TNCC 9th Edition, TNCC 9th Edition
FINAL TEST, TNCC 9th Edition 2025/2026
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
You are caring for a patient who was thrown from a bike and was not wearing a helmet.
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While performing the head-to-toe assessment, you note clear drainage from the right ear.
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Which of the following is the most appropriate next step?
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A. Clean the ear with a cotton-tipped applicator.
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B. Pack the ear with gauze.
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C. Notify the physician
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D. Document and continue the exam.
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C. Notify the physician
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
A patient is brought to the emergency department of a rural hospital following a high-speed
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motor vehicle collision. When significant abdominal and pelvic injuries are noted in the
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primary survey, what is the priority intervention?
lh lh lh lh lh lh
A. Initiate transfer to a trauma center
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B. Attempt family notification
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C. Obtain additional imaging studies
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D. Place an indwelling urinary catheter
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A. Initiate transfer to a trauma center
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult who fell from a second story roof is brought to the emergency department by
lh lh lh lh lh lh lh lh lh lh lh lh
private vehicle. The patient is confused with unlabored respirations and has strong,
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
palpable radial pulses. There is an open wound in proximity to an obvious deformity of the
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left lower extremity. What is the priority intervention?
lh lh lh lh
A. Initiate cervical spine stabilization
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B. Apply a splint to the lower extremity
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C. Put the patient on portable oxygen.
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D. Log roll the patient onto a spine board
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A. Initiate cervical spine stabilization
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult patient who sustained a severe head trauma has been intubated and is being
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What
lh lh lh lh lh lh lh lh lh lh lh
is the most important intervention to manage the cerebral blood flow?
lh lh lh lh lh lh
A. Decrease the rate of manual ventilation.
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B. Initiate another fluid bolus.
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C. Recheck endotracheal tube placement.
lh lh lh lh lh lh
D. Increase the amount of oxygen delivered.
lh lh lh lh lh lh
A. Decrease the rate of manual ventilation.
lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult patient is brought to the emergency department following a vehicle "roll-over" with
lh lh lh lh lh lh lh lh lh lh lh lh
prolonged extrication. Assessment reveals swelling and bruising to the right proximal thigh
,lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
and a weak pedal pulse. Skin is pale, cool, and moist. What is the most appropriate initial
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intervention?
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A. Application of a tourniquet to the affected extremity
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B. Application of a pelvic binder
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C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour
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D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa)
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B. Application of a pelvic binder
lh lh lh lh lh lh lh lh lh lh lh lh
An adult arrives at the emergency department with superficial burns to the extremities
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
following a house fire. The patient is reporting a headache with nausea and is drowsy and
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confused. What is the most likely cause of these symptoms?
lh lh lh
A. Capillary leak syndrome
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B. Rhabdomyolysis
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C. Carbon monoxide poisoning
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D. Hypothermia lh lh lh lh lh lh lh lh lh lh
Using the American College of Surgeons Guidelines for Screening Patients with
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Suspected Spine Injury, what assessment finding would prompt the nurse to prepare a
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patient for cervical spine imaging?
lh lh lh lh lh lh lh lh
A. Alert with no neurologic deficits or neck pain
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B. Multiple abrasions to the extremities
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C. Ecchymosis to the flank
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D. Responds to verbal stimulation using AVPU
lh lh lh lh lh lh lh lh lh lh lh lh
A 5-month pregnant patient arrives in the emergency department stating she tripped and
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fell, landing on her abdomen. Assessment reveals bruising to the abdomen, both arms,
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
and her neck. She states she does not take any medications and has not had any prenatal
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
care. The nurse suspects the findings are most likely related to which of the following?
