TNCC final exam test 2025/2026 over 250 questions
abd answers updated with complete solution
TNCC final exam test 2025/2026 over 250 questions
abd answers updated with complete solution
1. *Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?*
*c) to gauge end-organ perfusion and tissue hypoxia*
2. *A trauma patient is restless and repeatedly asking “where am I?” vital signs upon
arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is
cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The
patient is demonstrating signs and symptoms of which stage of shock?*
*A) compensated*
3. *An elderly patient with a history of anticoagulant use presents after a fall at home
that day. She denies any loss of consciousness. She has a hematoma to her forehead
and complains of headache, dizziness, and nausea. Which is a most likely cause of her
symptoms?*
*D) subdural hematoma*
4. *EMS brings a patient who fell riding his bicycle. Using the American College of
Surgeons screening guidelines, which assessment finding would prompt the nurse to
prepare the patient for radiologic spine clearance?*
*D) Smell of alcohol on breath*
,5. *Which of the following occurs during the third impact of a motor vehicle crash?*
*C) the aorta is torn at its attachment with the ligamentum arteriosum*
6. *A passenger is brought to the emergency department of a rural hospital following a
high-speed MVC. When significant abdominal and pelvic injuries are noted in the
primary survey, which of the following is the priority interventions?*
*A) initiate transfer to a trauma center*
7. *Which of the following injuries is LEAST likely to be promptly identified?*
*C) bowel*
8. *Patients with a crush injury should be monitored for which of the following
conditions?*
*C) Dysrhythmias*
9. *What finding raises suspicion of complete spinal cord injury?*
*B) Priapism*
10. *A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?*
*D) Bradycardia and absent motor function below the level of the injury*
11. *A 5-year old child presents to the ED 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 the maltreatment in accordance with local regulations*
,12. *A patient with lower extremity fracture complains of severe pain and tightness in his
calf, minimally relieved by pain medications. Which of the following is the priority nursing
intervention?*
*C) Elevating the extremity to the level of the heart*
13. *See an expert-written answer: A 36-year old female has a deformity of the left wrist
after a fall. She is reluctant to move her hand due to pain. Which of the following is the
most appropriate intervention?*
*B) apply a splint and elevate above the level of the heart*
14. *Which of the following is a late sign of increased intracranial pressure?*
*D) decreased respiratory effort*
15. *Tearing of the bridging veins is most frequently associated with which brain injury?*
*B) subdural hematoma*
16. *See an expert-written answer: 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 palpation, 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?*
*A) placental abruption*
17. *Which of the following is true about the log-roll?*
*C) it can worsen cord damage from an unstable spinal injury*
18. *All of these are considered a critical communication point in trauma care EXCEPT
which of the following?*
*D) defusings*
, 19. *What bedside monitoring parameters are used to assess for adequacy of
oxygenation and effectiveness of ventilation?*
*A) pulse oximetry and capnography*
20. *See an expert-written answer: Caregivers carry in a 2 y/o into the ED who fell out of
a second-story window. The pt is awake and crying with increased work of breathing
and pale skin. Which of the following interventions has the highest priority?*
*Padding the upper back while stabilizing the cervical spine*
21. *Which of the following injuries is LEAST likely to be promptly identified?*
*B) bowel*
22. *A 49-year-old male involved in a motor vehicle collision presents to the trauma
center complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs
are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT
which of the following?*
*A) Diagnostic peritoneal lavage*
23. *Why is a measure of serum lactate obtained in the initial assessment of a trauma
patient?*
*To gauge end-organ perfusion and tissue hypoxia*
24. *See an expert-written answer: During the primary survey of an unconscious patient
with multi-system trauma, the nurse notes snoring respirations. Which priority nursing
intervention should be performed next?*
*Insert an oropharyngeal airway if there is no gag reflex*
25. *See an expert-written answer: Which of the following assessment findings
differentiates a tension pneumothorax from a simple pneumothorax?*
*Hypotension that worsens with inspiration*
