TNCC COMPLETE LATEST 9TH EDITION
TRAUMA NURSING BASED QUESTIONS
AND ANSWERS
What should you ask yourself after completing all of your interventions and reassessments? - ANSWER-
Does this patient need to be transferred to another hospital, to surgery, or to critical care?
What happens prior to patient arrival? 1-3 - ANSWER-1. Activate trauma team
2. Prepare trauma room
3. Don PPE
What happens following patient arrival but before a decision to intubate has been made? 4-8
may change based on C-ABC - ANSWER-4. Assess for obvious uncontrolled external hemorrhage or
unresponsiveness/apnea and the need to reprioritize to C-ABC
5**. Assess level of consciousness using AVPU
6. Open the airway
7**. Assess the patency and protection of the airway
8**. Assess breathing effectiveness
Continue the TNP assuming the patient was intubated. 9-11 - ANSWER-9**. If intubated, assess
endotracheal tube placement
10. If intubated, assess ETT position and securement
11. If intubated, state the need to begin mechanical ventilation or continue assisted ventilation
Continue the TNP following assessments of ETT. 12-15
**12, 13, and 15 are double-starred - ANSWER-12**. Assess circulation
13**. Assess neurologic status using GCS
14. Assess pupils
15**. Remove all clothing AND inspect for obvious abnormalities or injuries
Continue the TNP following assessments of circulation, neuro status, and removal of clothing to inspect
for injury. 16-18 - ANSWER-16. Provide warmth
17. Obtain a full set of vital signs and weight in kilograms (if not determined earlier)
18. Facilitate family presence
Continue the TNP using the LMNOP mnemonic. 19-23 - ANSWER-19. L - trauma panel labs
20. M - monitor (Cardiac, consider EKG)
21. N - consider need for NG/OG
22. O - assess O2 and end-tidal capnography
23**. P - assess pain using appropriate pain scale
Continue TNP after LMNOP (so after pain has been assessed). 24-26 - ANSWER-24. Non-pharmacological
comfort measures
25. Consider analgesic med order
26. Obtain pertinent history
Head-to-Toe 27-43 - ANSWER-27. Inspect and palpate head for injuries
28. Inspect and palpate face for injuries
29. Inspect and palpate neck for injuries
-- Demonstrate removal AND reapplication of cervical collar for assessment (if indicated).
30. Inspect and palpate chest for injuries
31. Auscultate breath sounds
32. Auscultate heart sounds
, 33. Inspect the abdomen for injuries
34. Auscultate bowel sounds
35. Palpate all four quadrants of the abdomen for injuries
36. Inspect and palpate the flanks for injuries
37. Inspect the pelvis for injuries
38. Apply gentle pressure over iliac crests downward and medially
39. Apply gentle pressure on the symphysis pubis (if iliac crests are stable)
40. Inspect the perineum for injuries
41. Consider GU - urinary output
42. Inspect and palpate all four extremities for neurovascular status and injuries
43. Inspect and palpate posterior surfaces -- NOT if the patient has suspected spinal or pelvic injuries
After the head-to-toe, the learner should summarize injuries identified throughout the scenario and ask
themselves: - ANSWER-"What interventions or diagnostics can you anticipate for this patient?"
Following the completion of head-to-toe assessment in TNP, you must do what? 44 - ANSWER-44.
Identify at least THREE interventions or diagnostics
these may include the following:
Antibiotics
Consults
Head CT for any alterations in mental status
Imaging (other radiographs, CT, ultrasound, interventional radiology as indicated)
Law enforcement
Mandatory reporting
Psychosocial support
Social services
Splinting
Tetanus immunization
Wound care
After identifying potential interventions/diagnostics and completing your assessments and interventions,
you should ask yourself what? - ANSWER-"What findings will you continue to reevaluate while the
patient is in your care?"
"Just keep re-evaluating"
Just Keep Reevaluating. 45-48 - ANSWER-45. Reevaluate vital signs
46. Reevaluate all identified injuries and effectiveness of interventions
47. Reevaluate primary survey
48. Reevaluate pain
What do you ask yourself after re-evaluations are done? 49-50 - ANSWER-49. "What is the definitive care
for this patient?"
50. Consider need for transfer to a trauma center or admission
After all of the assessments, interventions, reassessments, etc. are done, what is the last thing to ask? -
ANSWER-"Is there anything you would like to add at this time?"
