TNCC 8th Edition Provider Exam: Questions & Answers
A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He
complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2
94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? -
ANSWER:Expedite transfer to the closest trauma center
Which of the following considerations is the most important when caring for a geriatric trauma pt? -
ANSWER:a pertinent medical hx is crucial
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
EMS brings a pt who fell while riding his bicycle. Using the American College of Surgeons screening
guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine
clearance? - ANSWER:Alcohol
All tools and guidelines require the patient to be awake, alert, not under the influence of any substances,
and without neurologic abnormalities
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? - ANSWER:hemoglobin
does not readily release O2 for use by the tissues
Which of the following is a component of the trauma triad of death? - ANSWER:acidosis
EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary
incontinence and priapism. These assessment findings are most consistent with which of the following
types of spinal cord injury? - ANSWER:Complete
Which of the following is an expected finding in a pt with a tube thoracstomy connected to a chest
drainage system? - ANSWER:flucuation in the water seal chamber
During the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring
respirations. What priority nursing interventions should be preformed next? - ANSWER:insert an
oropharyngeal airway if there is no gag reflex
A 35 y/o M 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
A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24.
Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which
stage of shock? - ANSWER:compensated
An unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, and
dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted
,intubation but was unsuccessful. What is the most appropriate immediate next step? -
ANSWER:ventilate with a bag mask device
When is the tertiary survey completed fora trauma pt? - ANSWER:within 24 hrs of trauma
An intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing
compartment syndrome. What is the most reliable indication of compartment syndrome in a patient
who is unconscious? - ANSWER:pressure
Which of the following is possible complication of positive-pressure ventilation? - ANSWER:worsening
pneumothorax
the most reassuring finding for a male pt with hip pain after a fall is which of the following? -
ANSWER:pelvic stability
Which of the following pulse pressures indicate early hypovolemic shock? - ANSWER:narrowed
Patients with a crush injury should be monitored for which of the following conditions? -
ANSWER:dysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? - ANSWER:subdural
hematoma
A 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle
cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd
tenderness and scrotal ecchymosis. Which of the following orders would the RN question? -
ANSWER:straight cath for urine sample
You are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary
survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show.
Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent
with which of the following? - ANSWER:placental abruption
Which of the following is true about the log-roll? - ANSWER:it can worsen cord damage from an unstable
spinal injury
All of these are considered a critical communication point in trauma care EXCEPT which of the following?
- ANSWER:defusings
What bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of
ventilation? - ANSWER:pulse oximetry and capnography
Caregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt 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 pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic
injuries are noted in the primary survey, which of the following is the priority interventions? -
ANSWER:Initiate transfer to a trauma center
,A pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which
other clinical signs? - ANSWER:bardycardia and absent motor function below the level of injury
a 37 y/o F has a deformity of the L 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 splint and elevate above the level
of the heart
which of the following occurs during the third impact of a motor vehicle crash? - ANSWER:the aorta is
torn at its attachment with the ligamentum arteriosum
a 5 y/o child presents to the ED with bruises to the upper arm 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 survey. Which of
the following is the priority nursing intervention? - ANSWER:Report your suspicion of maltreatment in
accordance with local regulations
Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? - ANSWER:to
guage end-organ perfusion and tissue hypoxia
A pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain
medications. Which of the following is the priority nursing intervention? - ANSWER:elevating the
extremity to the level of the heart
What factor contributes most to the kinetic energy of a body in motion? - ANSWER:velocity
An elderly patient with a history of anticoagulant use presents after a fall at home today. She denies any
loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and
nausea. What is the most likely cause of her symptoms? - ANSWER:subdural hematoma
a pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib fractures and a
femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that
he suddenly became anxious and confused. Upon reassessment, the pt is restless with respiratory
distress and petechiae to his neck. The pt is exhibiting s/sx most commonly associated with which of the
following conditions? - ANSWER:fat embolism
Which of the following is a late sign of increased intracranial pressure? - ANSWER:Late signs of increased
intracranial pressure include: dilated nonreactive pupils, unresponsive to verbal or painful stimuli,
abnormal motor posturing, and Cushing response (widening pulse pressure, reflex bradycardia,
decreased respiratory effort)
a 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd, pelvic,
and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these after a negative
FAST exam EXCEPT which of the following? - ANSWER:serial FAST exams
Which of the following is NOT considered goal-directed therapy for cardiogenic shock? -
ANSWER:pericardiocentesis
The trauma nurse knows that placing a bariatric patient in a ramped position providers better
visualization during the insertion of which device? - ANSWER:endotracheal tube
, which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax? - ANSWER:increased work of breathing
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe
respiratory distress, and absent breath sounds on the injured side
if a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is
most likely to drop and require supplementation? - ANSWER:calcium
Which of the following is NOT considered a benefit of debriefings? - ANSWER:identifying individuals who
made mistakes during the traumatic event
You are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA
burned is deferred due to the need for emergent intubation. At what rate should you begin fluid
resuscitation? - ANSWER:500 mL/hr
Which of the following is most likely to contribute to inadequate oxygenation and ventilation? -
ANSWER:advanced age
Which of the following patients warrants referral to a burn center? - ANSWER:a 52 y/o diabetic male
with a partial thickness burn to the left lower leg
A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital
providers placed a nonporous dressing over the chest wound and taped it on three 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 immediate intervention? - ANSWER:dressing
removal
EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the
drivers side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to
remove the cervical collar? - ANSWER:after a physical examination if the pt has no radiologic
abnormalities on CT
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage? - ANSWER:MARCH
A branch of mechanics (energy transfer) that refers to motion and does not consider the concepts of
force and mass of the object or body. - ANSWER:What is kinematics?
