TNCC 9TH REAL EXAM WITH 250
MULTIPLE CHOICE QUESTIONS AND
ANSWERS EACH | EXPERT VERIFIED
DETAILED ANSWERS | GUARANTEED PASS
| ALREADY GRADED A+
Each question addresses a distinct clinical scenario, injury pattern, or intervention, systematically
exploring all components of the Trauma Nursing Process. Topics include primary and secondary
surveys, airway and breathing management, circulation and hemorrhage control, disability and
neurologic assessment, and exposure. The questions cover specific injuries (head, chest,
abdomen, pelvic, spinal, extremity, burns), shock types (hemorrhagic, neurogenic, obstructive,
cardiogenic, spinal), special populations (pregnant, pediatric, older adult, obese), complications
(compartment syndrome, DIC, fat embolism, autonomic dysreflexia, rhabdomyolysis),
pharmacology, fluid resuscitation, mnemonics (ABCDE, AMPLE, AVPU, START), and
psychosocial aspects. Calculations for CPP and GCS interpretation are included. All questions
are unique, providing thorough preparation for TNCC certification.
1. A trauma patient involved in a high-speed motor vehicle collision has snoring
respirations. What is the most appropriate initial action?
A) Insert an oropharyngeal airway
B) Perform a jaw-thrust maneuver
C) Prepare for endotracheal intubation
D) Apply oxygen via a non-rebreather mask
Answer: B
Rationale: Snoring respirations indicate a partial airway obstruction, often from the
tongue. The jaw-thrust maneuver opens the airway while maintaining cervical
spine precautions, which is critical in trauma patients. An oropharyngeal airway
may be used as a secondary adjunct after the jaw thrust.
1
,2. Which of the following patients is most likely experiencing functional grief?
A) A patient who lost their home in a fire
B) A patient with a new below-knee amputation
C) A patient whose spouse died in the crash
D) A patient whose car was destroyed in the collision
Answer: B
Rationale: Functional grief is associated with the loss of body function or body
parts, such as amputation, paralysis, or loss of sight. This is distinct from grief
related to the loss of a person, home, or possession.
3. When should the definitive calculation for intravenous fluid resuscitation be
performed for a patient with burns?
A) As soon as the patient arrives
B) After removal of clothing
C) Only at a burn center
D) During the circulation assessment
Answer: B
Rationale: An accurate total body surface area (TBSA) burned assessment,
required for the Parkland formula, requires complete visualization of the skin. This
can only be accurately calculated after all clothing has been removed to see the full
extent of the burns.
4. A patient with a lower extremity fracture complains of severe pain and tightness
in the calf, which is minimally relieved by pain medications. What is the priority
nursing intervention?
A) Elevating the leg above the level of the heart
B) Repositioning the leg and applying ice
2
,C) Elevating the leg to the level of the heart
D) Preparing the patient for ultrasound of the leg
Answer: C
Rationale: This patient is exhibiting signs of possible compartment syndrome, a
dangerous complication of fractures. The pain is often out of proportion to the
injury. The limb should be elevated to the level of the heart to decrease dependent
edema without increasing venous congestion and compartment pressure, which can
happen if elevated above the heart.
5. An adult patient with a severe head trauma has been intubated and is being
manually ventilated at 18 breaths/min. The PaCO2 is 30 mm Hg, and the SpO2 is
92%. What is the most important intervention to manage cerebral blood flow?
A) Decrease the rate of manual ventilation
B) Initiate another fluid bolus
C) Recheck endotracheal tube placement
D) Increase the amount of oxygen delivered
Answer: A
Rationale: A PaCO2 of 30 mm Hg is below the target of 35-45 mm Hg for a
patient with a traumatic brain injury. This low level causes cerebral
vasoconstriction, decreasing cerebral blood flow and potentially causing secondary
brain injury. The priority is to reduce the ventilation rate to allow the PaCO2 to
rise.
6. A patient is brought to the emergency department of a rural hospital following a
high-speed motor vehicle collision. When significant abdominal and pelvic injuries
are noted in the primary survey, what is the priority intervention?
A) Initiate transfer to a trauma center
B) Attempt family notification
C) Obtain additional imaging studies
3
, D) Place an indwelling urinary catheter
Answer: A
Rationale: Rural hospitals may lack the immediate surgical or interventional
radiology capabilities required to manage life-threatening hemorrhage from
abdominal and pelvic injuries. Early transfer to a designated trauma center is the
priority to ensure the patient receives definitive care.
7. An adult who fell from a second-story roof is brought to the emergency
department by private vehicle. The patient is confused with unlabored respirations
and strong radial pulses. There is an open wound near an obvious deformity of the
left lower extremity. What is the priority intervention?
A) Initiate cervical spine stabilization
B) Apply a splint to the lower extremity
C) Put the patient on portable oxygen
D) Log roll the patient onto a spine board
Answer: A
Rationale: A fall from a significant height, combined with an altered mental status,
warrants the presumption of a cervical spine injury until proven otherwise. The
priority is to initiate manual in-line stabilization as part of the primary survey and
airway management.
8. What is the most important consideration during the initial assessment when
caring for an older adult who has sustained serious injuries?
