TNCC 8th edition exam with complete solution
EMS brings a patient who fell while 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: Alert with no
neurological deficits
The trauma nurse knows that placing a bariatric patient in a "ramped position"
provides better visualization during the insertion of which device? - ANSWER:
Endotracheal tube
A 35-year-old male presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is
suspected? - ANSWER: Globe rupture
Caregivers carry a 2-year-old into the emergency department who fell out of a
second-story window. The patient is awake and crying with increased work of
breathing and pale skin. Which of the following interventions has the highest
priority? - ANSWER: Padding the upper back while stabilizing the cervical spine
Which of the following injuries is LEAST likely to be promptly identified? - ANSWER:
Bowel
A 49-year-old restrained driver involved in a motor vehicle collision presents to the
trauma center complaining of abdominal, pelvic, and bilateral lower extremity pain.
Vital signs are stable. The nurse can anticipate all of these after a negative FAST
exam EXCEPT which of the following? - ANSWER: Diagnostic peritoneal lavage
Why is a measure of serum lactate obtained in the initial assessment of a trauma
patient? - ANSWER: To gauge end-organ perfusion and tissue hypoxia
During the primary survey of an unconscious patient with multi-system trauma, the
nurse notes snoring respirations. Which priority nursing intervention should be
performed next? - ANSWER: Insert an oropharyngeal airway if there is no gag reflex
Which of the following assessment findings differentiates a tension pneumothorax
from a simple pneumothorax? - ANSWER: Hypotension that worsens with inspiration
(pulsus paradoxus)
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? -
ANSWER: Hemoglobin does not readily release oxygen for use by the tissues (Left
shift)
A trauma patient is en route to a rural emergency department. Radiology notifies the
charge nurse that the computed tomography (CT) scanner will be out of service for
, several hours. The team gathers to plan accordingly. Which of the following terms
best describes this trauma team's communication? - ANSWER: Huddle
What finding raises suspicion of a complete spinal cord injury? - ANSWER: Priapism
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
capillary refill. Which of the following interventions would be most appropriate for
this patient based on the disaster triage principles? - ANSWER: Initiate two large-
caliber intravenous lines for Ringer's lactate solution administration.
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: Apply a splint and elevate the extremity above the level of
the heart
Which of the following is a late sign of increased intracranial pressure? - ANSWER:
Decreased respiratory effort
Tearing of the bridging veins is most frequently associated with which brain injury? -
ANSWER: Subdural hematoma
You are caring for a patient who was involved in a motor vehicle crash and is 32
weeks pregnant. Findings of your secondary survey include abdominal pain on
palpation, fundal height at the costal margin, and some dark bloody show. Varying
accelerations and decelerations are noted on cardiotocography. These findings are
most consistent with which of the following? - ANSWER: Placental abruption
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? - ANSWER: Bradycardia and absent
motor function below the level of injury
Following a review of recent drills and a real disaster event, a hospital has identified
deficiencies and is taking steps to minimize the impact of a future disaster. Which
phase of the disaster life cycle does this describe? - ANSWER: Mitigation
Which of the following considerations is most important when caring for a geriatric
trauma patient? - ANSWER: Medical history
The nurse is caring for a 120 kg male brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to the
entire surface of both upper extremities and superficial burns to the anterior chest.
Using the modified Lund and Browder chart to calculate the total body surface area
burned, how much intravenous fluid would be administered in the first 8 hours? -
ANSWER: 2280 mL
EMS brings a patient who fell while 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: Alert with no
neurological deficits
The trauma nurse knows that placing a bariatric patient in a "ramped position"
provides better visualization during the insertion of which device? - ANSWER:
Endotracheal tube
A 35-year-old male presents with facial trauma after being struck in the face with a
baseball. A teardrop-shaped left pupil is noted on exam. What type of injury is
suspected? - ANSWER: Globe rupture
Caregivers carry a 2-year-old into the emergency department who fell out of a
second-story window. The patient is awake and crying with increased work of
breathing and pale skin. Which of the following interventions has the highest
priority? - ANSWER: Padding the upper back while stabilizing the cervical spine
Which of the following injuries is LEAST likely to be promptly identified? - ANSWER:
Bowel
A 49-year-old restrained driver involved in a motor vehicle collision presents to the
trauma center complaining of abdominal, pelvic, and bilateral lower extremity pain.
Vital signs are stable. The nurse can anticipate all of these after a negative FAST
exam EXCEPT which of the following? - ANSWER: Diagnostic peritoneal lavage
Why is a measure of serum lactate obtained in the initial assessment of a trauma
patient? - ANSWER: To gauge end-organ perfusion and tissue hypoxia
During the primary survey of an unconscious patient with multi-system trauma, the
nurse notes snoring respirations. Which priority nursing intervention should be
performed next? - ANSWER: Insert an oropharyngeal airway if there is no gag reflex
Which of the following assessment findings differentiates a tension pneumothorax
from a simple pneumothorax? - ANSWER: Hypotension that worsens with inspiration
(pulsus paradoxus)
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? -
ANSWER: Hemoglobin does not readily release oxygen for use by the tissues (Left
shift)
A trauma patient is en route to a rural emergency department. Radiology notifies the
charge nurse that the computed tomography (CT) scanner will be out of service for
, several hours. The team gathers to plan accordingly. Which of the following terms
best describes this trauma team's communication? - ANSWER: Huddle
What finding raises suspicion of a complete spinal cord injury? - ANSWER: Priapism
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
capillary refill. Which of the following interventions would be most appropriate for
this patient based on the disaster triage principles? - ANSWER: Initiate two large-
caliber intravenous lines for Ringer's lactate solution administration.
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: Apply a splint and elevate the extremity above the level of
the heart
Which of the following is a late sign of increased intracranial pressure? - ANSWER:
Decreased respiratory effort
Tearing of the bridging veins is most frequently associated with which brain injury? -
ANSWER: Subdural hematoma
You are caring for a patient who was involved in a motor vehicle crash and is 32
weeks pregnant. Findings of your secondary survey include abdominal pain on
palpation, fundal height at the costal margin, and some dark bloody show. Varying
accelerations and decelerations are noted on cardiotocography. These findings are
most consistent with which of the following? - ANSWER: Placental abruption
A patient with a complete spinal cord injury in neurogenic shock will demonstrate
hypotension and which other clinical signs? - ANSWER: Bradycardia and absent
motor function below the level of injury
Following a review of recent drills and a real disaster event, a hospital has identified
deficiencies and is taking steps to minimize the impact of a future disaster. Which
phase of the disaster life cycle does this describe? - ANSWER: Mitigation
Which of the following considerations is most important when caring for a geriatric
trauma patient? - ANSWER: Medical history
The nurse is caring for a 120 kg male brought in after a warehouse fire and is
calculating the patient's fluid resuscitation needs. He has painful red blistering to the
entire surface of both upper extremities and superficial burns to the anterior chest.
Using the modified Lund and Browder chart to calculate the total body surface area
burned, how much intravenous fluid would be administered in the first 8 hours? -
ANSWER: 2280 mL
