TNCC WRITTEN EXAM 2 EXAM PREPARATION
PACK 2026 KEY CONCEPTS AND REVISION
NOTES
◉ Report your suspicion of maltreatment in accordance with local
regulations
Answer: a 5 y/o child presents to the ED with bruises to the upper
arm and buttocks in various stages of healing and multiple small,
clean, round burns to the back. There are no abnormalities found
based on the pediatric assessment triangle or primary survey. Which
of the following is the priority survey. Which of the following is the
priority nursing intervention?
◉ to guage end-organ perfusion and tissue hypoxia
Answer: Why is a measure of serum lactate obtained in the initial
assessment of a trauma patient?
◉ elevating the extremity to the level of the heart
Answer: A pt with a lower extremity fracture complains of severe
pain and tightness in his calf, minimally by pain medications. Which
of the following is the priority nursing intervention?
◉ velocity
,Answer: What factor contributes most to the kinetic energy of a
body in motion?
◉ subdural hematoma
Answer: An elderly patient with a history of anticoagulant use
presents after a fall at home today. She denies any loss of
consciousness. She has a hematoma to her forehead and complains
of headache, dizziness, and nausea. What is the most likely cause of
her symptoms?
◉ fat embolism
Answer: a pt has been in the ED for several hrs waiting to be
admitted. He sustained multiple rib fractures and a femur fracture
after a fall. He has been awake, alert, and complaining of leg pain. His
wife reported that he suddenly became anxious and confused. Upon
reassessment, the pt is restless with respiratory distress and
petechiae to his neck. The pt is exhibiting s/sx most commonly
associated with which of the following conditions?
◉ nausea and vomiting
Answer: Which of the following is a late sign of increased
intracranial pressure?
◉ serial FAST exams
,Answer: a 49 y/o restrained driver involved in a MVC presents to the
trauma center complaining of abd, pelvic, and bilateral lower
extremity pain. VS are stable. The nurse can anticipate all of these
after a negative FAST exam EXCEPT which of the following?
◉ pericardiocentesis
Answer: Which of the following is NOT considered goal-directed
therapy for cardiogenic shock?
◉ endotracheal tube
Answer: The trauma nurse knows that placing a bariatric patient in
a ramped position providers better visualization during the
insertion of which device?
◉ increased work of breathing?
Answer: which of the following assessment findings differentiates a
tension pneumothorax from a simple pneumothorax?
◉ calcium
Answer: if a pt has received multiple transfusions of banked blood
preserved with citrate, which electrolyte is most likely to drop and
require supplementation?
, ◉ identifying individuals who made mistakes during the traumatic
event
Answer: Which of the following is NOT considered a benefit of
debriefings?
◉ 500 mL/hr
Answer: You are treating a 27 y/o M in respiratory distress who was
involved in a house fire. Calculating TBSA burned is deferred due to
the need for emergent intubation. At what rate should you begin
fluid resuscitation?
◉ advanced age
Answer: Which of the following is most likely to contribute to
inadequate oxygenation and ventilation?
◉ a 52 y/o diabetic male with a partial thickness burn to the left
lower leg
Answer: Which of the following patients warrants referral to a burn
center?
◉ dressing removal
Answer: A patient arrives with a large open chest wound after being
assaulted with a machete. Prehospital providers placed a nonporous
dressing over the chest wound and taped it on three sides. he is now
showing signs of anxiety, restlessness, severe respiratory distress,
PACK 2026 KEY CONCEPTS AND REVISION
NOTES
◉ Report your suspicion of maltreatment in accordance with local
regulations
Answer: a 5 y/o child presents to the ED with bruises to the upper
arm and buttocks in various stages of healing and multiple small,
clean, round burns to the back. There are no abnormalities found
based on the pediatric assessment triangle or primary survey. Which
of the following is the priority survey. Which of the following is the
priority nursing intervention?
◉ to guage end-organ perfusion and tissue hypoxia
Answer: Why is a measure of serum lactate obtained in the initial
assessment of a trauma patient?
◉ elevating the extremity to the level of the heart
Answer: A pt with a lower extremity fracture complains of severe
pain and tightness in his calf, minimally by pain medications. Which
of the following is the priority nursing intervention?
◉ velocity
,Answer: What factor contributes most to the kinetic energy of a
body in motion?
◉ subdural hematoma
Answer: An elderly patient with a history of anticoagulant use
presents after a fall at home today. She denies any loss of
consciousness. She has a hematoma to her forehead and complains
of headache, dizziness, and nausea. What is the most likely cause of
her symptoms?
◉ fat embolism
Answer: a pt has been in the ED for several hrs waiting to be
admitted. He sustained multiple rib fractures and a femur fracture
after a fall. He has been awake, alert, and complaining of leg pain. His
wife reported that he suddenly became anxious and confused. Upon
reassessment, the pt is restless with respiratory distress and
petechiae to his neck. The pt is exhibiting s/sx most commonly
associated with which of the following conditions?
◉ nausea and vomiting
Answer: Which of the following is a late sign of increased
intracranial pressure?
◉ serial FAST exams
,Answer: a 49 y/o restrained driver involved in a MVC presents to the
trauma center complaining of abd, pelvic, and bilateral lower
extremity pain. VS are stable. The nurse can anticipate all of these
after a negative FAST exam EXCEPT which of the following?
◉ pericardiocentesis
Answer: Which of the following is NOT considered goal-directed
therapy for cardiogenic shock?
◉ endotracheal tube
Answer: The trauma nurse knows that placing a bariatric patient in
a ramped position providers better visualization during the
insertion of which device?
◉ increased work of breathing?
Answer: which of the following assessment findings differentiates a
tension pneumothorax from a simple pneumothorax?
◉ calcium
Answer: if a pt has received multiple transfusions of banked blood
preserved with citrate, which electrolyte is most likely to drop and
require supplementation?
, ◉ identifying individuals who made mistakes during the traumatic
event
Answer: Which of the following is NOT considered a benefit of
debriefings?
◉ 500 mL/hr
Answer: You are treating a 27 y/o M in respiratory distress who was
involved in a house fire. Calculating TBSA burned is deferred due to
the need for emergent intubation. At what rate should you begin
fluid resuscitation?
◉ advanced age
Answer: Which of the following is most likely to contribute to
inadequate oxygenation and ventilation?
◉ a 52 y/o diabetic male with a partial thickness burn to the left
lower leg
Answer: Which of the following patients warrants referral to a burn
center?
◉ dressing removal
Answer: A patient arrives with a large open chest wound after being
assaulted with a machete. Prehospital providers placed a nonporous
dressing over the chest wound and taped it on three sides. he is now
showing signs of anxiety, restlessness, severe respiratory distress,
