TNCC Test 2026/2027 Actual Final
Exam Test Bank | 100 Complete Expert
Questions and Correct Answers
graded A+
1. A 56-year-old male involved in a motor vehicle crash is brought to a rural ED.
He complains of neck pain, SOB, and diffuse abdominal pain. GCS 15. Vital
signs: BP 98/71, HR 125, RR 26, SpO₂ 94% on high-flow O₂. What is the priority
intervention?
• Answer: Expedite transfer to the closest trauma center
• Rationale: This patient shows signs of hemorrhagic shock (tachycardia,
hypotension, tachypnea) from a high-energy mechanism. Rural facilities often
lack resources for definitive trauma care, so early transfer is critical for survival.
2. Which of the following is the most important consideration when caring for a
geriatric trauma patient?
• Answer: A pertinent medical history is crucial
• Rationale: Geriatric patients often have multiple comorbidities and age-
related physiologic changes that can mask or exacerbate trauma.
3. Why is a measure of serum lactate obtained in the initial assessment of the
trauma patient?
• Answer: To gauge end-organ perfusion and tissue hypoxia
• Rationale: Elevated serum lactate is a marker of inadequate tissue perfusion
and anaerobic metabolism, indicating shock and the need for aggressive
resuscitation.
4. A trauma patient is restless and repeatedly asking "where am I?" Vital signs
upon arrival: BP 110/60, HR 96, RR 24. Her skin is cool and dry. Current VS are
BP 104/84, HR 108, RR 28. The patient is demonstrating signs of which stage of
shock?
• Answer: Compensated shock
• Rationale: In compensated shock, the body maintains near-normal blood
pressure through vasoconstriction and tachycardia. Restlessness and cool skin
are early signs.
,5. 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 capillary refill. Which intervention is most appropriate?
• Answer: Initiate two large-caliber intravenous lines for Ringer's lactate
solution administration
• Rationale: This patient is in hemorrhagic shock and requires immediate fluid
resuscitation with two large-bore IV lines.
6. What is the most reliable sign of a tension pneumothorax?
• Answer: A shift of the trachea to the opposite side and decreased/absent
breath sounds on the affected side.
• Rationale: Tension pneumothorax causes air to accumulate in the pleural
space, shifting mediastinal structures away from the affected side.
7. In a patient with a suspected pelvic fracture, what is a priority nursing
intervention?
• Answer: Stabilize the pelvis (e.g., with a pelvic binder) and assess for signs of
retroperitoneal hemorrhage.
8. A patient with a spinal cord injury at C5 is being cared for in the ED while
awaiting transport. Which of the following represents the highest priority for
ongoing assessment and management?
• Answer: Maintain adequate respiratory status
• Rationale: Injuries at C3-C5 can cause loss of phrenic nerve function, resulting
in a paralyzed diaphragm and inability to breathe. Maintenance of respiratory
function is the highest priority.
9. What is the best position for maintaining an open airway in an obese patient?
• Answer: Reverse Trendelenburg.
• Rationale: This position helps reduce pressure from abdominal contents on
the diaphragm and can improve ventilation and airway management.
10. An adult patient sustained a knife injury to the neck. The airway is intact
and the patient is hemodynamically stable. They complain of difficulty
swallowing and speaking. What is the most likely cause?
• Answer: Damage to the cervical spine
• Rationale: Penetrating neck trauma may include concurrent injuries to the
cervical spine and cord, airway, or vascular neck structures.
, 11. What is the leading cause of preventable death for the trauma patient in the
prehospital environment?
• Answer: Uncontrolled external hemorrhage.
12. A patient arrives at the ED by private vehicle after sustaining an injury to
the right lower extremity. There is a large gaping wound with significant
bleeding. What is the priority intervention?
• Answer: Apply direct pressure to the wound.
13. In a patient with severe traumatic brain injury, hypocapnia causes which
condition?
• Answer: Cerebral vasoconstriction
• Rationale: Hypocapnia causes vasoconstriction, especially in the cerebral
vasculature, which can reduce cerebral blood flow.
14. What is the best measure of the adequacy of cellular perfusion and can help
predict the outcome of resuscitation?
• Answer: Base deficit
• Rationale: Base deficit serves as an endpoint measurement of the adequacy
of cellular perfusion and, when used in conjunction with serum lactate, helps
predict the success of resuscitation.
15. What technique is most appropriate when obtaining a history from a
trauma patient?
• Answer: Applying active listening.
16. Following a review of recent drills and a real disaster event, a hospital has
identified deficiencies and is taking steps to minimize the impact of a future
disaster. Which phase of the disaster life cycle does this describe?
• Answer: Mitigation.
17. Using the American College of Surgeons screening guidelines, which
assessment finding would prompt the nurse to prepare the patient for
radiologic spine clearance?
• Answer: Alert with no neurological deficits.
18. What is the effect of hypothermia on the oxyhemoglobin dissociation
curve?