A) They are likely to be fearful in the emergency department
B) Medical history including current medications
C) Availability of support systems after discharge
D) Accessibility to a primary care physician
Answer: B
4
MULTIPLE CHOICE QUESTIONS AND
ANSWERS EACH | EXPERT VERIFIED
DETAILED ANSWERS | GUARANTEED PASS
| ALREADY GRADED A+
Each question addresses a distinct clinical scenario, injury pattern, or intervention, systematically
exploring all components of the Trauma Nursing Process. Topics include primary and secondary
surveys, airway and breathing management, circulation and hemorrhage control, disability and
neurologic assessment, and exposure. The questions cover specific injuries (head, chest,
abdomen, pelvic, spinal, extremity, burns), shock types (hemorrhagic, neurogenic, obstructive,
cardiogenic, spinal), special populations (pregnant, pediatric, older adult, obese), complications
(compartment syndrome, DIC, fat embolism, autonomic dysreflexia, rhabdomyolysis),
pharmacology, fluid resuscitation, mnemonics (ABCDE, AMPLE, AVPU, START), and
psychosocial aspects. Calculations for CPP and GCS interpretation are included. All questions
are unique, providing thorough preparation for TNCC certification.
1. A trauma patient involved in a high-speed motor vehicle collision has snoring
respirations. What is the most appropriate initial action?
A) Insert an oropharyngeal airway
B) Perform a jaw-thrust maneuver
C) Prepare for endotracheal intubation
D) Apply oxygen via a non-rebreather mask
Answer: B
Rationale: Snoring respirations indicate a partial airway obstruction, often from the
tongue. The jaw-thrust maneuver opens the airway while maintaining cervical
spine precautions, which is critical in trauma patients. An oropharyngeal airway
may be used as a secondary adjunct after the jaw thrust.
1
,2. Which of the following patients is most likely experiencing functional grief?
A) A patient who lost their home in a fire
B) A patient with a new below-knee amputation
C) A patient whose spouse died in the crash
D) A patient whose car was destroyed in the collision
Answer: B
Rationale: Functional grief is associated with the loss of body function or body
parts, such as amputation, paralysis, or loss of sight. This is distinct from grief
related to the loss of a person, home, or possession.
3. When should the definitive calculation for intravenous fluid resuscitation be
performed for a patient with burns?
A) As soon as the patient arrives
B) After removal of clothing
C) Only at a burn center
D) During the circulation assessment
Answer: B
Rationale: An accurate total body surface area (TBSA) burned assessment,
required for the Parkland formula, requires complete visualization of the skin. This
can only be accurately calculated after all clothing has been removed to see the full
extent of the burns.
4. A patient with a lower extremity fracture complains of severe pain and tightness
in the calf, which is minimally relieved by pain medications. What is the priority
nursing intervention?
A) Elevating the leg above the level of the heart
B) Repositioning the leg and applying ice
2
,C) Elevating the leg to the level of the heart
D) Preparing the patient for ultrasound of the leg
Answer: C
Rationale: This patient is exhibiting signs of possible compartment syndrome, a
dangerous complication of fractures. The pain is often out of proportion to the
injury. The limb should be elevated to the level of the heart to decrease dependent
edema without increasing venous congestion and compartment pressure, which can
happen if elevated above the heart.
5. An adult patient with a severe head trauma has been intubated and is being
manually ventilated at 18 breaths/min. The PaCO2 is 30 mm Hg, and the SpO2 is
92%. What is the most important intervention to manage cerebral blood flow?
A) Decrease the rate of manual ventilation
B) Initiate another fluid bolus
C) Recheck endotracheal tube placement
D) Increase the amount of oxygen delivered
Answer: A
Rationale: A PaCO2 of 30 mm Hg is below the target of 35-45 mm Hg for a
patient with a traumatic brain injury. This low level causes cerebral
vasoconstriction, decreasing cerebral blood flow and potentially causing secondary
brain injury. The priority is to reduce the ventilation rate to allow the PaCO2 to
rise.
6. A patient is brought to the emergency department of a rural hospital following a
high-speed motor vehicle collision. When significant abdominal and pelvic injuries
are noted in the primary survey, what is the priority intervention?
A) Initiate transfer to a trauma center
B) Attempt family notification
C) Obtain additional imaging studies
3
, D) Place an indwelling urinary catheter
Answer: A
Rationale: Rural hospitals may lack the immediate surgical or interventional
radiology capabilities required to manage life-threatening hemorrhage from
abdominal and pelvic injuries. Early transfer to a designated trauma center is the
priority to ensure the patient receives definitive care.
7. An adult who fell from a second-story roof is brought to the emergency
department by private vehicle. The patient is confused with unlabored respirations
and strong radial pulses. There is an open wound near an obvious deformity of the
left lower extremity. What is the priority intervention?
A) Initiate cervical spine stabilization
B) Apply a splint to the lower extremity
C) Put the patient on portable oxygen
D) Log roll the patient onto a spine board
Answer: A
Rationale: A fall from a significant height, combined with an altered mental status,
warrants the presumption of a cervical spine injury until proven otherwise. The
priority is to initiate manual in-line stabilization as part of the primary survey and
airway management.
8. What is the most important consideration during the initial assessment when
caring for an older adult who has sustained serious injuries?
A) They are likely to be fearful in the emergency department
B) Medical history including current medications
C) Availability of support systems after discharge
D) Accessibility to a primary care physician
Answer: B
4
