TNCC 9th Edition TNP latest 2024-2025
What is the key to a high performing trauma team? - anseffective communication
rationale: skilled communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care
When obtaining a history for an injured patient, understanding the kinematic concepts
associated with the mechanism of injury and energy transfer can initially assist the trauma
provider in: - ansevaluating and anticipating the types of injuries that may be present
rationale: mechanism of injury and energy transfer can assist the provider in evaluating and
anticipating damage
the major preventable cause of death in the trauma patient is: - ansuncontrolled hemorrhage
rationale: uncontrolled hemorrhage is the major cause of preventable death after injury, so
assessment to identify uncontrolled hemorrhage is key to the initial assessment process
the across-the-room observation step in the initial assessment provides the opportunity to -
ansreprioritize circulation before airway or breathing
rationale: the across-the-room observation is done at the beginning of the primary survey to
rapidly assess the need to reprioritize circulation before airway or breathing. This is done if
uncontrolled external hemorrhage is identified.
Which of the following accurately describes ventilation prinicples associated with a bag-mask
device? - ansventilate at a rate of 10-12 breaths/minute
rationale: if ventilation is ineffective, assist ventilation at 10-12 breaths/minute or one every 5-
6 seconds
Which of the following is the best measure of the adequacy of cellular perfusion and helps to
predict the outcome of resuscitation? - ansbase deficit
rationale: base deficit serves as an endpoint measurement of the adequacy of cellular
perfusion and when used in conjunction with serum lactate helps predict the success of
resuciation
What is the safe pharmacological alternative to opioids for rib fracture pain management in
the anticoagulated patient? - ansintercostal nerve blocks
rationale: continuous intercostal nerve blocks use long-acting anesthetics and can provide
safe and effective pain management for the anticoagulated patient.
In a patient with severe traumatic brain injury, hypocapnia causes: - anscerebral
vasoconstriction
rationale: hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially
in the cerebra; vasculature
,TNCC 9th Edition TNP latest 2024-2025
A patient with a knife injury to the neck has an intact airway and is hemodynamically stable.
He complains of difficulty swallowing and speaking. Further assessment is indicated next for
which of the following? - ansdamage to spinal cord
rationale: penetrating neck trauma may include concurrent injuries to the spinal cord, airway,
or vascular neck structures. With an intact airway and hemodynamic stability, the other
common concurrent injury is to the spinal cord
What is the appropriate technique for palpating the pelvis for stability? - ansapply gentle
pressure over the iliac downward and medially
rationale: to assess for pelvic instability, gentle pressure is applied over the iliac crests
downward and medially
a patient with a spinal cord injury at C5 is being cared for in the emergency department while
awaiting transport to a trauma center. which of the following represents the highest priority
for ongoing assessment and management? - ansmaintain adequate respiratory status
rationale: spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function,
resulting in a paralyzed diaphragm and inability to breathe
Based on proper bleeding control techniques, what is the first step to stop the bleeding of a
penetrating injury to the lower extremity? - ansinitiate direct pressure
rationale: the first step in controlling any bleeding is direct pressure. if that is not adequate,
the application of a tourniquet may be needed
treatment for frostbite includes: - ansadminister tissue plasminogen activator
rationale: with frostbite, thrombus formation is a risk. tissue plasminogen or nonsteroidal anti-
inflammatory medication can be administered. The tissue plasminogen activator has been
effective in maintaining perfusion and decreasing the need for amputation when administered
within 24 hours of rewarming
A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm Hg and
a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency
nurse interprets the patient's hemodynamic findings as an indication of which of the
following? - ansnormal vital signs in pregnancy
rationale: in pregnancy, the resting heart rate increases by 10 to 20 bpm and a small decrease
in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease
in peripheral resistance. Normal fetal rate is between 120 and 160 bpm
While performing an assessment on a 13-month old involved in a motor vehicle collision, the
nurse identifies which of the following findings from the patient as a potential sign of mental
status change? - anscooperation with the assessment
rationale: an alert older infant or toddler will recognize his or her caregiver, be cautious of
strangers, and may not respond to commands, which is a normal response
, TNCC 9th Edition TNP latest 2024-2025
What is the best position for maintaining an open airway in the bariatric patient? - ansreverse
trendelenburg
rationale: the reverse trendelenburg position will benefit both airway maintenance and work of
breathing in the bariatric patient.
