TNP ACTUAL EXAM QUESTIONS AND
COMPLETE STUDY GUIDE 2026
▶ A patient is brought to the ED following a snowmobile crash with
prolonged exposure time prior to transport. The patient is confused. Vitals
are BP 96/54, HR 114, RR 24, T 34.6C (94.2F) and an SpO2 90% on
oxygen at 15L per non-rebreather mask. Other findings include ETCO2 24,
serum lactate 6 mmol/L, and pH 6.8. Based on these findings, what is the
most appropriate intervention?
a) initiate warming measures
b) titrate oxygen to 6L per nasal cannula
bolus with 500 mL isotonic crytstalloids
d) vigorously massage the extremities. Answer: a) initate warming
measures
This patient is exhibiting signs of hypothermia. This is a low metabolic
environment and causes a shift to the left in the oxyhemoglobin
dissociation curve causing an increase in hemoglobin's affinity for oxygen,
making it harder to release bound oxygen to the tissues. Warming the
patient will shift the curve back and allow oxygen to be released and help
normalize those values.
▶ What position optimizes ventilation in the obese patient with lumbar
facture?
a) reverse trendelenburg
b) supine
c) prone
d) Fowlers. Answer: a) reverse trendelenburg
▶ A patient arrives following prolonged exposure of their left hand to the
cold. the patient is awake and alert and complains of a tingling sensation in
the fingers. Assessment reveals swelling and bright red skin to the left hand
and a 1-inch round clear blister to the dorsum of that hand. Which of the
following nursing interventions is most appropriate for this patient?
a) massage the injured areas to promote circulation
b) drain and debride the blister on the hand
COMPLETE STUDY GUIDE 2026
▶ A patient is brought to the ED following a snowmobile crash with
prolonged exposure time prior to transport. The patient is confused. Vitals
are BP 96/54, HR 114, RR 24, T 34.6C (94.2F) and an SpO2 90% on
oxygen at 15L per non-rebreather mask. Other findings include ETCO2 24,
serum lactate 6 mmol/L, and pH 6.8. Based on these findings, what is the
most appropriate intervention?
a) initiate warming measures
b) titrate oxygen to 6L per nasal cannula
bolus with 500 mL isotonic crytstalloids
d) vigorously massage the extremities. Answer: a) initate warming
measures
This patient is exhibiting signs of hypothermia. This is a low metabolic
environment and causes a shift to the left in the oxyhemoglobin
dissociation curve causing an increase in hemoglobin's affinity for oxygen,
making it harder to release bound oxygen to the tissues. Warming the
patient will shift the curve back and allow oxygen to be released and help
normalize those values.
▶ What position optimizes ventilation in the obese patient with lumbar
facture?
a) reverse trendelenburg
b) supine
c) prone
d) Fowlers. Answer: a) reverse trendelenburg
▶ A patient arrives following prolonged exposure of their left hand to the
cold. the patient is awake and alert and complains of a tingling sensation in
the fingers. Assessment reveals swelling and bright red skin to the left hand
and a 1-inch round clear blister to the dorsum of that hand. Which of the
following nursing interventions is most appropriate for this patient?
a) massage the injured areas to promote circulation
b) drain and debride the blister on the hand
