TNCC Exam 9th Edition Study Guide 2025 Q&A
1.Whateisetheeeffecteofehypothermiaeonetheeoxyhemoglobinedissociationecurvee-
CORRECTeANSWER-
e
HemoglobinedoesenotereadilyereleaseeoxygeneforeuseebyetheetissueseAeshiftetoetheelefteoccurseineane
environmenteofelowemetabolicedemande(hypothermia,ehypocapnia,ealkalosis),eincreasingehemogl
obin'seaffinityeforeoxygen.
EMSearrivesewithetheeintoxicatededrivereofeaecareinvolvedeineaemotorevehicleecrash.eEMSereportsesig
nificantedamageetoetheedriver'sesideeofetheecar.eTheepatienteiseaskingetoehaveetheecervicalecollarere
moved.eWheneiteiseappropriateetoeremoveetheecervicalecollar?e-eCORRECTeANSWER-
AftereaephysicaleexaminationeifetheepatientehasenoeradiologiceabnormalitieseoneCTeAeCTeiserecomm
endedeforespinaleclearanceeineaneimpairedepatient.
Theenurseeisecaringeforeae120ekgemaleebroughteineaftereaewarehouseefireeandeisecalculatingetheepati
ent'sefluideresuscitationeneeds.eHeehasepainfuleredeblisteringetoetheeentireesurfaceeofebotheupperee
xtremitieseandesuperficialeburnsetoetheeanteriorechest.
UsingetheemodifiedeLundeandeBrowderechartetoecalculateetheetotalebodyesurfaceeareaeburned,eh
owemucheIVefluidewouldebeeadministeredeinetheefirste8ehours?e-eCORRECTeANSWER-
2280emLeBotheupperearmse=e8%,ebothelowerearmse=e6%,eandebothehandse=e5%,eyieldinge19e*e2e*e
120e=e4560emL.eHalfeofetheetotaleiseequaletoe2280emL.eSuperficialeburnseareenoteincludedeinetheeT
BSAecalculationeforefluideresuscitation.
Whicheofetheefollowingeiseaneexpectedefindingeineaepatientewitheaetubeethoracostomyeconnectedetoe
aechestedrainageesysteme-eCORRECTeANSWER-
FluctuationeinetheewateresealechambereFluctuationeinetheewateresealechambereindicatesetheetubeei
seplacedecorrectlyeinetheepleuralespace.
.Ae35-year-
oldemaleepresentsewithefacialetraumaeafterebeingestruckeinetheefaceewitheaebaseball.eAeteardrop-
shapedeleftepupileisenotedeoneexam.eWhatetypeeofeinjuryeisesuspected?e-eCORRECTeANSWER-
GlobeeruptureeAeteardrop-shapedepupilesuggestseaeglobeerupture.
, .Aepatientewitheaecompleteespinalecordeinjuryeineneurogeniceshockewilledemonstrateehypotensionea
ndewhicheothereclinicalesigns?e-eCORRECTeANSWER-
BradycardiaeandeabsentemotorefunctionebelowetheeleveleofeinjuryePatientsewitheaecompleteespinale
cordeinjuryewillehaveeabsentemotorefunctionebelowetheeleveleofetheelesion.eTheyebecomeehypotensi
veeandebradycardicedueetoelosseofeautonomicenervousesystemefunction.
Whicheofetheefollowingepatientsewarrantsereferraletoeaeburnecenter?e-eCORRECTeANSWER-Ae52-
year-oldediabeticemaleewitheaepartial-
thicknesseburnetoetheeleftelowerelegeThisepatientehaseae7%eTBSAeburnewitheaepreexistingemedicalehi
storyethatecouldecomplicateemanagement,eprolongerecovery,eoreaffectemortality.
1.Whateisetheeeffecteofehypothermiaeonetheeoxyhemoglobinedissociationecurvee-
CORRECTeANSWER-
e
HemoglobinedoesenotereadilyereleaseeoxygeneforeuseebyetheetissueseAeshiftetoetheelefteoccurseineane
environmenteofelowemetabolicedemande(hypothermia,ehypocapnia,ealkalosis),eincreasingehemogl
obin'seaffinityeforeoxygen.
EMSearrivesewithetheeintoxicatededrivereofeaecareinvolvedeineaemotorevehicleecrash.eEMSereportsesig
nificantedamageetoetheedriver'sesideeofetheecar.eTheepatienteiseaskingetoehaveetheecervicalecollarere
moved.eWheneiteiseappropriateetoeremoveetheecervicalecollar?e-eCORRECTeANSWER-
AftereaephysicaleexaminationeifetheepatientehasenoeradiologiceabnormalitieseoneCTeAeCTeiserecomm
endedeforespinaleclearanceeineaneimpairedepatient.
Theenurseeisecaringeforeae120ekgemaleebroughteineaftereaewarehouseefireeandeisecalculatingetheepati
ent'sefluideresuscitationeneeds.eHeehasepainfuleredeblisteringetoetheeentireesurfaceeofebotheupperee
xtremitieseandesuperficialeburnsetoetheeanteriorechest.
UsingetheemodifiedeLundeandeBrowderechartetoecalculateetheetotalebodyesurfaceeareaeburned,eh
owemucheIVefluidewouldebeeadministeredeinetheefirste8ehours?e-eCORRECTeANSWER-
2280emLeBotheupperearmse=e8%,ebothelowerearmse=e6%,eandebothehandse=e5%,eyieldinge19e*e2e*e
120e=e4560emL.eHalfeofetheetotaleiseequaletoe2280emL.eSuperficialeburnseareenoteincludedeinetheeT
BSAecalculationeforefluideresuscitation.
Whicheofetheefollowingeiseaneexpectedefindingeineaepatientewitheaetubeethoracostomyeconnectedetoe
aechestedrainageesysteme-eCORRECTeANSWER-
FluctuationeinetheewateresealechambereFluctuationeinetheewateresealechambereindicatesetheetubeei
seplacedecorrectlyeinetheepleuralespace.
.Ae35-year-
oldemaleepresentsewithefacialetraumaeafterebeingestruckeinetheefaceewitheaebaseball.eAeteardrop-
shapedeleftepupileisenotedeoneexam.eWhatetypeeofeinjuryeisesuspected?e-eCORRECTeANSWER-
GlobeeruptureeAeteardrop-shapedepupilesuggestseaeglobeerupture.
, .Aepatientewitheaecompleteespinalecordeinjuryeineneurogeniceshockewilledemonstrateehypotensionea
ndewhicheothereclinicalesigns?e-eCORRECTeANSWER-
BradycardiaeandeabsentemotorefunctionebelowetheeleveleofeinjuryePatientsewitheaecompleteespinale
cordeinjuryewillehaveeabsentemotorefunctionebelowetheeleveleofetheelesion.eTheyebecomeehypotensi
veeandebradycardicedueetoelosseofeautonomicenervousesystemefunction.
Whicheofetheefollowingepatientsewarrantsereferraletoeaeburnecenter?e-eCORRECTeANSWER-Ae52-
year-oldediabeticemaleewitheaepartial-
thicknesseburnetoetheeleftelowerelegeThisepatientehaseae7%eTBSAeburnewitheaepreexistingemedicalehi
storyethatecouldecomplicateemanagement,eprolongerecovery,eoreaffectemortality.