The nurse is obtaining for a patient who presents following sexual assault. The history is
completed using which of the following techniques? - ansuse direct quotes to record
information
rationale: history includes a detailed description of the incident that is objective, using direct
quotes
A trauma nurse cared for a child with devasting burns 2 weeks ago. She called in sick for a
couple of days and is now back working on the team. Which of the following behaviors would
indicate this nurse is coping well? - ansshe is talking about taking the emergency nursing
certification examination
A 35-year-old male presents with facial trauma after being struck in the face with a baseball.
A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
A.Oculomotor nerve palsy
B.Globe rupture
C.Retrobulbar hematoma
D.Retinal detachment - ANSGlobe rupture
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?
A.Report your suspicion of maltreatment in accordance with local regulations
B.Apply ice to the bruises and provide wound care
C.Engage in therapeutic communicati - ANSA.Report your suspicion of maltreatment in
accordance with local regulations
A driver involved in a high-speed motor vehicle collision arrives in the emergency department.
The vehicle's air-bag failed to deploy. The patient is drowsy but arousable and complaining of
chest pain with ecchymosis noted to the chest. The patient is tachycardic and hypotensive
with no evidence of uncontrolled bleeding. Cardiac monitor shows premature ventricular
contractions. Which of the following is the most appropriate intervention for this patient?
A.Rapid fluid boluses
B.Tranexamic acid - ANSC.Inotropic support
A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during
a staffing crisis. The nurse expresses anger stating that the patients did not receive quality
care and begins exhibiting aggression toward colleagues. This is most consistent with which
condition?
A.Compassion fatigue
B.Vicarious trauma
What is the key to a high performing trauma team? - anseffective communication
rationale: skilled communication, cooperation, and coordination are the cornerstones of high-
performance teams and high-quality trauma care
When obtaining a history for an injured patient, understanding the kinematic concepts
associated with the mechanism of injury and energy transfer can initially assist the trauma
provider in: - ansevaluating and anticipating the types of injuries that may be present
rationale: mechanism of injury and energy transfer can assist the provider in evaluating and
anticipating damage
the major preventable cause of death in the trauma patient is: - ansuncontrolled hemorrhage
rationale: uncontrolled hemorrhage is the major cause of preventable death after injury, so
assessment to identify uncontrolled hemorrhage is key to the initial assessment process
the across-the-room observation step in the initial assessment provides the opportunity to -
ansreprioritize circulation before airway or breathing
rationale: the across-the-room observation is done at the beginning of the primary survey to
rapidly assess the need to reprioritize circulation before airway or breathing. This is done if
uncontrolled external hemorrhage is identified.
Which of the following accurately describes ventilation prinicples associated with a bag-mask
device? - ansventilate at a rate of 10-12 breaths/minute
rationale: if ventilation is ineffective, assist ventilation at 10-12 breaths/minute or one every 5-
6 seconds
Which of the following is the best measure of the adequacy of cellular perfusion and helps to
predict the outcome of resuscitation? - ansbase deficit
rationale: base deficit serves as an endpoint measurement of the adequacy of cellular
perfusion and when used in conjunction with serum lactate helps predict the success of
resuciation
What is the safe pharmacological alternative to opioids for rib fracture pain management in
the anticoagulated patient? - ansintercostal nerve blocks
rationale: continuous intercostal nerve blocks use long-acting anesthetics and can provide
safe and effective pain management for the anticoagulated patient.
In a patient with severe traumatic brain injury, hypocapnia causes: - anscerebral
vasoconstriction
rationale: hypocapnia, or low levels of carbon dioxide, will cause vasoconstriction, especially
in the cerebra; vasculature
,TNCC 9th Edition TNP latest 2024-2025
A patient with a knife injury to the neck has an intact airway and is hemodynamically stable.