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A.Intentional violence lh
B.Pregnancy-related changes lh
C.Undiagnosed embolus lh
D.Iron deficiency lh lh lh lh lh lh lh lh lh lh lh lh
During the primary survey of an unconscious patient with multi-system trauma, the nurse
lh lh lh lh lh lh lh lh lh lh lh
notes snoring respirations. Which priority nursing intervention should be performed next?
lh lh lh lh lh lh
A.Open the airway with the head-tilt/chin-lift maneuver lh lh lh
B.Auscultate bilateral breath sounds lh lh lh lh lh
C.Assist respirations using a bag-mask device lh lh lh lh lh lh lh lh lh
D.Insert an oropharyngeal airway if there is no gag reflex
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult was thrown against a concrete wall during a factory explosion and sustained a
lh lh lh lh lh lh lh lh lh lh lh lh lh
femur fracture, liver laceration, and a small subdural hematoma. These injuries most likely
lh lh lh lh lh lh lh
occurred during what level of blast trauma?
A.Primary
B.Secondary
, C.Tertiary
D.Quaternary
lh lh lh lh lh lh lh lh lh lh lh lh lh
A patient presents to the emergency department with a degloving injury involving the entire
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
forearm. What should the nurse consider when planning care for a patient with this injury?
lh lh lh lh lh lh lh
A.Wound edges can be easily approximated for suturing. lh lh lh lh
B.Surgical intervention will be needed lh lh lh lh lh lh lh lh lh
C.Extent of tissue damage does not affect potential limb salvage
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D.Only soft tissue has been damaged
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
A 35-year-old male presents with facial trauma after being struck in the face with a
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
lh lh
A.Oculomotor nerve palsy lh
B.Globe rupture lh
C.Retrobulbar hematoma lh
D.Retinal detachment
lh lh lh lh lh lh lh lh lh lh lh lh
A driver involved in a high-speed motor vehicle collision arrives in the emergency
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
department. The vehicle's air-bag failed to deploy. The patient is drowsy but arousable and
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
complaining of chest pain with ecchymosis noted to the chest. The patient is tachycardic
lh lh lh lh lh lh lh lh lh lh lh
and hypotensive with no evidence of uncontrolled bleeding. Cardiac monitor shows
lh lh lh lh lh lh lh lh lh lh lh
premature ventricular contractions. Which of the following is the most appropriate
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intervention for this patient?
lh lh
A.Rapid fluid boluses lh lh
B.Tranexamic acid administration lh
C.Inotropic support lh
D.Epinephrine administration
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A trauma patient who is 30-weeks pregnant arrives at the emergency department following
lh lh lh lh lh lh lh lh lh lh lh lh
a motor vehicle collision. Which normal physiologic change should be considered when
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assessing ventilatory status?
lh lh lh
A.Increased functional reserve capacity lh lh
B.Increased oxygen consumption lh lh
C.Decreased minute ventilation lh lh lh lh
D.Slower desaturation rates with apnea
lh lh lh lh lh lh lh lh lh lh lh lh
A trauma patient is being resuscitated in the emergency department when the radiology
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
staff notifies the charge nurse that the computed tomography (CT) scanner will be out of
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
service for several hours. The team gathers to plan accordingly. Which of the following
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terms best describes this trauma team's communication?
A.Brief
B.Closed-loop
C.Debrief
D.Huddle lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph.
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
The patient is awake and alert and the right leg is shortened. Following initial resuscitation
FINAL TEST, TNCC 9th Edition 2025/2026
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
You are caring for a patient who was thrown from a bike and was not wearing a helmet.
lh lh lh lh lh lh lh lh lh lh lh lh lh
While performing the head-to-toe assessment, you note clear drainage from the right ear.
lh lh lh lh lh lh lh lh lh lh
Which of the following is the most appropriate next step?
lh lh lh lh lh lh lh
A. Clean the ear with a cotton-tipped applicator.
lh lh lh lh lh
B. Pack the ear with gauze.
lh lh lh
C. Notify the physician
lh lh lh lh lh
D. Document and continue the exam.
lh lh lh
C. Notify the physician
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
A patient is brought to the emergency department of a rural hospital following a high-speed
lh lh lh lh lh lh lh lh lh lh lh lh lh
motor vehicle collision. When significant abdominal and pelvic injuries are noted in the
lh lh lh lh lh lh lh
primary survey, what is the priority intervention?
