TPATC CERTIFICATION REAL EXAM 2026 | 150
QUESTIONS, ANSWERS, AND RATIONALES |
TRANSPORT TRAUMA COURSE STUDY GUIDE |
INSTANT PDF DOWNLOAD
Q1.
A 34-year-old male is brought in by ambulance after a high-speed motor vehicle collision.
He is unconscious, has snoring respirations, visible facial trauma, and suspected cervical
spine injury. The trauma team has not yet intubated him. The nurse notes oxygen saturation
is dropping rapidly on room air. What is the priority action the nurse should perform
immediately while maintaining spinal precautions?
A. Insert an oropharyngeal airway and begin bag-valve-mask ventilation with 100%
oxygen
B. Place the patient in Trendelenburg position to improve cerebral perfusion
C. Obtain a full set of vital signs and document baseline findings
D. Prepare the patient for CT scan of the head and cervical spine
Answer: A. Insert an oropharyngeal airway and begin bag-valve-mask ventilation with
100% oxygen
**Rationale: The patient is showing airway obstruction with declining oxygenation. In
trauma, airway is the highest priority. Because the patient is unconscious and has no gag
reflex, an oropharyngeal airway plus bag-valve-mask ventilation with 100% oxygen is
required immediately. Cervical spine precautions must be maintained.
Q2.
A 28-year-old female is admitted after being trapped in a collapsed building for several
hours. On arrival, she is pale, diaphoretic, tachycardic at 132 bpm, and hypotensive at
82/40 mmHg. Her extremities are cool, and capillary refill is delayed. The nurse suspects
internal bleeding but no obvious external hemorrhage is present. What is the priority
nursing intervention at this time?
A. Apply warming blankets and monitor temperature closely
B. Initiate two large-bore IV lines and begin rapid infusion of isotonic crystalloid
, solution
C. Prepare the patient for MRI to identify internal injuries
D. Encourage oral fluids to restore circulating volume
Answer: B. Initiate two large-bore IV lines and begin rapid infusion of isotonic
crystalloid solution
**Rationale: The patient is in hypovolemic shock, likely from internal hemorrhage.
Immediate vascular access and rapid fluid resuscitation are priority actions to restore
perfusion and prevent cardiovascular collapse.
Q3.
A trauma patient arrives with asymmetric chest rise, absent breath sounds on the right side,
severe respiratory distress, and tracheal deviation to the left. Blood pressure is 78/50 mmHg
and heart rate is 138 bpm. The nurse recognizes a life-threatening condition. What is the
most appropriate immediate intervention before diagnostic imaging?
A. Obtain a portable chest X-ray
B. Prepare for thoracotomy in the operating room
C. Perform needle decompression of the right chest
D. Administer IV antibiotics for possible infection
Answer: C. Perform needle decompression of the right chest
**Rationale: The patient has classic signs of tension pneumothorax, which is immediately
life-threatening. Needle decompression must be performed without waiting for imaging.
Q4.
A 42-year-old male presents with a suspected traumatic brain injury after falling from a
construction scaffold. He is increasingly confused, has a worsening headache, and now
demonstrates unequal pupils with sluggish reaction on the left side. Vital signs show rising
blood pressure and decreasing heart rate. What condition is most concerning, and what is
the priority nursing response?
A. Stroke; prepare for thrombolytic therapy
B. Increased intracranial pressure; notify provider and prepare for emergency
neuroimaging and airway protection
QUESTIONS, ANSWERS, AND RATIONALES |
TRANSPORT TRAUMA COURSE STUDY GUIDE |
INSTANT PDF DOWNLOAD
Q1.
A 34-year-old male is brought in by ambulance after a high-speed motor vehicle collision.
He is unconscious, has snoring respirations, visible facial trauma, and suspected cervical
spine injury. The trauma team has not yet intubated him. The nurse notes oxygen saturation
is dropping rapidly on room air. What is the priority action the nurse should perform
immediately while maintaining spinal precautions?
A. Insert an oropharyngeal airway and begin bag-valve-mask ventilation with 100%
oxygen
B. Place the patient in Trendelenburg position to improve cerebral perfusion
C. Obtain a full set of vital signs and document baseline findings
D. Prepare the patient for CT scan of the head and cervical spine
Answer: A. Insert an oropharyngeal airway and begin bag-valve-mask ventilation with
100% oxygen
**Rationale: The patient is showing airway obstruction with declining oxygenation. In
trauma, airway is the highest priority. Because the patient is unconscious and has no gag
reflex, an oropharyngeal airway plus bag-valve-mask ventilation with 100% oxygen is
required immediately. Cervical spine precautions must be maintained.
Q2.
A 28-year-old female is admitted after being trapped in a collapsed building for several
hours. On arrival, she is pale, diaphoretic, tachycardic at 132 bpm, and hypotensive at
82/40 mmHg. Her extremities are cool, and capillary refill is delayed. The nurse suspects
internal bleeding but no obvious external hemorrhage is present. What is the priority
nursing intervention at this time?
A. Apply warming blankets and monitor temperature closely
B. Initiate two large-bore IV lines and begin rapid infusion of isotonic crystalloid
, solution
C. Prepare the patient for MRI to identify internal injuries
D. Encourage oral fluids to restore circulating volume
Answer: B. Initiate two large-bore IV lines and begin rapid infusion of isotonic
crystalloid solution
**Rationale: The patient is in hypovolemic shock, likely from internal hemorrhage.
Immediate vascular access and rapid fluid resuscitation are priority actions to restore
perfusion and prevent cardiovascular collapse.
Q3.
A trauma patient arrives with asymmetric chest rise, absent breath sounds on the right side,
severe respiratory distress, and tracheal deviation to the left. Blood pressure is 78/50 mmHg
and heart rate is 138 bpm. The nurse recognizes a life-threatening condition. What is the
most appropriate immediate intervention before diagnostic imaging?
A. Obtain a portable chest X-ray
B. Prepare for thoracotomy in the operating room
C. Perform needle decompression of the right chest
D. Administer IV antibiotics for possible infection
Answer: C. Perform needle decompression of the right chest
**Rationale: The patient has classic signs of tension pneumothorax, which is immediately
life-threatening. Needle decompression must be performed without waiting for imaging.
Q4.
A 42-year-old male presents with a suspected traumatic brain injury after falling from a
construction scaffold. He is increasingly confused, has a worsening headache, and now
demonstrates unequal pupils with sluggish reaction on the left side. Vital signs show rising
blood pressure and decreasing heart rate. What condition is most concerning, and what is
the priority nursing response?
A. Stroke; prepare for thrombolytic therapy
B. Increased intracranial pressure; notify provider and prepare for emergency
neuroimaging and airway protection
