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[NEW] TNCC 10TH EDITION ACTUAL FINAL EXAM –
JUST RELEASED 2026 | VERIFIED SOURCES | GRADED
A+ | ALL VERSIONS INCLUDED
1. Which of the following situations could cause functional grief?
A. Inability to live at home
B. Amputation of a limb
C. Loss of one's self-image
D. Destruction of the patient's car
B. Amputation of a limb
Rationale: Preparation and Ongoing Care\Psychosocial Aspects
Functional grief relates to the loss of body function or body parts such as amputation of a limb,
paralysis, or loss of sight.
2. What is the most important consideration during the initial assessment when caring for
an older adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician
B. Medical history including current medications
3. You are caring for a patient who was thrown from a bike and was not wearing a helmet.
While performing the head-to-toe assessment, you note clear drainage from the right ear.
Which of the following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam.
C. Notify the physician
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4. When should the definitive calculation for intravenous fluid resuscitation rate be
performed for a patient with burns?
A. As soon as the patient arrives
B. After removal of clothing
C. Only at a burn center
D. During the circulation assessment
B. After removal of clothing
Rationale: Musculoskeletal and Wounds\Burns
Some fluid will be given initially, but an accurate fluid total is based on percentage of total body
surface area which requires a good skin assessment and is calculated after clothing is removed.
5. In a motor vehicle collision, which injury pathway is most likely to increase the patient's
morbidity and mortality?
A. Rotational
B. Ejection
C. Lateral
D. Rollover
B. Ejection
6. A patient with a 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?
A. Elevating the leg above the level of the heart
B. Repositioning the leg and applying ice
C. Elevating the leg to the level of the heart
D. Preparing the patient for ultrasound of the leg
C. Elevating the leg to the level of the heart
Rationale: Musculoskeletal and Wounds\Musculoskeletal
This patient is exhibiting signs of possible compartment syndrome which is a dangerous
complication of fractured extremities. The pain is often out of proportion to the injury and might
not respond to pain medications. Elevate the limb to the level of the heart to decrease dependent
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edema but not above the heart, which can cause increased venous congestion and pressure within
the compartment.
7. A teenaged patient presents to the emergency department with left arm pain after a
ground level fall. The patient identifies as transgender and shares they are homeless. The
ED staff are concerned the patient is experiencing human trafficking. What is most
consistent with human trafficking?
A. The individual appears well nourished.
B. Those who are being trafficked rarely seek medical care.
C. It is infrequently associated with substance abuse.
D. Those experiencing human trafficking rarely self-disclose.
D. Those experiencing human trafficking rarely self-disclose.
8. An intubated trauma patient has just been transported back from CT scan. Upon arrival
to their room in the emergency department, resistance is noted with bag-mask ventilations
and auscultation reveals unequal breath sounds. What is the most appropriate initial
intervention for this patient?
A. Place the patient back on the ventilator.
B. Extubated the patient.
C. Reposition the endotracheal tube.
D. Suction the endotracheal tube.
C. Reposition the endotracheal tube.
10. Which of the following assessment findings differentiates a tension pneumothorax from
a simple pneumothorax?
A. Increased work of breathing
B. Unilaterally diminished breath sounds
C. Tachycardia
D. Hypotension
D. Hypotension
11. A patient is brought to the emergency department of a rural hospital following a high-
speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in
the primary survey, what is the priority intervention?
, 4|Page
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter
A. Initiate transfer to a trauma center
12. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is
the priority intervention?
A. Initiate two intravenous access sites
B. Place the patient on supplemental oxygen
C. Apply direct pressure to the wound
D. Use a tourniquet to control the bleeding
C. Apply direct pressure to the wound
13. A trauma patient involved in a fall from 25 feet has a traumatic brain injury, three
anterior rib fractures on the right side, a small pneumothorax on the right, and a Grade III
liver injury. The patient was intubated and placed on a ventilator with PEEP. Chest tube
was deferred at this time. Upon reassessment, which finding is most concerning?
A. Severely diminished breath sounds on the right
B. Guarding in the right upper quadrant
C. Ecchymosis in the right upper quadrant
D. Crepitus to the right chest
A. Severely diminished breath sounds on the right
14. A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm
Hg (8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is
most likely an indication of the body's response to these findings?
A. Increased respiratory effort
B. Widening pulse pressure
C. Reflex tachycardia
D. Reflex hypotension
B. Widening pulse pressure
[NEW] TNCC 10TH EDITION ACTUAL FINAL EXAM –
JUST RELEASED 2026 | VERIFIED SOURCES | GRADED
A+ | ALL VERSIONS INCLUDED
1. Which of the following situations could cause functional grief?
A. Inability to live at home
B. Amputation of a limb
C. Loss of one's self-image
D. Destruction of the patient's car
B. Amputation of a limb
Rationale: Preparation and Ongoing Care\Psychosocial Aspects
Functional grief relates to the loss of body function or body parts such as amputation of a limb,
paralysis, or loss of sight.
