TNCC 9th Edition 2024-2025 300 EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY 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 found based on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?
Answer: A - ANSA) report your suspicion of the maltreatment in accordance with local
regulations ***
apply ice to the bruises and consult wound care
engage in therapeutic communication to determine the MOI
provide the family with injury prevention resourse
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on
the bicycle cross bars which performing an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the nurse questions?
Answer: C - ANSA) Fast exam
CT scan
straight cath for urine sample ***
ice and elevation of the scrotum
A 35-year old male presents with facial trauma after bring struck inthe face with a
baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is
suspected?
Answer: B - ANSA) oculomotor nerve palsy
globe rupture ***
uncal herniation
retinal detachment
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 - ANSA) apply a sling and elevate the extremity to the level of the heart.
apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
Apply a sling and elevate the extremity above the level of the heart
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 fast exam except which of the following?
,TNCC 9th Edition 2024-2025 300 EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
Answer: A
The FAST exam is done at the bedside to identify pathological fluid in the abdominal
and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal
lavage and can be repeated if clinical changes or hemodynamic changes occur. A
negative FAST study does not rule out injury and may warrant a follow-up computed
tomography scan. Serial FAST exams can identify increasing abdominal fluid collections
from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
performed by the surgical team to rapidly identify the presence of hemorrhage in
patients who are hemodynamically unstable after trauma. - ANSA) diagnostic peritoneal
lavage ***
serial fast exams
abdominal and pelvic CT scans
serial abdominal assessments
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as
follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
Answer: C - ANSA) Expedite transport to the CT scanner
prepare the patient for spinal radiographs
expedite transfer to the closest trauma center ***
notify the patients family
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 - ANSA) initiate transfer to a trauma center **
provide report to the operating room nurse
Obtained imaging studies
Place a gastric tube
A patient arrives with a large open chest wound after being assault ed with a machete,
Prehospital providers placed a nonporous dressing over the chest wound and tapes it
,TNCC 9th Edition 2024-2025 300 EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
on 3 sides. He is now showing signs of anxiety, restlessness, severe respiratory
distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST
appropriate interventions?
Answer: C - ANSA) needle decompression
tube thoracostomy
dressing removal **
surgical repair
A patient has been in the ED for several hours waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o
leg pain. His wife reported suddenly becoming anxious and confused. 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
following conditions?
Answer: B - ANSA) acute lung injury
fat embolism ***
PTX
pulmonary contusion
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab
values is expected with a musculoskeletal complication associated with this
presentation?
Answer: A - ANSA) elevated creatine kinase ***
decreased potassium level
decreased WBC
elevated GFR
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 - ANSA) initiate two large caliber intravenous lines for Ringers lactate
solution administration ***
Administer Dilaudid for pain control and provide comfort care
Place the patient in an observation area for care within the next few hours
Contact the command center for the personnel to notify next of kin.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
, TNCC 9th Edition 2024-2025 300 EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
Answer: D - ANSA) Bradycardia and ipsilateral absences of motor function
Tachycardia and respiratory depression
Tachycardia and absent motor function below the level of injury
Bradycardia and absent motor function below the level of the injury ***
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 - ANSA) elevating the extremity above the level of the heart
repositioning and apply ice
Elevating the extremity to the level of the heart ***
Preparing the patient for ultrasound
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the
CT scanner will be out of service for several of hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma teams
communication?
Answer: D - ANSA) Brief
loop
debrief
huddle ***
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 - ANSA) compensated **
Progressive
irreversible
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 - ANSA) epidural hematoma
diffuse axonal injury
post-concussive syndrome
ANSWERS|ALREADY 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 found based on the pediatric assessment triangle or primary survey.
Which of the following is the priority nursing intervention?
Answer: A - ANSA) report your suspicion of the maltreatment in accordance with local
regulations ***
apply ice to the bruises and consult wound care
engage in therapeutic communication to determine the MOI
provide the family with injury prevention resourse
A 20-year old male presents to the ED c/o severe lower abd pain after landing hard on
the bicycle cross bars which performing an aerial BMX maneuver. Secondary
assessment reveals lower abd tenderness and scrotal ecchymosis. Which of the
following orders would the nurse questions?
