TNP CERTIFICATION EXAM
QUESTIONS AND VERIFIED
ANSWERS 2026
if the blood is not sufficiently warmed when transfused, it can produce
hypothermia. IN the oxyhemoglobin dissociation curve, a shift to the left
increases the affinity of hemoglobin for oxygen making it harder to release
for use by the tissues. Factors that can cause this shift include an elevated
pH, decreased carbon dioxide, decreased temperature, and low metabolic
demand
▶ A trauma patient is restless and repeatedly asking "where am i?" Vital
signs upon arrival were BP 110/60, HR 96 bpm, RR 24 bpm. Skin is cool
and moist. Current vitals are BP 86/68, HR 118 bpm, RR 28 bpm. The
patient is demonstrating signs and symptoms of which stage of shock?
a) compensated
b) refractory
c) irreversible
d) decompensated. Answer: d) decompensated
▶ Which commonly prescribed medication may worsen a complication that
is associated with massive blood transfusion?
a) lisinopril
b) metformin
c) metoprolol
d) diltiazem. Answer: d) diltiazem
diltiazem is a CCB and, in combination with the citrate used as a
preservative in blood products, puts the patient at a higher risk for
significant hypocalcemia and cardiac dysrhythmias
▶ An adult patient involved in an assault presents with shortness of breath,
Bp 88/50, HR of 130 bpm, and RR 32. The patient has muffle heart sounds
and is cyanotic. What is the primary intervention?
a) needle thoracostomy
, b) chest tube insertion
c) pericardiocentesis
d) tracheal intubation. Answer: c) pericardiocentesis
▶ Which blood pressure finding is associated with early or compenstated
hypovolemic shock?
a) rising systolic
b) rising diastolic
c) decreasing diastolic
d decreasing systolic. Answer: b) rising diastolic
▶ A patient has received multiple transfusions of banked blood in the past
2 hours. The patient has now developed muscle tremors, and short runs of
ventricular tachycardia. Which of the following medications does the nurse
anticipate administering?
a) hypertonic saline
b) calcitonin
c) insulin and glucose
d) calcium gluconate. Answer: d) calcium gluconate
▶ Which of the following characteristics is found in high performing teams?
a) interdisciplinary collaboration
b) provide on-the-job training
c) work individually
d) minimal feedback to decrease confusion. Answer: a) interdisciplinary
collaboration
▶ a 5-year-old child presents to the ED with bruises to the upper arms and
buttocks in various stages of healing and multiple small, clean, round burns
on 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. Answer: a) report
your suspicion of maltreatment in accordance with local regulations
QUESTIONS AND VERIFIED
ANSWERS 2026
if the blood is not sufficiently warmed when transfused, it can produce
hypothermia. IN the oxyhemoglobin dissociation curve, a shift to the left
increases the affinity of hemoglobin for oxygen making it harder to release
for use by the tissues. Factors that can cause this shift include an elevated
pH, decreased carbon dioxide, decreased temperature, and low metabolic
demand
▶ A trauma patient is restless and repeatedly asking "where am i?" Vital
signs upon arrival were BP 110/60, HR 96 bpm, RR 24 bpm. Skin is cool
and moist. Current vitals are BP 86/68, HR 118 bpm, RR 28 bpm. The
patient is demonstrating signs and symptoms of which stage of shock?
a) compensated
b) refractory
c) irreversible
d) decompensated. Answer: d) decompensated
▶ Which commonly prescribed medication may worsen a complication that
is associated with massive blood transfusion?
a) lisinopril
b) metformin
c) metoprolol
d) diltiazem. Answer: d) diltiazem
diltiazem is a CCB and, in combination with the citrate used as a
preservative in blood products, puts the patient at a higher risk for
significant hypocalcemia and cardiac dysrhythmias
▶ An adult patient involved in an assault presents with shortness of breath,
Bp 88/50, HR of 130 bpm, and RR 32. The patient has muffle heart sounds
and is cyanotic. What is the primary intervention?
a) needle thoracostomy
, b) chest tube insertion
c) pericardiocentesis
d) tracheal intubation. Answer: c) pericardiocentesis
▶ Which blood pressure finding is associated with early or compenstated
hypovolemic shock?
a) rising systolic
b) rising diastolic
c) decreasing diastolic
d decreasing systolic. Answer: b) rising diastolic
▶ A patient has received multiple transfusions of banked blood in the past
2 hours. The patient has now developed muscle tremors, and short runs of
ventricular tachycardia. Which of the following medications does the nurse
anticipate administering?
a) hypertonic saline
b) calcitonin
c) insulin and glucose
d) calcium gluconate. Answer: d) calcium gluconate
▶ Which of the following characteristics is found in high performing teams?
a) interdisciplinary collaboration
b) provide on-the-job training
c) work individually
d) minimal feedback to decrease confusion. Answer: a) interdisciplinary
collaboration
▶ a 5-year-old child presents to the ED with bruises to the upper arms and
buttocks in various stages of healing and multiple small, clean, round burns
on 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. Answer: a) report
your suspicion of maltreatment in accordance with local regulations
