TNCC 9th Edition Exam Questions and
Answers (Verified Answers) (Latest Update)
Question 1
A patient is brought to the ED following a snowmobile crash with prolonged exposure
time prior to transport. The patient is confused. Vitals are BP 96/54, HR 114, RR 24, T
34.6C (94.2F) and an SpO2 90% on oxygen at 15L per non-rebreather mask. Other
findings include ETCO2 24, serum lactate 6 mmol/L, and pH 6.8. Based on these
findings, what is the most appropriate intervention?
a) initiate warming measures
b) titrate oxygen to 6L per nasal cannula
bolus with 500 mL isotonic crytstalloids
d) vigorously massage the extremities
Correct Answer
a) initate warming measures
This patient is exhibiting signs of hypothermia. This is a low metabolic environment
and causes a shift to the left in the oxyhemoglobin dissociation curve causing an
increase in hemoglobin's affinity for oxygen, making it harder to release bound
oxygen to the tissues. Warming the patient will shift the curve back and allow
oxygen to be released and help normalize those values.
Question 2
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which
finding is consistent with spinal shock?
a) bradycardia
b) loss of reflexes
c) widened pulse pressure
d) warm skin
Correct Answer
b) loss of reflexes
Page 1 of 72
,Question 3
A patient arrives with a 3-inch laceration to their forearm from a tree branch. Which of
the following methods will the nurse use to remove small pieces of bark and debris
from the wound?
a) low pressure irrigation
b) high pressure irrigation
c) scrubbing with normal saline
d) scrubbing with tap water
Correct Answer
b) high pressure irrigation
low pressure irrigation used for larger wounds
Question 4
An adult patient was a restrained passenger involved in a high-speed motor vehicle
collision. The patient complained of a generalized abdominal and left leg pain. A FAST
exam was negative for fluid in the abdominal cavity with rebound tenderness, fever,
and an elevated white blood cell count. These findings are most consistent with an
injury to which organ?
a) spleen
b) kidney
c) small bowel
d) liver
Correct Answer
c) small bowel
Hollow organs such as the small bowel are susceptible to blunt trauma and can leak
contents into the peritoneum. Restrained occupants of motor vehicles are at a
higher risk from seatbelts, which compress the anterior-lying hollow organs.
Diagnosis is often delayed until symptoms of peritoneal irritation develop, which
include fever, leukocytosis, and rebound tenderness
Page 2 of 72
,Question 5
A trauma patient is restless and repeatedly asking "where am i?" Vital signs upon
arrival were BP 110/60, HR 96 bpm, RR 24 bpm. Skin is cool and moist. Current vitals
are BP 86/68, HR 118 bpm, RR 28 bpm. The patient is demonstrating signs and
symptoms of which stage of shock?
a) compensated
b) refractory
c) irreversible
d) decompensated
Correct Answer
d) decompensated
Question 6
A patient is brought to the ED following a motor vehicle rollover and is complaining
of left upper abdominal pain and left shoulder pain. This presentation is most
consistent with an injury to which organ?
a) kidney
b) liver
c) spleen
d) pancreas
Correct Answer
c) spleen
Question 7
In a motor vehicle collision, which injury pathway is most likely to increase the
patient's morbidity and mortality?
a) rotational
b) ejection
c) lateral
d) rollover
Correct Answer
b) ejection
Page 3 of 72
, Question 8
What is the rationale for obtaining serum lactate level during the initial assessment of
a trauma patient?
a) measures oxygenation and ventilation
b) assesses the degree of alkalosis and base deficit
c) gauges end-organ perfusion and tissue hypoxemia
d) determines underlying cause of shock
Correct Answer
c) gauges end-organ perfusion and tissue hypoxemia
Question 9
While caring for a trauma patient in the ED, what finding raises suspicion of complete
spinal cord injury?
a) weakness in the lower extremities
b) urinary incontinence
c) sacral sparing
d) spastic paralysis of the legs
Correct Answer
b) urinary incontinence
with complete spinal lesion, all motor and sensory function below the level of the
lesion is lost. Loss of autonomic nervous system response leads to bradycardia,
hypotension, and loss of bowel and bladder function
Question 10
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill.
