TNCC 9th Edition Exam UPDATED
ACTUAL QUESTIONS AND CORRECT
ANSWERS
Which intervention is recommended regarding the use of drug-assisted intubation and rapid sequence
intubation? - CORRECT ANSWER Pre-oxygenate to prolong the time to hypoxia
Which normal anatomic or physiologic change in an older adult places them at a higher risk for
aspiration? - CORRECT ANSWER Relaxed muscles of the oropharynx
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would
indicate sacral sparing? - CORRECT ANSWER Voluntary anal sphincter tone
An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their body 2
hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400 ml/hour. The urine
output over the last hour was 15ml. What intervention should the nurse anticipate? - CORRECT
ANSWER Increase isotonic crystalloid infusion rate
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is
consistent with spinal shock? - CORRECT ANSWER Loss of reflexes
A patient is brought to the emergency department following a motor vehicle rollover and is
complaining of left upper abdominal pain and left shoulder pain. This presentation is most consistent
with an injury to which organ? - CORRECT ANSWER Spleen
An adult patient is brought to the emergency department following a motor vehicle collision with
complaints of neck pain. They have identified as a person in the process of transitioning from male to
female. What effect of hormone therapy should be considered when planning care for this patient? -
CORRECT ANSWER Testosterone therapy may decrease blood pressure
Correct rationale: A person who is in the process of transitioning from male to female will usually be
taking female hormones such as estrogen/estradiol to assist with the transition. This can cause a
decrease in muscle mass, increased risk of thromboembolism, and possibly increased bone density.
These patients would not be taking testosterone.
, An adult patient presents to the emergency department after sustaining severe facial injuries during an
altercation. The patient is awake, confused, and smells heavily of alcohol. Pulse oximetry is 94% on
room air. Immediate intubation should be anticipated based on which clinical indicator? - CORRECT
ANSWER Severe facial injuries
A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There is a
small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding is most
consistent with an injury to the diaphragm? - CORRECT ANSWER Bowel sounds heard in the
left lower chest
A severely injured patient has been intubated and is being mechanically ventilated. The patient has
received a balanced resuscitation including multiple blood products. Under which circumstance will it
be harder for the hemoglobin to release oxygen to the tissues? - CORRECT
ANSWER Decreased body temperature
A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted in the
water seal chamber during inspiration and expiration. What is the best action for the nurse to take? -
CORRECT ANSWER Continue to the intensive care unit
An adult was thrown against a concrete wall during a factory explosion and sustained a femur
fracture, liver laceration, and a small subdural hematoma. These injuries most likely occurred during
what level of blast trauma? - CORRECT ANSWER Tertiary
An obese trauma patient requires intubation. Assuming there are no contraindications, which position
will provide the best visualization for insertion of the endotracheal tube? - CORRECT
ANSWER Ramped
A patient who jumped out of a second-floor window landing on their feet is diagnosed with a lumbar
spine fracture. What is the most likely concurrent injury to have occurred? - CORRECT
ANSWER Calcaneus fracture
A patient arrives with a large metal rod embedded in their left thigh and no active bleeding. Which
intervention is most appropriate for this patient? - CORRECT ANSWER Prepare the patient for
surgery to remove the rod
Which findings are most consistent with a complete transection of the spinal cord? - CORRECT
ANSWER Absence of sensory and motor function below the level of injury
ACTUAL QUESTIONS AND CORRECT
ANSWERS
Which intervention is recommended regarding the use of drug-assisted intubation and rapid sequence
intubation? - CORRECT ANSWER Pre-oxygenate to prolong the time to hypoxia
Which normal anatomic or physiologic change in an older adult places them at a higher risk for
aspiration? - CORRECT ANSWER Relaxed muscles of the oropharynx
A patient has been diagnosed with an incomplete spinal cord injury at L1. Which finding would
indicate sacral sparing? - CORRECT ANSWER Voluntary anal sphincter tone
An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their body 2
hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400 ml/hour. The urine
output over the last hour was 15ml. What intervention should the nurse anticipate? - CORRECT
ANSWER Increase isotonic crystalloid infusion rate
A patient is diagnosed with a T12 spinal cord injury following a 20-foot fall. Which finding is
consistent with spinal shock? - CORRECT ANSWER Loss of reflexes
A patient is brought to the emergency department following a motor vehicle rollover and is
complaining of left upper abdominal pain and left shoulder pain. This presentation is most consistent
with an injury to which organ? - CORRECT ANSWER Spleen
An adult patient is brought to the emergency department following a motor vehicle collision with
complaints of neck pain. They have identified as a person in the process of transitioning from male to
female. What effect of hormone therapy should be considered when planning care for this patient? -
CORRECT ANSWER Testosterone therapy may decrease blood pressure
Correct rationale: A person who is in the process of transitioning from male to female will usually be
taking female hormones such as estrogen/estradiol to assist with the transition. This can cause a
decrease in muscle mass, increased risk of thromboembolism, and possibly increased bone density.
These patients would not be taking testosterone.
, An adult patient presents to the emergency department after sustaining severe facial injuries during an
altercation. The patient is awake, confused, and smells heavily of alcohol. Pulse oximetry is 94% on
room air. Immediate intubation should be anticipated based on which clinical indicator? - CORRECT
ANSWER Severe facial injuries
A patient involved in a high-speed rollover is complaining of increased difficulty breathing. There is a
small penetrating wound to the sixth intercostal space in the left lateral chest. Which finding is most
consistent with an injury to the diaphragm? - CORRECT ANSWER Bowel sounds heard in the
left lower chest
A severely injured patient has been intubated and is being mechanically ventilated. The patient has
received a balanced resuscitation including multiple blood products. Under which circumstance will it
be harder for the hemoglobin to release oxygen to the tissues? - CORRECT
ANSWER Decreased body temperature
A patient with a chest tube is being transported to the intensive care unit and fluctuation is noted in the
water seal chamber during inspiration and expiration. What is the best action for the nurse to take? -
CORRECT ANSWER Continue to the intensive care unit
An adult was thrown against a concrete wall during a factory explosion and sustained a femur
fracture, liver laceration, and a small subdural hematoma. These injuries most likely occurred during
what level of blast trauma? - CORRECT ANSWER Tertiary
An obese trauma patient requires intubation. Assuming there are no contraindications, which position
will provide the best visualization for insertion of the endotracheal tube? - CORRECT
ANSWER Ramped
A patient who jumped out of a second-floor window landing on their feet is diagnosed with a lumbar
spine fracture. What is the most likely concurrent injury to have occurred? - CORRECT
ANSWER Calcaneus fracture
A patient arrives with a large metal rod embedded in their left thigh and no active bleeding. Which
intervention is most appropriate for this patient? - CORRECT ANSWER Prepare the patient for
surgery to remove the rod
Which findings are most consistent with a complete transection of the spinal cord? - CORRECT
ANSWER Absence of sensory and motor function below the level of injury
