TNCC Exam 8th edition study guide
exam questions with 100% correct
answers
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - Answer-
Haemoglobin does not readily release oxygen for use by the tissues A shift to the left
occurs in an environment of low metabolic demand (hypothermia, hypocapnia,
alkalosis), increasing haemoglobin’s affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS
reports significant damage to the driver's side of the car. The patient is asking to have
the cervical collar removed. When it is appropriate to remove the cervical collar? -
Answer-After a physical examination if the patient has no radiologic abnormalities on CT
A CT is recommended for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to the
entire surface of both upper extremities and superficial burns to the anterior chest.
Using the modified Lund and Browder chart to calculate the total body surface area
burned, how much IV fluid would be administered in the first 8 hours? - Answer-2280
mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2
* 120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not
included in the TBSA calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy
connected to a chest drainage system - Answer-Fluctuation in the water seal chamber
Fluctuation in the water seal chamber indicates the tube is placed correctly in the
pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is
suspected? - Answer-Globe rupture A teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? - Answer-Bradycardia and absent motor
function below the level of injury Patients with a complete spinal cord injury will have
absent motor function below the level of the lesion. They become hypotensive and
bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - Answer-A 52-year-
old diabetic male with a partial-thickness burn to the left lower leg This patient has a 7%
TBSA burn with a preexisting medical history that could complicate management,
prolong recovery, or affect mortality.
, 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? - Answer-Placental abruption The findings of abdominal
pain, elevated fundal height, dark bloody show, and fatal distress are most consistent
with placental abruption.
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? - Answer-Straight catheter for
urine sample Insertion of a urinary catheter is contraindicated if urethral transection is
suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? -
Answer-The aorta is torn at its attachment with the ligamentum arteriosum This occurs
during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT
which of the following? - Answer-Defusings A defusing is part of critical incident stress
management but is not considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient
with massive uncontrolled hemorrhage? - Answer-MARCH The MARCH mnemonic
stands for massive hemorrhage, airway, respiration, circulation, and head
injury/hypothermia. The MARCH mnemonic recognizes uncontrolled hemorrhage as the
major cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house
fire. Calculating total body surface area (TBSA) burned is deferred due to the need for
emergent intubation. At what rate should you begin fluid resuscitation? - Answer-500
mL/hour Prior to calculating TBSA, this is the recommended starting point for fluid
resuscitation for patients 14 years of age and older
A 49-year-old restrained driver 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? - Answer-Diagnostic peritoneal lavage Diagnostic
peritoneal lavage is indicated for hemodynamically unstable patients or if FAST and CT
are not available.
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
exam questions with 100% correct
answers
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve - Answer-
Haemoglobin does not readily release oxygen for use by the tissues A shift to the left
occurs in an environment of low metabolic demand (hypothermia, hypocapnia,
alkalosis), increasing haemoglobin’s affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS
reports significant damage to the driver's side of the car. The patient is asking to have
the cervical collar removed. When it is appropriate to remove the cervical collar? -
Answer-After a physical examination if the patient has no radiologic abnormalities on CT
A CT is recommended for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to the
entire surface of both upper extremities and superficial burns to the anterior chest.
Using the modified Lund and Browder chart to calculate the total body surface area
burned, how much IV fluid would be administered in the first 8 hours? - Answer-2280
mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 * 2
* 120 = 4560 mL. Half of the total is equal to 2280 mL. Superficial burns are not
included in the TBSA calculation for fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy
connected to a chest drainage system - Answer-Fluctuation in the water seal chamber
Fluctuation in the water seal chamber indicates the tube is placed correctly in the
pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is
suspected? - Answer-Globe rupture A teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? - Answer-Bradycardia and absent motor
function below the level of injury Patients with a complete spinal cord injury will have
absent motor function below the level of the lesion. They become hypotensive and
bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center? - Answer-A 52-year-
old diabetic male with a partial-thickness burn to the left lower leg This patient has a 7%
TBSA burn with a preexisting medical history that could complicate management,
prolong recovery, or affect mortality.
, 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? - Answer-Placental abruption The findings of abdominal
pain, elevated fundal height, dark bloody show, and fatal distress are most consistent
with placental abruption.
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? - Answer-Straight catheter for
urine sample Insertion of a urinary catheter is contraindicated if urethral transection is
suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash? -
Answer-The aorta is torn at its attachment with the ligamentum arteriosum This occurs
during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT
which of the following? - Answer-Defusings A defusing is part of critical incident stress
management but is not considered a critical communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient
with massive uncontrolled hemorrhage? - Answer-MARCH The MARCH mnemonic
stands for massive hemorrhage, airway, respiration, circulation, and head
injury/hypothermia. The MARCH mnemonic recognizes uncontrolled hemorrhage as the
major cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house
fire. Calculating total body surface area (TBSA) burned is deferred due to the need for
emergent intubation. At what rate should you begin fluid resuscitation? - Answer-500
mL/hour Prior to calculating TBSA, this is the recommended starting point for fluid
resuscitation for patients 14 years of age and older
A 49-year-old restrained driver 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? - Answer-Diagnostic peritoneal lavage Diagnostic
peritoneal lavage is indicated for hemodynamically unstable patients or if FAST and CT
are not available.
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