2. What is the most important consideration during the initial assessment when caring for
an older adult who has sustained serious injuries?
A. They are likely to be fearful in the emergency department
B. Medical history including current medications
C. Availability of support systems after discharge
D. Accessibility to a primary care physician
B. Medical history including current medications
3. You are caring for a patient who was thrown from a bike and was not wearing a helmet.
While performing the head-to-toe assessment, you note clear drainage from the right ear.
Which of the following is the most appropriate next step?
A. Clean the ear with a cotton-tipped applicator.
B. Pack the ear with gauze.
C. Notify the physician
D. Document and continue the exam.
C. Notify the physician
,2|Page
4. When should the definitive calculation for intravenous fluid resuscitation rate be
performed for a patient with burns?
A. As soon as the patient arrives
B. After removal of clothing
C. Only at a burn center
D. During the circulation assessment
B. After removal of clothing
Rationale: Musculoskeletal and Wounds\Burns
Some fluid will be given initially, but an accurate fluid total is based on percentage of total body
surface area which requires a good skin assessment and is calculated after clothing is removed.
5. In a motor vehicle collision, which injury pathway is most likely to increase the patient's
morbidity and mortality?
A. Rotational
B. Ejection
C. Lateral
D. Rollover
B. Ejection
6. A patient with a 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?
A. Elevating the leg above the level of the heart
B. Repositioning the leg and applying ice
C. Elevating the leg to the level of the heart
D. Preparing the patient for ultrasound of the leg
C. Elevating the leg to the level of the heart
Rationale: Musculoskeletal and Wounds\Musculoskeletal
This patient is exhibiting signs of possible compartment syndrome which is a dangerous
complication of fractured extremities. The pain is often out of proportion to the injury and might
not respond to pain medications. Elevate the limb to the level of the heart to decrease dependent
,3|Page
edema but not above the heart, which can cause increased venous congestion and pressure within
the compartment.
7. A teenaged patient presents to the emergency department with left arm pain after a
ground level fall. The patient identifies as transgender and shares they are homeless. The
ED staff are concerned the patient is experiencing human trafficking. What is most
consistent with human trafficking?
A. The individual appears well nourished.
B. Those who are being trafficked rarely seek medical care.
C. It is infrequently associated with substance abuse.
D. Those experiencing human trafficking rarely self-disclose.
D. Those experiencing human trafficking rarely self-disclose.
8. An intubated trauma patient has just been transported back from CT scan. Upon arrival
to their room in the emergency department, resistance is noted with bag-mask ventilations
and auscultation reveals unequal breath sounds. What is the most appropriate initial
intervention for this patient?
A. Place the patient back on the ventilator.
B. Extubated the patient.
C. Reposition the endotracheal tube.
D. Suction the endotracheal tube.
C. Reposition the endotracheal tube.
10. Which of the following assessment findings differentiates a tension pneumothorax from
a simple pneumothorax?
A. Increased work of breathing
B. Unilaterally diminished breath sounds
C. Tachycardia
D. Hypotension
D. Hypotension
11. A patient is brought to the emergency department of a rural hospital following a high-
speed motor vehicle collision. When significant abdominal and pelvic injuries are noted in
the primary survey, what is the priority intervention?
, 4|Page
A. Initiate transfer to a trauma center
B. Attempt family notification
C. Obtain additional imaging studies
D. Place an indwelling urinary catheter
A. Initiate transfer to a trauma center
12. A patient has uncontrolled bleeding from a wound to his right upper extremity. What is
the priority intervention?
A. Initiate two intravenous access sites
B. Place the patient on supplemental oxygen
C. Apply direct pressure to the wound
D. Use a tourniquet to control the bleeding
C. Apply direct pressure to the wound
13. A trauma patient involved in a fall from 25 feet has a traumatic brain injury, three
anterior rib fractures on the right side, a small pneumothorax on the right, and a Grade III
liver injury. The patient was intubated and placed on a ventilator with PEEP. Chest tube
was deferred at this time. Upon reassessment, which finding is most concerning?
A. Severely diminished breath sounds on the right
B. Guarding in the right upper quadrant
C. Ecchymosis in the right upper quadrant
D. Crepitus to the right chest
A. Severely diminished breath sounds on the right
14. A patient with a traumatic brain injury has a mean arterial pressure (MAP) of 65 mm
Hg (8.66 kPa) and an intracranial pressure (ICP) of 22 mm Hg (2.93 kPa). Which finding is
most likely an indication of the body's response to these findings?
A. Increased respiratory effort
B. Widening pulse pressure
C. Reflex tachycardia
D. Reflex hypotension
B. Widening pulse pressure
