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Exam (elaborations)

Trauma Nursing Core Course (TNCC) 9th Edition – Final Exam Study Guide and Practice Questions

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This document covers key questions and essential concepts from the Trauma Nursing Core Course (TNCC) 9th Edition final exam. It focuses on trauma assessment, emergency nursing priorities, and critical decision-making skills required for trauma care. The material is designed to help learners review important TNCC topics and prepare effectively for the final certification exam.

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TNCC 9 TH EDITION FINAL ACTUAL EXAM NEWEST VERSION 2025/2026
QUESTION AND CORRECT DETAILED VERIFIED ANSWERS FROM VERIFIED
SOURCES RATED A GRADE.
Study online at https://quizlet.com/_hep4i8
1. You are caring for a patient who was thrown from a bike and was not wear-
ing 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. A patient is brought to the emergency department of a rural hospital follow-
ing a high-speed motor vehicle collision. When significant abdominal and pelvic
injuries are noted in the primary survey, what is the priority intervention?

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
3. An adult who fell from a second story roof is brought to the emergency
department by private vehicle. The patient is confused with unlabored res-
pirations and has strong, palpable radial pulses. There is an open wound in
proximity to an obvious deformity of the left lower extremity. What is the
priority intervention?

A. Initiate cervical spine stabilization
B. Apply a splint to the lower extremity
C. Put the patient on portable oxygen.
D. Log roll the patient onto a spine board: A. Initiate cervical spine stabilization
4. An adult patient who sustained a severe head trauma has been intubat-
ed 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



, TNCC 9 TH EDITION FINAL ACTUAL EXAM NEWEST VERSION 2025/2026
QUESTION AND CORRECT DETAILED VERIFIED ANSWERS FROM VERIFIED
SOURCES RATED A GRADE.
Study online at https://quizlet.com/_hep4i8
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. Decrease the rate of manual ventilation.
5. An adult patient is brought to the emergency department following a vehicle
"roll-over" with prolonged extrication. Assessment reveals swelling and bruis-
ing to the right proximal thigh and a weak pedal pulse. Skin is pale, cool, and
moist. What is the most appropriate initial intervention?

A. Application of a tourniquet to the affected extremity
B. Application of a pelvic binder
C. Fluid resuscitation to maintain a urine output of 0.5 mL/kg/hour
D. Oxygen to maintain the ETCO2 between 30-35 mm Hg (3.9-4.6 kPa): B. Application
of a pelvic binder
6. 2. 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.
7. 3. 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



, TNCC 9 TH EDITION FINAL ACTUAL EXAM NEWEST VERSION 2025/2026
QUESTION AND CORRECT DETAILED VERIFIED ANSWERS FROM VERIFIED
SOURCES RATED A GRADE.
Study online at https://quizlet.com/_hep4i8
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
8. 4. 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
9. 5. 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.
10. 6. 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
11. 7. 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?

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