abd answers updated with complete solution
TNCC final exam test 2025/2026 over 250 questions
abd answers updated with complete solution
1. *Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?*
*c) to gauge end-organ perfusion and tissue hypoxia*
2. *A trauma patient is restless and repeatedly asking “where am I?” vital signs upon
arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her skin is
cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28 breaths/min. The
patient is demonstrating signs and symptoms of which stage of shock?*
*A) compensated*
3. *An elderly patient with a history of anticoagulant use presents after a fall at home
that day. She denies any loss of consciousness. She has a hematoma to her forehead
and complains of headache, dizziness, and nausea. Which is a most likely cause of her
symptoms?*
*D) subdural hematoma*
4. *EMS brings a patient who fell riding his bicycle. Using the American College of
Surgeons screening guidelines, which assessment finding would prompt the nurse to
prepare the patient for radiologic spine clearance?*
*D) Smell of alcohol on breath*
,5. *Which of the following occurs during the third impact of a motor vehicle crash?*
*C) the aorta is torn at its attachment with the ligamentum arteriosum*
6. *A passenger is brought to the emergency department of a rural hospital following a
high-speed MVC. When significant abdominal and pelvic injuries are noted in the
primary survey, which of the following is the priority interventions?*
*A) initiate transfer to a trauma center*
7. *Which of the following injuries is LEAST likely to be promptly identified?*
*C) bowel*
8. *Patients with a crush injury should be monitored for which of the following
conditions?*
*C) Dysrhythmias*
9. *What finding raises suspicion of complete spinal cord injury?*
*B) Priapism*
10. *A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?*
*D) Bradycardia and absent motor function below the level of the injury*
11. *A 5-year old child presents to the ED 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 the maltreatment in accordance with local regulations*
,12. *A patient with lower extremity fracture complains of severe pain and tightness in his
calf, minimally relieved by pain medications. Which of the following is the priority nursing
intervention?*
*C) Elevating the extremity to the level of the heart*
13. *See an expert-written answer: A 36-year old female has a deformity of the left wrist
after a fall. She is reluctant to move her hand due to pain. Which of the following is the
most appropriate intervention?*
*B) apply a splint and elevate above the level of the heart*
14. *Which of the following is a late sign of increased intracranial pressure?*
*D) decreased respiratory effort*
15. *Tearing of the bridging veins is most frequently associated with which brain injury?*
*B) subdural hematoma*
16. *See an expert-written answer: 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 palpation, 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?*
*A) placental abruption*
17. *Which of the following is true about the log-roll?*
*C) it can worsen cord damage from an unstable spinal injury*
18. *All of these are considered a critical communication point in trauma care EXCEPT
which of the following?*
*D) defusings*
, 19. *What bedside monitoring parameters are used to assess for adequacy of
oxygenation and effectiveness of ventilation?*
*A) pulse oximetry and capnography*
20. *See an expert-written answer: Caregivers carry in a 2 y/o into the ED who fell out of
a second-story window. The pt is awake and crying with increased work of breathing
and pale skin. Which of the following interventions has the highest priority?*
*Padding the upper back while stabilizing the cervical spine*
21. *Which of the following injuries is LEAST likely to be promptly identified?*
*B) bowel*
22. *A 49-year-old male involved in a motor vehicle collision presents to the trauma
center complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs
are stable. The nurse can anticipate all of these after a negative FAST exam EXCEPT
which of the following?*
*A) Diagnostic peritoneal lavage*
23. *Why is a measure of serum lactate obtained in the initial assessment of a trauma
patient?*
*To gauge end-organ perfusion and tissue hypoxia*
24. *See an expert-written answer: During the primary survey of an unconscious patient
with multi-system trauma, the nurse notes snoring respirations. Which priority nursing
intervention should be performed next?*
*Insert an oropharyngeal airway if there is no gag reflex*
25. *See an expert-written answer: Which of the following assessment findings
differentiates a tension pneumothorax from a simple pneumothorax?*
*Hypotension that worsens with inspiration*