lh lh lh lh lh lh
A. Initiate transfer to a trauma center
lh lh lh
B. Attempt family notification
lh lh lh lh
C. Obtain additional imaging studies
lh lh lh lh lh
D. Place an indwelling urinary catheter
lh lh lh lh lh lh
A. Initiate transfer to a trauma center
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult who fell from a second story roof is brought to the emergency department by
lh lh lh lh lh lh lh lh lh lh lh lh
private vehicle. The patient is confused with unlabored respirations and has strong,
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
palpable radial pulses. There is an open wound in proximity to an obvious deformity of the
lh lh lh lh lh lh lh lh
left lower extremity. What is the priority intervention?
lh lh lh lh
A. Initiate cervical spine stabilization
lh lh lh lh lh lh lh
B. Apply a splint to the lower extremity
lh lh lh lh lh lh
C. Put the patient on portable oxygen.
lh lh lh lh lh lh lh lh
D. Log roll the patient onto a spine board
lh lh lh lh
A. Initiate cervical spine stabilization
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult patient who sustained a severe head trauma has been intubated and is being
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
manually ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
received one intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
PaCO2 is 30 mm Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What
lh lh lh lh lh lh lh lh lh lh lh
is the most important intervention to manage the cerebral blood flow?
lh lh lh lh lh lh
A. Decrease the rate of manual ventilation.
lh lh lh lh
B. Initiate another fluid bolus.
lh lh lh lh
C. Recheck endotracheal tube placement.
lh lh lh lh lh lh
D. Increase the amount of oxygen delivered.
lh lh lh lh lh lh
A. Decrease the rate of manual ventilation.
lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult patient is brought to the emergency department following a vehicle "roll-over" with
lh lh lh lh lh lh lh lh lh lh lh lh
prolonged extrication. Assessment reveals swelling and bruising to the right proximal thigh
,lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
and a weak pedal pulse. Skin is pale, cool, and moist. What is the most appropriate initial
lh
intervention?
lh lh lh lh lh lh lh lh
A. Application of a tourniquet to the affected extremity
lh lh lh lh lh
B. Application of a pelvic binder
lh lh lh lh lh lh lh lh lh lh
C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour
lh lh lh lh lh lh lh lh lh lh lh
D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa)
lh lh lh lh lh
B. Application of a pelvic binder
lh lh lh lh lh lh lh lh lh lh lh lh
An adult arrives at the emergency department with superficial burns to the extremities
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
following a house fire. The patient is reporting a headache with nausea and is drowsy and
lh lh lh lh lh lh lh lh lh lh
confused. What is the most likely cause of these symptoms?
lh lh lh
A. Capillary leak syndrome
lh
B. Rhabdomyolysis
lh lh lh
C. Carbon monoxide poisoning
lh
D. Hypothermia lh lh lh lh lh lh lh lh lh lh
Using the American College of Surgeons Guidelines for Screening Patients with
lh lh lh lh lh lh lh lh lh lh lh lh lh
Suspected Spine Injury, what assessment finding would prompt the nurse to prepare a
lh lh lh lh lh
patient for cervical spine imaging?
lh lh lh lh lh lh lh lh
A. Alert with no neurologic deficits or neck pain
lh lh lh lh lh
B. Multiple abrasions to the extremities
lh lh lh lh
C. Ecchymosis to the flank
lh lh lh lh lh lh
D. Responds to verbal stimulation using AVPU
lh lh lh lh lh lh lh lh lh lh lh lh
A 5-month pregnant patient arrives in the emergency department stating she tripped and
lh lh lh lh lh lh lh lh lh lh lh lh lh
fell, landing on her abdomen. Assessment reveals bruising to the abdomen, both arms,
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
and her neck. She states she does not take any medications and has not had any prenatal
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
care. The nurse suspects the findings are most likely related to which of the following?