Answer: C - ANSA) Fast exam
CT scan
straight cath for urine sample ***
ice and elevation of the scrotum
A 35-year old male presents with facial trauma after bring struck inthe face with a
baseball. a tear-drop shaped left pupil is noted on exam. What type of injury is
suspected?
Answer: B - ANSA) oculomotor nerve palsy
globe rupture ***
uncal herniation
retinal detachment
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 - ANSA) apply a sling and elevate the extremity to the level of the heart.
apply a splint and ELEVATE ABOVE THE LEVEL OF THE HEART ***
Apply a sling and elevate the extremity above the level of the heart
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 fast exam except which of the following?
,TNCC 9th Edition 2024-2025 300 EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
Answer: A
The FAST exam is done at the bedside to identify pathological fluid in the abdominal
and pelvic cavities. FAST exams reduce the use of more invasive diagnostic peritoneal
lavage and can be repeated if clinical changes or hemodynamic changes occur. A
negative FAST study does not rule out injury and may warrant a follow-up computed
tomography scan. Serial FAST exams can identify increasing abdominal fluid collections
from hemorrhage. Diagnostic peritoneal lavage/diagnostic peritoneal aspiration is
performed by the surgical team to rapidly identify the presence of hemorrhage in
patients who are hemodynamically unstable after trauma. - ANSA) diagnostic peritoneal
lavage ***
serial fast exams
abdominal and pelvic CT scans
serial abdominal assessments
A 56-year- male patient involved in a MVC is brought to the ED of a rural critical access
facility. He c/o neck pain, SOB, and diffuse abd pain. His GCS is 15. His vitals are as
follows:
BP 98/71
HR 125 beats/min
RR 26 breaths/min
SpO2 94% on high flow O2 via NRB mask
which of the following is the priority intervention for this patient?
Answer: C - ANSA) Expedite transport to the CT scanner
prepare the patient for spinal radiographs
expedite transfer to the closest trauma center ***
notify the patients family
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 - ANSA) initiate transfer to a trauma center **
provide report to the operating room nurse
Obtained imaging studies
Place a gastric tube
A patient arrives with a large open chest wound after being assault ed with a machete,
Prehospital providers placed a nonporous dressing over the chest wound and tapes it
,TNCC 9th Edition 2024-2025 300 EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
on 3 sides. He is now showing signs of anxiety, restlessness, severe respiratory
distress, cyanosis, and decreasing blood pressure. Which of the following is the MOST
appropriate interventions?
Answer: C - ANSA) needle decompression
tube thoracostomy
dressing removal **
surgical repair
A patient has been in the ED for several hours waiting to be admitted. He sustained
multiple rib fractures and a femur fracture after a fall. He has been awake, alert, and c/o
leg pain. His wife reported suddenly becoming anxious and confused. 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
following conditions?
Answer: B - ANSA) acute lung injury
fat embolism ***
PTX
pulmonary contusion
A patient is found lying on the floor after falling 13 hours ago. Which of the following lab
values is expected with a musculoskeletal complication associated with this
presentation?
Answer: A - ANSA) elevated creatine kinase ***
decreased potassium level
decreased WBC
elevated GFR
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 - ANSA) initiate two large caliber intravenous lines for Ringers lactate
solution administration ***
Administer Dilaudid for pain control and provide comfort care
Place the patient in an observation area for care within the next few hours
Contact the command center for the personnel to notify next of kin.
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs?
, TNCC 9th Edition 2024-2025 300 EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS|ALREADY GRADED A+
Answer: D - ANSA) Bradycardia and ipsilateral absences of motor function
Tachycardia and respiratory depression
Tachycardia and absent motor function below the level of injury
Bradycardia and absent motor function below the level of the injury ***
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 - ANSA) elevating the extremity above the level of the heart
repositioning and apply ice
Elevating the extremity to the level of the heart ***
Preparing the patient for ultrasound
A trauma patient is en route to a rural ED. Radiology notifies the charge nurse that the
CT scanner will be out of service for several of hours. The team gathers to plan
accordingly. Which of the following terms best describes this trauma teams
communication?
Answer: D - ANSA) Brief
loop
debrief
huddle ***
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 - ANSA) compensated **
Progressive
irreversible
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 - ANSA) epidural hematoma
diffuse axonal injury
post-concussive syndrome
