,TNCC final exam test 2024/2025
open book updated with complete
solution
1. Which of the following best describes the priority intervention for a trauma patient with a suspected
cervical spine injury?
A) Apply a cervical collar and place the patient supine
B) Perform a jaw-thrust maneuver while maintaining manual cervical spine stabilization
C) Hyperextend the neck to open the airway
D) Administer high-flow oxygen via non-rebreather mask
Correct Answer: Perform a jaw-thrust maneuver while maintaining manual cervical spine stabilization
Rationale: The trauma nursing process begins with A: airway and alertness with simultaneous cervical
spine stabilization. The jaw-thrust opens the airway without extending the neck. A cervical collar alone
does not ensure airway patency, and hyperextension is contraindicated.
2. A patient arrives at the emergency department after a motor vehicle collision. The nurse notes
tracheal deviation to the left, absent breath sounds on the right, and jugular venous distention. What
should the nurse suspect?
A) Cardiac tamponade
B) Tension pneumothorax on the right
C) Flail chest
D) Pulmonary contusion
Correct Answer: Tension pneumothorax on the right
Rationale: Tracheal deviation away from the affected side, absent breath sounds, and distended neck
veins indicate a tension pneumothorax. Immediate needle decompression is required to release trapped
air and restore venous return.
,3. According to the trauma nursing process, after completing the primary survey (ABCDE), the next step
is to
A) Get resuscitation adjuncts
B) Perform a head-to-toe assessment
C) Obtain a full set of vital signs and facilitate family presence
D) Inspect the posterior surfaces
Correct Answer: Obtain a full set of vital signs and facilitate family presence
Rationale: The A-J mnemonic places F after E. F stands for full set of vital signs and family presence. This
step monitors the patient’s response and includes the family early in the process.
4. The nurse is caring for a trauma patient with a Glasgow Coma Scale score of 8. What does this score
indicate?
A) Mild head injury
B) Moderate head injury
C) Fully alert neurologic function
D) Severe head injury, indicating the need for definitive airway management
Correct Answer: Severe head injury, indicating the need for definitive airway management
Rationale: A GCS of 8 or less indicates severe brain injury and coma, often requiring endotracheal
intubation to protect the airway and prevent secondary brain injury from hypoxia or aspiration.
5. Which of the following is the most reliable early indicator of shock in a pediatric trauma patient?
A) Tachycardia and prolonged capillary refill time
B) Hypotension
C) Decreased urine output
D) Altered mental status
, Correct Answer: Tachycardia and prolonged capillary refill time
Rationale: Children compensate well; tachycardia and delayed capillary refill are early signs of
hypovolemia. Hypotension is a late and ominous finding, often preceding cardiovascular collapse.
6. The nurse is caring for a patient with a pelvic fracture who is hypotensive. Which intervention is most
appropriate initially?
A) Administer high-dose vasopressors
B) Apply a pelvic binder or external fixation to reduce pelvic volume and hemorrhage
C) Perform a FAST exam before any intervention
D) Elevate the legs
Correct Answer: Apply a pelvic binder or external fixation to reduce pelvic volume and hemorrhage
Rationale: Pelvic binders stabilize the fracture and reduce pelvic volume, tamponading venous and bony
bleeding. This is a critical early intervention for suspected pelvic hemorrhage.
7. According to the TNCC, the definitive airway for a trauma patient with a GCS ≤8 is
A) Oropharyngeal airway
B) Nasopharyngeal airway
C) Endotracheal intubation
D) Laryngeal mask airway
Correct Answer: Endotracheal intubation
Rationale: A definitive airway requires a cuffed tube in the trachea. Endotracheal intubation is the gold
standard for patients unable to protect their airway, providing a secure, protected airway.
8. The nurse is assessing a patient with a spinal cord injury at T6 who is at risk for neurogenic shock.
Which finding is characteristic?
open book updated with complete
solution
1. Which of the following best describes the priority intervention for a trauma patient with a suspected
cervical spine injury?
A) Apply a cervical collar and place the patient supine
B) Perform a jaw-thrust maneuver while maintaining manual cervical spine stabilization
C) Hyperextend the neck to open the airway
D) Administer high-flow oxygen via non-rebreather mask
Correct Answer: Perform a jaw-thrust maneuver while maintaining manual cervical spine stabilization
Rationale: The trauma nursing process begins with A: airway and alertness with simultaneous cervical
spine stabilization. The jaw-thrust opens the airway without extending the neck. A cervical collar alone
does not ensure airway patency, and hyperextension is contraindicated.
2. A patient arrives at the emergency department after a motor vehicle collision. The nurse notes
tracheal deviation to the left, absent breath sounds on the right, and jugular venous distention. What
should the nurse suspect?
A) Cardiac tamponade
B) Tension pneumothorax on the right
C) Flail chest
D) Pulmonary contusion
Correct Answer: Tension pneumothorax on the right
Rationale: Tracheal deviation away from the affected side, absent breath sounds, and distended neck
veins indicate a tension pneumothorax. Immediate needle decompression is required to release trapped
air and restore venous return.
,3. According to the trauma nursing process, after completing the primary survey (ABCDE), the next step
is to
A) Get resuscitation adjuncts
B) Perform a head-to-toe assessment
C) Obtain a full set of vital signs and facilitate family presence
D) Inspect the posterior surfaces
Correct Answer: Obtain a full set of vital signs and facilitate family presence
Rationale: The A-J mnemonic places F after E. F stands for full set of vital signs and family presence. This
step monitors the patient’s response and includes the family early in the process.
4. The nurse is caring for a trauma patient with a Glasgow Coma Scale score of 8. What does this score
indicate?
A) Mild head injury
B) Moderate head injury
C) Fully alert neurologic function
D) Severe head injury, indicating the need for definitive airway management
Correct Answer: Severe head injury, indicating the need for definitive airway management
Rationale: A GCS of 8 or less indicates severe brain injury and coma, often requiring endotracheal
intubation to protect the airway and prevent secondary brain injury from hypoxia or aspiration.
5. Which of the following is the most reliable early indicator of shock in a pediatric trauma patient?
A) Tachycardia and prolonged capillary refill time
B) Hypotension
C) Decreased urine output
D) Altered mental status
, Correct Answer: Tachycardia and prolonged capillary refill time
Rationale: Children compensate well; tachycardia and delayed capillary refill are early signs of
hypovolemia. Hypotension is a late and ominous finding, often preceding cardiovascular collapse.
6. The nurse is caring for a patient with a pelvic fracture who is hypotensive. Which intervention is most
appropriate initially?
A) Administer high-dose vasopressors
B) Apply a pelvic binder or external fixation to reduce pelvic volume and hemorrhage
C) Perform a FAST exam before any intervention
D) Elevate the legs
Correct Answer: Apply a pelvic binder or external fixation to reduce pelvic volume and hemorrhage
Rationale: Pelvic binders stabilize the fracture and reduce pelvic volume, tamponading venous and bony
bleeding. This is a critical early intervention for suspected pelvic hemorrhage.
7. According to the TNCC, the definitive airway for a trauma patient with a GCS ≤8 is
A) Oropharyngeal airway
B) Nasopharyngeal airway
C) Endotracheal intubation
D) Laryngeal mask airway
Correct Answer: Endotracheal intubation
Rationale: A definitive airway requires a cuffed tube in the trachea. Endotracheal intubation is the gold
standard for patients unable to protect their airway, providing a secure, protected airway.
8. The nurse is assessing a patient with a spinal cord injury at T6 who is at risk for neurogenic shock.
Which finding is characteristic?