lh
A.Intentional violence lh
B.Pregnancy-related changes lh
C.Undiagnosed embolus lh
D.Iron deficiency lh lh lh lh lh lh lh lh lh lh lh lh
During the primary survey of an unconscious patient with multi-system trauma, the nurse
lh lh lh lh lh lh lh lh lh lh lh
notes snoring respirations. Which priority nursing intervention should be performed next?
lh lh lh lh lh lh
A.Open the airway with the head-tilt/chin-lift maneuver lh lh lh
B.Auscultate bilateral breath sounds lh lh lh lh lh
C.Assist respirations using a bag-mask device lh lh lh lh lh lh lh lh lh
D.Insert an oropharyngeal airway if there is no gag reflex
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult was thrown against a concrete wall during a factory explosion and sustained a
lh lh lh lh lh lh lh lh lh lh lh lh lh
femur fracture, liver laceration, and a small subdural hematoma. These injuries most likely
lh lh lh lh lh lh lh
occurred during what level of blast trauma?
A.Primary
B.Secondary
, C.Tertiary
D.Quaternary
lh lh lh lh lh lh lh lh lh lh lh lh lh
A patient presents to the emergency department with a degloving injury involving the entire
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
forearm. What should the nurse consider when planning care for a patient with this injury?
lh lh lh lh lh lh lh
A.Wound edges can be easily approximated for suturing. lh lh lh lh
B.Surgical intervention will be needed lh lh lh lh lh lh lh lh lh
C.Extent of tissue damage does not affect potential limb salvage
lh lh lh lh lh
D.Only soft tissue has been damaged
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
A 35-year-old male presents with facial trauma after being struck in the face with a
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
lh lh
A.Oculomotor nerve palsy lh
B.Globe rupture lh
C.Retrobulbar hematoma lh
D.Retinal detachment
lh lh lh lh lh lh lh lh lh lh lh lh
A driver involved in a high-speed motor vehicle collision arrives in the emergency
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
department. The vehicle's air-bag failed to deploy. The patient is drowsy but arousable and
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
complaining of chest pain with ecchymosis noted to the chest. The patient is tachycardic
lh lh lh lh lh lh lh lh lh lh lh
and hypotensive with no evidence of uncontrolled bleeding. Cardiac monitor shows
lh lh lh lh lh lh lh lh lh lh lh
premature ventricular contractions. Which of the following is the most appropriate
lh lh lh lh
intervention for this patient?
lh lh
A.Rapid fluid boluses lh lh
B.Tranexamic acid administration lh
C.Inotropic support lh
D.Epinephrine administration
lh lh lh lh lh lh lh lh lh lh lh lh
A trauma patient who is 30-weeks pregnant arrives at the emergency department following
lh lh lh lh lh lh lh lh lh lh lh lh
a motor vehicle collision. Which normal physiologic change should be considered when
lh lh lh
assessing ventilatory status?
lh lh lh
A.Increased functional reserve capacity lh lh
B.Increased oxygen consumption lh lh
C.Decreased minute ventilation lh lh lh lh
D.Slower desaturation rates with apnea
lh lh lh lh lh lh lh lh lh lh lh lh
A trauma patient is being resuscitated in the emergency department when the radiology
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
staff notifies the charge nurse that the computed tomography (CT) scanner will be out of
lh lh lh lh lh lh lh lh lh lh lh lh lh lh
service for several hours. The team gathers to plan accordingly. Which of the following
lh lh lh lh lh lh lh
terms best describes this trauma team's communication?
A.Brief
B.Closed-loop
C.Debrief
D.Huddle lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
An adult pedestrian was struck on the right side by a sport utility vehicle traveling at 40 mph.
lh lh lh lh lh lh lh lh lh lh lh lh lh lh lh
The patient is awake and alert and the right leg is shortened. Following initial resuscitation