He complains of difficulty swallowing and speaking. Further assessment is indicated next for
which of the following? - ansdamage to spinal cord
rationale: penetrating neck trauma may include concurrent injuries to the spinal cord, airway,
or vascular neck structures. With an intact airway and hemodynamic stability, the other
common concurrent injury is to the spinal cord
What is the appropriate technique for palpating the pelvis for stability? - ansapply gentle
pressure over the iliac downward and medially
rationale: to assess for pelvic instability, gentle pressure is applied over the iliac crests
downward and medially
a patient with a spinal cord injury at C5 is being cared for in the emergency department while
awaiting transport to a trauma center. which of the following represents the highest priority
for ongoing assessment and management? - ansmaintain adequate respiratory status
rationale: spinal cord injuries at C3 to C5 can cause the loss of phrenic nerve function,
resulting in a paralyzed diaphragm and inability to breathe
Based on proper bleeding control techniques, what is the first step to stop the bleeding of a
penetrating injury to the lower extremity? - ansinitiate direct pressure
rationale: the first step in controlling any bleeding is direct pressure. if that is not adequate,
the application of a tourniquet may be needed
treatment for frostbite includes: - ansadminister tissue plasminogen activator
rationale: with frostbite, thrombus formation is a risk. tissue plasminogen or nonsteroidal anti-
inflammatory medication can be administered. The tissue plasminogen activator has been
effective in maintaining perfusion and decreasing the need for amputation when administered
within 24 hours of rewarming
A 30-week pregnant trauma patient's vital signs include a blood pressure of 94/62 mm Hg and
a heart rate of 108 beats/minute. Fetal heart tones are 124 beats/minute. The emergency
nurse interprets the patient's hemodynamic findings as an indication of which of the
following? - ansnormal vital signs in pregnancy
rationale: in pregnancy, the resting heart rate increases by 10 to 20 bpm and a small decrease
in systolic blood pressure and a larger decrease in diastolic blood pressure due to a decrease
in peripheral resistance. Normal fetal rate is between 120 and 160 bpm
While performing an assessment on a 13-month old involved in a motor vehicle collision, the
nurse identifies which of the following findings from the patient as a potential sign of mental
status change? - anscooperation with the assessment
rationale: an alert older infant or toddler will recognize his or her caregiver, be cautious of
strangers, and may not respond to commands, which is a normal response
, TNCC 9th Edition TNP latest 2024-2025
What is the best position for maintaining an open airway in the bariatric patient? - ansreverse
trendelenburg
rationale: the reverse trendelenburg position will benefit both airway maintenance and work of
breathing in the bariatric patient.
The nurse is obtaining for a patient who presents following sexual assault. The history is
completed using which of the following techniques? - ansuse direct quotes to record
information
rationale: history includes a detailed description of the incident that is objective, using direct
quotes
A trauma nurse cared for a child with devasting burns 2 weeks ago. She called in sick for a
couple of days and is now back working on the team. Which of the following behaviors would
indicate this nurse is coping well? - ansshe is talking about taking the emergency nursing
certification examination
A 35-year-old male presents with facial trauma after being struck in the face with a baseball.
A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
A.Oculomotor nerve palsy
B.Globe rupture
C.Retrobulbar hematoma
D.Retinal detachment - ANSGlobe rupture
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?
A.Report your suspicion of maltreatment in accordance with local regulations
B.Apply ice to the bruises and provide wound care
C.Engage in therapeutic communicati - ANSA.Report your suspicion of maltreatment in
accordance with local regulations
A driver involved in a high-speed motor vehicle collision arrives in the emergency department.
The vehicle's air-bag failed to deploy. The patient is drowsy but arousable and complaining of
chest pain with ecchymosis noted to the chest. The patient is tachycardic and hypotensive
with no evidence of uncontrolled bleeding. Cardiac monitor shows premature ventricular
contractions. Which of the following is the most appropriate intervention for this patient?
A.Rapid fluid boluses
B.Tranexamic acid - ANSC.Inotropic support
A nurse verbalizes guilt and remorse after caring for multiple severely injured patients during
a staffing crisis. The nurse expresses anger stating that the patients did not receive quality
care and begins exhibiting aggression toward colleagues. This is most consistent with which
condition?
A.Compassion fatigue
B.Vicarious trauma
