TNCC 8TH EDITION STUDY GUIDE 2026
ACCURATE QUESTION SET AND CORRECT
ANSWERS
◉ Globe Rupture.
Answer: Assessment Findings: Irregular or teardrop-shaped pupils,
periorbital ecchymosis, decreased visual acuity and EOM, severe
subconjunctival hemorrhage, deep eye pain, nausea
Treatment: Avoid any pressure on the globe, apply a rigid shielf to
protect the affected eye, consider tetanus vaccine, keep patient NPO,
assess and treat pain, administer antiemetics to decrease risk of n/v,
elevate the HOB to decrease IOP, avoid ophthalmic drops or
medications, administer systemic abx
Follow up: Emergency consultation with ophthalmology; prepare pt
for CT scan and OR
◉ Ocular Burns.
Answer: Assessment Findings: Swelling of the sclera, conjunctival
irritation, corneal clouding (may be indicative of severe burn, pain
Treatment: Determine baseline pH of the eye, topical anesthesia,
immediate copious irrigation until the pH returns to normal range
(7.4) which may require >2L of irrigating solution, visual acuity
reassessment
Follow up: Ophthalmology consultation and close follow up.
, ◉ Neck Injuries.
Answer: 3 zones.
Mortality is the highest with injuries to zone 1 and patients who
have dysphonia, dysphagia, subcutaneous emphysema, or
hematomas to the neck region indicating vascular trauma, airway
injuries, or esophageal injuries that may not be diagnosed on
imaging studies.
◉ Penetrating thoracic wound below the fourth intercostal space.
Answer: Penetration into the abdominal cavity is suspected until
proven otherwise
◉ Thoracic Skeletal Fractures and Associated Injuries.
Answer: Sternal: Blunt cardiac injury; pneumothorax
First and second rib: Great vessel injuries, brachial plexus injuries,
head and spinal cord injuries
Multiple ribs and flail chest: pulmonary contusion; pneumothorax;
hemothorax
Lower ribs 7-12: Liver for right sided; spleen for left sided
◉ Beck's Triad.
Answer: Three signs of acute cardiac tamponade:
1. Low arterial blood pressure
ACCURATE QUESTION SET AND CORRECT
ANSWERS
◉ Globe Rupture.
Answer: Assessment Findings: Irregular or teardrop-shaped pupils,
periorbital ecchymosis, decreased visual acuity and EOM, severe
subconjunctival hemorrhage, deep eye pain, nausea
Treatment: Avoid any pressure on the globe, apply a rigid shielf to
protect the affected eye, consider tetanus vaccine, keep patient NPO,
assess and treat pain, administer antiemetics to decrease risk of n/v,
elevate the HOB to decrease IOP, avoid ophthalmic drops or
medications, administer systemic abx
Follow up: Emergency consultation with ophthalmology; prepare pt
for CT scan and OR
◉ Ocular Burns.
Answer: Assessment Findings: Swelling of the sclera, conjunctival
irritation, corneal clouding (may be indicative of severe burn, pain
Treatment: Determine baseline pH of the eye, topical anesthesia,
immediate copious irrigation until the pH returns to normal range
(7.4) which may require >2L of irrigating solution, visual acuity
reassessment
Follow up: Ophthalmology consultation and close follow up.
, ◉ Neck Injuries.
Answer: 3 zones.
Mortality is the highest with injuries to zone 1 and patients who
have dysphonia, dysphagia, subcutaneous emphysema, or
hematomas to the neck region indicating vascular trauma, airway
injuries, or esophageal injuries that may not be diagnosed on
imaging studies.
◉ Penetrating thoracic wound below the fourth intercostal space.
Answer: Penetration into the abdominal cavity is suspected until
proven otherwise
◉ Thoracic Skeletal Fractures and Associated Injuries.
Answer: Sternal: Blunt cardiac injury; pneumothorax
First and second rib: Great vessel injuries, brachial plexus injuries,
head and spinal cord injuries
Multiple ribs and flail chest: pulmonary contusion; pneumothorax;
hemothorax
Lower ribs 7-12: Liver for right sided; spleen for left sided
◉ Beck's Triad.
Answer: Three signs of acute cardiac tamponade:
1. Low arterial blood pressure
