TNCC 9TH EDITION TNP EXAM QUESTIONS AND ANSWERS
What does the J stand for at the end of the secondary survery? - CORRECT ANSWER✅✅just keep
evaluating - vipp
What does VIPP stand for? - CORRECT ANSWER✅✅vital signs, injuries/interventions, primary survey,
pain
During the head-to-toe, where would you find Grey-Turner's sign? - CORRECT ANSWER✅✅flank
During the head-to-toe, where would you find Cullen's sign? - CORRECT ANSWER✅✅umbilicus
What is sometimes deferred at the end of the head-to-toe? - CORRECT ANSWER✅✅inspecting
posterior
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting, psychosocial support,
social services, splinting, tetanus, and wound care are all interventions that you do AFTER and before
WHAT? - CORRECT ANSWER✅✅AFTER head-to-toe, BEFORE J (VIPP)
What three items are obtained during the pertinent history assessment? - CORRECT
ANSWER✅✅Medical records, prehospital report, SAMPLE
What are examples of nonpharmacologic measures? (must identify at least one during testing) -
CORRECT ANSWER✅✅Distraction, family presence, padding bony prominences, repositioning, splinting,
verbal reassurance
For whom is capnography highly recommended? - CORRECT ANSWER✅✅all patients
In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? - CORRECT
ANSWER✅✅EKG
,In Step 16 of "Exposure and Environment", you must name at least one of these interventions: -
CORRECT ANSWER✅✅blankets, room temp increase, warmed fluids, warming lights
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries? - CORRECT
ANSWER✅✅In Step 15 of "Exposure and Environment"
In Step 13 of "Disability", what is assessed if pt is altered? - CORRECT ANSWER✅✅glucose
To assess circulation, you must do these two main tasks: - CORRECT ANSWER✅✅1. inspect AND
palpate skin color, temp, moisture and 2. palpate a pulse
What do you do when alterations are identified in any of the steps in the primary survery? - CORRECT
ANSWER✅✅intervene as appropriate and reassess
What three assessments must be done if the patient is intubated? - CORRECT ANSWER✅✅1. attach
CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of the chest w/ assisted
ventilations; 3. auscultate over epigastrium for gurgling AND lungs for bilateral breath sounds
Four of these must be identified to assess breathing effectiveness: - CORRECT ANSWER✅✅Breath
sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema, increased work of
breathing, symmetrical chest rise and fall, tracheal deviation/JVD, open wounds/deformities, skin color
What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which credit is given in
the LMNOP section? - CORRECT ANSWER✅✅cardiac monitor
When should 2 IV sites be established? - CORRECT ANSWER✅✅During "Circulation" assessment
If the patient is intubated and you've already assessed ETT placement, what else needs to be done with
the ETT? (step 10) - CORRECT ANSWER✅✅assess ETT position by noting the number at teeth/gums
AND secure ETT
, What should you verbalize after completing all ETT assessments? - CORRECT ANSWER✅✅moving
patient from assisted ventilation to mechanical
During which part of the primary survey would you anticipate the need for a chest tube, intubation,
decompression of pneumothorax, oxygen, or BVMs? - CORRECT ANSWER✅✅"Breathing and
Ventilation"
Four of these must be identified to assess patency and protection of the airway: - CORRECT
ANSWER✅✅bony deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns,
fluids, foreign objects, vocalization
During which part of the primary survey would there be anticipation for intubation, insertion of
OPA/NPA, removal of any loose teeth or foreign objects, or suctioning? - CORRECT
ANSWER✅✅Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
If c-spine stabilization is necessary, what need should be stated? - CORRECT ANSWER✅✅the need for a
second person to provide manual c-spine stabilization
An adult patient who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0
kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to
manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered. - CORRECT ANSWER✅✅A.Decrease the rate of manual
ventilation.
