1
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2025
CONTAINS QUESTIONS AND CORRECT ANSWER
VERIFIED ANSWERS
THIS STUDY GUIDE MATCH WITH THE ACTUAL EXAM TIPS
placental abruption -ANS- You are caring for a pt who was involved in a
MVC and is 32 weeks pregnant. Findings of your secondary survey
include abd pain on palpation, fundal ht at the costal margin, and some
dark bloody show. Varying accelerations and decelerations are noted
on cariocgraphy. These findings are most consistent with which of the
following?
pressure -ANS- An intubated and sedated pt in the ED has multiple
extremity injuries with the potential for causing compartment
syndrome. What is the most reliable indication of compartment
syndrome in a patient who is unconscious?
pulse oximetry and capnography -ANS- What bedside monitoring
parameters are used to assess for adequacy of O2 and effectiveness of
ventilation?
Report your suspicion of maltreatment in accordance with local
regulations -ANS- a 5 y/o child presents to the ED with bruises to the
upper arm 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 survey. Which of the following is the priority
nursing intervention?
serial FAST exams -ANS- a 49 y/o restrained driver involved in a MVC
presents to the trauma center complaining of abd, pelvic, and bilateral
,2
lower extremity pain. VS are stable. The nurse can anticipate all of
these after a negative FAST exam EXCEPT which of the following?
straight cath for urine sample -ANS- A 20 y/o M presents to the ED
complaining of severe lower abd pain after landing hard on the bicycle
cross bars while preforming an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis.
Which of the following orders would the RN question?
subdural hematoma -ANS- An elderly patient with a history of
anticoagulant use presents after a fall at home today. She denies any
loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. What is the most likely
cause of her symptoms?
subdural hematoma -ANS- Tearing of the bridging veins is most
frequently associated with which brain injury?
the aorta is torn at its attachment with the ligamentum arteriosum -
ANS- which of the following occurs during the third impact of a motor
vehicle crash?
to guage end-organ perfusion and tissue hypoxia -ANS- Why is a
measure of serum lactate obtained in the initial assessment of a trauma
patient?
velocity -ANS- What factor contributes most to the kinetic energy of a
body in motion?
ventilate with a bag mask device -ANS- An unresponsive trauma pt has
an oropharygeal airway in place, shallow and labored respirations, and
dusky skin. The trauma team has administered medications for drug-
,3
assisted intubation and attempted intubation but was unsuccessful.
What is the most appropriate immediate next step?
within 24 hrs of trauma -ANS- When is the tertiary survey completed
fora trauma pt?
worsening pneumothorax -ANS- Which of the following is possible
complication of positive-pressure ventilation? 500 mL/hr -ANS- You are
treating a 27 y/o M in respiratory distress who was involved in a house
fire. Calculating TBSA burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation?
a 52 y/o diabetic male with a partial thickness burn to the left lower leg
-ANS- Which of the following patients warrants referral to a burn
center?
a pertinent medical hx is crucial -ANS- Which of the following
considerations is the most important when caring for a geriatric trauma
pt?
acidosis -ANS- Which of the following is a component of the trauma
triad of death?
advanced age -ANS- Which of the following is most likely to contribute
to inadequate oxygenation and ventilation?
after a physical examination if the pt has no radiologic abnormalities on
CT -ANS- EMS arrives with the intoxicated driver of a car involved in a
MVC. EMS reports significant damage to the drivers side of the car. The
pt is asking to have the cervical collar removed. When it is appropriate
to remove the cervical collar?
, 4
apply splint and elevate above the level of the heart -ANS- a 37 y/o F
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 most appropriate
intervention?
bardycardia and absent motor function below the level of injury -ANS-
A pt with a complete spinal cord injury in neurogenic shock will
demonstrate hypotension and which other clinical signs?
bowel -ANS- Which of the following injuries is LEAST likely to be
promptly identified?
calcium -ANS- if a pt has received multiple transfusions of banked blood
preserved with citrate, which electrolyte is most likely to drop and
require supplementation?
compensated -ANS- A trauma pt is restless and repeatedly asking
"where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool
and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is
demonstrating s/sx of which stage of shock?
Complete -ANS- EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12,
temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism.
