TNCC 9TH EDITION – QUESTIONS AND
ANSWERS GRADED A+ (SOLVED 2023/2024)
1. 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 receive one intravenous fluid bolus 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.
2. A patient with complete spinal cord injury who is in neurogenic shock will demonstrate
hypotension and which other clinical signs?
A. Bradycardia and ipsilateral a sense of motor function.
B. Tachycardia and respiratory depression.
C. Tachycardia and piokilothermia.
D. Bradycardia and absent motor function below the level of injury.***
3. You are caring for a patient who was shot multiple times in the chest and abdomen. The
patient is unresponsive with snoring, shallow respirations. Assessment reveals absent
radial pulses, weak and rapid carotid pulse, and cool, diaphoretic skin. Which
management strategy should the nurse anticipate?
A. Autotransfusion
B. Massive transfusion
C. Controlled fluid boluses***
D. Inotropic medications
4. Three adults present at different times during a one-hour with a high fever, fatigue, and
headache. All three patients have a rash which started on their mouth, face, and arms
with progression to the chest and abdomen. They all visited the same grocery store
within the last week. What is the most appropriate intervention from triage for these
patients?
A. Move them to a decontamination area
B. Mask the patients and send them to the waiting room
C. Immediately initiate isolation precautions***
D. Send them to the waiting room without a mask
, 5. 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
6. An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their
body 2 hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400
mL/hr. The urine output over the last hour was 15mL. What intervention should the nurse
anticipate?
A. Add blood products to the resuscitation
B. Increase isotonic crystalloid infusion rate***
C. Administer an intravenous diuretic
D. Switch to a hypertonic saline solution
7. An adult pedestrian was struck on the right side by a sport utility vehicle traveling 40
mph. The patient is awake and alert and the right leg is shortened. Following initial
resuscitation with fluids, the patient remains hypotensive. What would the priority
intervention be?
A. Send blood for type and crossmatch
B. Apply a pelvic binder***
C. Prepare the patient for surgery
D. Insert a urinary catheter
8. You are speaking with the family of a critically injured patient. The spouse is crying
loudly and the daughter is angry and yelling at staff. Which of the following nursing
interventions is most appropriate?
A. Have the family escorted out of the department
B. Ask if the family would like spiritual support***
C. Allow only the spouse to see the patient
D. Do not include the family in decision-making at this time
9. A severely injured patient has been intubated and is being mechanically ventilated. The
patient has received a balanced resuscitation including multiple blood products. Under
which circumstance will it be harder for hemoglobin to release oxygen to the tissues?
A. Decreased pH
B. Elevated carbon dioxide level
C. Decreased body temperature***
ANSWERS GRADED A+ (SOLVED 2023/2024)
1. 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 receive one intravenous fluid bolus 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.
2. A patient with complete spinal cord injury who is in neurogenic shock will demonstrate
hypotension and which other clinical signs?
A. Bradycardia and ipsilateral a sense of motor function.
B. Tachycardia and respiratory depression.
C. Tachycardia and piokilothermia.
D. Bradycardia and absent motor function below the level of injury.***
3. You are caring for a patient who was shot multiple times in the chest and abdomen. The
patient is unresponsive with snoring, shallow respirations. Assessment reveals absent
radial pulses, weak and rapid carotid pulse, and cool, diaphoretic skin. Which
management strategy should the nurse anticipate?
A. Autotransfusion
B. Massive transfusion
C. Controlled fluid boluses***
D. Inotropic medications
4. Three adults present at different times during a one-hour with a high fever, fatigue, and
headache. All three patients have a rash which started on their mouth, face, and arms
with progression to the chest and abdomen. They all visited the same grocery store
within the last week. What is the most appropriate intervention from triage for these
patients?
A. Move them to a decontamination area
B. Mask the patients and send them to the waiting room
C. Immediately initiate isolation precautions***
D. Send them to the waiting room without a mask
, 5. 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
6. An adult patient weighing 75 kg sustained partial and full thickness burns to 32% of their
body 2 hours prior to arrival. Intravenous fluid resuscitation was calculated to be 400
mL/hr. The urine output over the last hour was 15mL. What intervention should the nurse
anticipate?
A. Add blood products to the resuscitation
B. Increase isotonic crystalloid infusion rate***
C. Administer an intravenous diuretic
D. Switch to a hypertonic saline solution
7. An adult pedestrian was struck on the right side by a sport utility vehicle traveling 40
mph. The patient is awake and alert and the right leg is shortened. Following initial
resuscitation with fluids, the patient remains hypotensive. What would the priority
intervention be?
A. Send blood for type and crossmatch
B. Apply a pelvic binder***
C. Prepare the patient for surgery
D. Insert a urinary catheter
8. You are speaking with the family of a critically injured patient. The spouse is crying
loudly and the daughter is angry and yelling at staff. Which of the following nursing
interventions is most appropriate?
A. Have the family escorted out of the department
B. Ask if the family would like spiritual support***
C. Allow only the spouse to see the patient
D. Do not include the family in decision-making at this time
9. A severely injured patient has been intubated and is being mechanically ventilated. The
patient has received a balanced resuscitation including multiple blood products. Under
which circumstance will it be harder for hemoglobin to release oxygen to the tissues?
A. Decreased pH
B. Elevated carbon dioxide level
C. Decreased body temperature***
