patient arrives with a large metal rod embedded in their left thigh and no active bleeding.
Which intervention is most appropriate for this patient? - ANS -Prepare the patient for surgery
to remove the rod
Which findings are most consistent with a complete transection of the spinal cord? - ANS
-Absence of sensory and motor function below the level of injury
Your patient is a pedestrian struck by a car and thrown 35 feet. They were unconscious at the
scene but became responsive with initial and subsequent Glasgow Coma Scale (GCS) scores
of 13 (E-3, V-4, M-6). The patient has bilateral subdural hematomas and is awaiting transfer to
the ICU. Your next assessment reveals a GCS of 9 (E-2, V-2, M-5). What is the priority nursing
intervention? - ANS -Notify the provider of the change
While caring for a child who has been injured, what nursing intervention is consistent with a
family-center approach? - ANS -Allowing family to participate in the care of the patient
Identification of delayed complications following blunt abdominal trauma is best accomplished
by which method? - ANS -Repeat computerized tomography with contrast
