Answers – Trauma Nursing Core Course Preparation
Material
Introduction:
This document provides a comprehensive pre-course study guide and
exam with verified correct answers for the Trauma Nursing Core
Course (TNCC). It covers essential trauma nursing concepts such as
the primary and secondary survey (ABCDE approach), types of shock,
airway management, spinal injuries, burns, pediatric trauma, and
geriatric and obstetric trauma considerations. Additional sections
include cultural humility, trauma-informed care, disaster
management, and post-resuscitation complications. Designed for
nurses preparing for TNCC certification, it offers detailed Q&A
explanations aligned with ENA guidelines.
Exam Questions and Answers
40. Describe why trauma to the ab/pelvis can cause significant
hemorrhage.--- correct precise answer --- -
major vessels in ab/pelvic cavities
41. What equipment may be used to stabilize a suspected or
known pelvic fracture?--- correct precise answer --- pelvic binder
42. What assessment finding is a contraindication to inserting an
indwelling catheter?--- correct precise answer --- - blood in the
meatus
- severe urethral injuries
,43. How can a FAST exam be used to help direct appropriate
interventions?--- correct precise answer --- help identify
pathological fluid in abdominal/pelvic cavity
44. When is resuscitative endovascular balloon occulsion of the
aorta (REBOA) used?--- correct precise answer --- - hemorrhage
control at noncompressible torso sites below diaphragm
- ruptured aortic aneurysm
- postpartum bleeding
- hypotension from hemorrhagic shock
45. What are contraindications for REBOA?--- correct precise
answer --- - traumatic aortic injury
- hemorrhage proximal to zones of occlusion
- PEA > 10 minutes
- terminal illness
46. What are the characteristics of anterior -posterior
compression fracture?--- correct precise answer --- - produces
external rotation of hemipelvis
- separation of the symphysis pubis that tears the posterior
ligaments
- disrupted pelvic ring tears posterior plexus and brances of
iliac arterial system
- high incidence of vascular injury and hemorrhage
,47. What are the characteristics of a lateral compression
fracture?--- correct precise answer --- - lateral force is directed
into the pelvis
- hemipelvis rotates internally reducing pelvic volume and
injuring pelvic vascular structure resulting in hemorrhage
- most common type of fracture
48. What are the characteristics of a vertical shear fracture?---
correct precise answer --- - occurs secondary to falls when the
sacroiliac joint is vertically displaced
- iliac vasculature is disrupted and may result in severe
hemorrhage
- high incidence of vascular injury and hemorrhage
49. What interventions can be anticipated for suspected
compartment syn- drome?--- correct precise answer --- - frequent
assessment
- continuous measurement of intramuscular pressure
- is a predictor of need for faciotomy
- perfusion of > 20 hg for more than 2 hours = 93 % positive
predictive value
- faciotomy
- if perfusion pressure is < 30 hg
50. What is the difference between a primary and secondary
injury in spinal cord trauma?--- correct precise answer --- primary
- initial mechanical damage to the spinal cord secondary
, - resulting from biochemical/cellular reactions that cause
inflammation of tissues - can lead to permanent loss of function
w/out proper interventions
51. What is the difference between spinal and neurogenic shock?--
- correct precise answer --- spinal
- occurs when normal activity in spinal cord at/below injury
ceases b/c of disruption/inhibition of impulses in spinal cord
neurogenic
- occurs when high thoracic or cervical damage to spinal cord
results in abrupt disruption of sympathetic innervation and
regulation of vasomotor and vagal tone - producing loss of vascular
resistance and dilation
52. What are the levels of burn depth?--- correct precise answer -
-- - superficial (1st degree)
- superficial partial thickness (2nd degree)
- deep partial thickness (2nd degree)
- full thickness (3rd/4th degree)
53. Describe the methods to estimate extent of burn injuries.---
correct precise answer --- Lund & Browder
- age/burned area Rule of 9s
- divides body into areas of 9% or multiples of 9% (except
perineum 1%) Rule of palms
- measure small/ scattered burns - patient palm = 1%