These assessment findings are most consistent with which of the
following types of spinal cord injury?
defusings -ANS- All of these are considered a critical communication
point in trauma care EXCEPT which of the following?
dressing removal -ANS- A patient arrives with a large open chest wound
after being assaulted with a machete. Prehospital providers placed a
nonporous dressing over the chest wound and taped it on three sides.
he is now showing signs of anxiety, restlessness, severe respiratory
TNCC FINAL EXAM 4 LATEST VERSIONS 2023-2025
CONTAINS QUESTIONS AND CORRECT ANSWER
VERIFIED ANSWERS
THIS STUDY GUIDE MATCH WITH THE ACTUAL EXAM TIPS
placental abruption -ANS- You are caring for a pt who was involved in a
MVC and is 32 weeks pregnant. Findings of your secondary survey
include abd pain on palpation, fundal ht at the costal margin, and some
dark bloody show. Varying accelerations and decelerations are noted
on cariocgraphy. These findings are most consistent with which of the
following?
pressure -ANS- An intubated and sedated pt in the ED has multiple
extremity injuries with the potential for causing compartment
syndrome. What is the most reliable indication of compartment
syndrome in a patient who is unconscious?
pulse oximetry and capnography -ANS- What bedside monitoring
parameters are used to assess for adequacy of O2 and effectiveness of
ventilation?
Report your suspicion of maltreatment in accordance with local
regulations -ANS- a 5 y/o child presents to the ED with bruises to the
upper arm 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 survey. Which of the following is the priority
nursing intervention?
serial FAST exams -ANS- a 49 y/o restrained driver involved in a MVC
presents to the trauma center complaining of abd, pelvic, and bilateral
,2
lower extremity pain. VS are stable. The nurse can anticipate all of
these after a negative FAST exam EXCEPT which of the following?
straight cath for urine sample -ANS- A 20 y/o M presents to the ED
complaining of severe lower abd pain after landing hard on the bicycle
cross bars while preforming an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis.
Which of the following orders would the RN question?
subdural hematoma -ANS- An elderly patient with a history of
anticoagulant use presents after a fall at home today. She denies any
loss of consciousness. She has a hematoma to her forehead and
complains of headache, dizziness, and nausea. What is the most likely
cause of her symptoms?
subdural hematoma -ANS- Tearing of the bridging veins is most
frequently associated with which brain injury?
the aorta is torn at its attachment with the ligamentum arteriosum -
ANS- which of the following occurs during the third impact of a motor
vehicle crash?
to guage end-organ perfusion and tissue hypoxia -ANS- Why is a
measure of serum lactate obtained in the initial assessment of a trauma
patient?
velocity -ANS- What factor contributes most to the kinetic energy of a
body in motion?
ventilate with a bag mask device -ANS- An unresponsive trauma pt has
an oropharygeal airway in place, shallow and labored respirations, and
dusky skin. The trauma team has administered medications for drug-
,3
assisted intubation and attempted intubation but was unsuccessful.
What is the most appropriate immediate next step?
within 24 hrs of trauma -ANS- When is the tertiary survey completed
fora trauma pt?
worsening pneumothorax -ANS- Which of the following is possible
complication of positive-pressure ventilation? 500 mL/hr -ANS- You are
treating a 27 y/o M in respiratory distress who was involved in a house
fire. Calculating TBSA burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation?
a 52 y/o diabetic male with a partial thickness burn to the left lower leg
-ANS- Which of the following patients warrants referral to a burn
center?
a pertinent medical hx is crucial -ANS- Which of the following
considerations is the most important when caring for a geriatric trauma
pt?
acidosis -ANS- Which of the following is a component of the trauma
triad of death?
advanced age -ANS- Which of the following is most likely to contribute
to inadequate oxygenation and ventilation?
after a physical examination if the pt has no radiologic abnormalities on
CT -ANS- EMS arrives with the intoxicated driver of a car involved in a
MVC. EMS reports significant damage to the drivers side of the car. The
pt is asking to have the cervical collar removed. When it is appropriate
to remove the cervical collar?
, 4
apply splint and elevate above the level of the heart -ANS- a 37 y/o F
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 most appropriate
intervention?
bardycardia and absent motor function below the level of injury -ANS-
A pt with a complete spinal cord injury in neurogenic shock will
demonstrate hypotension and which other clinical signs?
bowel -ANS- Which of the following injuries is LEAST likely to be
promptly identified?
calcium -ANS- if a pt has received multiple transfusions of banked blood
preserved with citrate, which electrolyte is most likely to drop and
require supplementation?
compensated -ANS- A trauma pt is restless and repeatedly asking
"where am i?" VS upon arrival: BP 110/60, HR96, RR 24. Her skin is cool
and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is
demonstrating s/sx of which stage of shock?
Complete -ANS- EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12,
temp 97.2F (36.2 C). The pt exhibits urinary incontinence and priapism.
These assessment findings are most consistent with which of the
following types of spinal cord injury?
defusings -ANS- All of these are considered a critical communication
point in trauma care EXCEPT which of the following?
dressing removal -ANS- A patient arrives with a large open chest wound
after being assaulted with a machete. Prehospital providers placed a
nonporous dressing over the chest wound and taped it on three sides.
he is now showing signs of anxiety, restlessness, severe respiratory
