TNCC Final Exam Study Guide
2025 – Key Concepts & Practice
Questions REAL EXAM!!!
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: A - ANSWER ✔---A) initiate trANSWERfer 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?
ANSWERwer: C - ANSWER ✔---A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following conditions?
ANSWERwer: C - ANSWER ✔---A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
What finding raises suspicion of complete spinal cord injury?
ANSWERwer: 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?
ANSWERwer: D - ANSWER ✔---A) Bradycardia and ipsilateral absences of motor function
2025 – Key Concepts & Practice
Questions REAL EXAM!!!
Why is a measure of serum lactate obtained in the initial assessment of the trauma patient?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: 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?
ANSWERwer: A - ANSWER ✔---A) initiate trANSWERfer 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?
ANSWERwer: C - ANSWER ✔---A) spleen
B) lung
C) bowel ***
D) brain
Patients with a crush injury should be monitored for which of the following conditions?
ANSWERwer: C - ANSWER ✔---A) Hypernatremia
B) Hypercalcemia
C) Dysrhthmias **
D) polyuria
What finding raises suspicion of complete spinal cord injury?
ANSWERwer: 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?
ANSWERwer: D - ANSWER ✔---A) Bradycardia and ipsilateral absences of motor function
