TNCC final exam REVISION
QUESTIONS AND CORRECT ANSWERS ||
100% GUARANTEED PASS <RECENT
VERSION>
Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?
Answer: c - ANSWER ✅a) to measure oxygenation and ventilation
b) to quantify the base deficit for the adequacy of cellular perfusion
c) *to gauge end-organ perfusion and tissue hypoxia **
d) to determine the underlying cause of shock
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon
arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her
skin is cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28
breaths/min. The patient is demonstrating signs and symptoms of which stage of
shock?
Answer: A - ANSWER ✅A) compensated **
B) Progressive
C) irreversible
D) decompensated
An elderly patient with a history of anticoagulant use presents after a fall at home
that day. she denies any loss of consciousness. She has a hematoma to her forehead
and complains of headache, dizziness, and nausea. Which is a most likely cause of
her symptoms?
Answer: D - ANSWER ✅A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
, EMS brings a patient who fell riding his bicycle. Using the American College of
Surgeons screening guidelines, which assessment finding would prompt the nurse
to prepare the patient for radiologic spine clearance?
Answer: D - ANSWER ✅A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
Which of the following occurs during the third impact of a motor vehicle crash?
Answer: C - ANSWER ✅A) The driver of the vehicle collides with the steering
wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger ***
A passenger is brought to the emergency department of a rural hospital following
a high-speed MVC. When significant abdominal and pelvic injuries are noted in
the primary survey, which of the following is the priority interventions?
Answer: A - ANSWER ✅A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
Which of the following injuries is LEAST likely to be promptly identified?
Answer: C - ANSWER ✅A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following
conditions?
Answer: C - ANSWER ✅A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
,D) polyuria
What finding raises suspicion of complete spinal cord injury?
Answer: B - ANSWER ✅A) Weakness in the lower extremities
B) Priapism ***
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
Answer: D - ANSWER ✅A) Bradycardia and ipsilateral absences of motor
function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury ***
A 5-year old child presents to the ED with bruises to the upper arms and buttocks
in various stages of healing and multiple small, clean, round burns to the back.
There are no abnormalities found based on the pediatric assessment triangle or
primary survey. Which of the following is the priority nursing intervention?
Answer: A - ANSWER ✅A) report your suspicion of the maltreatment in
accordance with local regulations ***
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse
A patient with lower extremity fracture complains of severe pain and tightness in
his calf, minimally relieved by pain medications. Which of the following is the
priority nursing intervention?
Answer: C - ANSWER ✅A) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
, A 36-year old female has a deformity of the left wrist after a fall. She is reluctant
to move her hand due to pain. Which of the following is the most appropriate
intervention?
Answer: B - ANSWER ✅A) apply a sling and elevate the extremity to the level of
the heart.
B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart.
Which of the following is a late sign of increased intracranial pressure?
Answer: C
Cushing Response
Widening pulse pressure
Reflex bradycardia
Decreased RR - ANSWER ✅A) Restlessness or drowsiness
B) Nausea and vomiting
C) Decreased respiratory effort**
D) amnesia and anxiety
Which of the following mnemonics can help the nurse prioritize care for a trauma
patient with massive uncontrolled hemorrhage?
Answer: B - ANSWER ✅A) ABC
B) MARCH***
C) AVPU
D) VIPP
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?
Answer: A - ANSWER ✅A) initiate two large caliber intravenous lines for
Ringers lactate solution administration ***
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
QUESTIONS AND CORRECT ANSWERS ||
100% GUARANTEED PASS <RECENT
VERSION>
Why is a measure of serum lactate obtained in the initial assessment of the trauma
patient?
Answer: c - ANSWER ✅a) to measure oxygenation and ventilation
b) to quantify the base deficit for the adequacy of cellular perfusion
c) *to gauge end-organ perfusion and tissue hypoxia **
d) to determine the underlying cause of shock
A trauma patient is restless and repeatedly asking "where am I?" vital signs upon
arrival were BP 100/60 mm Hg, HR 96 beats/min, and RR 24 breaths/min. Her
skin is cool and dry. Current vital signs are BP 104/84mm Hg, HR 108, RR 28
breaths/min. The patient is demonstrating signs and symptoms of which stage of
shock?