A body at rest will remain at rest. A body in motion will remain in motion until acted on by an outside
force. - ANSWER:What is Newton's First Law?
Energy can neither be created nor destroyed. It is only changed from one form to another. -
ANSWER:What is the Law of Conservation of Energy?
Force equals mass multiplied by acceleration of deceleration. - ANSWER:What is Newton's Second Law?
KE equals 1/2 the mass (M) multiplied by the velocity squared. - ANSWER:What is kinetic energy (KE)?
A 56 y/o M pt involved in a motor vehicle crash is brought to the ED of a rural critical access facility. He
complains of neck pain, SOB, and diffuse abd pain. His GCS is 15. His VS: BP 98/71, HR 125, RR 26, SpO2
94% on high-flow O2 via NRB mask. Which of the following is the priority intervention for this patient? -
ANSWER:Expedite transfer to the closest trauma center
Which of the following considerations is the most important when caring for a geriatric trauma pt? -
ANSWER:a pertinent medical hx is crucial
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
EMS brings a pt who fell while riding his bicycle. Using the American College of Surgeons screening
guidelines, which assessment finding would prompt the RN to prepare the pt for a radiologic spine
clearance? - ANSWER:Alcohol
All tools and guidelines require the patient to be awake, alert, not under the influence of any substances,
and without neurologic abnormalities
What is the effect of hypothermia on the oxyhemoglobin dissociation curve? - ANSWER:hemoglobin
does not readily release O2 for use by the tissues
Which of the following is a component of the trauma triad of death? - ANSWER:acidosis
EMS brings a pt from MVC. VS: BP 90/49, HR 48, RR 12, temp 97.2F (36.2 C). The pt exhibits urinary
incontinence and priapism. These assessment findings are most consistent with which of the following
types of spinal cord injury? - ANSWER:Complete
Which of the following is an expected finding in a pt with a tube thoracstomy connected to a chest
drainage system? - ANSWER:flucuation in the water seal chamber
During the primary survey of an unconscious pt with multi-system trauma, the nurse notes snoring
respirations. What priority nursing interventions should be preformed next? - ANSWER:insert an
oropharyngeal airway if there is no gag reflex
A 35 y/o M 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
A trauma pt is restless and repeatedly asking "where am i?" VS upon arrival: BP 110/60, HR96, RR 24.
Her skin is cool and dry. Current VS are BP 104/84, HR 108, RR 28. The pt is demonstrating s/sx of which
stage of shock? - ANSWER:compensated
An unresponsive trauma pt has an oropharygeal airway in place, shallow and labored respirations, and
dusky skin. The trauma team has administered medications for drug-assisted intubation and attempted
,intubation but was unsuccessful. What is the most appropriate immediate next step? -
ANSWER:ventilate with a bag mask device
When is the tertiary survey completed fora trauma pt? - ANSWER:within 24 hrs of trauma
An intubated and sedated pt in the ED has multiple extremity injuries with the potential for causing
compartment syndrome. What is the most reliable indication of compartment syndrome in a patient
who is unconscious? - ANSWER:pressure
Which of the following is possible complication of positive-pressure ventilation? - ANSWER:worsening
pneumothorax
the most reassuring finding for a male pt with hip pain after a fall is which of the following? -
ANSWER:pelvic stability
Which of the following pulse pressures indicate early hypovolemic shock? - ANSWER:narrowed
Patients with a crush injury should be monitored for which of the following conditions? -
ANSWER:dysrhythmias
Tearing of the bridging veins is most frequently associated with which brain injury? - ANSWER:subdural
hematoma
A 20 y/o M presents to the ED complaining of severe lower abd pain after landing hard on the bicycle
cross bars while preforming an aerial BMX maneuver. Secondary assessment reveals lower abd
tenderness and scrotal ecchymosis. Which of the following orders would the RN question? -
ANSWER:straight cath for urine sample
You are caring for a pt who was involved in a MVC and is 32 weeks pregnant. Findings of your secondary
survey include abd pain on palpation, fundal ht at the costal margin, and some dark bloody show.
Varying accelerations and decelerations are noted on cariocgraphy. These findings are most consistent
with which of the following? - ANSWER:placental abruption
Which of the following is true about the log-roll? - ANSWER:it can worsen cord damage from an unstable
spinal injury
All of these are considered a critical communication point in trauma care EXCEPT which of the following?
