TNCC FINAL EXAM – EMERGENCY TRAUMA NURSING
CORE COURSE EXAM Q&A | UPDATED 2025
GUIDELINES, PRIORITIZATION, SHOCK, TRIAGE, AND
TRAUMA RESPONSE | EMERGENCY NURSES
ASSOCIATION (ENA)
CURRENLY TESTING
Which of the following mnemonics can help a nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage?
MARCH
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpitation, fundal height at the
costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following?
Placental abruption
Which of the following is NOT considered goal-directed therapy for cardiogenic shock?
Pericardiocentesis
A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory
values is expected with a musculoskeletal complication associated with this presentation?
Elevated creatinine kinase
Tearing of the bridging veins is most frequently associated with which brain injury?
Subdural hematoma
What bedside monitoring parameters are used to assess for adequacy of oxygenation and
effectiveness of ventilation?
Pulse oximetry and capnography
Which of the following is a possible complication of positive-pressure ventilation?
Worsening pneumothorax
Which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax?
, Hypotension that worsens with inspiration
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were
B/P 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry.
Current vital signs are B/P 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The
patient is demonstrating signs and symptoms of which stage of shock?
Compensated
Which pulse pressure description is an indication of early hypovolemic shock?
Narrowed
A trauma patient is en route to a rural emergency department. Radiology notifies the charge
nurse that the computed tomography (CT) scanner will be out of service for several hours. The
team gathers to plan accordingly. Which of the following terms best describes this trauma team's
communication?
Loop
A 36 year old female has a deformity of the L wrist after a fall. She is reluctant to move her hand
due to pain. Which of the following is the next appropriate intervention?
Apply a splint and elevate the extremity above the level of the heart
An intubated trauma patient is being transferred to a tertiary care center. After moving the patient
to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is
the priority intervention?
Check to make sure the ventilator is plugged in
Which of the following injuries is LEAST likely to be promptly identified?
bowel
Which of the following occurs during the third impact of a motor vehicle crash?
The aorta is torn at its attachment with the ligamentum arteriosum
What finding raises suspicion of a complete spinal cord injury?
priapism
A 20 year old male presents to the ED complaining of severe lower abdominal pain after landing
hard on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment
reveals lower abdominal tenderness and scrotal ecchymosis. Which of the following orders
would the nurse question?
Straight catheter for a urine sample
CORE COURSE EXAM Q&A | UPDATED 2025
GUIDELINES, PRIORITIZATION, SHOCK, TRIAGE, AND
TRAUMA RESPONSE | EMERGENCY NURSES
ASSOCIATION (ENA)
CURRENLY TESTING
Which of the following mnemonics can help a nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage?
MARCH
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpitation, fundal height at the
costal margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following?
Placental abruption
Which of the following is NOT considered goal-directed therapy for cardiogenic shock?
Pericardiocentesis
A patient is found lying on the floor after falling 13 hours ago. Which of the following laboratory
values is expected with a musculoskeletal complication associated with this presentation?
Elevated creatinine kinase
Tearing of the bridging veins is most frequently associated with which brain injury?
Subdural hematoma
What bedside monitoring parameters are used to assess for adequacy of oxygenation and
effectiveness of ventilation?
Pulse oximetry and capnography
Which of the following is a possible complication of positive-pressure ventilation?
Worsening pneumothorax
Which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax?
, Hypotension that worsens with inspiration
A trauma patient is restless and repeatedly asking "Where am I?" Vital signs upon arrival were
B/P 110/60 mm Hg, HR 96 beats/minute and RR 24 breaths/minute. Her skin is cool and dry.
Current vital signs are B/P 104/84 mm Hg, HR 108 beats/minute, and RR 28 breaths/minute. The
patient is demonstrating signs and symptoms of which stage of shock?
Compensated
Which pulse pressure description is an indication of early hypovolemic shock?
Narrowed
A trauma patient is en route to a rural emergency department. Radiology notifies the charge
nurse that the computed tomography (CT) scanner will be out of service for several hours. The
team gathers to plan accordingly. Which of the following terms best describes this trauma team's
communication?
Loop
A 36 year old female has a deformity of the L wrist after a fall. She is reluctant to move her hand
due to pain. Which of the following is the next appropriate intervention?
Apply a splint and elevate the extremity above the level of the heart
An intubated trauma patient is being transferred to a tertiary care center. After moving the patient
to the stretcher for transport, a drop in pulse oximetry to 85% is noted. Which of the following is
the priority intervention?
Check to make sure the ventilator is plugged in
Which of the following injuries is LEAST likely to be promptly identified?
bowel
Which of the following occurs during the third impact of a motor vehicle crash?
The aorta is torn at its attachment with the ligamentum arteriosum
What finding raises suspicion of a complete spinal cord injury?
priapism
A 20 year old male presents to the ED complaining of severe lower abdominal pain after landing
hard on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment
reveals lower abdominal tenderness and scrotal ecchymosis. Which of the following orders
would the nurse question?
Straight catheter for a urine sample
