1|Page
TNCC 10TH EDITION EXAM LATEST VERSIONS
(VERSION A & B) ACTUAL TEST PROVIDING
REAL EXAM TIPS
PASS ON 1ST ATTEMPT
"Breathing and Ventilation" -ANS-During which part of the primary
survey would you anticipate the need for a chest tube, intubation,
decompression of pneumothorax, oxygen, or BVMs?
1. attach CO2 detector and assess for evidence of exhaled CO2; 2.
observe for rise and fall of the chest w/ assisted ventilations; 3.
auscultate over epigastrium for gurgling AND lungs for bilateral breath
sounds -ANS-What three assessments must be done if the patient is
intubated?
1. inspect AND palpate skin color, temp, moisture and 2. palpate a
pulse -ANS-To assess circulation, you must do these two main tasks:
A.Alert with no neurologic deficits -ANS-Using the American College of
Surgeons screening guidelines, what assessment finding would prompt
the nurse to prepare a patient for cervical spine imaging?
A.Alert with no neurologic deficits
B.Multiple abrasions to the
extremities C.Ecchymosis to
the flank D.Responds to verbal
stimulation
A.Cardiogenic -ANS-A patient is brought to the emergency department
with chest pain and shortness of breath following a high-speed motor
vehicle collision in which they were the unrestrained driver. There is
crepitus to the left chest with clear and equal breath sounds. The vital
,2|Page
signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40
breaths/minute. Cardiac monitor shows sinus tachycardia with
premature ventricular contractions. These findings are most consistent
with which type of shock?
A.Cardiogenic
B.Neurogenic
C.Hypovolemic
D.Obstructive
A.Decrease the rate of manual ventilation. -ANS-An adult patient who
sustained a severe head trauma has been intubated and is being
manually ventilated via a bag-mask device at a rate of 18
breaths/minute. The patient has received one intravenous fluid bolus
of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm
Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What
is the most important intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
A.Initiate warming measures -ANS-A patient is brought to the
emergency department following a snowmobile crash with prolonged
exposure time prior to transport. The
,3|Page
patient is confused. Vital signs are BP 96/54 mm Hg, HR 114
beats/minute, RR 24 breaths/minute, T 34.6oC (94.2oF) and an SpO2
of 90% on oxygen at 15L per non- rebreather mask. Other findings
include ETCO2 24, serum lactate of 6 mmol/L, and a pH of 6.8. Based
on these findings, what is the most appropriate intervention?
A.Initiate warming measures
B.Titrate oxygen to 6 L per nasal
cannula C.Bolus with 500 mL
isotonic crystalloids D.Vigorously
massage the extremities
A.Report your suspicion of maltreatment in accordance with local
regulations -ANS-A 5- year-old child presents to the emergency
department 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?
A.Report your suspicion of maltreatment in accordance with local
regulations
B.Apply ice to the bruises and provide wound care
C.Engage in therapeutic communication to determine the mechanism of
injury
D.Provide the family with injury prevention resources
A.Reverse Trendelenburg -ANS-What position optimizes ventilation in
the obese patient with a lumbar fracture?
A.Reverse
Trendelenburg
B.Supine
C.Prone
D.Fowler's
, 4|Page
AFTER head-to-toe, BEFORE J (VIPP) -ANS-Antibiotics, consults, head
CT, imaging, law enforcement, mandatory reporting, psychosocial
support, social services, splinting, tetanus, and wound care are all
interventions that you do AFTER and before WHAT?
all patients -ANS-For whom is capnography highly recommended?
Apply a pelvic binder -ANS-An adult pedestrian was struck on the right
side by a sport utility vehicle traveling at 40 mph. The patient is awake
and alert and the right leg is shortened. Following initial resuscitation
with fluids, the patient remains hypotensive. What would be the
priority intervention?