Answer: A - ANSWER ✅A) compensated **
B) Progressive
C) irreversible
D) decompensated
An elderly patient with a history of anticoagulant use presents after a fall at home
that day. she denies any loss of consciousness. She has a hematoma to her forehead
and complains of headache, dizziness, and nausea. Which is a most likely cause of
her symptoms?
Answer: D - ANSWER ✅A) epidural hematoma
B) diffuse axonal injury
C) post-concussive syndrome
D) subdural hematoma ***
, EMS brings a patient who fell riding his bicycle. Using the American College of
Surgeons screening guidelines, which assessment finding would prompt the nurse
to prepare the patient for radiologic spine clearance?
Answer: D - ANSWER ✅A) Alert with no neurologic deficits
B) Multiple abrasions to the extremities
C) Multiple requests of water
D) Smell of alcohol on breath ***
Which of the following occurs during the third impact of a motor vehicle crash?
Answer: C - ANSWER ✅A) The driver of the vehicle collides with the steering
wheel
B) the vehicle collides with a tree
C) the aorta is torn at its attachment with the ligamentum arteriosum
D) the airbag deploys and strikes the front seat passenger ***
A passenger is brought to the emergency department of a rural hospital following
a high-speed MVC. When significant abdominal and pelvic injuries are noted in
the primary survey, which of the following is the priority interventions?
Answer: A - ANSWER ✅A) initiate transfer to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
Which of the following injuries is LEAST likely to be promptly identified?
Answer: C - ANSWER ✅A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following
conditions?
Answer: C - ANSWER ✅A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
,D) polyuria
What finding raises suspicion of complete spinal cord injury?
Answer: B - ANSWER ✅A) Weakness in the lower extremities
B) Priapism ***
C) voluntary anal sphincter tone
D) intact reflexes distal to the injury
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
Answer: D - ANSWER ✅A) Bradycardia and ipsilateral absences of motor
function
B) Tachycardia and respiratory depression
C) Tachycardia and absent motor function below the level of injury
D) Bradycardia and absent motor function below the level of the injury ***
A 5-year old child presents to the ED with bruises to the upper arms and buttocks
in various stages of healing and multiple small, clean, round burns to the back.
There are no abnormalities found based on the pediatric assessment triangle or
primary survey. Which of the following is the priority nursing intervention?
Answer: A - ANSWER ✅A) report your suspicion of the maltreatment in
accordance with local regulations ***
B) apply ice to the bruises and consult wound care
C) engage in therapeutic communication to determine the MOI
D) provide the family with injury prevention resourse
A patient with lower extremity fracture complains of severe pain and tightness in
his calf, minimally relieved by pain medications. Which of the following is the
priority nursing intervention?
Answer: C - ANSWER ✅A) elevating the extremity above the level of the heart
B) repositioning and apply ice
C) Elevating the extremity to the level of the heart ***
D) Preparing the patient for ultrasound
, A 36-year old female has a deformity of the left wrist after a fall. She is reluctant
to move her hand due to pain. Which of the following is the most appropriate
intervention?
Answer: B - ANSWER ✅A) apply a sling and elevate the extremity to the level of
the heart.
B) apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
C) Apply a sling and elevate the extremity above the level of the heart
D) apply a splint and elevate the extremity to the level of the heart.
Which of the following is a late sign of increased intracranial pressure?
Answer: C
Cushing Response
Widening pulse pressure
Reflex bradycardia
Decreased RR - ANSWER ✅A) Restlessness or drowsiness
B) Nausea and vomiting
C) Decreased respiratory effort**
D) amnesia and anxiety
Which of the following mnemonics can help the nurse prioritize care for a trauma
patient with massive uncontrolled hemorrhage?
Answer: B - ANSWER ✅A) ABC
B) MARCH***
C) AVPU
D) VIPP
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?
Answer: A - ANSWER ✅A) initiate two large caliber intravenous lines for
Ringers lactate solution administration ***
B) Administer Dilaudid for pain control and provide comfort care
C) Place the patient in an observation area for care within the next few hours