Exam Test Bank | 100 Complete Expert
Questions and Correct Answers
graded A+
1. A 56-year-old male involved in a motor vehicle crash is brought to a rural ED.
He complains of neck pain, SOB, and diffuse abdominal pain. GCS 15. Vital
signs: BP 98/71, HR 125, RR 26, SpO₂ 94% on high-flow O₂. What is the priority
intervention?
• Answer: Expedite transfer to the closest trauma center
• Rationale: This patient shows signs of hemorrhagic shock (tachycardia,
hypotension, tachypnea) from a high-energy mechanism. Rural facilities often
lack resources for definitive trauma care, so early transfer is critical for survival.
2. Which of the following is the most important consideration when caring for a
geriatric trauma patient?
• Answer: A pertinent medical history is crucial
• Rationale: Geriatric patients often have multiple comorbidities and age-
related physiologic changes that can mask or exacerbate trauma.
3. Why is a measure of serum lactate obtained in the initial assessment of the
trauma patient?
• Answer: To gauge end-organ perfusion and tissue hypoxia
• Rationale: Elevated serum lactate is a marker of inadequate tissue perfusion
and anaerobic metabolism, indicating shock and the need for aggressive
resuscitation.
4. A trauma patient is restless and repeatedly asking "where am I?" Vital signs
upon arrival: BP 110/60, HR 96, RR 24. Her skin is cool and dry. Current VS are
BP 104/84, HR 108, RR 28. The patient is demonstrating signs of which stage of
shock?
• Answer: Compensated shock
• Rationale: In compensated shock, the body maintains near-normal blood
pressure through vasoconstriction and tachycardia. Restlessness and cool skin
are early signs.
,5. 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 capillary refill. Which intervention is most appropriate?
• Answer: Initiate two large-caliber intravenous lines for Ringer's lactate
solution administration
• Rationale: This patient is in hemorrhagic shock and requires immediate fluid
resuscitation with two large-bore IV lines.
6. What is the most reliable sign of a tension pneumothorax?
• Answer: A shift of the trachea to the opposite side and decreased/absent
breath sounds on the affected side.
• Rationale: Tension pneumothorax causes air to accumulate in the pleural
space, shifting mediastinal structures away from the affected side.
7. In a patient with a suspected pelvic fracture, what is a priority nursing
intervention?
• Answer: Stabilize the pelvis (e.g., with a pelvic binder) and assess for signs of
retroperitoneal hemorrhage.
8. A patient with a spinal cord injury at C5 is being cared for in the ED while
awaiting transport. Which of the following represents the highest priority for
ongoing assessment and management?
• Answer: Maintain adequate respiratory status
• Rationale: Injuries at C3-C5 can cause loss of phrenic nerve function, resulting
in a paralyzed diaphragm and inability to breathe. Maintenance of respiratory
function is the highest priority.
9. What is the best position for maintaining an open airway in an obese patient?
• Answer: Reverse Trendelenburg.
• Rationale: This position helps reduce pressure from abdominal contents on
the diaphragm and can improve ventilation and airway management.
10. An adult patient sustained a knife injury to the neck. The airway is intact
and the patient is hemodynamically stable. They complain of difficulty
swallowing and speaking. What is the most likely cause?
• Answer: Damage to the cervical spine
• Rationale: Penetrating neck trauma may include concurrent injuries to the
cervical spine and cord, airway, or vascular neck structures.
, 11. What is the leading cause of preventable death for the trauma patient in the
prehospital environment?
• Answer: Uncontrolled external hemorrhage.
12. A patient arrives at the ED by private vehicle after sustaining an injury to
the right lower extremity. There is a large gaping wound with significant
bleeding. What is the priority intervention?
• Answer: Apply direct pressure to the wound.
13. In a patient with severe traumatic brain injury, hypocapnia causes which
condition?
• Answer: Cerebral vasoconstriction
• Rationale: Hypocapnia causes vasoconstriction, especially in the cerebral
vasculature, which can reduce cerebral blood flow.
14. What is the best measure of the adequacy of cellular perfusion and can help
predict the outcome of resuscitation?
• Answer: Base deficit
• Rationale: Base deficit serves as an endpoint measurement of the adequacy
of cellular perfusion and, when used in conjunction with serum lactate, helps
predict the success of resuscitation.
15. What technique is most appropriate when obtaining a history from a
trauma patient?
• Answer: Applying active listening.
16. Following a review of recent drills and a real disaster event, a hospital has
identified deficiencies and is taking steps to minimize the impact of a future
disaster. Which phase of the disaster life cycle does this describe?
• Answer: Mitigation.
17. Using the American College of Surgeons screening guidelines, which
assessment finding would prompt the nurse to prepare the patient for
radiologic spine clearance?
• Answer: Alert with no neurological deficits.
18. What is the effect of hypothermia on the oxyhemoglobin dissociation
curve?