A.Send blood for type and crossmatch
B.Apply a pelvic binder
C.Prepare the patient for surgery
D.Insert a urinary catheter
TNCC 10TH EDITION EXAM LATEST VERSIONS
(VERSION A & B) ACTUAL TEST PROVIDING
REAL EXAM TIPS
PASS ON 1ST ATTEMPT
"Breathing and Ventilation" -ANS-During which part of the primary
survey would you anticipate the need for a chest tube, intubation,
decompression of pneumothorax, oxygen, or BVMs?
1. attach CO2 detector and assess for evidence of exhaled CO2; 2.
observe for rise and fall of the chest w/ assisted ventilations; 3.
auscultate over epigastrium for gurgling AND lungs for bilateral breath
sounds -ANS-What three assessments must be done if the patient is
intubated?
1. inspect AND palpate skin color, temp, moisture and 2. palpate a
pulse -ANS-To assess circulation, you must do these two main tasks:
A.Alert with no neurologic deficits -ANS-Using the American College of
Surgeons screening guidelines, what assessment finding would prompt
the nurse to prepare a patient for cervical spine imaging?
A.Alert with no neurologic deficits
B.Multiple abrasions to the
extremities C.Ecchymosis to
the flank D.Responds to verbal
stimulation
A.Cardiogenic -ANS-A patient is brought to the emergency department
with chest pain and shortness of breath following a high-speed motor
vehicle collision in which they were the unrestrained driver. There is
crepitus to the left chest with clear and equal breath sounds. The vital
,2|Page
signs are BP 80/40 mmHg, HR 140 beats/minute, and RR 40
breaths/minute. Cardiac monitor shows sinus tachycardia with
premature ventricular contractions. These findings are most consistent
with which type of shock?
A.Cardiogenic
B.Neurogenic
C.Hypovolemic
D.Obstructive
A.Decrease the rate of manual ventilation. -ANS-An adult patient who
sustained a severe head trauma has been intubated and is being
manually ventilated via a bag-mask device at a rate of 18
breaths/minute. The patient has received one intravenous fluid bolus
of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm
Hg (4.0 kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What
is the most important intervention to manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered.
A.Initiate warming measures -ANS-A patient is brought to the
emergency department following a snowmobile crash with prolonged
exposure time prior to transport. The
,3|Page
patient is confused. Vital signs are BP 96/54 mm Hg, HR 114
beats/minute, RR 24 breaths/minute, T 34.6oC (94.2oF) and an SpO2
of 90% on oxygen at 15L per non- rebreather mask. Other findings
include ETCO2 24, serum lactate of 6 mmol/L, and a pH of 6.8. Based
on these findings, what is the most appropriate intervention?
A.Initiate warming measures
B.Titrate oxygen to 6 L per nasal
cannula C.Bolus with 500 mL
isotonic crystalloids D.Vigorously
massage the extremities
A.Report your suspicion of maltreatment in accordance with local
regulations -ANS-A 5- year-old child presents to the emergency
department 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?
A.Report your suspicion of maltreatment in accordance with local
regulations
B.Apply ice to the bruises and provide wound care
C.Engage in therapeutic communication to determine the mechanism of
injury
D.Provide the family with injury prevention resources
A.Reverse Trendelenburg -ANS-What position optimizes ventilation in
the obese patient with a lumbar fracture?
A.Reverse
Trendelenburg
B.Supine
C.Prone
D.Fowler's
, 4|Page
AFTER head-to-toe, BEFORE J (VIPP) -ANS-Antibiotics, consults, head
CT, imaging, law enforcement, mandatory reporting, psychosocial
support, social services, splinting, tetanus, and wound care are all
interventions that you do AFTER and before WHAT?
all patients -ANS-For whom is capnography highly recommended?
Apply a pelvic binder -ANS-An adult pedestrian was struck on the right
side by a sport utility vehicle traveling at 40 mph. The patient is awake
and alert and the right leg is shortened. Following initial resuscitation
with fluids, the patient remains hypotensive. What would be the
priority intervention?
A.Send blood for type and crossmatch
B.Apply a pelvic binder
C.Prepare the patient for surgery
D.Insert a urinary catheter