When considering GU and how to monitor urinary output: - ANSWER-- Assess for contraindications for
an indwelling urinary catheter
- External catheter
- Weighing diapers (pediatrics and adults)
TRAUMA NURSING BASED QUESTIONS
AND ANSWERS
What should you ask yourself after completing all of your interventions and reassessments? - ANSWER-
Does this patient need to be transferred to another hospital, to surgery, or to critical care?
What happens prior to patient arrival? 1-3 - ANSWER-1. Activate trauma team
2. Prepare trauma room
3. Don PPE
What happens following patient arrival but before a decision to intubate has been made? 4-8
may change based on C-ABC - ANSWER-4. Assess for obvious uncontrolled external hemorrhage or
unresponsiveness/apnea and the need to reprioritize to C-ABC
5**. Assess level of consciousness using AVPU
6. Open the airway
7**. Assess the patency and protection of the airway
8**. Assess breathing effectiveness
Continue the TNP assuming the patient was intubated. 9-11 - ANSWER-9**. If intubated, assess
endotracheal tube placement
10. If intubated, assess ETT position and securement
11. If intubated, state the need to begin mechanical ventilation or continue assisted ventilation
Continue the TNP following assessments of ETT. 12-15
**12, 13, and 15 are double-starred - ANSWER-12**. Assess circulation
13**. Assess neurologic status using GCS
14. Assess pupils
15**. Remove all clothing AND inspect for obvious abnormalities or injuries
Continue the TNP following assessments of circulation, neuro status, and removal of clothing to inspect
for injury. 16-18 - ANSWER-16. Provide warmth
17. Obtain a full set of vital signs and weight in kilograms (if not determined earlier)
18. Facilitate family presence
Continue the TNP using the LMNOP mnemonic. 19-23 - ANSWER-19. L - trauma panel labs
20. M - monitor (Cardiac, consider EKG)
21. N - consider need for NG/OG
22. O - assess O2 and end-tidal capnography
23**. P - assess pain using appropriate pain scale
Continue TNP after LMNOP (so after pain has been assessed). 24-26 - ANSWER-24. Non-pharmacological
comfort measures
25. Consider analgesic med order
26. Obtain pertinent history
Head-to-Toe 27-43 - ANSWER-27. Inspect and palpate head for injuries
28. Inspect and palpate face for injuries
29. Inspect and palpate neck for injuries
-- Demonstrate removal AND reapplication of cervical collar for assessment (if indicated).
30. Inspect and palpate chest for injuries
31. Auscultate breath sounds
32. Auscultate heart sounds
, 33. Inspect the abdomen for injuries
34. Auscultate bowel sounds
35. Palpate all four quadrants of the abdomen for injuries
36. Inspect and palpate the flanks for injuries
37. Inspect the pelvis for injuries
38. Apply gentle pressure over iliac crests downward and medially
39. Apply gentle pressure on the symphysis pubis (if iliac crests are stable)
40. Inspect the perineum for injuries
41. Consider GU - urinary output
42. Inspect and palpate all four extremities for neurovascular status and injuries
43. Inspect and palpate posterior surfaces -- NOT if the patient has suspected spinal or pelvic injuries
After the head-to-toe, the learner should summarize injuries identified throughout the scenario and ask
themselves: - ANSWER-"What interventions or diagnostics can you anticipate for this patient?"
Following the completion of head-to-toe assessment in TNP, you must do what? 44 - ANSWER-44.
Identify at least THREE interventions or diagnostics
these may include the following:
Antibiotics
Consults
Head CT for any alterations in mental status
Imaging (other radiographs, CT, ultrasound, interventional radiology as indicated)
Law enforcement
Mandatory reporting
Psychosocial support
Social services
Splinting
Tetanus immunization
Wound care
After identifying potential interventions/diagnostics and completing your assessments and interventions,
you should ask yourself what? - ANSWER-"What findings will you continue to reevaluate while the
patient is in your care?"
"Just keep re-evaluating"
Just Keep Reevaluating. 45-48 - ANSWER-45. Reevaluate vital signs
46. Reevaluate all identified injuries and effectiveness of interventions
47. Reevaluate primary survey
48. Reevaluate pain
What do you ask yourself after re-evaluations are done? 49-50 - ANSWER-49. "What is the definitive care
for this patient?"
50. Consider need for transfer to a trauma center or admission
After all of the assessments, interventions, reassessments, etc. are done, what is the last thing to ask? -
ANSWER-"Is there anything you would like to add at this time?"
When considering GU and how to monitor urinary output: - ANSWER-- Assess for contraindications for
an indwelling urinary catheter
- External catheter
- Weighing diapers (pediatrics and adults)