Which of the following interventions would be most appropriate for this patient
based on the disaster triage principle?
a) initiate two large-caliber IV lines for isotonic crystalloid administration
b) administer IV meds for pain
c) place the patient in an observation area for care within the next few hours
d) contact the command center for personnel to notify next of kin
Correct Answer
a) initiate two large-caliber IV lines for isotonic crystalloid administration
Page 4 of 72
Answers (Verified Answers) (Latest Update)
Question 1
A patient is brought to the ED following a snowmobile crash with prolonged exposure
time prior to transport. The patient is confused. Vitals are BP 96/54, HR 114, RR 24, T
34.6C (94.2F) and an SpO2 90% on oxygen at 15L per non-rebreather mask. Other
findings include ETCO2 24, serum lactate 6 mmol/L, and pH 6.8. Based on these
findings, what is the most appropriate intervention?
a) initiate warming measures
b) titrate oxygen to 6L per nasal cannula
bolus with 500 mL isotonic crytstalloids
d) vigorously massage the extremities
Correct Answer
a) initate warming measures
This patient is exhibiting signs of hypothermia. This is a low metabolic environment
and causes a shift to the left in the oxyhemoglobin dissociation curve causing an
increase in hemoglobin's affinity for oxygen, making it harder to release bound
oxygen to the tissues. Warming the patient will shift the curve back and allow
oxygen to be released and help normalize those values.
Question 2
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which
finding is consistent with spinal shock?
a) bradycardia
b) loss of reflexes
c) widened pulse pressure
d) warm skin
Correct Answer
b) loss of reflexes
Page 1 of 72
,Question 3
A patient arrives with a 3-inch laceration to their forearm from a tree branch. Which of
the following methods will the nurse use to remove small pieces of bark and debris
from the wound?
a) low pressure irrigation
b) high pressure irrigation
c) scrubbing with normal saline
d) scrubbing with tap water
Correct Answer
b) high pressure irrigation
low pressure irrigation used for larger wounds
Question 4
An adult patient was a restrained passenger involved in a high-speed motor vehicle
collision. The patient complained of a generalized abdominal and left leg pain. A FAST
exam was negative for fluid in the abdominal cavity with rebound tenderness, fever,
and an elevated white blood cell count. These findings are most consistent with an
injury to which organ?
a) spleen
b) kidney
c) small bowel
d) liver
Correct Answer
c) small bowel
Hollow organs such as the small bowel are susceptible to blunt trauma and can leak
contents into the peritoneum. Restrained occupants of motor vehicles are at a
higher risk from seatbelts, which compress the anterior-lying hollow organs.
Diagnosis is often delayed until symptoms of peritoneal irritation develop, which
include fever, leukocytosis, and rebound tenderness
Page 2 of 72
,Question 5
A trauma patient is restless and repeatedly asking "where am i?" Vital signs upon
arrival were BP 110/60, HR 96 bpm, RR 24 bpm. Skin is cool and moist. Current vitals
are BP 86/68, HR 118 bpm, RR 28 bpm. The patient is demonstrating signs and
symptoms of which stage of shock?
a) compensated
b) refractory
c) irreversible
d) decompensated
Correct Answer
d) decompensated
Question 6
A patient is brought to the ED following a motor vehicle rollover and is complaining
of left upper abdominal pain and left shoulder pain. This presentation is most
consistent with an injury to which organ?
a) kidney
b) liver
c) spleen
d) pancreas
Correct Answer
c) spleen
Question 7
In a motor vehicle collision, which injury pathway is most likely to increase the
patient's morbidity and mortality?
a) rotational
b) ejection
c) lateral
d) rollover
Correct Answer
b) ejection
Page 3 of 72
, Question 8
What is the rationale for obtaining serum lactate level during the initial assessment of
a trauma patient?
a) measures oxygenation and ventilation
b) assesses the degree of alkalosis and base deficit
c) gauges end-organ perfusion and tissue hypoxemia
d) determines underlying cause of shock
Correct Answer
c) gauges end-organ perfusion and tissue hypoxemia
Question 9
While caring for a trauma patient in the ED, what finding raises suspicion of complete
spinal cord injury?
a) weakness in the lower extremities
b) urinary incontinence
c) sacral sparing
d) spastic paralysis of the legs
Correct Answer
b) urinary incontinence
with complete spinal lesion, all motor and sensory function below the level of the
lesion is lost. Loss of autonomic nervous system response leads to bradycardia,
hypotension, and loss of bowel and bladder function
Question 10
A patient is thrown against a car during a tornado and presents with obvious bilateral
femoral fractures. The patient is pale, alert, disoriented, and has delayed cap refill.
Which of the following interventions would be most appropriate for this patient
based on the disaster triage principle?
a) initiate two large-caliber IV lines for isotonic crystalloid administration
b) administer IV meds for pain
c) place the patient in an observation area for care within the next few hours
d) contact the command center for personnel to notify next of kin
Correct Answer
a) initiate two large-caliber IV lines for isotonic crystalloid administration
Page 4 of 72
