2025 TNCC final exam Question and
Answers test open book Graded A+
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 f ound based on
the pediatric assessment triangle or primary survey. Which of the f ollowing is the priority nursing
intervention?
Answer: A - ANSA) 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 f amily with injury prevention resourse
A 20-year old male presents to the ED c/o severe lower abd pain af ter landing hard on the bicycle cro ss
bars which perf orming an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness
and scrotal ecchymosis. Which of the f ollowing orders would the nurse questions?
Answer: C - ANSA) Fast exam
B) CT scan
C) straight cath f or urine sample ***
D) ice and elevation of the scrotum
A 35-year old male presents with f acial trauma af ter bring struck inthe f ace with a baseball. a tear-drop
shaped lef t pupil is noted on exam. What type of injury is suspected?
Answer: B - ANSA) oculomotor nerve palsy
B) globe rupture ***
C) uncal herniation
D) retinal detachment
A 36-year old f emale has a def ormity of the lef t wrist af ter a f all. She is reluctant to move her hand due to
pain. Which of the f ollowing is the most appropriate intervention?
Answer: B - ANSA) 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.
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic, and bil
lower extremity pain Vitals signs are stable. The nurse can anticipate all of these negative f ast ex am
except which of the f ollowing?
Answer: A
, The FAST exam is done at the bedside to identif y pathological fluid in the abdominal and pelvic cavities.
FAST exams reduce the use of more invasive diagnostic peritoneal lavage and can be repeated if clinica l
changes or hemodynamic changes occur. A negative FAST study does not rule out injury and may
warrant a f ollow-up computed tomography scan. Serial FAST exams can identif y increasing abdominal
f luid collections f rom hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
perf ormed by the surgical team to rapidly identif y the presence of hemorrhage in patients who are
hemodynamically unstable af ter trauma. - ANSA) diagnostic peritoneal lavage ***
B) serial f ast exams
C) abdominal and pelvic CT scans
D) serial abdominal assessments
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access f acility. He c/o
neck pain, SOB, and dif f use abd pain. His GCS is 15. His vitals are as f ollows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high f low O2 via NRB mask
which of the f ollowing is the priority intervention f or this patient?
Answer: C - ANSA) Expedite transport to the CT scanner
B) prepare the patient f or spinal radiographs
C) expedite transf er to the closest trauma center ***
D) notif y the patients f amily
A passenger is brought to the emergency department of a rural hospital f ollowing a high-speed MVC.
When signif icant abdominal and pelvic injuries are noted in the primary survey, whic h of the f ollowing is
the priority interventions?
Answer: A - ANSA) initiate transf er to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
A patient arrives with a large open chest wound af ter being assault ed with a machete, Prehospital
providers placed a nonporous dressing over the chest wound and tapes it on 3 sides. He is now showing
signs of anxiety, restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure.
Which of the f ollowing is the MOST appropriate interventions?
Answer: C - ANSA) needle decompression
B) tube thoracostomy
C) dressing removal **
D) surgical repair
A patient has been in the ED f or several hours waiting to be admitted. He sustained multip le rib f ractures
and a f emur f racture af ter a f all. He has been awake, alert, and c/o leg pain. His wif e reported suddenly
becoming anxious and conf used. Upon reassessment, the patient is restless, with respiratory distress and
petechiae to his neck. the patient is exhibiting signs of symptoms commonly associated with which of the
f ollowing conditions?
Answer: B - ANSA) acute lung injury
B) f at embolism ***
C) PTX
D) pulmonary contusion
Answers test open book Graded A+
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 f ound based on
the pediatric assessment triangle or primary survey. Which of the f ollowing is the priority nursing
intervention?
Answer: A - ANSA) 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 f amily with injury prevention resourse
A 20-year old male presents to the ED c/o severe lower abd pain af ter landing hard on the bicycle cro ss
bars which perf orming an aerial BMX maneuver. Secondary assessment reveals lower abd tenderness
and scrotal ecchymosis. Which of the f ollowing orders would the nurse questions?
Answer: C - ANSA) Fast exam
B) CT scan
C) straight cath f or urine sample ***
D) ice and elevation of the scrotum
A 35-year old male presents with f acial trauma af ter bring struck inthe f ace with a baseball. a tear-drop
shaped lef t pupil is noted on exam. What type of injury is suspected?
Answer: B - ANSA) oculomotor nerve palsy
B) globe rupture ***
C) uncal herniation
D) retinal detachment
A 36-year old f emale has a def ormity of the lef t wrist af ter a f all. She is reluctant to move her hand due to
pain. Which of the f ollowing is the most appropriate intervention?
Answer: B - ANSA) 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.
A 49-year old restrained driver involved in a MVC presents to the trauma center c/o abd, pelvic, and bil
lower extremity pain Vitals signs are stable. The nurse can anticipate all of these negative f ast ex am
except which of the f ollowing?
Answer: A
, The FAST exam is done at the bedside to identif y pathological fluid in the abdominal and pelvic cavities.
FAST exams reduce the use of more invasive diagnostic peritoneal lavage and can be repeated if clinica l
changes or hemodynamic changes occur. A negative FAST study does not rule out injury and may
warrant a f ollow-up computed tomography scan. Serial FAST exams can identif y increasing abdominal
f luid collections f rom hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
perf ormed by the surgical team to rapidly identif y the presence of hemorrhage in patients who are
hemodynamically unstable af ter trauma. - ANSA) diagnostic peritoneal lavage ***
B) serial f ast exams
C) abdominal and pelvic CT scans
D) serial abdominal assessments
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access f acility. He c/o
neck pain, SOB, and dif f use abd pain. His GCS is 15. His vitals are as f ollows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high f low O2 via NRB mask
which of the f ollowing is the priority intervention f or this patient?
Answer: C - ANSA) Expedite transport to the CT scanner
B) prepare the patient f or spinal radiographs
C) expedite transf er to the closest trauma center ***
D) notif y the patients f amily
A passenger is brought to the emergency department of a rural hospital f ollowing a high-speed MVC.
When signif icant abdominal and pelvic injuries are noted in the primary survey, whic h of the f ollowing is
the priority interventions?
Answer: A - ANSA) initiate transf er to a trauma center **
B) provide report to the operating room nurse
C) Obtained imaging studies
D) Place a gastric tube
A patient arrives with a large open chest wound af ter being assault ed with a machete, Prehospital
providers placed a nonporous dressing over the chest wound and tapes it on 3 sides. He is now showing
signs of anxiety, restlessness, severe respiratory distress, cyanosis, and decreasing blood pressure.
Which of the f ollowing is the MOST appropriate interventions?
Answer: C - ANSA) needle decompression
B) tube thoracostomy
C) dressing removal **
D) surgical repair
A patient has been in the ED f or several hours waiting to be admitted. He sustained multip le rib f ractures
and a f emur f racture af ter a f all. He has been awake, alert, and c/o leg pain. His wif e reported suddenly
becoming anxious and conf used. Upon reassessment, the patient is restless, with respiratory distress and
petechiae to his neck. the patient is exhibiting signs of symptoms commonly associated with which of the
f ollowing conditions?
Answer: B - ANSA) acute lung injury
B) f at embolism ***
C) PTX
D) pulmonary contusion
