TNP PRACTICE EXAM QUESTIONS
AND DETAILED SOLUTIONS 2026
▶ 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
▶ A trauma patient who is 30-weeks pregnant arrives at the ED following a
motor vehicle collision. Which normal physiologic change should be
considered when assessing ventilatory status?
a) increased functional reserve capacity
, b) increased oxygen consumption
c) decreased minute ventilation
d) slower desaturation rates with apnea. Answer: a) increased functional
reserve capacity?
Physiologic changes during pregnancy include increased consumption of
oxygen along with decrease in functional reserve capacity which can place
a mother and fetus at risk for hypoxia. Minute ventilation increases and the
patient desaturates faster when apneic
▶ 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 DETAILED SOLUTIONS 2026
▶ 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
▶ A trauma patient who is 30-weeks pregnant arrives at the ED following a
motor vehicle collision. Which normal physiologic change should be
considered when assessing ventilatory status?
a) increased functional reserve capacity
, b) increased oxygen consumption
c) decreased minute ventilation
d) slower desaturation rates with apnea. Answer: a) increased functional
reserve capacity?
Physiologic changes during pregnancy include increased consumption of
oxygen along with decrease in functional reserve capacity which can place
a mother and fetus at risk for hypoxia. Minute ventilation increases and the
patient desaturates faster when apneic
▶ 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
