TNCC Exam 8th edition study 2024
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve
Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in an
environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports
significant damage to the driver's side of the car. The patient is asking to have the cervical collar
removed. When it is appropriate to remove the cervical collar?
After a physical examination if the patient has no radiologic abnormalities on CT A CT is recommended
for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate
the total body surface area burned, how much IV fluid would be administered in the first 8 hours?
2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 2 120 = 4560
mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA calculation for
fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system
Fluctuation in the water seal chamber Fluctuation in the water seal chamber indicates the tube is placed
correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
Globe rupture A teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs?
Bradycardia and absent motor function below the level of injury Patients with a complete spinal cord
injury will have absent motor function below the level of the lesion. They become hypotensive and
bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center?
A 52-year-old diabetic male with a partial-thickness burn to the left lower leg This patient has a 7% TBSA
burn with a preexisting medical history that could complicate management, prolong recovery, or affect
mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
, margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following?
Placental abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal
distress are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard
on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals
lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse
question?
Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash?
The aorta is torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following?
Defusings A defusing is part of critical incident stress management but is not considered a critical
communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage?
MARCH The MARCH mnemonic stands for massive hemorrhage, airway, respiration, circulation, and
head injury/hypothermia. The MARCH mnemonic recognizes uncontrolled hemorrhage as the major
cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house fire.
Calculating total body surface area (TBSA) burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation?
500 mL/hour Prior to calculating TBSA, this is the recommended starting point for fluid resuscitation for
patients 14 years of age and older
A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center
complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs are stable. The nurse
can anticipate all of these after a negative FAST exam EXCEPT which of the following?
Diagnostic peritoneal lavage Diagnostic peritoneal lavage is indicated for hemodynamically unstable
patients or if FAST and CT are not available.
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?
1.What is the effect of hypothermia on the oxyhemoglobin dissociation curve
Hemoglobin does not readily release oxygen for use by the tissues A shift to the left occurs in an
environment of low metabolic demand (hypothermia, hypocapnia, alkalosis), increasing hemoglobin's
affinity for oxygen.
EMS arrives with the intoxicated driver of a car involved in a motor vehicle crash. EMS reports
significant damage to the driver's side of the car. The patient is asking to have the cervical collar
removed. When it is appropriate to remove the cervical collar?
After a physical examination if the patient has no radiologic abnormalities on CT A CT is recommended
for spinal clearance in an impaired patient.
The nurse is caring for a 120 kg male brought in after a warehouse fire and is calculating the patient's
fluid resuscitation needs. He has painful red blistering to the entire surface of both upper extremities
and superficial burns to the anterior chest. Using the modified Lund and Browder chart to calculate
the total body surface area burned, how much IV fluid would be administered in the first 8 hours?
2280 mL Both upper arms = 8%, both lower arms = 6%, and both hands = 5%, yielding 19 2 120 = 4560
mL. Half of the total is equal to 2280 mL. Superficial burns are not included in the TBSA calculation for
fluid resuscitation.
Which of the following is an expected finding in a patient with a tube thoracostomy connected to a
chest drainage system
Fluctuation in the water seal chamber Fluctuation in the water seal chamber indicates the tube is placed
correctly in the pleural space.
.A 35-year-old male presents with facial trauma after being struck in the face with a baseball. A
teardrop-shaped left pupil is noted on exam. What type of injury is suspected?
Globe rupture A teardrop-shaped pupil suggests a globe rupture.
.A patient with a complete spinal cord injury in neurogenic shock will demonstrate hypotension and
which other clinical signs?
Bradycardia and absent motor function below the level of injury Patients with a complete spinal cord
injury will have absent motor function below the level of the lesion. They become hypotensive and
bradycardic due to loss of autonomic nervous system function.
Which of the following patients warrants referral to a burn center?
A 52-year-old diabetic male with a partial-thickness burn to the left lower leg This patient has a 7% TBSA
burn with a preexisting medical history that could complicate management, prolong recovery, or affect
mortality.
You are caring for a patient who was involved in a motor vehicle crash and is 32 weeks pregnant.
Findings of your secondary survey include abdominal pain on palpation, fundal height at the costal
, margin, and some dark bloody show. Varying accelerations and decelerations are noted on
cardiotocography. These findings are most consistent with which of the following?
Placental abruption The findings of abdominal pain, elevated fundal height, dark bloody show, and fetal
distress are most consistent with placental abruption.
A 20-year-old male presents to the ED complaining of severe lower abdominal pain after landing hard
on the bicycle cross bars while performing an aerial BMX maneuver. Secondary assessment reveals
lower abdominal tenderness and scrotal ecchymosis. Which of the following orders would the nurse
question?
Straight catheter for urine sample Insertion of a urinary catheter is contraindicated if urethral
transection is suspected. Signs and symptoms of urethral injury include blood at the meatus, perineal
ecchymosis, scrotal ecchymosis, and a high-riding or non-palpable prostate.
Which of the following occurs during the third impact of a motor vehicle crash?
The aorta is torn at its attachment with the ligamentum arteriosum This occurs during the third impact.
All of these are considered a critical communication point in trauma care EXCEPT which of the
following?
Defusings A defusing is part of critical incident stress management but is not considered a critical
communication point in trauma care.
Which of the following mnemonics can help the nurse prioritize care for a trauma patient with
massive uncontrolled hemorrhage?
MARCH The MARCH mnemonic stands for massive hemorrhage, airway, respiration, circulation, and
head injury/hypothermia. The MARCH mnemonic recognizes uncontrolled hemorrhage as the major
cause of preventable death after injury.
You are treating a 27-year-old male in respiratory distress who was involved in a house fire.
Calculating total body surface area (TBSA) burned is deferred due to the need for emergent
intubation. At what rate should you begin fluid resuscitation?
500 mL/hour Prior to calculating TBSA, this is the recommended starting point for fluid resuscitation for
patients 14 years of age and older
A 49-year-old restrained driver involved in a motor vehicle collision presents to the trauma center
complaining of abdominal, pelvic, and bilateral lower extremity pain. Vital signs are stable. The nurse
can anticipate all of these after a negative FAST exam EXCEPT which of the following?
Diagnostic peritoneal lavage Diagnostic peritoneal lavage is indicated for hemodynamically unstable
patients or if FAST and CT are not available.
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?