- ANSWER:defusings
What bedside monitoring parameters are used to assess for adequacy of O2 and effectiveness of
ventilation? - ANSWER:pulse oximetry and capnography
Caregivers carry in a 2 y/o into the ED who fell out of a second-story window. The pt 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 pt is brought to the ED of a rural hospital following a high-speed MVC. When significant abd and pelvic
injuries are noted in the primary survey, which of the following is the priority interventions? -
ANSWER:Initiate transfer to a trauma center
,A pt with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and which
other clinical signs? - ANSWER:bardycardia and absent motor function below the level of injury
a 37 y/o F has a deformity of the L 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 splint and elevate above the level
of the heart
which of the following occurs during the third impact of a motor vehicle crash? - ANSWER:the aorta is
torn at its attachment with the ligamentum arteriosum
a 5 y/o child presents to the ED with bruises to the upper arm 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 survey. Which of
the following is the priority nursing intervention? - ANSWER:Report your suspicion of maltreatment in
accordance with local regulations
Why is a measure of serum lactate obtained in the initial assessment of a trauma patient? - ANSWER:to
guage end-organ perfusion and tissue hypoxia
A pt with a lower extremity fracture complains of severe pain and tightness in his calf, minimally by pain
medications. Which of the following is the priority nursing intervention? - ANSWER:elevating the
extremity to the level of the heart
What factor contributes most to the kinetic energy of a body in motion? - ANSWER:velocity
An elderly patient with a history of anticoagulant use presents after a fall at home today. She denies any
loss of consciousness. She has a hematoma to her forehead and complains of headache, dizziness, and
nausea. What is the most likely cause of her symptoms? - ANSWER:subdural hematoma
a pt has been in the ED for several hrs waiting to be admitted. He sustained multiple rib fractures and a
femur fracture after a fall. He has been awake, alert, and complaining of leg pain. His wife reported that
he suddenly became anxious and confused. Upon reassessment, the pt is restless with respiratory
distress and petechiae to his neck. The pt is exhibiting s/sx most commonly associated with which of the
following conditions? - ANSWER:fat embolism
Which of the following is a late sign of increased intracranial pressure? - ANSWER:Late signs of increased
intracranial pressure include: dilated nonreactive pupils, unresponsive to verbal or painful stimuli,
abnormal motor posturing, and Cushing response (widening pulse pressure, reflex bradycardia,
decreased respiratory effort)
a 49 y/o restrained driver involved in a MVC presents to the trauma center complaining of abd, pelvic,
and bilateral lower extremity pain. VS are stable. The nurse can anticipate all of these after a negative
FAST exam EXCEPT which of the following? - ANSWER:serial FAST exams
Which of the following is NOT considered goal-directed therapy for cardiogenic shock? -
ANSWER:pericardiocentesis
The trauma nurse knows that placing a bariatric patient in a ramped position providers better
visualization during the insertion of which device? - ANSWER:endotracheal tube
, which of the following assessment findings differentiates a tension pneumothorax from a simple
pneumothorax? - ANSWER:increased work of breathing
Assessment findings associated with tension pneumothorax include anxiety, severe restlessness, severe
respiratory distress, and absent breath sounds on the injured side
if a pt has received multiple transfusions of banked blood preserved with citrate, which electrolyte is
most likely to drop and require supplementation? - ANSWER:calcium
Which of the following is NOT considered a benefit of debriefings? - ANSWER:identifying individuals who
made mistakes during the traumatic event
You are treating a 27 y/o M in respiratory distress who was involved in a house fire. Calculating TBSA
burned is deferred due to the need for emergent intubation. At what rate should you begin fluid
resuscitation? - ANSWER:500 mL/hr
Which of the following is most likely to contribute to inadequate oxygenation and ventilation? -
ANSWER:advanced age
Which of the following patients warrants referral to a burn center? - ANSWER:a 52 y/o diabetic male
with a partial thickness burn to the left lower leg
A patient arrives with a large open chest wound after being assaulted with a machete. Prehospital
providers placed a nonporous dressing over the chest wound and taped it on three 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 immediate intervention? - ANSWER:dressing
removal
EMS arrives with the intoxicated driver of a car involved in a MVC. EMS reports significant damage to the
drivers side of the car. The pt is asking to have the cervical collar removed. When it is appropriate to
remove the cervical collar? - ANSWER:after a physical examination if the pt has no radiologic
abnormalities on CT
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with massive
uncontrolled hemorrhage? - ANSWER:MARCH
A branch of mechanics (energy transfer) that refers to motion and does not consider the concepts of
force and mass of the object or body. - ANSWER:What is kinematics?
A body at rest will remain at rest. A body in motion will remain in motion until acted on by an outside
force. - ANSWER:What is Newton's First Law?
Energy can neither be created nor destroyed. It is only changed from one form to another. -
ANSWER:What is the Law of Conservation of Energy?
Force equals mass multiplied by acceleration of deceleration. - ANSWER:What is Newton's Second Law?
KE equals 1/2 the mass (M) multiplied by the velocity squared. - ANSWER:What is kinetic energy (KE)?
