TNCC FINAL EXAM
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
✪ 40 Questions and Answers
✪ Multiple-choice and True/False Format
✪ Expert-Verified Explanations
✪ Verified with Trusted Textbooks
1. Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
A) To measure oxygenation and ventilation
B) To quantify the base deficit for adequacy of cellular perfusion
C) To gauge end-organ perfusion and tissue hypoxia
D) To determine the underlying cause of shock
Answer: C
Explanation: Serum lactate is a marker for tissue hypoxia and helps assess whether end-organ perfusion
is adequate in critically ill trauma patients.
2. A trauma patient is restless and repeatedly asking "where am I?" Vital signs show mild hypotension
and tachycardia. What stage of shock is likely?
A) Compensated
B) Progressive
C) Irreversible
D) Decompensated
Answer: A
Explanation: Early signs of shock (restlessness, mild tachycardia) indicate the compensated stage, where
the body maintains perfusion.
3. An elderly patient on anticoagulants presents with a headache and a forehead hematoma after a
fall. Most likely diagnosis?
A) Epidural hematoma
B) Diffuse axonal injury
C) Post-concussive syndrome
D) Subdural hematoma
Answer: D
Explanation: Subdural hematomas are common in elderly patients on anticoagulants due to tearing of
bridging veins.
4. Which finding would prompt spine clearance imaging per ACS guidelines?
A) Alert with no neurologic deficits
B) Multiple abrasions to extremities
, C) Multiple requests for water
D) Smell of alcohol on breath
Answer: D
Explanation: Intoxication impairs reliable neurological assessment and necessitates radiologic spine
clearance.
5. What occurs during the third impact of a motor vehicle crash?
A) Collision with steering wheel
B) Car hits a tree
C) Aorta tears at ligamentum arteriosum
D) Airbag deployment
Answer: C
Explanation: The third impact involves internal organs hitting internal structures, such as the aortic tear.
6. MVC victim presents with abdominal and pelvic injuries. Priority action in rural ED?
A) Initiate transfer to trauma center
B) Provide report to OR
C) Obtain imaging
D) Insert gastric tube
Answer: A
Explanation: Timely transfer ensures definitive care that may not be available in a rural setting.
7. Which injury is LEAST likely to be identified promptly?
A) Spleen
B) Lung
C) Bowel
D) Brain
Answer: C
Explanation: Bowel injuries may present with delayed signs and are often missed initially.
8. Crush injury patients are at risk for what complication?
A) Hypernatremia
B) Hypercalcemia
C) Dysrhythmias
D) Polyuria
Answer: C
Explanation: Electrolyte shifts (e.g., hyperkalemia) from muscle breakdown can trigger dysrhythmias.
9. What finding raises suspicion of complete spinal cord injury?
A) Weakness
B) Priapism
C) Voluntary anal sphincter tone
D) Intact reflexes
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
✪ 40 Questions and Answers
✪ Multiple-choice and True/False Format
✪ Expert-Verified Explanations
✪ Verified with Trusted Textbooks
1. Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
A) To measure oxygenation and ventilation
B) To quantify the base deficit for adequacy of cellular perfusion
C) To gauge end-organ perfusion and tissue hypoxia
D) To determine the underlying cause of shock
Answer: C
Explanation: Serum lactate is a marker for tissue hypoxia and helps assess whether end-organ perfusion
is adequate in critically ill trauma patients.
2. A trauma patient is restless and repeatedly asking "where am I?" Vital signs show mild hypotension
and tachycardia. What stage of shock is likely?
A) Compensated
B) Progressive
C) Irreversible
D) Decompensated
Answer: A
Explanation: Early signs of shock (restlessness, mild tachycardia) indicate the compensated stage, where
the body maintains perfusion.
3. An elderly patient on anticoagulants presents with a headache and a forehead hematoma after a
fall. Most likely diagnosis?
A) Epidural hematoma
B) Diffuse axonal injury
C) Post-concussive syndrome
D) Subdural hematoma
Answer: D
Explanation: Subdural hematomas are common in elderly patients on anticoagulants due to tearing of
bridging veins.
4. Which finding would prompt spine clearance imaging per ACS guidelines?
A) Alert with no neurologic deficits
B) Multiple abrasions to extremities
, C) Multiple requests for water
D) Smell of alcohol on breath
Answer: D
Explanation: Intoxication impairs reliable neurological assessment and necessitates radiologic spine
clearance.
5. What occurs during the third impact of a motor vehicle crash?
A) Collision with steering wheel
B) Car hits a tree
C) Aorta tears at ligamentum arteriosum
D) Airbag deployment
Answer: C
Explanation: The third impact involves internal organs hitting internal structures, such as the aortic tear.
6. MVC victim presents with abdominal and pelvic injuries. Priority action in rural ED?
A) Initiate transfer to trauma center
B) Provide report to OR
C) Obtain imaging
D) Insert gastric tube
Answer: A
Explanation: Timely transfer ensures definitive care that may not be available in a rural setting.
7. Which injury is LEAST likely to be identified promptly?
A) Spleen
B) Lung
C) Bowel
D) Brain
Answer: C
Explanation: Bowel injuries may present with delayed signs and are often missed initially.
8. Crush injury patients are at risk for what complication?
A) Hypernatremia
B) Hypercalcemia
C) Dysrhythmias
D) Polyuria
Answer: C
Explanation: Electrolyte shifts (e.g., hyperkalemia) from muscle breakdown can trigger dysrhythmias.
9. What finding raises suspicion of complete spinal cord injury?
A) Weakness
B) Priapism
C) Voluntary anal sphincter tone
D) Intact reflexes