An older adult presents to the emergency department with complaints of dizziness, headache, and
nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
What does the J stand for at the end of the secondary survery? - CORRECT ANSWER✅✅just keep
evaluating - vipp
What does VIPP stand for? - CORRECT ANSWER✅✅vital signs, injuries/interventions, primary survey,
pain
During the head-to-toe, where would you find Grey-Turner's sign? - CORRECT ANSWER✅✅flank
During the head-to-toe, where would you find Cullen's sign? - CORRECT ANSWER✅✅umbilicus
What is sometimes deferred at the end of the head-to-toe? - CORRECT ANSWER✅✅inspecting
posterior
Antibiotics, consults, head CT, imaging, law enforcement, mandatory reporting, psychosocial support,
social services, splinting, tetanus, and wound care are all interventions that you do AFTER and before
WHAT? - CORRECT ANSWER✅✅AFTER head-to-toe, BEFORE J (VIPP)
What three items are obtained during the pertinent history assessment? - CORRECT
ANSWER✅✅Medical records, prehospital report, SAMPLE
What are examples of nonpharmacologic measures? (must identify at least one during testing) -
CORRECT ANSWER✅✅Distraction, family presence, padding bony prominences, repositioning, splinting,
verbal reassurance
For whom is capnography highly recommended? - CORRECT ANSWER✅✅all patients
In step M of "Get Adjuncts", what else might be indicated besides cardiac monitor? - CORRECT
ANSWER✅✅EKG
,In Step 16 of "Exposure and Environment", you must name at least one of these interventions: -
CORRECT ANSWER✅✅blankets, room temp increase, warmed fluids, warming lights
At what point PRIOR TO the head-to-toe is the patient inspected for obvious injuries? - CORRECT
ANSWER✅✅In Step 15 of "Exposure and Environment"
In Step 13 of "Disability", what is assessed if pt is altered? - CORRECT ANSWER✅✅glucose
To assess circulation, you must do these two main tasks: - CORRECT ANSWER✅✅1. inspect AND
palpate skin color, temp, moisture and 2. palpate a pulse
What do you do when alterations are identified in any of the steps in the primary survery? - CORRECT
ANSWER✅✅intervene as appropriate and reassess
What three assessments must be done if the patient is intubated? - CORRECT ANSWER✅✅1. attach
CO2 detector and assess for evidence of exhaled CO2; 2. observe for rise and fall of the chest w/ assisted
ventilations; 3. auscultate over epigastrium for gurgling AND lungs for bilateral breath sounds
Four of these must be identified to assess breathing effectiveness: - CORRECT ANSWER✅✅Breath
sounds, depth/pattern/rate, spontaneous breathing, subcutaneous emphysema, increased work of
breathing, symmetrical chest rise and fall, tracheal deviation/JVD, open wounds/deformities, skin color
What can be applied in step 12 of "Circulation and Control of Hemorrhage" for which credit is given in
the LMNOP section? - CORRECT ANSWER✅✅cardiac monitor
When should 2 IV sites be established? - CORRECT ANSWER✅✅During "Circulation" assessment
If the patient is intubated and you've already assessed ETT placement, what else needs to be done with
the ETT? (step 10) - CORRECT ANSWER✅✅assess ETT position by noting the number at teeth/gums
AND secure ETT
, What should you verbalize after completing all ETT assessments? - CORRECT ANSWER✅✅moving
patient from assisted ventilation to mechanical
During which part of the primary survey would you anticipate the need for a chest tube, intubation,
decompression of pneumothorax, oxygen, or BVMs? - CORRECT ANSWER✅✅"Breathing and
Ventilation"
Four of these must be identified to assess patency and protection of the airway: - CORRECT
ANSWER✅✅bony deformity, loose teeth, edema, inhalation injury, sounds, tongue obstruction, burns,
fluids, foreign objects, vocalization
During which part of the primary survey would there be anticipation for intubation, insertion of
OPA/NPA, removal of any loose teeth or foreign objects, or suctioning? - CORRECT
ANSWER✅✅Assessing patency and protection of the airway, Step 7 of
"Alertness and Airway with Simultaneous Cervical Spinal Stabilization"
If c-spine stabilization is necessary, what need should be stated? - CORRECT ANSWER✅✅the need for a
second person to provide manual c-spine stabilization
An adult patient who sustained a severe head trauma has been intubated and is being manually
ventilated via a bag-mask device at a rate of 18 breaths/minute. The patient has received one
intravenous fluid bolus of 500 mL of warmed isotonic crystalloid solution. The PaCO2 is 30 mm Hg (4.0
kPa), and the pulse oximetry is 92%. BP is 142/70 mm Hg. What is the most important intervention to
manage the cerebral blood flow?
A.Decrease the rate of manual ventilation.
B.Initiate another fluid bolus.
C.Recheck endotracheal tube placement.
D.Increase the amount of oxygen delivered. - CORRECT ANSWER✅✅A.Decrease the rate of manual
ventilation.
An older adult presents to the emergency department with complaints of dizziness, headache, and
nausea. The patient was involved in a motor vehicle collision 10 days ago. There was no loss of
consciousness and a hematoma is noted to the forehead. The patient is currently on anticoagulant
therapy. What is most likely the cause of their symptoms?
